With the rapid advancement of modern medicine, clinical observations indicate a growing trend of ischemic ocular disease with an increasingly younger age of onset. This condition remains a prominent and challenging focus in ophthalmic clinical practice. Treatment approaches focused solely on ophthalmic interventions yield less than satisfactory clinical outcomes. Some ischemic ocular disease patients concurrently suffer from obstructive sleep apnea hypopnea syndrome(OSAHS). These patients show rapid Ischemic ocular disease progression, difficulty in stabilizing blood pressure, and increased susceptibility to cardiovascular and cerebrovascular events during ophthalmic treatment. This review primarily examines the correlation between ischemic ocular disease and OSAHS, the pathophysiological changes in ischemic ocular disease patients and the risk factors in OSAHS patients. It aims to provide a theoretical basis for clinical management and disease prevention in this patient population.

Pancreatic ductal adenocarcinoma （PDAC） has an extremely poor prognosis， and resistance to gemcitabine is one of the key reasons for treatment failure， with an underlying mechanism closely associated with lipid metabolic reprogramming in tumor cells. This article aims to systematically elaborate on the multidimensional drug resistance network constructed by such reprogramming and the feasibility of targeted intervention. Lipid metabolic reprogramming comprehensively remodels the metabolic homeostasis of PDAC cells by enhancing lipid uptake， de novo synthesis， storage， and oxidative catabolism in a synergistic manner. This process alters membrane lipid composition to impede drug influx and promote efflux， thereby reducing intracellular drug concentration. Meanwhile， it activates pathways involving sterol regulatory element-binding protein and peroxisome proliferator-activated receptor δ， couples lipid synthesis with cell survival， stemness， and anti-apoptotic capacity， and synergizes with autophagy to provide survival support through “lipophagy”. In addition， it reshapes the tumor microenvironment through “lipid hijacking” and the secretion of immunosuppressive mediators. Based on the above mechanisms， targeting key lipid metabolic enzymes （such as fatty acid synthase， stearoyl-CoA desaturase， carnitine palmitoyltransferase 1） or their upstream regulators has shown certain potential in reversing such drug resistance in preclinical studies. Although clinical translation faces the challenges such as systemic toxicity， metabolic redundancy in tumors， and patient heterogeneity， the development of biomarkers， intelligent drug delivery systems， and combined therapies may provide new ideas for overcoming drug resistance.

Ligusticum sinense cv.Fuxiong derived from"Xiongqiong",and in the Song Dynasty's Tai Ping Hui Min He Ji Ju Fang,it was already distinguished from Chuanxiong Rhizoma in usage.Doctors in the Ming Dynasty further clarified the differences in efficacy between the two.However,with the widespread circulation of Chuanxiong Rhizoma,Ligusticum sinense cv.Fuxiong gradually became marginalized,serving as a substitute,and is now only cultivated and used in small quantities within Jiangxi Province.This article reviewed the prescriptions and the ancient Chinese medical books that have records of Ligusticum sinense cv.Fuxiong,analyzed its specific applications alongside Chuanxiong Rhizoma in prescriptions and case studies to elucidate their differences in efficacy:Ligusticum sinense cv.Fuxiong is pungent and has strong dispersing power and is good at unblocking meridians and promoting qi circulation,which is suitable for excessive syndromes;Chuanxiong Rhizoma is good at promoting blood circulation and relieving pain,and is good at regulating and nourishing,which is suitable for patients with deficiency syndromes,aiming to provide insights and recommendations for the further development and rational clinical medication of Ligusticum sinense cv.Fuxiong.

