ObjectiveAge-related macular degeneration （AMD） is one of the leading causes of low vision and blindness in people over 50 years old， and dry AMD （dAMD） is one type for which there is currently no clear treatment. On the basis of the diagnosis and clinical characteristics of dAMD in traditional Chinese and Western medicine， this paper evaluated the fitting degrees of existing animal models of dAMD with clinical characteristics according to the evaluation methods of animal models， and put forward suggestions and prospects. MethodsLiterature on animal models of dAMD was searched against database， and the characteristics of the models were assigned according to the diagnosis criteria of diseases and syndromes of traditional Chinese and Western medicine， and the fitting degrees of the models with clinical characteristics were analyzed and evaluated. ResultsAt present， the animal models of dAMD are mainly established targeting complement factors， chemokines， oxidative damage， lipid/glucose metabolism， and natural strains. Most of the models can simulate the major pathological changes of dAMD， showing the fitting degree of 25%-50% with clinical characteristics in Western medicine. However， the evaluation of traditional Chinese medicine （TCM） syndromes， especially the evaluation of secondary syndromes， is missing， and the models present low fitting degrees with the clinical characteristics in TCM. ConclusionExisting animal models of dAMD are mostly established under the guidance of Western diagnostic standards， which reproduce the main disease characteristics of Western medicine and lack observation of TCM syndromes. Future studies can pay attention to the intervention factors and evaluation systems of spleen deficiency Qi deficiency and liver-kidney Yin deficiency syndrome and build the animal model of dAMD with integration of disease and syndrome based on clinical characteristics of traditional Chinese and Western medicine.

ObjectiveRetinal vein occlusion （RVO） is the second most common vascular disease leading to vision loss. Since its pathogenesis remains unclear， current Western medical treatments primarily target complications such as macular edema and neovascularization. The main therapeutic approaches include intravitreal injections of anti-vascular endothelial growth factor （VEGF） agents or corticosteroids， laser photocoagulation， and pars plana vitrectomy. However， these treatments cannot fully reverse disease progression or structural damage. Traditional Chinese medicine （TCM） has unique advantages in the clinical diagnosis and treatment of RVO， and integrated Chinese and Western medicine approaches may offer better clinical outcomes. This study， based on the clinical manifestations of RVO， systematically reviews the existing literature and evaluates the alignment of current RVO animal models with clinical manifestations. The aim is to identify the characteristics and limitations of existing models and provide recommendations and prospects for developing RVO animal models featuring the combination of disease and syndrome. MethodsDatabases including CNKI， Wanfang Data， PubMed， and Web of Science were searched with the keywords of "retinal vein occlusion" and "animal model". Model characteristics were assessed based on the diagnostic criteria for diseases and syndromes in both TCM and Western medicine. The alignment of each model with clinical manifestations was analyzed and evaluated. ResultsThe available RVO models were primarily established via methods such as laser photocoagulation， photodynamic therapy， diathermy， intravitreal drug injection， and mechanical modeling. These models demonstrated moderate overall alignment with clinical manifestations， mainly reflecting disease characteristics. However， they generally lack representation of TCM syndrome features. ConclusionExisting RVO models are predominantly based on Western medicine and lack TCM syndrome features. Western medical treatments for RVO have certain limitations， while syndrome differentiation and treatment in TCM offer potential advantages. Future research should focus on developing disease-syndrome integrated animal models that incorporate both pathological features and TCM syndrome characteristics. This approach will enhance the design of RVO models and facilitate both basic and clinical research， which make it a scientifically valuable and necessary endeavor.

