ObjectiveTo explore the clinical safety of Feilike Mixture （FLK） in the real world. MethodsThe safety of all children who received FLK from 29 institutions in 12 provinces between January 21，2021 and December 25，2021 was evaluated through prospective centralized surveillance and a nested case control study. ResultsA total of 3 035 juveniles were included. There were 29 research centers involved，which are distributed across 12 provinces，including one traditional Chinese medicine （TCM） hospital and 28 general hospitals. The average age among the juveniles was （4.77±3.56） years old，and the average weight was （21.81±12.97） kg. Among them，119 cases （3.92%） of juveniles had a history of allergies. Acute bronchitis was the main diagnosis for juveniles，with 1 656 cases （54.46%）. FLK was first used in 2 016 cases （66.43%），and 142 juvenile patients had special dosages，accounting for 4.68%. Among them，92 adverse drug reactions （ADRs） occurred，including 73 cases of gastrointestinal system disorders，10 cases of metabolic and nutritional disorders，eight cases of skin and subcutaneous tissue diseases，two cases of vascular and lymphatic disorders，and one case of systemic diseases and various reactions at the administration site. The manifestations of ADRs were mainly diarrhea，stool discoloration，and vomiting，and no serious ADRs occurred. The results of multi-factor analysis indicated that special dosages （the use of FLK）［odds ratio （OR） of 2.642， 95% confidence interval （CI） of 1.105-6.323］，combined administration： spleen aminopeptide （OR of 4.978， 95%CI of 1.200-20.655），and reason for combined administration： anti-infection （OR of 1.814， 95%CI of 1.071-3.075） were the risk factors for ADRs caused by FLK. Conclusion92 ADRs occurred among 3 035 juveniles using FLK. The incidence of ADRs caused by FLK was 3.03%，and the severity was mainly mild or moderate. Generally，the prognosis was favorable after symptomatic treatment such as drug withdrawal or dosage reduction，suggesting that FLK has good clinical safety.

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.

Qingfeitang， specialized in resolving phlegm to stop cough and producing fluid to moisten dryness， is a classic prescription inherited and developed by physicians of successive generations and has been included in the Catalogue of Ancient Classic Prescriptions （First Batch） published by the National Administration of Traditional Chinese Medicine （TCM） in 2018. Relevant ancient books data and modern literature were collected by bibliometrics to analyze the historic origin， formula composition， herb origin， preparation methods， processing methods， clinical effect， and indications of Qingfeitang. The key information of Qingfeitang was summarized to provide reference for the clinical application of the decoction. In this study， a total of 43 pieces of effective data on relevant ancient literature， including 35 ancient TCM books， were collected based on a systematic collation of relevant historic and modern literature. Results showed that "Qingfeitang" was originated from the "Renshen Qingfeitang" recorded in the Taiping Holy Prescriptions for Universal Relief from the Qing dynasty. The name of "Qinfeitang" was first recorded in the Yeshi Luyanfang written by YE Dalian in the Song dynasty. We suggested the modern dosage and usage of Qingfeitang as follows： "Scutellariae Radix of 5.60 g， Platycodon grandiflora， Poria， Tangerine， Fritillaria， and Cortex Mori of 3.73 g respectively， Angelicae Sinensis Radix， Asparagi Radix， Gardeniae Fructus， Armeniacae Semen Amarum， and Ophiopogonis Radix of 2.61 g respectively， Schisandra of 1 g， and Glycyrrhizae Radix et Rhizoma of 1.12 g， and they were taken 3 times daily. The above formula is recommended to be decocted with 400 mL of water， with 3.37 g ginger and 6 g jujubae fructus， to 320 mL， and taken after a meal， three times per day". Qingfeitang has the effect of resolving phlegm to stop cough and producing fluid to moisten dryness， specialized in treating cough， asthma， rash， and other symptoms in ancient times. Modern applications are mainly focused on the respiratory system， used for treating diseases such as bronchopneumonia and cough. The above research results provide a reference basis for the later development and research of Qingfeitang.

