The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi， impaired qi transformation， and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology， chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi， blood， and essence， while "stagnation" refers to the accumulation of phlegm， turbid dampness， and blood stasis. These two components interact reciprocally， forming a vicious cycle where deficiency leads to stagnation， and stagnation further damages the healthy qi. In the early stage of mild myelosuppression， chemotoxicity begins to accumulate in the bone marrow， leading to qi consumption， blood deficiency， yin injury， and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression， the accumulation of toxicity causes qi sinking， exhaustion of essence， and marrow depletion， along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation， with an emphasis on assessing the severity of the condition， balancing deficiency and excess， and achieving both symptomatic relief and root cause resolution.

Clinical pharmacology is an important discipline that bridges clinical medicine and pharmacology. In the teaching practice, it is necessary to keep up with educational reform and adopt the seminar teaching method combined with case-based learning (CBL), so as to practically improve the benefits of both "teaching" and "learning". The teaching of ideology and politics in the curriculum is the key to cultivate students' high sense of responsibility and noble medical ethics, and realize the goal of moral education. At present, in the teaching of clinical pharmacology of antineoplastic drugs, there are problems such as students' weak basic knowledge of oncology pharmacology, separation of "teaching" and "learning" due to the traditional teaching method, outdated teaching materials, and low motivation of students. Therefore, this paper takes this part of the course teaching as an example to initially explore the role of the innovative model of "Seminar-CBL-Ideological and Political Education " in the teaching practice of clinical pharmacology, with the hope of stimulating the students' interest in learning, cultivating students' correct outlook on the world, life, and values, achieving the goals of "teaching" and "learning", and providing reference for optimizing clinical pharmacology education.

To analyze the infection and drug-resistant gene 23S rRNA mutations of mycoplasma pneumoniae (Mp) in hospitalized children aged 0-17 in Ningbo City from 2019 to 2023. Throat swabs were collected from hospitalized children with respiratory tract infections in Ningbo University Affiliated Women and Children′s Hospital from 2019 to 2023. They were subjected to real-time fluorescence quantitative polymerase chain reaction detection to analyze Mp infection and drug-resistant gene (23S rRNA) mutations. Intergroup comparisons were made by the Chi-square test or Fisher′s exact probability method. A total of 18 968 hospitalized children were included, with a total positive rate of 30.37% (5 760/18 968). The total positive rate of drug-resistant gene mutations was 82.45% (4 749/5 760). The positive rate of Mp in male children was 29.26%, which was lower than that in female children (31.67%, χ 2=12.948, P<0.001). The positive rate of Mp drug-resistant gene mutations in male children was 82.52%, which was higher than that in female children(82.37%, χ 2=0.021, P=0.885). The positive rates of Mp increased with age ( χ 2=1 722.21, P<0.001). The positive rates of Mp drug-resistant gene mutations also increased with age ( χ 2=13.152, P<0.001). In the four seasons, the total positive rate of Mp in summer and autumn was significantly higher than that in winter and spring ( χ 2=1 085.149, P<0.001). Among them, the Mp positive rates in the summer and autumn of 2019 were as high as 38.26% and 34.49%, while in the summer and autumn of 2020, the Mp positive rates were 2.55% and 1.65%, respectively, which were the lowest in previous years. In the summer and autumn of 2023, the Mp positive rates increased to 47.22% and 51.06%. There was no statistically significant difference in the detection rate of Mp drug-resistant gene mutations among the four seasons. In Conclusion, Mp infection was more prevalent in the summer and autumn in Ningbo city and females and children aged 7-17 were more susceptible. The epidemic of Mp infection in Ningbo occurred in the summer of 2019. After the COVID-19 pandemic in 2020, the positive rate of Mp rapidly decreased and later remained in a low incidence state. After the lifting of restrictive prevention and control measures in 2023, the Mp positive rate returned to an epidemic state. The positive rate of Mp drug-resistant gene (23S rRNA) mutations was relatively high.