ObjectiveAge-related macular degeneration （AMD） is one of the leading causes of low vision and blindness in people over 50 years old， and dry AMD （dAMD） is one type for which there is currently no clear treatment. On the basis of the diagnosis and clinical characteristics of dAMD in traditional Chinese and Western medicine， this paper evaluated the fitting degrees of existing animal models of dAMD with clinical characteristics according to the evaluation methods of animal models， and put forward suggestions and prospects. MethodsLiterature on animal models of dAMD was searched against database， and the characteristics of the models were assigned according to the diagnosis criteria of diseases and syndromes of traditional Chinese and Western medicine， and the fitting degrees of the models with clinical characteristics were analyzed and evaluated. ResultsAt present， the animal models of dAMD are mainly established targeting complement factors， chemokines， oxidative damage， lipid/glucose metabolism， and natural strains. Most of the models can simulate the major pathological changes of dAMD， showing the fitting degree of 25%-50% with clinical characteristics in Western medicine. However， the evaluation of traditional Chinese medicine （TCM） syndromes， especially the evaluation of secondary syndromes， is missing， and the models present low fitting degrees with the clinical characteristics in TCM. ConclusionExisting animal models of dAMD are mostly established under the guidance of Western diagnostic standards， which reproduce the main disease characteristics of Western medicine and lack observation of TCM syndromes. Future studies can pay attention to the intervention factors and evaluation systems of spleen deficiency Qi deficiency and liver-kidney Yin deficiency syndrome and build the animal model of dAMD with integration of disease and syndrome based on clinical characteristics of traditional Chinese and Western medicine.

ObjectiveRetinal vein occlusion （RVO） is the second most common vascular disease leading to vision loss. Since its pathogenesis remains unclear， current Western medical treatments primarily target complications such as macular edema and neovascularization. The main therapeutic approaches include intravitreal injections of anti-vascular endothelial growth factor （VEGF） agents or corticosteroids， laser photocoagulation， and pars plana vitrectomy. However， these treatments cannot fully reverse disease progression or structural damage. Traditional Chinese medicine （TCM） has unique advantages in the clinical diagnosis and treatment of RVO， and integrated Chinese and Western medicine approaches may offer better clinical outcomes. This study， based on the clinical manifestations of RVO， systematically reviews the existing literature and evaluates the alignment of current RVO animal models with clinical manifestations. The aim is to identify the characteristics and limitations of existing models and provide recommendations and prospects for developing RVO animal models featuring the combination of disease and syndrome. MethodsDatabases including CNKI， Wanfang Data， PubMed， and Web of Science were searched with the keywords of "retinal vein occlusion" and "animal model". Model characteristics were assessed based on the diagnostic criteria for diseases and syndromes in both TCM and Western medicine. The alignment of each model with clinical manifestations was analyzed and evaluated. ResultsThe available RVO models were primarily established via methods such as laser photocoagulation， photodynamic therapy， diathermy， intravitreal drug injection， and mechanical modeling. These models demonstrated moderate overall alignment with clinical manifestations， mainly reflecting disease characteristics. However， they generally lack representation of TCM syndrome features. ConclusionExisting RVO models are predominantly based on Western medicine and lack TCM syndrome features. Western medical treatments for RVO have certain limitations， while syndrome differentiation and treatment in TCM offer potential advantages. Future research should focus on developing disease-syndrome integrated animal models that incorporate both pathological features and TCM syndrome characteristics. This approach will enhance the design of RVO models and facilitate both basic and clinical research， which make it a scientifically valuable and necessary endeavor.