Ligusticum sinense cv.Fuxiong derived from"Xiongqiong",and in the Song Dynasty's Tai Ping Hui Min He Ji Ju Fang,it was already distinguished from Chuanxiong Rhizoma in usage.Doctors in the Ming Dynasty further clarified the differences in efficacy between the two.However,with the widespread circulation of Chuanxiong Rhizoma,Ligusticum sinense cv.Fuxiong gradually became marginalized,serving as a substitute,and is now only cultivated and used in small quantities within Jiangxi Province.This article reviewed the prescriptions and the ancient Chinese medical books that have records of Ligusticum sinense cv.Fuxiong,analyzed its specific applications alongside Chuanxiong Rhizoma in prescriptions and case studies to elucidate their differences in efficacy:Ligusticum sinense cv.Fuxiong is pungent and has strong dispersing power and is good at unblocking meridians and promoting qi circulation,which is suitable for excessive syndromes;Chuanxiong Rhizoma is good at promoting blood circulation and relieving pain,and is good at regulating and nourishing,which is suitable for patients with deficiency syndromes,aiming to provide insights and recommendations for the further development and rational clinical medication of Ligusticum sinense cv.Fuxiong.

Pancreatic cancer is an extremely malignant tumor of digestive system, featuring high heterogeneity and poor prognosis. The emergence of pancreatic cancer organoids has provided a new perspectivel for the study of pancreatic cancer. Organoids can accurately simulate the tumor microenvironment and biological characteristics, and reveal the interaction between the tumor and the microenvironment. This article elaborates on the important of organoids in simulating tumor microenvironment, establishing drug screening platform, drug resistance mechanism and promoting personalized therapy. At the same time, the challenges faced by organoids, such as high cost and long modeling time, were analyzed. Pancreatic cancer organoids will play a greater role in personalized treatment and bring new breakthroughs in the research and treatment of pancreatic cancer.

Objective To analyze the characteristic influencing factors for enlarged perivascular spaces(EPVS)in different regions of acute ischemic stroke(AIS)patients and explore their un-derlying pathogenesis.Methods A total of 172 AIS patients admitted to our department from September 2020 to September 2023 were consecutively enrolled.According to the distribution of EPVS,they were divided into basal ganglia EPVS group(n=103)and non-basal ganglia EPVS group(n=69),as well as centrum semiovale EPVS group(n=77)and non-centrum semiovale EPVS group(n=95).General information,NIHSS score at onset,TOAST classification,fasting blood glucose,liver function,coagulation function,and homocysteine(Hcy)level were collected in all the patients.Multivariate logistic regression analysis was used to identify independent influen-cing factors for EPVS in different regions.Results The basal ganglia EPVS group had significant-ly advanced age and larger proportion of hypertension than the non-basal ganglia EPVS group,while the centrum semiovale EPVS group had smaller proportion of hyperhomocysteinemia,and larger ratios of smoking and alcohol consumption,higher alanine aminotransferase(ALT)level,and longer thrombin time than the non-centrum semiovale EPVS group(P＜0.05,P＜0.01).Mul-tivariate logistic regression analysis showed that hypertension(OR=2.093,95％CI:1.045-4.192,P=0.037)and age(OR=1.071,95％CI:1.016-1.130,P=0.011)were independent influ-encing factors for basal ganglia EPVS,while alcohol consumption(OR=2.418,95％CI:1.097-5.330,P=0.029)and thrombin time(OR=1.593,95％CI:1.129-2.249,P=0.008)were inde-pendent influencing factors for centrum semiovale EPVS.Conclusion EPVS in different regions of AIS patients are associated with distinct risk factors.Age and hypertension are primary influen-cing factors for basal ganglia EPVS,while alcohol consumption and prolonged thrombin time are significant factors for centrum semiovale EPVS.

