ObjectiveTo investigate the efficacy of Poge Jiuxin decoction （PGJXD） on fluid resuscitation in septic shock patients and its effects on vascular endothelial function based on clinical randomized controlled trials （RCTs） and network pharmacology， and to reveal its molecular mechanisms and signaling pathways through network pharmacology. MethodsSeventy-two septic shock patients were enrolled and randomly assigned to either the treatment group or the control group （36 cases each） through a random number table. Both groups received conventional Western medical treatment for sepsis. Additionally， the treatment group received PGJXD （100 mL， twice daily） for 3 consecutive days. The two groups were compared in terms of the Sequential Organ Failure Assessment （SOFA） score， Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） score， vascular endothelial function indicators ［endothelium-derived relaxing factor （EDRF）， nitric oxide （NO）， and 6-keto-prostaglandin F_1α （6-keto-PGF_1α）］， inflammation indicators ［tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， nuclear factor kappa-B （NF-κB）， and procalcitonin （PCT）］， perfusion indicators ［mean arterial pressure （MAP）， lactate （Lac）， and 72-hour lactate clearance rate （Lcr）］， fluid resuscitation target achievement time， vasopressor use duration， length of hospital stay， and 28-day mortality. Databases including TCMSP， HIT 2.0， and Uniprot were searched for active components of PGJXD and their targets. Gene targets for septic shock were obtained from GeneCards， OMIM， and DrugBank databases. Venny software was used to identify common targets between PGJXD and septic shock. Cytoscape software and the STRING database were utilized to construct a "drug-component-target-disease" network and a protein-protein interaction （PPI） network. Gene Ontology （GO） functional enrichment analysis， Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis， and molecular docking were performed to explore the molecular mechanisms and signaling pathways of PGJXD in treating septic shock. ResultsFive patients withdrew from the treatment group and seven from the control group. After treatment， both groups showed decreases （P<0.01） in APACHE Ⅱ score， SOFA score， EDRF， 6-keto-PGF_1α， TNF-α， IL-6， NF-κB， PCT， MAP， and Lac， and increases in NO （P<0.01）. The treatment group exhibited more significant decreases （P<0.05， P<0.01） in APACHE Ⅱ score， SOFA score， 6-keto-PGF_1α， TNF-α， IL-6， NF-κB， MAP， Lac， Lcr， fluid resuscitation target achievement time， and vasopressor use duration than the control group. Differences in EDRF， NO， PCT， length of hospital stay， and 28-day mortality were not statistically significant. No significant adverse reactions were observed in either group during treatment. Network pharmacology identified 189 components and 257 potential targets of PGJXD， and 136 common targets shared by PGJXD and septic shock. GO enrichment analysis primarily involved positive regulation of cell migration， response to peptide， response to inorganic substance， etc. KEGG enrichment analysis mainly implicated signaling pathways such as NF-κB， VEGF， and Relaxin. ConclusionPGJXD can significantly ameliorate the condition of septic shock patients and enhance the efficacy of fluid resuscitation. Its key mechanism may involve protecting vascular endothelial cells by regulating the TNF-α/NF-κB signaling pathway and reducing the inflammatory response.

Public hospitals play a dominant role in providing medical services.Meanwhile,they are also critical for un-dertaking missions to handle health emergencies.This paper analyzes the necessity,current situation,and existing weaknesses of the health emergency capacity of public hospitals.It also conducts a comparative study of the emergency response mechanisms of foreign medical institutions.This paper aims to explore a well-developed design for health emergency in public hospitals that is suitable for China's medical conditions and to provide a feasible model for promoting high-quality health emergency management.

Objective To establish an HPLC quantitative method for the content determination of baicalin in Kangdeling capsule .Methods The chromatography column was Agilent Tc-C18-WR (4 .6 mm × 250 mm ,5μm) ,and the column temper-ature was 30 ℃ .The mobile phase consisted of acetonitrile and 0 .5‰ phosphoric acid (26 ∶ 74 ) .The flow rate was 1 .0 ml/min ,and the detection wavelength was 265 nm .Results The retention time of baicalin was about 16 min .The calibra-tion equation was Y=22 114 .67 X -112 836 .7(r=0998 8)with good linearity in the range of 5 .410-108 .2 μg/ml for baicalin . The average recovery was 98 .78% while RSD were 0 .74% .Conclusion This method is simple ,time-saving and accurate which could be used to routine analysis of baicalin in Kangdeling capsule .