B-cell lymphoma is a group of hematological malignancies characterized by variable genetic and biological features and clinical behaviors. The tumor microenvironment (TME) is a complex network in tumors, which consists of surrounding blood vessels, extracellular matrix, immune and non-immune cells, and signaling molecules. Increasing evidence has shown that the TME, especially immune cells within, is a double-edged sword, acting either as a tumor killer or as a promoter of tumor progression. These pro-tumor activities are driven by subpopulations of immune cells that express typical markers but have unique transcriptional characteristics, making tumor-associated immune cells good targets for human anti-cancer therapy by ablating immunosuppressive cells or enhancing immune-activated cells. Thus, exploring the role of immune cells in the TME provides distinct insights for immunotherapy in B-cell lymphoma. In this review, we elucidated the interaction between immune cells and tumor cells and their function in the initiation, progression, and prognosis of B-cell lymphoma, from preclinical experiments to clinical trials. Furthermore, we outlined potential therapeutic approaches and discussed the potential clinical value and future perspectives of targeting immune cells in patients with B-cell lymphoma.

Background::Although significant advances have been made in the treatment of multiple myeloma (MM), leading to unprecedented response and survival rates among patients, the majority eventually relapse, and a cure remains elusive. This situation is closely related to an incomplete understanding of the immune microenvironment, especially monocytes/macrophages in patients with treatment-na?ve MM. The aim of this study was to provide insight into the immune microenvironment, especially monocytes/macrophages, in patients with treatment-na?ve MM.Methods::This study used the single-cell RNA sequencing (scRNA-seq) data of both patients with MM and heathy donors to identify immune cells, including natural killer (NK) cells, T cells, dendritic cells (DCs), and monocytes/macrophages. Transcriptomic data and flow cytometry analysis of monocytes/macrophages were used to further examine the effect of monocytes/macrophages in treatment-na?ve MM patients.Results::A significant difference was observed between the bone marrow (BM) immune cells of the healthy controls and treatment-na?ve MM patients through scRNA-seq. It is noteworthy that, through an scRNA-seq data analysis, this study found that interferon (IFN)-induced NK/T cells, terminally differentiated effector memory (TEMRA) cells, T-helper cells characterized by expression of IFN-stimulated genes (ISG +Th cells), IFN-responding exhausted T cells, mannose receptor C-type 1 (MRC1) + DCs, IFN-responding DCs, MHCII + DCs, and immunosuppressive monocytes/macrophages were enriched in patients with treatment-na?ve MM. Significantly, transcriptomic data of monocytes/macrophages demonstrated that "don’t eat me" -related genes and IFN-induced genes increase in treatment-na?ve MM patients. Furthermore, scRNA-seq, transcriptomic data, and flow cytometry also showed an increased proportion of CD16 + monocytes/macrophages and expression level of CD16. Cell-cell communication analysis indicated that monocytes/macrophages, whose related important signaling pathways include migration inhibitory factor (MIF) and interleukin 16 (IL-16) signaling pathway, are key players in treatment-na?ve MM patients. Conclusions::Our findings provide a comprehensive and in-depth molecular characterization of BM immune cell census in MM patients, especially for monocytes/macrophages. Targeting macrophages may be a novel treatment strategy for patients with MM.