Central nervous system diseases refer to complex disorders that affect the structure and function of the central nervous system （brain and spinal cord）. Due to their complex pathogenesis and the lack of effective therapies， the diseases have become one of the leading causes of human death and have imposed a heavy economic burden on families and society. Rehmanniae Radix Preparata， a representative traditional Chinese medicine for "nourishing essence and enriching marrow"， has multi-target and multi-pathway advantages in the treatment of central nervous system diseases. It contains various active components such as catapol， verbascoside， and echinacoside and has multiple pharmacological effects including anti-depression， neuroprotection， antioxidation， anti-inflammation， and immunomodulation. In Alzheimer's disease， Rehmanniae Radix Preparata can regulate the processing of beta-amyloid precursor protein to reduce its production， and its antioxidative and neuroprotective effects can alleviate related pathological damage. In Parkinson's disease， it can protect dopaminergic neurons by regulating intracellular signal transduction pathways. In ischemic stroke， its antioxidative， anti-inflammatory， and neuroprotective effects can alleviate pathological reactions. Multiple sclerosis is an autoimmune demyelinating disease， and its pathogenesis is related to the autoimmune response attacking the myelin sheath of the central nervous system. The anti-inflammatory effect of Rehmanniae Radix Preparata can help inhibit this autoimmune response， reduce the damage of inflammation to the myelin sheath， and protect damaged neurons while promoting myelin sheath repair. In depression， Rehmanniae Radix Preparata can improve neural plasticity， and its anti-inflammatory effect can regulate neuroendocrine function and influence the metabolism of neurotransmitters. This paper explored the action mechanism of Rehmanniae Radix Preparata in central nervous system diseases and summarized the relevant basic research and research progress on its active components and traditional Chinese medicine formulas for treating central nervous system diseases， providing a theoretical basis for the development of traditional Chinese medicine products for the prevention and treatment of central nervous system diseases with Radix Rehmanniae Preparata.

OBJECTIVE To investigate the influence of CYP2C19 gene polymorphism on platelet function and inflammatory cytokines in elderly patients with ischemic stroke， and to analyze potential factors associated with poor prognosis. METHODS A retrospective study was conducted on elderly patients with ischemic stroke admitted to our hospital from June 2024 to June 2025， wh o underwent CYP2C19 genotype testing and received antiplatelet therapy with clopidogrel. The levels of platelet function indicators and inflammatory cytokines before and after treatment were compared among patients with different metabolic phenotypes. Based on the prognosis at 6 months post-treatment， patients were divided into poor prognosis group and good prognosis group. Univariate analysis was performed on general data， metabolic phenotype， the levels of platelet function indicators and inflammatory cytokines. Variables with P ＜0.05 and the levels of inflammatory cytokines before treatment were included in a multivariate Logistic regression analysis to identify independent risk factors for poor prognosis. Multiple linear regression was used to further analyze the relationship between metabolic phenotypes and inflammatory cytokines. RESULTS A total of 448 elderly patients with ischemic stroke were included； among them， 162 cases were normal metabolic phenotype， 218 were intermediate metabolic phenotype， and 68 were poor metabolic phenotype. No rapid or ultrarapid metabolic phenotypes were observed. After treatment， platelet aggregation rate， the levels of P-selectin and platelet activated complex-1 （PAC-1）， high-sensitivity C-reactive Protein （hs-CRP）， interleukin-1β （IL-1β）， IL-6 and tumor necrosis factor-α （TNF-α） in the normal metabolic phenotype group， intermediate metabolic phenotype group， and poor metabolic phenotype group （except for platelet aggregation rate， and the levels of P-selectin and PAC-1 in the poor metabolic phenotype group） were significantly lower than those before treatment in the same group. Moreover， the above indicators in the normal metabolic phenotype group were significantly lower than those in the intermediate and poor metabolic phenotype groups at the corresponding time， and the levels of platelet function indicators in the intermediate metabolic phenotype group were significantly lower than those in the poor metabol ic phenotype group at the corresponding time （ P ＜0.05）. Univariate and multivariate Logistic regression analyses showed that combined with hypertension， combined with diabetes mellitus， and intermediate or poor metabolic genotypes were independent risk factors for poor prognosis in elderly patients with ischemic stroke （ P ＜0.05）. Multiple linear regression analysis showed that serum levels of hs-CRP， IL-1β， IL-6 and TNF-α before treatment were significantly higher in patients with intermediate and poor metabolic genotypes compared to those with normal metabolic genotype （ P ＜0.05）， with a greater magnitude of increase in inflammatory cytokines observed in the patients with poor metabolic genotype. CONCLUSIONS The elderly ischemic stroke patients with CYP2C19 intermediate and poor metabolic genotypes have poor inhibition effect on platelet and higher levels of inflammatory cytokines than normal metabolic genotype； CYP2C19 gene polymorphism， and in combination with hypertension and diabetes， can be used as independent predictors of poor prognosis.

