Stroke is the leading cause of death and disability among adults in China， and its common complications include digestive system abnormalities， cognitive impairment， depression， stroke-associated pneumonia， and hemiplegia. The combination of traditional Chinese and Western medicine has great potential in treating post-stroke complications. Xinglou Chengqitang （XLCQT） is a representative prescription of alleviating the disease in the upper part by treating the lower part. It has definite therapeutic effect and high safety. Clinically， XLCQT is often used to treat stroke and its complications. However， the quantity and quality of clinical trials of XLCQT in treating post-stroke complications need to be improved. Additionally， since the basic research is weak， the material basis and multi-target mechanism for the efficacy of this prescription are unknown. This article reviews XLCQT in terms of the pharmacodynamic basis， medicinal properties， safety evaluation， and progress in clinical research and mechanisms in treating post-stroke complications. This article summarizes 22 key active ingredients of XLCQT in treating acute stroke complicated with syndrome of phlegm heat and fu-organ excess. Among these key active ingredients， resveratrol， kaempferol， luteolin， chrysoeriol， apigenin， （+）-catechin， and adenosine have good pharmacokinetic properties and high bioavailability. The mechanisms of XLCQT in treating post-stroke complications are complex， including inflammatory response， brain-gut axis， hypothalamic-pituitary-adrenal （HPA） axis， intestinal flora， neurotrophic factors， autophagy， oxidative stress， and free radical damage. This review helps to deeply understand the pharmacodynamic basis and mechanisms of XLCQT in treating post-stroke complications and provides a theoretical basis for the clinical application of XLCQT against post-stroke complications and the development of drugs.

ObjectiveTo observe the effectiveness and safety of modified Taohong Siwu Decoction （桃红四物汤） for patients of chronic heart failure with lower limb deep vein thrombosis in the chronic stage of blood stasis syndrome. MethodsA total of 120 patients of chronic heart failure with lower limb deep vein thrombosis in chronic stage of blood stasis syndrome were randomly divided into 60 cases each in control group and observation group. Both groups were given basic treatment of western medicine， and the observation group was additionally given modified Taohong Siwu Decoction （桃红四物汤） for oral administration， one dose per day. The treatment course for both groups lasted for 4 weeks. The total effective rate and the incidence of adverse reactions were compared between the two groups after treatment. Cardiac function indexes including left ventricular ejection fraction （LVEF）， and left ventricular end-systolic internal diameter （LVESd）， left ventricular end-diastolic internal diameter （LVEDd）， serological indexes including N-terminal natriuretic natriuretic peptide precursor （NT-proBNP）， high sensitivity C-reactive protein （hs-CRP） and vascular endothelial growth factor （VEGF）， score of traditional Chinese medicine （TCM） symptom including chest pain， swelling of the affected limb， fixed tenderness， and bruising， haemodynamics indicators including high cut whole blood viscosity， low cut whole blood viscosity， and erythrocyte pressure， and coagulation indices including activated partial thromboplastin time （APTT）， plasminogen time （PT）， and fibrinogen （FIB） levels were compared before and after treatment. ResultsDuring the study， 3 cases were excluded and 2 cases lost follow-up in the observation group， while 2 cases were excluded and 3 cases lost follow-up in the control group. A total of 110 patients completed the trial， 55 cases in each of the two groups. The total effective rate in the observation group was 92.73% （51/55）， which was significantly higher than that of the control group， 78.18% （43/55， P＜0.05）. Compared within group before treatment， LVEF， APTT and PT levels increased， LVESd， LVEDd， NT-proBNP， hs-CRP， VEGF， high cut whole blood viscosity， low cut whole blood viscosity， erythrocyte pressure volume and FIB levels decreased， chest pain， swelling of the affected limbs， stationary pressure pain and bruising score decreased in both groups after treatment， and the improvement of all above indexes was better in the observation group than that in control group （P＜0.05 or P＜0.01）. The incidence of adverse reactions was 7.27% （4/55） in the observation group and 21.82% （12/55） in the control group， and the incidence of adverse reactions in the observation group was significantly lower than that in the control group （P＜0.05）. ConclusionModified Taohong Siwu Decoction （桃红四物汤） as adjuvant treatment for patients of chronic heart failure with lower limb deep vein thrombosis in the chronic stage of blood stasis syndrome showed better clinical effectiveness when compared with western basic treatment， which can improve the clinical symptoms， cardiac function， haemodynamics， and coagulation， with good safety.

