The Chinese Pharmacopoeia is the legal technical standard which should be followed during the research, production, use, and administration of drugs. At present, the new edition of the Chinese Pharmacopoeia is planned to be promulgated and implemented. This article summarizes and analyzes the main characteristics and the content of updates and amendments of the Chinese Pharmacopoeia 2025 Edition(Volume Ⅰ), to provide a reference for the correct understanding and accurate implementation the new edition of the pharmacopoeia.

Objective To explore the mediating role of activities of daily living (ADL) in pain and depressive symptoms in the elderly in China. Methods Utilizing the data from 2020 China Health and Retirement Longitudinal Study, 4403 Chinese elderly individuals aged ≥ 60 years old were selected as the research subjects. Depression Scale (CES-D 10) of the Center for Epidemiological Survey and ADL scale were used in the study. The PROCESS4.1 macro was used to test the mediating effect of daily living activities between pain and depressive symptoms, and the Bootstrap method was applied for verification of the mediating variables. Results A total of 2368 cases of depressive symptoms were detected in the elderly in China, with a detection rate of 53.78%. Pain was positively correlated with depressive symptoms (r=0.27, P<0.01), and activities of daily living were negatively correlated with pain and depressive symptoms (r=-0.27, -0.337, P<0.01). The results showed that the total effect value of pain on depressive symptoms was 0.33, the direct effect value was 0.24, and the mediating effect value of daily living activities was 0.09, accounting for 27.27%. Conclusion Pain and activities of daily living are important factors influencing depressive symptoms in the elderly, and activities of daily living play a partial mediating role in the relationship between pain and depressive symptoms in the elderly.

OBJECTIVE: To study incident and clinical characteristics of the coronary microcirculation dysfunction (CMD) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by myocardial contrast echocardiography (MCE) and to explore the predictive value of CMD for in-hospital acute heart failure event. METHODS: One hundred and forty five patients with AMI who had received PCI and completed MCE during hospitalization in Peking University People' s Hospital from November 2015 to July 2021 were enrolled in our study. The patients were divided into CMD group and normal group according to the coronary microcirculation status detected by MCE. Clinical data and MCE data of the two groups were collected and analyzed. The acute heart failure event during hospitalization was described. A multivariate Logistic regression model was built to analyze the risk of acute heart failure in patients with CMD. A receiver operating characteristic (ROC) curve was drawn to evaluate the value of CMD in predicting acute heart failure event. RESULTS: CMD detected by MCE occurred in 87 patients (60%). Compared with normal group, patients with CMD had higher troponin I (TnI) peak level [52.8 (8.1, 84.0) μg/L vs. 18.9 (5.7, 56.1) μg/L, P=0.005], poorer Killip grade on admission (P=0.030), different culprit vessel (P < 0.001) and more patients had thrombolysis in myocardial infarction (TIMI) flow pre-PCI less than grade 3 in culprit vessel (65.1% vs. 43.1%, P=0.025). Meanwhile, patients with CMD had poorer left ventricular ejection fraction (LVEF) [52% (43%, 58%) vs. 61% (54%, 66%)], poorer global longitudinal strain (GLS) [-11.2% (-8.7%, -14.0%) vs.-13.9% (-10.8%, -17.0%)] and worse wall motion score index (WMSI) (1.58±0.36 vs. 1.25± 0.24) (P all < 0.001). Acute left heart failure happened in 13.8% of the CMD patients, which were significant higher than that in the patients with normal coronary microcirculation perfusion (1.7%, P=0.013). After correcting for the culprit vessel, the TIMI flow pre-PCI in the culprit vessel and the peak TnI value, the risk of acute left heart failure in the patients with CMD was still high (OR=9.120, 95%CI: 1.152-72.192, P=0.036). The area under ROC curve (AUC) was 0.677 (95%CI: 0.551-0.804, P=0.035). CONCLUSION The incidence of CMD detected by MCE in patients with AMI post-PCI was 60%. Patients with CMD have a higher risk of acute left heart failure during hospitalization.
Humans ; Heart Failure/physiopathology* ; Microcirculation ; Percutaneous Coronary Intervention/adverse effects* ; Myocardial Infarction/complications* ; Male ; Female ; Hospitalization ; Middle Aged ; Aged ; Echocardiography ; Coronary Circulation ; Predictive Value of Tests ; Troponin I/blood*