OBJECTIVE To evaluate the cost-effectiveness of finerenone combined with standard treatment regimen in the treatment of diabetic nephropathy （DN）. METHODS From the perspective of healthcare service providers， a Markov model was established to simulate the dynamic changes of each stage in DN patients who received finerenone combined with the standard treatment regimen or the standard treatment regimen alone based on the phase Ⅲ clinical trial study of finerenone for DN. Markov model was used to perform the cost-effectiveness of long-term effects and the costs of the two therapies with a simulation cycle of 4 months， a simulation period of 15 years and an annual discount rate of 5%. At the same time， one-way sensitivity analysis and probability sensitivity analysis were performed， and the stability of the results was validated. RESULTS Accumulative cost of the standard treatment regimen was 579 329.54 yuan， and the accumulative utility was 8.052 4 quality-adjusted life year （QALYs）； the accumulative cost of finerenone combined with the standard treatment regimen was 332 520.61 yuan， and the accumulative utility was 8.187 4 QALYs. Finerenone combined with the standard treatment regimen was more cost-effective. The results of one-way sensitivity analysis showed that dialysis status utility value， DN stage 3 utility value and DN stage 4 utility value had a great influence on the incremental cost-effectiveness ratio， but did not affect the robustness of the model. The results of probability sensitivity analysis showed that finerenone combined with the standard treatment regimen was more cost-effective with 100% probability. CONCLUSIONS For DN patients， finerenone combined with the standard treatment regimen is more cost-effective as an absolute advantage option.

ObjectiveTo investigate the antitumor effect and mechanism of Guiqi Yiyuan ointment on Lewis lung cancer mice based on the extracellular regulatory protein kinase （ERK） signaling pathway. MethodsA Lewis lung cancer mouse model was established. Except for the blank group， the model mice were randomly divided into the model group， Guiqi Yiyuan ointment low， medium， and high dose groups， and the extracellular ERK1/2 inhibitor group， with 10 mice per group. The Guiqi Yiyuan ointment was administered by gavage at doses of 1.75， 3.5， 7.0 g·kg^-1·d^-1 for the low， medium， and high dose groups， respectively. The ERK1/2 inhibitor group was given the ERK1/2 inhibitor LY3214996 （100 mg·kg^-1·d^-1） by gavage. The treatment was administered for 14 consecutive days， after which samples were collected. Tumor histopathological changes were observed using hematoxylin-eosin （HE） staining. Transmission electron microscopy was used to observe ultrastructural changes in tumor cells. Immunofluorescence was performed to measure the phosphorylation of ERK1/2 （p-ERK1/2） and the expression of programmed cell death ligand-1 （PD-L1） in tumor tissues. Western blot and real-time quantitative polymerase chain reaction （Real-time PCR） were used to detect the expression of p-ERK1/2， PD-L1， the autophagy marker Beclin-1， the autophagic protein p62， and the microtubule-associated protein light chains LC3Ⅰ and LC3Ⅱ at both the protein and gene levels. ResultsCompared with the model group， the average tumor weight was significantly reduced in the low and medium dose groups of Guiqi Yiyuan ointment （P<0.05）， and markedly reduced in the high dose and inhibitor groups （P<0.01）. Tumor cells in all treatment groups became progressively irregular， with ruptured nuclei and expanded areas of cell disintegration and necrosis. The number of organellar ablations in tumor tissues increased， and the number of autophagic vesicles also increased in all groups. The mean fluorescence intensity of p-ERK1/2 and PD-L1 was reduced in the low and medium dose groups of Guiqi Yiyuan ointment （P<0.05）， and significantly reduced in the high dose and inhibitor groups （P<0.01）. The mRNA expression of ERK1/2， PD-L1， Beclin-1， and p62 was reduced in the medium dose group （P<0.05）， while LC3Ⅰ/Ⅱ mRNA expression was elevated （P<0.05）. In the high dose and inhibitor groups， mRNA expression of ERK1/2， PD-L1， Beclin-1， and p62 was significantly reduced （P<0.01）， while LC3Ⅰ/Ⅱ mRNA expression was significantly increased （P<0.01）. Protein expression of p-ERK1/2， PD-L1， Beclin-1， and p62 was reduced in the medium dose group （P<0.05）， and LC3Ⅰ/Ⅱ protein expression was elevated （P<0.05）. In the high dose and inhibitor groups， protein expression of p-ERK1/2， PD-L1， Beclin-1， and p62 was significantly reduced （P<0.01）， while LC3Ⅰ/Ⅱ protein expression was significantly elevated （P<0.01）. ConclusionGuiqi Yiyuan ointment may inhibit the activation of the ERK signaling pathway， downregulate the expression of p-ERK1/2， promote autophagic flux in tumor cells， and regulate the expression of PD-L1， thereby exerting an inhibitory effect on tumor growth in Lewis lung cancer mice.

