Sinisan is a classical prescription developed and applied by ancient medical experts and it is first recorded in the Treatise on Cold Damage written by ZHANG Zhongjing in the Eastern Han Dynasty. Later physicians have modified this prescription based on this original one. The bibliometrics methods were used to analyze the key information and research trend of Sinisan. According to the inclusion and exclusion criteria， 69 pieces of effective data were extracted， involving 67 ancient traditional Chinese medicine （TCM） books. The results showed that the name， composition， and decocting methods of Sinisan in later generations were inherited from the original record in the Treatise on Cold Damage. The original plants of medicinal materials used in Sinisan are basically clear. We recommend Bupleuri Radix as the dried root of Bupleurem scorzonerifolium， Paeoniae Radix Alba as the dried root of Paeonia lactiflora， Aurantii Fructus as the dried fruit of Citrus aurantium， Glycyrrhizae Radix et Rhizoma as the dry root and rhizome of Glycyrrhiza uralensis. Raw materials of Bupleuri Radix and Paeoniae Radix Alba， Aurantii Fructus stir-fried with bran， and stir-fried Glycyrrhizae Radix et Rhizoma should be used for preparation of Sinisan. According to measurement system in the Han Dynasty， a bag of Sinisan is composed of 1.25 g Bupleuri Radix， 1.25 g Paeoniae Radix Alba， 1.25 g Aurantii Fructus， and 1.25 g Glycyrrhizae Radix et Rhizoma. The materials should be grounded into coarse powder and taken with a proper amount of rice soup， 3 times a day. Sinisan has the effects of regulating qi movement and harmonizing the liver and spleen. It can be used for treating reversal cold in limbs and cold damage. In modern clinical practice， Sinisan can be used to treat chronic gastritis， irritable bowel syndrome， and dyspepsia. The above research results provide scientific reference for the future research and development of Sinisan.

As a traditional Chinese medicine (TCM), borneol has shown superior ability for anti-inflammatory and analgesic activities when coupled with other active ingredients from ancient times. Furthermore, borneol is believed to improve blood concentration and bioavailability of drugs. Thus, it has been paired with various TCM formulas since ancient time. The physiological barriers in human can cause significant limitations in drug efficiency as the drug is primarily restricted from entering into blood and brain. Borneol has been proven to enhance the permeability of biological barriers such as the blood-brain, transdermal, corneal, and intestinal barriers. Moreover, growing interest has been shown in the drug delivery system design for trans-barrier transport involving borneol. Nano-drug delivery system with increased surface area and improved active sites, has been applied to increase the bioactivity of water insoluble drugs. Nano-drug delivery system has been used to enhance drug efficacy by reducing the time of action as compared to conventional administration approach of TCM formulas. Given its ability to enhance cross-barrier permeation and drug efficacy, borneol has been integrated into TCM formulas of drug delivery system for precise and prolonged targeting at tumor sites. However, the design and preparation of a drug delivery system consisting of borneol still face great challenges. Current research fails to unravel the difference in mechanism of action between nano-drug delivery systems comprised of borneol and conventional drug systems coupled with borneol. Enhanced penetration of borneol in drug delivery system is rarely verified compared to conventional administration with identical drug formulation consisting of borneol regarding dosage and medical indications. This study outlines the current state of research on the properties, formulation and pharmacological effects of borneol, allowing cross-comparison of borneol coupled with single compound and classical TCM formulas for various medical indications. This study aims to provide insights into the design of borneol-based enhanced cross-barrier delivery drug formulation, and the potential development of nano-drug system for TCM formulas with borneol for enhanced bioavailability.