High-performance phototheranostics with combined photothermal therapy and photoacoustic imaging have been considered promising approaches for efficient cancer diagnosis and treatment. However, developing phototheranostic materials with efficient photothermal conversion efficiency (PCE), especially over the second near-infrared window (NIR-II, 1000-1700 nm), remains challenging. Herein, we report an ultraefficient NIR-II-activated nanomedicine with phototheranostic and vaccination capability for highly efficient in vivo tumor elimination and metastasis inhibition. The NIR-II nanomedicine of a semiconducting biradical oligomer with a motor-flexible design was demonstrated with a record-breaking PCE of 87% upon NIR-II excitation. This nanomedicine inherently features extraordinary photothermal stability, good biocompatibility, and excellent photoacoustic performance, contributing to high-contrast photoacoustic imaging in living mice and high-performance photothermal elimination of tumors. Moreover, a whole-cell vaccine based on a NIR-II nanomedicine with NIR-II-activated performance was further designed to remotely activate the antitumor immunologic memory and effectively inhibit tumor occurrence and metastasis in vivo, with good biosafety. Thus, this work paves a new avenue for designing NIR-II active semiconducting biradical materials as a promising theranostics platform and further promotes the development of NIR-II nanomedicine for personalized cancer treatment.

Objective To clarify the metabolic phenotypic changes in the serum and placenta of pre-eclampsia(PE)patients and their potential impact on fetal serum,and to identify and explore potential predic-tive biomarkers related to PE by using non-targeted metabolomics technology,thereby providing a reference for clinical diagnosis and disease monitoring.Methods Based on non-targeted metabolomics using liquid chro-matography-mass spectrometry(LC-MS),metabolomic analyses were performed on serum,placenta and um-bilical cord blood samples from 6 PE patients(PE group)and 6 healthy pregnant women in the late trimester(control group).Differential endogenous metabolites in each sample were screened using multivariate and uni-variate statistical methods.Metabolic pathways involved in the differential metabolites were enriched using MetaboAnalyst software.Additionally,potential biomarkers for predicting PE were identified based on binary logistic regression models.Results Compared with the control group,significant differences in the metabolic profiles of serum,placenta,and fetal serum were observed in the PE group.In the serum of PE patients,major metabolic abnormalities included α-linolenic acid metabolism,taurine metabolism,glycine,serine and threonine metabolism.In the placenta,abnormalities in linoleic acid metabolism,taurine metabolism,α-linolenic acid me-tabolism,and unsaturated fatty acid biosynthesis were detected.In the fetus of PE patients,metabolic abnor-malities were found in glutamine and glutamate metabolism,α-linolenic acid metabolism,and alanine,aspar-tate,and glutamate metabolism,involving polyunsaturated fatty acids and amino acids.The receiver operating characteristic(ROC)curves of differential metabolites were plotted using binary logistic regression models,and 4 serum metabolites with an area under the curve(AUC)＞0.9 were identified,mainly polyunsaturated fatty acid metabolites.The AUC of α-linolenic acid,a common differential metabolite in all three samples,was 0.806,with a sensitivity of 66.67％and specificity of 100.00％,indicating high diagnostic value.Conclusion The serum,placenta,and fetal serum metabolic profiles of PE patients and healthy pregnant women in the late trimester are significantly different and affect the metabolic phenotypes of offspring,providing insights into the pathogenesis of PE.