Objective To study the pharmaceutical quality of the thermos sensitive insulin anal liquid suppository .Meth-ods Orthogonal test method was used ,the forming of a gelatum time ,gel strength ,bio-adhesive force ,viscosity ,gelation temperature were taken as the evaluation index ,the prescription of poloxamer 407 and poloxamer 188 ,the proportion of chi-tosan and pH were investigated ,in order to determine the best optimized prescription and measure what was the best choice of the gel strength ,biological adhesion force ,suppository viscosity ,gelation temperature for the final prescription of liquid sup-pository .Result The best combination of the prescription were 15% of poloxamer 407 ,25% of poloxamer 188 and 0 .4% of chitosan with the pH of 5 ± 0 .2 .Conclusion The test proved to be equitable with the good intensity and bio-adhesive force of the liquid suppository .

Objective To develop a method for determination of the rosmarinic acid in Xiaokang capsules .Methods An HPLC method was developed .The determination was performed on Agilent C18 column at 30℃ with a mobile phase composed of methanol :0 .5% formic acid (50∶50) run at a flow rate of 1 .0 ml/min .The detection wavelength was set at 330 nm and the injection volume was 10 μl .Results The linear range of rosmarinic acid concentrations was 2 .88 to 20 .1μg/ml (r=0 .999 8) . The average recovery was 99 .5% (RSD=0 .40% ,r=9) .Conclusion An assay for the determination of the rosmarinic acid in Xiaokang capsule that is simple ,rapid ,accurate and reliable has been developed .

Objective To investigate the prognostic significance of follicular lymphoma international prognostic index (FLIPI) and FLIPI2 in Chinese FL patients for better prognostic model.Methods 63 newly diagnosed FL patients who received rituximab plus CHOP (cyclophosphamide,doxorubicin,vincristine and prednisone)-like chemotherapy from January 2003 to December 2010 were retrospectively analyzed according to FLIPI and FLIPI2 scoring system.Results According to FLIPI,31 patients (49.2 ％) were stratified into the low risk group (0-1 point),24 (38.1％) into the intermediate risk group (2 points),and 8 (12.7 ％) into the high risk group (3-5 points).As for FLIPI2 scoring,17 cases (27.0 ％) were classified in low risk group (0 point),42 cases (68.3 ％) in intermediate risk group (1-2 points),and 4 cases in high risk group (3-5 points).The overall response rates and 2-year progression free survival (PFS) rates of the three risk groups were 93.5 ％ (29/31),91.7 ％ (22/24),75.0 ％ (6/8) (P =0.27),and 85.7 ％,75.2 ％,58.8 ％ (Log-rank =1.063,P =0.59) respectively in FLIPI.In terms of FLIPI2,the overall response rates and 2-year PFS rates of the three groups were 100.0 ％ (17/17),90.7 ％ (39/42),50.0 ％ (2/4) (P =0.01) and 92.9 ％,74.0 ％,33.3 ％ (Log-rank =7.075,P =0.03).Conclusion FLIPI2 presents more robust prognostic significance than FLIPI in disease progression perspective for FL patients treated with R-CHOP like regimens in this study.

Objective To investigate the effect of microcireulation blood flow and altering immunity by Chuanxiongqin,ulinastain and thymosin α1 on sepsis patients.Methods 90 patients were randomly divided into 3 groups(n=30),namely ICU group,Chuanxiongqin group,ulinastain and thymosin α1 group.HLA-DR/CD14+and IL-6,TNF-α,Lac,DD were measured.Results (1)DD showed no significant difference at every time point between ICU group and ulinastain+thymosin α1 group(P＞0.05).DD decreased in Chuanxiongqin group,and was significantly different from the others on the third day.(2)Lac unchanged significantly at every time point in ICU group(P＞0.05).Lac in Chuanxiongqin group and ulinastain+thymeain α1 group tended to decrease,and was statistically different from ICU group on the second day.(3)IL-6 and TNF-α tended to increase at every time point in ICU group(P＜0.05).In ulinastain+thymosin α1 group,IL-6 and TNF-α returned to the level before treatment,HLA-DR/(D14+increased significantly,and was higher than Chuanxiongqin group and ICU group statistically.Conclusion Chuanxiongqin could ameliorate circulation;ulinastsin and thymosin α1 could depress IL-6,TNF-α.So ulinastain and thymosin α1 might protect the immunity of sepsis patients.