OBJECTIVE From the perspective of China’s healthcare system， to evaluate the cost-effectiveness of amivantamab combined with chemotherapy versus chemotherapy alone for patients with EGFR-mutated advanced non-small cell lung cancer （NSCLC） who experience disease progression during or after treatment with osimertinib monotherapy. METHODS The Markov model was established according to MARIPOSA-2 clinical trial. The simulation time limit was 10 years and the cycle period lasted for 21 days. The incremental cost-effectiveness ratio（ICER） of amivantamab combined with chemotherapy versus chemotherapy alone for the treatment of EGFR-mutated advanced NSCLC was calculated， and then compared with the willingness-to-pay（WTP） threshold set in this study[3 times the per capita gross domestic product（GDP） of China in 2023， which was 268 200 yuan per quality-adjusted life year（QALY）]， in order to assess its cost-effectiveness. Single-factor sensitivity analysis and probability sensitivity analysis were performed to evaluate the stability of the model； scenario analysis was carried out to determine the potential price of amivantamab at which the regimen became cost-effective. RESULTS Compared with chemotherapy alone， the cost of amivantamab combined with chemotherapy was higher （1 248 411.60 yuan vs. 89 023.39 yuan）， but at the same time， there were also more benefits of survival （0.756 QALY vs. 0.584 QALY）， ICER was 6 757 285.38 yuan/QALY. ICER was most affected by the utility of progression-free survival and the price of amivantamab. The price of amivantamab decreased to 310.3 yuan per 350 mg， and the combination therapy became cost-effective， compared with chemotherapy alone. CONCLUSIONS From the perspective of Chinese health system， when the WTP threshold is set at three times the per capita GDP of the Chinese population in 2023， amivantamab combined with chemotherapy is not cost-effective for EGFR-mutated advanced NSCLC； the patients’ affordability can be improved when the price of amivantamab experiences a significant decrease.

Xiang thinking is a cognitive approach that reflects the relationships between phenomena and their underlying principles by analyzing their external manifestations through methods such as analogy， reasoning， deduction， and symbolism. This article applied xiang thinking to analyze the etiology and pathogenesis of "wind， fire， phlegm， and blood stasis" in stroke， thereby exploring its impact on the principles of syndrome differentiation and treatment of this condition. Meanwhile， the article traced the construction process of xiang thinking， and interpreted the concept of "toxin pathogen" in traditional Chinese medicine from four perspectives， state， attribute， origin， and law. Furthermore， the relationship between the process of constructing xiang thinking and the origin of etiology， identification methods， pathogenesis evolution， and treatment strategies for stroke with syndrome of combined blood stasis and toxin was explored， so as to provide insights into research on the etiology and pathogenesis of stroke， as well as clinical diagnosis and treatment approaches.