The Chinese Pharmacopoeia is the legal technical standard which should be followed during the research,production,use,and administration of drugs.At present,the new edition of the Chinese Pharmacopoeia is planned to be promulgated and implemented.This article summarizes and analyzes the main characteristics and the content of updates and amendments of the Chinese Pharmacopoeia 2025 Edition(Volume Ⅰ),to provide a reference for the correct understanding and accurate implementation the new edition of the pharmacopoeia.

Objective To investigate the changing trend and epidemiological characteristics of the incidence and mortality of chronic kidney disease (CKD) with age, period and birth cohort in Chinese population. Methods Based on the data of incidence and mortality of CKD in Chinese population aged 20-80 years from 1990 to 2019 in GHDx database, joinpoint regression model was used to analyze the incidence and mortality trend of CKD. An age-period-cohort model was constructed to analyze the effects of age, period, and birth cohort on the trend of CKD incidence and mortality. Results Joinpoint regression analysis showed that the standardized incidence rate of chronic kidney disease in Chinese population increased from 146.37/100 000 in 1990 to 161.52/100 000 in 2019, while the standardized mortality rate decreased from 12.98/100 000 in 1990 to 11.23/100 000 in 2019. The APC model analysis showed that the risk of CKD incidence and death in the Chinese population increased with age, while the risk of CKD incidence increased with the increase of period. The risk of death did not change significantly with the increase of period. The cohort born later had a lower risk of CKD incidence and death compared to the cohort born earlier. Conclusion At present, the age effect and period effect of the incidence and death risk of chronic kidney disease in China are dominant. It is important to take effective measures and intervene in a timely manner, especially to strengthen the protection of older high-risk groups born earlier.

BACKGROUND:Irreducible femoral neck fracture was difficult to obtain anatomic reduction.As a new type of internal fixation,the femoral neck system is still blank for the treatment of non-anatomical reduced femoral neck fractures. OBJECTIVE:To explore the biomechanical stability of femoral neck system internal fixation under nonanatomical reduction in the treatment of femoral neck fractures based on finite element analysis. METHODS:CT data of the hip joint of a healthy female adult were obtained.Anatomical reduction of femoral neck fracture models with Pauwels angles of 30°,50°,and 70° were established using Mimics 21.0,Geomagic Wrap 2021,and SolidWorks 2020.The fracture proximal ends of the three anatomical reduction models were shifted upward by 2 mm along the fracture line,and three positive buttress models with different Pauwels angles were obtained.In the same way,three negative buttress models were acquired by shifting downward by 2 mm.SolidWorks 2020 was used to make the femoral neck system internal fixation,and the nine femoral neck fracture models were assembled with the femoral neck system.Then Ansys 19.0 was used for finite element analysis.The displacement distribution and maximum displacement,stress distribution and maximum stress of the femur and femoral neck system were recorded under 2100 N stress. RESULTS AND CONCLUSION:(1)When Pauwels angles were 30°,50°,and 70°,the maximum stresses of the femoral neck system appeared to be concentrated at the junction of the sliding hip screw and anti-rotation screw.The maximum femur stresses appeared to be concentrated in the medial cortex of the femur.The maximum displacement was concentrated at the upper of the femoral head and femoral neck system.(2)When Pauwels angles were 30° and 50°,the maximum displacement and maximum stress of the femoral neck system and femur were:negative buttress>anatomical reduction>positive buttress.(3)When Pauwels angle was 70°,the maximum displacement and maximum stress of the femoral neck system were:negative buttress>anatomical reduction>positive buttress;the maximum displacement and maximum stress of the femur were:negative buttress>positive buttress>anatomical reduction.(4)With the increase of Pauwels angle,the biomechanical advantage of the positive buttress was weakening.However,it was better than a negative buttress.When Pauwels angle was 30°,positive buttress was more stable than anatomical reduction.When Pauwels angle was 50°,the biomechanical difference between positive buttress and anatomical reduction became smaller.When Pauwels angle was 70°,the stability of anatomical reduction was slightly better than positive buttress.(5)If it was difficult to achieve anatomical reduction of femoral neck fracture during operation,but the positive buttress had been displaced within 2 mm,the femoral neck system could be used to offer stable mechanical fixation.It is necessary to avoid negative buttress reduction.