Objective To determine the anti-lung cancer effect of koumine(KOU)and total alkaloids of Gelsemium elegans Benth(TAG)and investigate the underlying mechanism.Methods After low,medium and high concentrations(100,150,200 μg/mL)of KOU were used to treat human lung adenocarcinoma cell lines A549 and SPCA1,Live Cell Imaging and Analysis by Sartorius colony formation assay was employed to detect the cell proliferation.The transplanted tumor model of lung cancer cells in mice was constructed and divided into model group(model group),cyclophosphamide group(CTX group,20 mg/kg),KOU group(2 mg/kg)and TAG group(0.5 mg/kg).After the mice of the CTX,KOU and TAG groups were intraperitoneally injected with 0.1 mL/10 g corresponding agents every other day for 10 d,the growth of lung cancer solid tumors was observed grossly and with HE staining,immunohistochemical(IHC)assay and TUNEL staining to and calculate the tumor size and growth inhibitory rate.RNA sequencing analysis was performed on A549 cells treated with TAG for 48 h to screen the differentially expressed genes(DEGs)between the treatment group and the control group,and the obtained DEGs were further analyzed with Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)functional enrichment analyses.RT-qPCR was applied to further analyze and verify the expression of related genes.Results Live Cell Imaging and Analysis fitted that the confluence of A549 and SPCA1 cells was decreased and the number of cells in the treated groups was observed to decrease,with poor growth.The results of colony formation assay confirmed that KOU reduced the number of cell clones,especially at a dose of 200 μg/mL(P＜0.01).Animal experiments showed that KOU and TAG treatment inhibited the tumor growth by 24.55％and 36.08％,respectively.TAG treatment resulted in significantly decreased tumor size when compared with the model group(P＜0.05).RNA sequencing analysis revealed that there were totally 2 793 DEGs,including 1 433 up-regulated genes and 1 360 down-regulated ones.Enrichment analysis displayed that the DEGs were mainly enriched in IL-17 signaling pathway,tumor necrosis factor signaling pathway and P53 signaling pathway.The results of RT-qPCR were consistent with the results of RNA sequencing analysis.The expression levels of GADD34,ZFP36,GADD45 A,GADD45 B and TP53INP2 genes were significantly increased in the TAG group(P＜0.01).Conclusion Alkaloids of Gelsemium elegans Benth inhibits the proliferation of lung cancer in vivo and in vitro.Transcriptomics find that KOU and TAG inhibit multiple DEGs and pathways of lung cancer.

To analyze the infection and drug-resistant gene 23S rRNA mutations of mycoplasma pneumoniae (Mp) in hospitalized children aged 0-17 in Ningbo City from 2019 to 2023. Throat swabs were collected from hospitalized children with respiratory tract infections in Ningbo University Affiliated Women and Children′s Hospital from 2019 to 2023. They were subjected to real-time fluorescence quantitative polymerase chain reaction detection to analyze Mp infection and drug-resistant gene (23S rRNA) mutations. Intergroup comparisons were made by the Chi-square test or Fisher′s exact probability method. A total of 18 968 hospitalized children were included, with a total positive rate of 30.37% (5 760/18 968). The total positive rate of drug-resistant gene mutations was 82.45% (4 749/5 760). The positive rate of Mp in male children was 29.26%, which was lower than that in female children (31.67%, χ 2=12.948, P<0.001). The positive rate of Mp drug-resistant gene mutations in male children was 82.52%, which was higher than that in female children(82.37%, χ 2=0.021, P=0.885). The positive rates of Mp increased with age ( χ 2=1 722.21, P<0.001). The positive rates of Mp drug-resistant gene mutations also increased with age ( χ 2=13.152, P<0.001). In the four seasons, the total positive rate of Mp in summer and autumn was significantly higher than that in winter and spring ( χ 2=1 085.149, P<0.001). Among them, the Mp positive rates in the summer and autumn of 2019 were as high as 38.26% and 34.49%, while in the summer and autumn of 2020, the Mp positive rates were 2.55% and 1.65%, respectively, which were the lowest in previous years. In the summer and autumn of 2023, the Mp positive rates increased to 47.22% and 51.06%. There was no statistically significant difference in the detection rate of Mp drug-resistant gene mutations among the four seasons. In Conclusion, Mp infection was more prevalent in the summer and autumn in Ningbo city and females and children aged 7-17 were more susceptible. The epidemic of Mp infection in Ningbo occurred in the summer of 2019. After the COVID-19 pandemic in 2020, the positive rate of Mp rapidly decreased and later remained in a low incidence state. After the lifting of restrictive prevention and control measures in 2023, the Mp positive rate returned to an epidemic state. The positive rate of Mp drug-resistant gene (23S rRNA) mutations was relatively high.

The killing effect of radiation therapy on healthy cells has led to the creation of targeted radionuclide therapy,which effectively reduces the damage to surrounding normal cells.At present,alpha(α)and beta(β)radionuclides are the research hotspots of targeted therapy.Numerous preclinical and clinical studies have shown that radiation therapy not only has local anti-tumor effects,but also exerts systemic anti-tumor effects by triggering the body's immune response.This paper describes in detail the characteristics and clinical applications of commonly used radionuclides,and discusses the mechanism of radiation-triggered body immune response as well as the related research on the combined use of radiation therapy,targeted radionuclide therapy and immunotherapy.