Objective:To evaluate the body composition of ulcerative colitis (UC) patients by bioelectrical impedance analysis (BIA) and explore the correlation between body composition indices and disease activity, laboratory indices, and readmission.Methods:Patients with active UC hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital were enrolled continuously, and age and sex ratio-matched healthy volunteers were recruited through recruitment posters. Body composition was measured via BIA. Appendicular skeletal muscle index (ASMI) and trunk skeletal muscle index (TSMI) were calculated and adjusted for height (m 2). Muscle function was evaluated via handgrip strength. Moreover, patients were followed up after discharge and the readmissions due to recurrence or aggravation of UC were recorded. Results:This study enrolled 62 UC patients and 38 healthy volunteers. TSMI decreased significantly ( P<0.001) while ASMI showed no significant difference in male patients compared with healthy controls. ASMI ( P<0.001) and TSMI ( P=0.002) in female patients were significantly lower than those in healthy controls. Compared with patients with normal TSMI, a larger proportion of patients with low TSMI tended to show severe disease activity ( P=0.075), while no such trend was observed in patients with low ASMI. Handgrip strength and phase angle were significantly positively correlated with ALB in UC patients ( P<0.05). The proportion of patients with readmission was significantly higher in the low phase angle group than that in the normal phase angle group (58.3% vs. 22.0%, P=0.040). Conclusions:There were abnormal body composition and gender differences in UC patients. TSMI correlated better with clinical characteristics than ASMI in UC patients. Low phase angle might be predictive for readmission in UC patients.

Objective:To explore the effectiveness of bundled cognitive-behavior intervention in postoperative patients with glioma.Methods:From January 2022 to June 2023, convenience sampling was used to select 95 patients with glioma who underwent surgical treatment at the Neurosurgery Department of Affiliated Hospital of Jining Medical University as subjects. The patients were divided into an observation group and a control group based on the order of enrollment. The control group received routine medical nursing intervention, while the observation group received bundled cognitive-behavior intervention on the basis of control group. The scores of the Chinese-Strategies Used by People to Promote Health (C-SUPPH), Short Form Health Survey (SF-36), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were compared between two groups of patients at different time points before and after intervention.Results:Repeated measures analysis of variance showed that there were intergroup, time, and interaction effects between the C-SUPPH, SF-36, SAS, and SDS scores of the two groups, and the differences were statistically significant (all P<0.05). At 1, 3, and 6 months after discharge, the C-SUPPH and SF-36 scores in observation group were lower than those in control group, and the differences were statistically significant (all P<0.05). At 3 and 6 months after discharge, the SAS and SDS scores of the observation group were lower than those of the control group, and the differences were statistically significant (all P<0.05) . Conclusions:Bundled cognitive-behavior intervention can increase the self-management efficacy of postoperative glioma patients, improve their quality of life, and alleviate their anxiety and depression.

Objective:To explore the relationship between social exclusion, rumination, executive function and mobile phone addiction among college students.Methods:From November to December 2023, a total of 516 college students were investigated by social exclusion questionnaire for undergraduate, ruminative responses scale, the Geurten-questionnaire of executive functioning in Chinese college students and mobile phone addiction tendency scale. SPSS 26.0 statistical software was used for common method bias test, descriptive statistics, correlation analysis, and PROCESS 3.5 macro program was used to test the mediation effect.Results:Social exclusion (31.21±12.69), rumination (42.85±12.38), executive function (71.46±9.41), and college students' mobile phone addiction tendency (43.53±11.74) were all significantly and positively correlated with each other ( r=0.299-0.500, all P<0.01). The direct effect of social exclusion on mobile phone addiction was significant (effect size=0.138, 95% CI=0.048-0.228), accounting for 37.91%(0.138/0.364) of the total effect. Rumination had a mediating effect between social exclusion and mobile phone addiction (effect size=0.053, 95% CI=0.001-0.112), accounting for 14.56%(0.053/0.364) of the total effect. Executive function mediates the relationship between social exclusion and mobile phone addiction (effect size=0.137, 95% CI=0.091-0.188), accounting for 37.64%(0.137/0.364) of the total effect.Rumination and executive function has a chain mediating effect between social exclusion and mobile phone addiction (effect size=0.036, 95% CI=0.016-0.061), accounting for 9.89%(0.036/0.364) of the total effect. Conclusion:Social exclusion can directly affect mobile phone addiction in college students and can also influence mobile phone addiction in college students through the independent mediating effects of rumination and executive function, as well as the chain mediating effect of rumination and executive function.

