The research and development of innovative drug have progressed remarkably, but the long development circle and high failure rate have become the bottleneck. Drug repurposing, discovering new indications of approved drugs, is a strategy to overcome these obstacles. By exploring new indications for approved drugs, rapid progress has been made in basic research and clinical translation in recent years. Rich resources of drugs, proven security, efficient development workflow and reduced cost are core advantages of this strategy, making the strategy a crucial direction of optimizing the pipeline of drug research and development. This review systematically summarizes drug repurposing cases that have received clinical approval over the past five years, and proposes core strategies for drug repurposing, including approaches based on targets, pathways, drug similarity, post-treatment phenotypes, and clinical side effects, aiming to provide some strategic guidance for drug repurposing efforts.

Flap transplantation is a critical surgical strategy for the reconstruction of tissue defects caused by trauma, tumor resection, and congenital malformations, and its survival rate directly determines surgical efficacy and patient prognosis. Following transplantation, flaps inevitably undergo ischemia-reperfusion (I/R) injury, during which oxidative stress, inflammatory responses, and metabolic disturbances are intricately intertwined, ultimately leading to cellular injury and tissue necrosis. Recent studies have demonstrated that multiple forms of programmed cell death—including apoptosis, pyroptosis, ferroptosis, necroptosis, and PANoptosis—play central roles in flap I/R injury. The extensive crosstalk and molecular interactions among these pathways form a highly complex cell death network. Specifically, apoptosis is mediated by the imbalance of Bcl-2 family proteins and the activation of cysteine-dependent aspartate-specific protease (caspase) cascades; pyroptosis is driven by the NLRP3-caspase-1-GSDMD axis, resulting in membrane pore formation and the release of pro-inflammatory cytokines; ferroptosis is characterized by iron-dependent lipid peroxidation and dysfunction of glutathione peroxidase 4 (GPX4); necroptosis is triggered by the receptor-interacting serine/threonine-protein kinase 1 (RIPK1)-RIPK3-MLKL signaling complex, leading to membrane rupture; and PANoptosis represents an integrated form of inflammatory cell death that coordinates multiple death pathways. Importantly, these forms of programmed cell death are not independent but are interconnected through extensive signaling crosstalk. Key regulatory molecules, including caspase-8, reactive oxygen species (ROS), nuclear factor-κB (NF-κB), and nuclear factor erythroid 2-related factor 2 (Nrf2), collectively modulate the dynamic balance among these pathways. Therefore, the multidimensional interplay and spatiotemporal dynamics of programmed cell death constitute a fundamental pathological basis of flap I/R injury. This review systematically summarizes the latest advances in the mechanisms and interactions of various programmed cell death pathways in flap I/R injury, aiming to elucidate the underlying regulatory network. These insights may provide novel theoretical foundations for optimizing flap protection strategies, improving flap survival, and promoting tissue repair.

Objective To systematically evaluate the incidence and influencing factors of axillary web syndrome(AWS)in postoperative breast cancer patients,and to provide evidence for reducing the incidence of axillary web syndrome.Methods A computer search was performed in China National Knowledge Infrastructure(CNKI),VIP,Wanfang,SinoMed,PubMed,Medline,Scopus,The Cochrane Library,Web of Science,Embase,searched for articles on AWS influencing factors of breast cancer published from the establishment of the database to January 6th,2025.The articles were screened according to the inclusion and exclusion criteria.Revman5.4 and Stata17.0 were used for systematic review.Results Fifteen studies involving 3979 breast cancer patients and 1 156 patients with AWS were included.The results of the Meta-analysis showed that there was significant statistical heterogeneity among the included studies(I2=97.0%,P<0.0001).Using the random effects model,the incidence of AWS was 32.2%[95%CI(0.24,0.40),P<0.0001].The influencing factors for AWS after breast cancer surgery are age,body mass index(BMI),total mastectomy,lymph node metastasis,and neoadjuvant chemotherapy.NAC),axillary lymph node dissection(ALND),and the number of harvested axillary lymph nodes.Conclusion The incidence of AWS after breast cancer surgery was high.Clinicians should give early nursing to the influencing factors,reduce the incidence of AWS and improve patients'quality of life after surgery.