Objective To analyze the characteristic influencing factors for enlarged perivascular spaces(EPVS)in different regions of acute ischemic stroke(AIS)patients and explore their un-derlying pathogenesis.Methods A total of 172 AIS patients admitted to our department from September 2020 to September 2023 were consecutively enrolled.According to the distribution of EPVS,they were divided into basal ganglia EPVS group(n=103)and non-basal ganglia EPVS group(n=69),as well as centrum semiovale EPVS group(n=77)and non-centrum semiovale EPVS group(n=95).General information,NIHSS score at onset,TOAST classification,fasting blood glucose,liver function,coagulation function,and homocysteine(Hcy)level were collected in all the patients.Multivariate logistic regression analysis was used to identify independent influen-cing factors for EPVS in different regions.Results The basal ganglia EPVS group had significant-ly advanced age and larger proportion of hypertension than the non-basal ganglia EPVS group,while the centrum semiovale EPVS group had smaller proportion of hyperhomocysteinemia,and larger ratios of smoking and alcohol consumption,higher alanine aminotransferase(ALT)level,and longer thrombin time than the non-centrum semiovale EPVS group(P＜0.05,P＜0.01).Mul-tivariate logistic regression analysis showed that hypertension(OR=2.093,95％CI:1.045-4.192,P=0.037)and age(OR=1.071,95％CI:1.016-1.130,P=0.011)were independent influ-encing factors for basal ganglia EPVS,while alcohol consumption(OR=2.418,95％CI:1.097-5.330,P=0.029)and thrombin time(OR=1.593,95％CI:1.129-2.249,P=0.008)were inde-pendent influencing factors for centrum semiovale EPVS.Conclusion EPVS in different regions of AIS patients are associated with distinct risk factors.Age and hypertension are primary influen-cing factors for basal ganglia EPVS,while alcohol consumption and prolonged thrombin time are significant factors for centrum semiovale EPVS.

Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Video-assisted thoracoscopic surgery (VATS) is the standard procedure for the treatment of lung cancer in the early and middle stages in recent years. The diaphragm is the main respiratory muscle that maintains effective pulmonary ventilation. Diaphragmatic dysfunction is a short-term or permanent dysfunction of one or both diaphragms caused by various factors, mainly manifested as diaphragm distension, diaphragm weakness and diaphragm paralysis, which can lead to respiratory dysfunction, even respiratory failure. This article reviews the etiology, clinical symptoms and signs, diagnosis, treatment and prognosis of diaphragmatic dysfunction after VATS lobectomy, aiming to provide clinicians with assessment methods and management framework for timely diagnosis and treatment of diaphragmatic dysfunction after VATS lobectomy, so as to optimize postoperative respiratory rehabilitation and improve long-term prognosis and quality of life of patients.

Objective To explore the mediating effects of potential mediating factors on occur-rence of stroke-associated pneumonia(SAP)in patients with varying degrees of neurological deficit based on real-world case data.Methods A total of 902 hospitalized patients in the acute phase of stroke were selected as study subjects.Clinical characteristics were compared among patients with dif-ferent degrees of neurological deficit and those with SAP.R studio was employed to generate a correla-tion heatmap of potential mediating factors,enabling the identification of primary potential mediating factors.Multivariate logistic regression analysis was conducted to assess the impact of the degree of neurological deficit,potential mediating factors,and stroke-associated pneumonia.R studio was also used to analyze the interaction between the degree of neurological deficit and potential mediating factors,as well as the mediating role of potential mediating factors in the association between neurological deficit and SAP.Results Based on the results of the correlation heatmap,this study screened out five major potential mediating factors,namely consciousness level,neutrophil-to-lymphocyte ratio(NLR),chlorine(Cl),fasting blood glucose(FBG)and albumin(ALB).Multivariate logistic re-gression analysis revealed that the degree of neurological deficit was significantly associated with the level of consciousness,NLR,Cl,FBG levels and the occurrence of SAP.Interaction analysis dem-onstrated an interaction between the degree of neurological deficit and FBG levels.Mediation analy-sis indicated that the total effect of the association between neurological deficit and SAP was 0.302.Both the level of consciousness and NLR exhibited partial mediating effects in the association be-tween neurological deficit and SAP,with mediating effect proportions of 25.92％and 15.15％,re-spectively.Conclusion Consciousness level and NLR have partial mediating effects in the occur-rence of SAP in patients with different neurological deficits.There is an interaction between the de-gree of neurological deficit and the level of FBG.