Objective To establish a HS-GC test method for the determination of enflurane,isoflurane,diflurane,sevoflurane and its metabolite hexafluoroisopropanol(HFIP)in blood,and to establish a LC-MS/MS method for the determination of trifluoroacetic acid(TFA),the co-metabolite of enflurane,isoflurane,and deflurane in blood.Methods Place 0.5 mL blood sample in a 10 mL headspace bottle,add 1.0 mL ultrapure water to mix,then add 0.5 mL n-butanol internal standard solution,sealed and heated at 70℃for 20 min,take the upper layer of gas for HS-GC analysis,qualitatived by dual-column retention time and quantified by the internal standard curve;Blood sample was acetonitrile precipitated protein,separated by liquid chromatography,scanned with electrospray ionization(ESI),negative ion mode,and examined in multiple reaction monitoring mode(MRM),qualitatived by retention time and characteristic ions,quantified by standard curve.Results The detection limits(LOD)of enflurane,isoflurane,desflurane,heptaflurane,HFIP and TFA are 0.05,0.2,0.5,0.05,0.5 μg/mL and 0.5 ng/mL,and linear range as 1～100 μg/mL(TFA:1～100 ng/mL),with correlation coefficients greater than 0.999.The extraction recovery rate is between 30%and 80%,and the intra-day and inter-day precision are less than 5%.The accuracy is between 85%and 115%.Conclusion This method is quick and simple,and can be used for qualitative and quantitative analysis of enflurane,isoflurane,desflurane,sevoflurane and their metabolites in blood.

Objective To analyze the application characteristics of acupuncture and moxibustion in the treatment of postherpetic neuralgia(PHN)using complex networks;To provide clinical acupuncture and moxibustion treatment with application basis for acupoint selection,acupuncture and moxibustion,and treatment ideas.Methods The clinical research literature on acupuncture and moxibustion treatment for PHN was retrieved from CNKI,Wanfang Data,VIP,PubMed and Web of Science.The literature was screened according to the inclusion and exclusion criteria,and Excel 2019 was used to establish an acupuncture and moxibustion treatment PHN database.SPSS Modeler 18.0 software was used for modeling and association rule analysis,and Gephi 0.10.1 software was used for complex network analysis.Results Totally 237 articles were included,and 262 acupuncture and moxibustion prescriptions data were extracted,involving a total of 115 acupoints,with a total use frequency of 1 432 times.The top 10 most frequently used acupoints were Ashi acupoint(214 times)and Jiaji acupoint(198 times),Zusanli(74 times),Taichong(74 times),Sanyinjiao(66 times),Hegu(65 times),Yanglingquan(62 times),Xuehai(60 times),Zhigou(53 times),and Quchi(52 times).The association rule analysis showed that the acupoint combination with the highest correlation was Ashi acupoint-Jiaji acupoint.K-core hierarchical analysis and community analysis on the complex network of the acupoint prescriptions obtained two core acupoint groups.Therapy analysis showed that filiform needle acupuncture was the most commonly used intervention for acupuncture treatment of PHN;syndrome type-acupoint analysis showed that the syndrome types with the highest frequency of PHN were liver meridian heat stagnation,blood stasis and collaterals obstruction,and spleen meridian damp-heat;tonic and diarrhea-acupoint analysis showed that the main operating techniques were neutral-tonifying and neutral-discharging.Conclusion Acupuncture and moxibustion treatment for PHN mainly selects local acupoints,Ashi acupoint and Jiaji acupoint are often selected,and focusing on the cooperation with distal acupoints.The external and internal meridians are mostly selected according to different syndrome types.The operation is performed using neutral-tonifying and neutral-discharging techniques.Commonly used filiform acupuncture combined with electro-acupuncture,pricking,cupping and other therapies.The application characteristics can provide clinical reference for the treatment of PHN.