Objective To systematically evaluate the incidence and influencing factors of axillary web syndrome(AWS)in postoperative breast cancer patients,and to provide evidence for reducing the incidence of axillary web syndrome.Methods A computer search was performed in China National Knowledge Infrastructure(CNKI),VIP,Wanfang,SinoMed,PubMed,Medline,Scopus,The Cochrane Library,Web of Science,Embase,searched for articles on AWS influencing factors of breast cancer published from the establishment of the database to January 6th,2025.The articles were screened according to the inclusion and exclusion criteria.Revman5.4 and Stata17.0 were used for systematic review.Results Fifteen studies involving 3979 breast cancer patients and 1 156 patients with AWS were included.The results of the Meta-analysis showed that there was significant statistical heterogeneity among the included studies(I2=97.0%,P<0.0001).Using the random effects model,the incidence of AWS was 32.2%[95%CI(0.24,0.40),P<0.0001].The influencing factors for AWS after breast cancer surgery are age,body mass index(BMI),total mastectomy,lymph node metastasis,and neoadjuvant chemotherapy.NAC),axillary lymph node dissection(ALND),and the number of harvested axillary lymph nodes.Conclusion The incidence of AWS after breast cancer surgery was high.Clinicians should give early nursing to the influencing factors,reduce the incidence of AWS and improve patients'quality of life after surgery.

Clostridioides difficile infection(CDI)is the leading cause of hospital-acquired diarrhea and has be-come a major challenge in the global public health field.In recent years,it has been found that nutrients and gut mi-crobes play key roles in regulating growth,metabolic activity,and virulence expression of Clostridioides difficile.However,current research focuses on the independent effects of a single nutrient or gut microbe,systematic under-standing on the interactions between them is still lacking.This paper reviews the specific effect of different nutrients on Clostridioides difficile,explores how other gut microbes inhibit the growth of Clostridioides difficile by com-peting or metabolizing nutrients.In addition,this paper also discusses the application of emerging technologies in CDI research and their potentiality in clinical intervention strategies.Future research needs to integrate multi-omics data and artificial intelligence analysis,deeply analyze the complex interactive network of nutrient-microbe-host,and provide new ideas for precise prevention and treatment of CDI.

Objective To systematically evaluate the effectiveness of acupuncture in treating chronic cough and analyze its acupoint selection patterns.Methods Randomized controlled trials(RCTs)on acupuncture for chronic cough were retrieved from databases including CNKI,VIP,Wan Fang Data,CBM,PubMed,and Web of Science,Cochrane Library and Embase from their inception to April 2025.Original data from the included studies were extracted.Meta-analysis was performed to compare the acupuncture treatment group with the western medicine control group[using leukotriene receptor antagonists(LTRAs)and/or glucocorticoids]on outcomes including cough symptom scores,serum tumor necrosis factor-α(TNF-α)levels,pulmonary function indicators[forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],overall clinical effectiveness,and incidence of adverse reactions.Publication bias was assessed using funnel plots,and descriptive analysis of the acupoint prescriptions from the included studies was conducted using Rstudio software to summarize the patterns of acupoint selection for chronic cough.Results A total of 10 studies involving 806 patients were included.Meta-analysis results showed that acupuncture was superior to the western medicine control group in improving cough symptom scores,reducing serum TNF-α levels,enhancing pulmonary function(FVC and FEV1),increasing overall clinical effectiveness,and reducing adverse reactions,with statistically significant differences.Further analysis of the 10 included studies revealed that the most frequently used acupoints were Feishu(BL13)(n=9 times),Zusanli(ST36)(n=7 times),Lieque(LU7)(n=6 times),and Pishu(BL20)(n=5 times).The most frequently utilized meridians were the Bladder Meridian of Foot-Taiyang(BL)(n=10 times),the Stomach Meridian of Foot-Yangming(ST)(n=7 times),and the Lung Meridian of Hand-Taiyin(LU)(n=7 times).Acupoints were primarily located on the lower back(36.92%),upper limbs(26.15%),and lower limbs(21.53%).Conclusion Acupuncture is effective in treating chronic cough.The acupoint prescriptions for chronic cough should follow the principles of symptomatic point selection and anterior-posterior point pairing,emphasizing the back-shu and front-mu point pairing method,as well as the upper-lower point pairing method.Points are predominantly selected from the Bladder meridian(BL),lung meridian(LU),and stomach meridian(ST).