Objective:It analyzes the flow characteristics and spatial distribution patterns of intra-provincial cross-regional medical patients in Guangdong,while comparing hospitalization cost differences between local and non-local care.Methods:Based on 2022-2023 cross-regional medical data from Guangdong,spatial visualization and descriptive analysis were conducted combined with Mann-Whitney U test to compare the cost burden.Results:Cross-Regional patients in Guangdong primarily flow to Guangzhou,accounting for 77.8％of the total intra-provincial cross-regional hospitalizations.Cross-regional medical expenses were significantly higher than the insured locations,with notable differences in mean total hospitalization costs and personal out-of-pocket payment ratios.Conclusion:Refining pre-approval procedures for cross-regional care,enhancing specialized medical departments in under-resourced regions,and strengthening coordination between healthcare insurance systems and primary healthcare strengthening initiatives are needed to promote balanced medical resource allocation and reduce the cost burden on patients.

Objective To investigate the effect of sodium glucose cotransporter 2 inhibitor(SGLT2i)on cardiac function in T2DM rats with heart failure(HF)by regulating the silencing signaling protein 1/mitochondrial uncoupling protein 2(SIRT1/UCP2)signaling pathway.Methods Forty SD rats were randomly divided into normal control(NC)group,T2DM combined with HF(T2DM-HF)group,SGLT2i group,and SGLT2i+SIRT1 inhibitor(EX527)(SGLT2i+EX527)group.Fasting blood glucose(FBG),cardiac function,and oxidative stress indicators were tested in each group.The pathological morphological changes of myocardial tissue were evaluated by HE and Masson staining,and the expression of SIRT1 and UCP2 proteins in myocardial tissue was evaluated by Western blot.Results Compared with NC group,the T2DM-HF,SGLT2i,and SGLT2i+EX527 groups showed a decrease in body weight(P<0.05)and an increase in cardiac mass index(P<0.05).Compared with T2DM-HF group,the SGLT2i group showed decreased protein expression of FBG,LVESD,LVEDD,LVEDP,MDA,and UCP2(P<0.05),while increased protein expression of LVFS,LVEF,LVSP,±dp/dtmax,SOD,and SIRT1(P<0.05).Compared with SGLT2i group,the SGLT2i+EX527 group showed an increase in FBG,LVESD,LVEDD,LVEDP,MDA,and UCP2 opal levels,while LVFS,LVEF,LVSP,±dp/dtmax,SOD,and SIRT1 opal levels decreased(P<0.05).Conclusions SGLT2i can improve the cardiac function in T2DM rats combined with HF,enhance antioxidant capacity,and exert a protective effect on cardiac function.Its mechanism of action may be related to the regulation of SIRT1/UCP2 signaling pathway.

Objective To investigate the correlation of fetuin-A and MGP with the degree of coro-nary artery calcification and prognosis in elderly patients with ACS.Methods A total of 187 eld-erly ACS patients admitted to our hospital from June 2021 to June 2023 were recruited in this study.All of them underwent coronary CT examination,and the prognosis at 1 year after treat-ment was statistically analyzed.According to their CACS of coronary CT,the patients were divid-ed into non-calcification group(50 cases),and mild,moderate and severe calcification groups(67,43 and 27 cases,respectively).They were also assigned into poor(58 cases)and good prognosis groups(129 cases)according to the prognosis.Serum fetuin-A and MGP levels were compared be-tween above groups.Pearson correlation analysis was used to analyze the correlation between CACS and fetuin-A as well as MGP levels.Multivariate logistic regression analysis was conducted to identify the prognostic factors in the elderly ACS patients.ROC curve was plotted to evaluate the predictive value of fetuin-A and MGP for poor prognosis in the patients.Results The serum fetuin-A and MGP levels were gradually decreased in the non-calcification group,and then fol-lowed by the mild,moderate and severe calcification groups in turn,with statistical differences(P＜0.05).CACS was negatively correlated with serum fetuin-A and MGP levels(r=-0.434,P=0.000;r=-0.512,P=0.000).The poor prognosis group had obviously older age and larger proportions of concomitant frailty syndrome,Killip grade Ⅲ-Ⅳ and coronary artery calcifica-tion,and notable lower serum fetuin-A and MGP levels than the good prognosis group(P＜0.05,P＜0.01).Age and coronary artery calcification were risk factors for poor prognosis in elderly ACS patients(OR=1.386,95％CI:1.227-1.565,P=0.000;OR=16.732,95％CI:4.747-58.968,P=0.000),while serum fetuin-A and MGP were protective factors(OR=0.856,95％CI:0.744-0.986,P=0.032;OR=0.760,95％CI:0.670-0.862,P=0.000).ROC curve analysis showed that the AUC value of fetuin-A and MGP levels and their combination in predicting the prognosis in elderly ACS patients was 0.731,0.841 and 0.928,respectively,and combined the two indicators showed better predictive performance than alone(P＜0.01).Conclusion Serum fetuin-A and MGP levels in elderly ACS patients are associated with the degree of coronary artery calci-fication and prognosis.The two indicators have certain prognostic value for the patients,and their combined detection can further improve the prognostic performance.