Objective It aims to construct an evaluation index system for the development level of intelligent health insurance,which can serve as a reference for health insurance management departments in assessing the develop-ment level of intelligent health insurance and the implementation of health insurance informatization.Methods Key events in intelligent health insurance were identified based on event system theory and text analysis.The evaluation index system was determined through a combination of expert interviews and Delphi expert consultations.The entro-py method was used to calculate the weights of each index,followed by the assessment of the current and ideal de-velopment levels.Results A total of 16 experts were consulted.After two rounds of Delphi expert consultation,two first-level indicators and 18 second-level indicators were finally included in the system.The current development level of intelligent health insurance in China is at the intelligent development stage(2.524 points),while the ideal de-velopment level is at the intelligent improvement stage(4.073 points).The positivity coefficient of both rounds of Del-phi expert consultation was 100%,with an authority coefficient of 0.842,and the degree of expert coordination im-proved with each round.Conclusion The constructed evaluation index system exhibits high scientificity,stability,and generalizability.It can provide an effective evaluation tool for the development of intelligent health insurance in various pooled areas.

Taking the reform of DRG payment methods as the background,it discusses how the medical in-surance department uses information technology to achieve refined monitoring and management of medical institu-tions,so as to improve the quality and efficiency of medical services and control the unreasonable growth of medical expenses.The three stages of"precision monitoring-refined supervision-precision governance"of medical insurance DRG based on"refined theory"are proposed;taking Nanjing's"medical insurance high-speed railway"as an example,a DRG refined supervision and governance model framework is constructed,and its analysis is carried out monitoring elements and governance elements,and finally put forward implementation suggestions,including hori-zontal collaboration led by medical insurance,establishing a service and cost evaluation mechanism that combines in-ternal and external services.

It dified framework of health system resilience analysis.The research integrates practical elements from the case of the online pandemic material procurement and allocation hall in Nanjing,categorizing the resilience-building of local health systems via informatization into two distinct dimensions:static foundation and dynamic endowment.It conducts an in-depth examination of the logical pathways that leverage informatization to bolster resilience,and further investigates the inherent advantages and potential areas for optimization within informatization.The findings suggest that the synergistic empowerment of both static foundation and dynamic endowment effectively amplifies the risk defense capability and resilience of local health systems.

Information collaboration is an important realisation path to deepen the reform of the medical and health system and to promote the collaborative development and governance of the"Three Medicine"during the"14th Five-Year Plan"period.It employs the SFIC model and makes appropriate modifications to it.The analytical framework comprises six elements:"initial conditions-external environment-catalytic leadership-institutional de-sign-collaborative process-results feedback".This framework is used to dissect the current collaborative dilemma in the"Three Medicine"information collaboration and governance.Based on this analysis,an optimized path for infor-mation collaborative governance is proposed:consolidating the foundation of"Three Medicine"information collabora-tion,enhancing the catalytic leadership capability of meta-governance,optimizing the institutional design of informa-tion life-cycle governance,reshaping the information collaboration process,and focusing on the evaluation feedback mechanism.

Digital transformation is driving the repositioning of government work and the reshaping of public ser-vice models.It uses TOE theory combined with a technology analysis framework as a theoretical perspective and a single-case study approach to explore the operational mechanism and optimization path of health insurance gover-nance modernization.The findings show that the digital transformation of health insurance is in line with the three-stage path of"structuring the enabling mechanism-forming digital service capacity-enabling value creation".The next stage is to promote the implementation of digital coding standards,accelerate the application of technology integration,respond to the needs of the insured,improve the supporting measures for the linkage of the three health care systems,and bring into play the effectiveness of modern governance of health care.It expands the scope of government governance modernisation research and has both theoretical and practical value.