Nuclear medicine plays an indispensable role in the diagnosis,treatment,and prognosis of a wide range of diseases.Nuclear medicine using radionuclides for diagnosis has the advantages of accuracy,speed,high sensitivity and high resolution.Currently,several radionuclides play pivotal roles in disease diagnosis.This article primarily examines the clinical application and research of diagnostic radionuclides,including 18 F,89 Zr,68 Ga,99m Tc,131 I,123 I,and 11 C.The objective is to offer valuable insights for disease diagnosis and staging of diseases.

Objective: To compare the adverse events, immune status, and short-term efficacy between chronomodulated chemotherapy (CCR) and routine chemotherapy (RCR) combined with intensity modulated radiotherapy (IMRT)in the treatment of patients with locally advanced nasopharyngeal carcinoma. Methods: A total of 159 patients with newly diagnosed locally advanced nasopharyngeal carcinoma were randomized into the CCR group and the RCR group to evaluate the short-term efficacy and adverse events. Results: No significant difference was found in CR, PR, SD, and PD between the CCR group and the RCR group (P>0.05), and no significant difference was observed in the response rate (CR+ PR) between the two groups (P>0.05). The incidence of leukopenia(Z=-2.222, P<0.05), neutropenia(Z=-1.999, P<0.05), vomiting(Z=-2.298, P<0.05), and oral mucositis(Z=-3.571, P<0.05)of the CCR group was lower than those of the RCR group with statistical significance. The CD16+ 56+ lymphocyte cell count was higher in the CCR group than that in the RCR group(Z=-2.332, P<0.05). Conclusions As a novel invention, CCR combined with IMRT can reduce the incidence and severity of treatment-related adverse events and improve immune status without diminishing clinical efficacy, therefore deserving clinical application.

Beijing Chaoyang Hospital of Capital Medical University has been designated as a pilot hospital for introduction of contemporary hospital management system. It actively explored a new model of rational drug use administration, namely setting up chief pharmacists, pharmacists classified management, precision drug use service, and strengthened management of rational drug use. These efforts have efficiently minimized patients′ burden of drug expenditure, and enhanced incentives of the pharmacists, achieving the pharmacy′s functional transformation and value enhancement.

Objective To investigate serum levels of small dense low-density lipoprotein cholesterol (sdLDL-C)in transient ischemic attacks(TIA)patients and assess their predictive values for subsequent stroke risk after TIA.Methods Clinical case-control study.Serum sdLDL-C levels were determined in 96 TIA patients who were admitted to Jinling Hospital from January 2016 to December 2016 and 44 healthy controls who had contemporaneously visited Jinling Hospital For a routine or the routine.ABCD3-I scores in TIA patients were calculated.All TIA patients were classified into three subgroups:high-risk(8≤ABCD3-I≤13,n=23), moderate-risk(4≤ABCD3-I≤7, n=36)and low-risk(0≤ABCD3-I≤3, n=37). Total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and other lipid/lipoprotein parameters in TIA patients and controls were also analyzed.Spearman correlation analyses and multivariate linear regression analyses were performed to investigate the association of serum sdLDL-C levels with ABCD3-I scores.Logistic regression analyses were performed to investigate the predictive values of serum sdLDL-C for TIA patients.Results Serum sdLDL-C levels were significantly increased in TIA patients compared with controls(t=-5.202,P<0.001).Furthermore,sdLDL-C levels in high-risk patients were significantly higher than that in moderate-risk(t=3.534, P=0.001)and low-risk(t=4.154,P<0.001)patients.Serum sdLDL-C levels were positively correlated with ABCD 3-I scores(r=0.317,P=0.002)in TIA patients.The stepwise multiple regression analysis showed that only sdLDL-C was a significant independent predictor of ABCD 3-I scores(β=0.481,P=0.032,adjusted R2=0.189), after adjusting for age, gender, blood pressure and other lipid/lipoprotein parameters.Binary Logistic analyses indicated that serum sdLDL-C levels were closely associated with TIA presence(OR=2.84,95%CI =1.42 -5.70, P=0.003), after adjustment with age, gender, blood pressure and other lipid/lipoprotein parameters.Conclusions Serum sdLDL-C levels were increased in TIA patients.The significantly independent associations of sdLDL-C levels with ABCD3-I scores were observed.Serum sdLDL-C levels may contribute to assessing subsequent stroke risk after TIA.(Chin J Lab Med,2018,41:316-320)