Objective To develop an evaluation system for assessing the service quality of pharmaceutical science We-Chat public accounts.Methods Drawing from the experience of pharmaceutical popular science creation,the primary indicators for evaluating the service quality of pharmaceutical popular science WeChat public accounts were identified through investigation and literature review.These preliminary indicators were refined through the application of the Delphi method.The corresponding index weights were determined using the analytic hierarchy process.This approach culminated in the formulation of a comprehen-sive evaluation system for the service quality of pharmaceutical popular science WeChat public accounts.Additionally,specific WeChat public accounts were selected for case analysis to further validate the scientific rigor of the proposed evaluation system.Results A comprehensive and scientific three-level index of service quality evaluation of WeChat public account for pharmaceu-tical science popularization was established,including three first-level indicators,nine second-level indicators and thirty-eight third-level indicators.Conclusion This evaluation index system can provide a reference for evaluating the service quality of pharmaceutical science popularization WeChat public accounts.

Objective:It analyzes the flow characteristics and spatial distribution patterns of intra-provincial cross-regional medical patients in Guangdong,while comparing hospitalization cost differences between local and non-local care.Methods:Based on 2022-2023 cross-regional medical data from Guangdong,spatial visualization and descriptive analysis were conducted combined with Mann-Whitney U test to compare the cost burden.Results:Cross-Regional patients in Guangdong primarily flow to Guangzhou,accounting for 77.8％of the total intra-provincial cross-regional hospitalizations.Cross-regional medical expenses were significantly higher than the insured locations,with notable differences in mean total hospitalization costs and personal out-of-pocket payment ratios.Conclusion:Refining pre-approval procedures for cross-regional care,enhancing specialized medical departments in under-resourced regions,and strengthening coordination between healthcare insurance systems and primary healthcare strengthening initiatives are needed to promote balanced medical resource allocation and reduce the cost burden on patients.

Tumor immunotherapy has attracted worldwide attention in cancer treatment because of its obvious advantages such as strong specificity and long curative effect.It is found that activation of STING signaling pathway in cells is one of directions to effec-tively realize tumor immunotherapy.However,due to low response rate of related drugs,difficult degradation,certain toxic and side effects,its clinical application has been seriously hindered.Nano-drug delivery system can achieve targeted drug delivery,improve drug stability,delivery rate,osmotic effect and long-term retention effect,reduce drug side effects,and show significant advantages in tumor immunotherapy.In this paper,research progress of nano-drug delivery system activating STING pathway in tumor immunother-apy in recent years is reviewed,and many nano-drug delivery systems that can activate STING signal pathway and their application ex-amples after loading drugs are listed,including nucleotide-based drug delivery system,non-nucleotide-based drug delivery system and metal-based drug delivery system,providing reference for application of nano-drugs in tumor immunotherapy.