ObjectiveTo explore the mechanism of Naoxintong capsules' intervention in cerebral ischemia-reperfusion by building a mouse cerebral ischemia-reperfusion model based on short-chain fatty acids. MethodC57BL/6J male mice were randomly divided into the sham group， model group， Naoxintong group （158.9 mg∙kg^-1）， and Ginaton group （12.1 mg∙kg^-1） according to the random number table method. The model of cerebral ischemia-reperfusion （MCAO/R） was prepared via the filament occlusion method. The effect of Naoxintong capsules on brain injury in MCAO/R mice was evaluated by the neuroethological score， cerebral infarction area determination， Nissl staining， and immunofluorescence staining. Hematoxylin-eosin （HE） staining and Western blot were employed to evaluate the effect of Naoxintong capsules on the intestinal barrier in MCAO/R mice. The content of short-chain fatty acids in mouse feces was detected by LC-MS/MS. ResultCompared to the sham group， the model group exhibited significant increases in the cerebral infarction area， neuroethological score， and cell apoptosis rate （P<0.01）， with a notable decrease in the number of Nissl bodies （P<0.01）. The protein expression levels of Claudin-1 and Occludin were significantly reduced （P<0.05）. Compared with the model group， the intervention of Naoxintong capsules significantly decreased the cerebral infarction area （P<0.05） and improved the neuroethological score （P<0.01） and cell apoptosis rate （P<0.01）， with the number of Nissl bodies （P<0.01） and expression levels of Claudin-1 and Occludin proteins （P<0.01） increased. LC-MS/MS results showed that compared to the sham group， the model group featured a significantly reduced content of acetic acid， propionic acid， and butyric acid in feces （P<0.01）， while valeric acid， isovaleric acid， and isobutyric acid levels were increased （P<0.01）. The intervention of Naoxintong capsules notably lowered the content of valeric acid， isovaleric acid， and isobutyric acid （P<0.01）. ConclusionNaoxintong capsules can improve brain and intestinal barrier damage and play a protective role in cerebral ischemia-reperfusion by regulating the content of short-chain fatty acids.

Objective To investigate the changes in interleukin-34 (IL-34)levels in serum and bronchoalveolar lavage fluid (BALF) of patients with severe pneumonia and their prognostic value. Methods A total of 66 patients with severe pneumonia (severe pneumonia group), 35 patients with non-severe pneumonia (non-severe pneumonia group), and 27 healthy adults (control group) were enrolled. The severe pneumonia group was further divided into survival group of 38 patients and non-survival group of 28 patients based on 28-day survival. Clinical data of all subjects were analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the predictive power of serum IL-34 and relative IL-34 gene expression in BALF for 28-day mortality in patients with severe pneumonia, as well as the predictive power of serum IL-34 for severe pneumonia. Kaplan-Meier survival curves were plotted, and the Log-rank test was used to compare cumulative survival rates. Cox regression analysis was conducted to explore risk factors for 28-day mortality in patients with severe pneumonia. Pearson correlation analysis was used to assess the correlation between serum IL-34 levels and relative IL-34 gene expression in BALF of patients with severe pneumonia. Results Serum IL-34 levels were higher in the severe pneumonia group than those in the non-severe pneumonia group, and were higher in the non-severe pneumonia group than in the control group (P < 0.05). Serum IL-34 levels and relative IL-34 gene expression in BALF were higher in the non-survival group than in the survival group (P < 0.05). ROC curve analysis showed that the areas under the curve for predicting 28-day mortality in patients with severe pneumonia were 0.908 for serum IL-34 levels and 0.878 for relative IL-34 gene expression in BALF. The optimal cutoff value for serum IL-34 levels in predicting severe pneumonia was 129.9 pg/mL. Multivariate Cox regression analysis showed that increased serum IL-34 levels and increased relative IL-34 gene expression in BALF were independent risk factors for 28-day mortality in patients with severe pneumonia (P < 0.05). The Kaplan-Meier survival analysis results indicate that, with a cutoff value of 129.9 pg/mL, patients with severe pneumonia who had high serum levels of IL-34 exhibited a lower cumulative survival rate compared to those with low IL-34 level(Log-rank P < 0.001). Conclusion Serum IL-34 levels are significantly increased in patients with severe pneumonia, and relative IL-34 gene expression in BALF is positively correlated with serum IL-34 levels. Both can be used as indicators for predicting the prognosis of 28-day mortality in patients with severe pneumonia.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.