Objective:To explore the intervention effect of moderate intensity aerobic exercise on body composition and glycolipid metabolism in obese adults.Methods:This was a self-controlled study, which enrolled 280 obese adults who received weight loss treatment in the Health Management Institute of the Chinese PLA General Hospital from November 2017 to March 2018 and performed a 12-week precise aerobic exercise intervention (40%-60% of heart reserved rate) based on an independently developed aerobic exercise intervention system for chronic diseases. The following requirements also need to be met as effective exercise time of ≥40 minutes every time, total exercise time of ≤100 minutes per day, effective exercise time of ≥200 minutes per week, exercise frequency of ≥4 times per week, and an interval of ≤48 hours between two exercises. During the research, 77 subjects were excluded due to illness, sports injuries, work reasons, etc., and 203 subjects were included in the analysis. These patients were divided into three groups based on weekly exercise duration, including 97 cases in short-term group (weekly exercise time <300 minutes), 63 cases in medium-term group (weekly exercise time of 300-400 minutes), and 43 cases in long-term group (weekly exercise time >400 minutes). Paired t-tests were used to compare the differences in indicators before and after intervention, and covariance analysis was used to compare the differences in indicators among three groups. The intervention effect of moderate intensity aerobic exercise on the body composition and glucose and lipid metabolism in obese adults was analyzed. Results:The resting heart rate, body weight, body mass index, body fat rate, body fat mass, muscle mass, visceral fat area, subcutaneous fat area, fasting insulin, insulin resistance index, total cholesterol, triglycerides, and low-density lipoprotein cholesterol were all decreased significantly in the 203 patients after the intervention [(66.67±9.38) vs (71.48±10.13)/min, (86.02±13.13) vs (90.16±13.93) kg, (30.33±3.08) vs (31.80±3.27) kg/m 2, 35.64%±7.19% vs 37.87%±7.21%, (30.78±8.14) vs (34.30±8.73) kg, (52±10.30) vs (52.74±10.61) kg, (100.82±38.63) vs (119.53±43.08) cm 2, (270.14±74.19) vs (305.24±77.12) cm 2, (12.33±6.92) vs (17.86±14.23) mmol/L, 3.08±2.22 vs 4.52±4.09, (4.42±0.78) vs (4.62±0.89) mmol/L, (1.46±0.82) vs (1.71±1.11) mmol/L, (2.93±0.70) vs (3.08±0.80) mmol/L] (all P<0.05). The reduction degree of indicators including body weight, body mass rate, body fat rate, and body fat mass were all significantly higher in long-term group when compared with those in medium-term and short-term group [(5.56±0.62) vs (3.97±0.51) vs (3.63±0.41) kg, (1.98±0.21) vs (1.39±0.17) vs (1.31±0.14) kg/m 2, 3.38%±0.40% vs 2.27%± 0.33% vs 1.69%±0.27%, (4.90±0.53) vs (3.54±0.43) vs (2.89±0.35) kg]. Besides, patients in long-term group had significantly higher reduction degree of fasting insulin and higher rising degree of high-density lipoprotein cholesterol [(7.38±0.94) vs (4.54±0.62) mmol/L, (0.07±0.02) vs (0.01±0.02) mmol/L] and higher reduction degree of visceral fat area [(28.45±4.53) vs (12.55±3.67) cm 2] than medium-term group (all P<0.05). Conclusions:Moderate intensity aerobic exercise can be an effective intervention for the body composition and glycolipid metabolism in obese adults. If the weekly exercise time is greater than 400 minutes, the potential benefits of improvement may be more evident.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.