AIM:To investigate the impact of es-ketamine-mediated opioid-free anesthesia(OFA)on postoperative gastrointestinal function in patients undergoing laparoscopic distal gastrectomy for gas-tric cancer.METHODS:A total of 150 pa-tients,scheduled for elective laparoscopic distal gas-trectomy for gastric cancer and meeting the inclu-sion and exclusion criteria,were randomly assigned to either the OFA group or the opioid-based anes-thesia(OBA)group using a random number ta-ble,with 75 patients in each group.The OFA group was administered an anesthesia regimen pri-marily consisting of esketamine,while the OBA group received conventional opioid anesthesia,pri-marily consisting of sufentanil and remifentanil.The primary outcome measure was postoperative flatus time,defined as the interval from the end of sur-gery to the first passage of gas.RESULTS:The OFA group exhibited a shorter postoperative flatus time compared to the OBA group(P＜0.01).Intraopera-tive blood loss and norepinephrine consumption were significantly less in the OFA group compared to the OBA group(P＜0.05);the postoperative HADS-D score was better in the OFA group than in the OBA group,and both the OFA and OBA groups showed significantly lower postoperative HADS-A and HADS-D scores compared to their preoperative levels(P＜0.05);the incidence rate of abdominal distension was significantly lower in the OFA group compared to the OBA group(P＜0.05).CONCLUSION:The use of esketamine-mediated opioid-free anesthesia can expedite gastrointestinal function recovery,reduce hospital stay duration,and decrease postoperative adverse reactions in patients undergoing laparo-scopic distal gastrectomy for gastric cancer.

Objective:To explore the differences in resting-state brain functional activity in obsessive-compulsive disorder (OCD) patients with and without sensory phenomena (SP).Methods:Clinical data from 102 OCD patients (60 males, 42 females; age 18-50(27±8) years) who visited the OCD outpatient clinic at the Affiliated Brain Hospital of Nanjing Medical University between August 2021 and December 2022 were prospectively collected. Based on the presence of sensory phenomena, patients were categorized into 70 cases with sensory phenomena (Sensory Phenomena Group) and 32 cases without sensory phenomena (Non-Sensory Phenomena Group). Additionally, 50 age-matched healthy controls (Control Group, 24 males, 26 females; age 18-49(25±6) years) were recruited. Resting-state functional magnetic resonance imaging (rs-fMRI) was analyzed using the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) between differential brain regions. One-way ANOVA and post-hoc tests were used to compare group differences. Spearman correlation and binary logistic stepwise regression were applied to analyze the associations between SP and brain functional activity.Results:Compared to healthy controls, OCD patients showed decreased ALFF in bilateral middle frontal gyri, left superior frontal gyrus, right angular gyrus, and right supramarginal gyrus ( F=17.29-32.99, all P<0.05). The SP group exhibited increased ALFF in the right triangular part of the inferior frontal gyrus ( F=23.47, P<0.05) and decreased ALFF in the left superior parietal gyrus and left postcentral gyrus ( F=18.80, 15.04; both P<0.05). The non-SP group demonstrated increased ALFF in the left supramarginal gyrus and left postcentral gyrus ( F=19.64, 15.04; both P<0.05) and decreased ALFF in the left superior frontal gyrus, right middle frontal gyrus, and left angular gyrus ( F=17.29-35.52, all P<0.05). Reduced FC was observed between the left middle frontal gyrus and left angular gyrus, left middle frontal gyrus and right angular gyrus and left and right angular gyri ( F=17.29-23.47, all P<0.05). The SP group showed lower FC between the left middle frontal and left angular gyrus than the non-SP group ( F=23.47, P<0.05). Positive correlations with SP were found for ALFF in the right triangular part of the inferior frontal gyrus, left superior frontal gyrus, and right middle frontal gyrus (r=0.40, 0.35, 0.31; all P<0.05). Negative correlations were observed for ALFF in the left supramarginal gyrus, left superior parietal gyrus, and left postcentral gyrus (r=-0.38, -0.47, -0.52; all P<0.05) and FC between the left middle frontal gyrus-left angular gyrus and left middle frontal gyrus-right angular gyrus (r=-0.24, -0.21; both P<0.05). OCD patients with increased ALFF in the left superior frontal gyrus and right middle frontal gyrus, along with decreased ALFF in the left supramarginal gyrus, left superior parietal gyrus, left postcentral gyrus, and reduced FC between the left middle frontal gyrus-right angular gyrus, had a higher likelihood of SP (log OR (95% CI)=8.5(4.0-14.2), 8.0(1.7-16.4), -8.9(-15.2--4.4), -5.2 (-9.1--2.3), -4.1(-6.9--1.7), -7.0(-13.2--1.8); all P<0.05). Conclusion:Altered functional activity in the left superior frontal gyrus, right middle frontal gyrus, left supramarginal gyrus, left superior parietal gyrus, left postcentral gyrus, and abnormal FC between the left middle frontal gyrus and right angular gyrus represent key neuroimaging features of OCD patients with SP.