Clostridioides difficile infection(CDI)is the leading cause of hospital-acquired diarrhea and has be-come a major challenge in the global public health field.In recent years,it has been found that nutrients and gut mi-crobes play key roles in regulating growth,metabolic activity,and virulence expression of Clostridioides difficile.However,current research focuses on the independent effects of a single nutrient or gut microbe,systematic under-standing on the interactions between them is still lacking.This paper reviews the specific effect of different nutrients on Clostridioides difficile,explores how other gut microbes inhibit the growth of Clostridioides difficile by com-peting or metabolizing nutrients.In addition,this paper also discusses the application of emerging technologies in CDI research and their potentiality in clinical intervention strategies.Future research needs to integrate multi-omics data and artificial intelligence analysis,deeply analyze the complex interactive network of nutrient-microbe-host,and provide new ideas for precise prevention and treatment of CDI.

Objective To systematically evaluate the effectiveness of acupuncture in treating chronic cough and analyze its acupoint selection patterns.Methods Randomized controlled trials(RCTs)on acupuncture for chronic cough were retrieved from databases including CNKI,VIP,Wan Fang Data,CBM,PubMed,and Web of Science,Cochrane Library and Embase from their inception to April 2025.Original data from the included studies were extracted.Meta-analysis was performed to compare the acupuncture treatment group with the western medicine control group[using leukotriene receptor antagonists(LTRAs)and/or glucocorticoids]on outcomes including cough symptom scores,serum tumor necrosis factor-α(TNF-α)levels,pulmonary function indicators[forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],overall clinical effectiveness,and incidence of adverse reactions.Publication bias was assessed using funnel plots,and descriptive analysis of the acupoint prescriptions from the included studies was conducted using Rstudio software to summarize the patterns of acupoint selection for chronic cough.Results A total of 10 studies involving 806 patients were included.Meta-analysis results showed that acupuncture was superior to the western medicine control group in improving cough symptom scores,reducing serum TNF-α levels,enhancing pulmonary function(FVC and FEV1),increasing overall clinical effectiveness,and reducing adverse reactions,with statistically significant differences.Further analysis of the 10 included studies revealed that the most frequently used acupoints were Feishu(BL13)(n=9 times),Zusanli(ST36)(n=7 times),Lieque(LU7)(n=6 times),and Pishu(BL20)(n=5 times).The most frequently utilized meridians were the Bladder Meridian of Foot-Taiyang(BL)(n=10 times),the Stomach Meridian of Foot-Yangming(ST)(n=7 times),and the Lung Meridian of Hand-Taiyin(LU)(n=7 times).Acupoints were primarily located on the lower back(36.92%),upper limbs(26.15%),and lower limbs(21.53%).Conclusion Acupuncture is effective in treating chronic cough.The acupoint prescriptions for chronic cough should follow the principles of symptomatic point selection and anterior-posterior point pairing,emphasizing the back-shu and front-mu point pairing method,as well as the upper-lower point pairing method.Points are predominantly selected from the Bladder meridian(BL),lung meridian(LU),and stomach meridian(ST).