Parkinson’s disease （PD） is a central neurodegenerative disorder with insidious onset and slow progression. It is pathologically characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta and the abnormal aggregation of α-synuclein （α-Syn）， resulting in the formation of Lewy bodies. These pathological changes give rise to motor dysfunction， sleep disturbances， cognitive impairment， and other symptoms， thereby markedly reducing patients’ quality of life. Current treatments remain largely symptomatic， including dopaminergic replacement therapy and deep brain stimulation （DBS）， while long-term adverse effects and declining efficacy in advanced stages remain unresolved. Therefore， the development of disease-modifying therapies capable of delaying or reversing disease progression is of critical importance. Aquaporin-4 （AQP4） is the most abundant water channel in the brain and is predominantly expressed in astrocytic endfeet， where it plays a key role in maintaining cerebral water homeostasis， blood–brain barrier integrity， and glymphatic waste clearance. Recent studies have demonstrated that both the expression level and polarization of AQP4 are altered in PD animal models and in brain tissues from patients with PD， and these alterations are closely associated with glymphatic dysfunction， impaired α-Syn clearance， disruption of central nervous system homeostasis， and activation of neuroinflammation. Following the cascade of “AQP4 alteration – impaired glymphatic clearance-α-Syn deposition-neuroinflammation-PD progression”， this review outlines the basis of AQP4 polarization and glymphatic function， summarizes the potential mechanisms by which AQP4 abnormalities promote α-Syn accumulation and inflammatory amplification， and synthesizes current clinical evidence and therapeutic advances. Nevertheless， inconsistencies across experimental models and PD subtypes remain， and the causal role of AQP4 as well as population heterogeneity has yet to be fully elucidated. Future large-scale， long-term， subtype-stratified studies are warranted to explore precise regulatory strategies targeting AQP4 and to validate its safety and efficacy as a novel disease-modifying therapeutic target for PD.

Retinal displacement refers to the strong fluorescent lines parallel to the retinal vessels that are detected through autofluorescence examination after rhegmatogenous retinal detachment(RRD)surgery. Actually, even if patients with RRD achieve macroscopic structural reattachment after the operation, the visual function of some patients remains suboptimal. This is associated with the incomplete recovery of retinal function, and retinal displacement is one of the critical influencing factors. This paper reviews the related concepts of retinal displacement and systematically summarizes the incidence of retinal displacement after RRD surgery and its impact on function, the possible mechanisms of retinal displacement, and the influence of various factors on the occurrence of retinal displacement reported in the recent 5 a. It is conducive to enabling surgeons to conduct better design and planning for retinal reattachment surgeries, then achieve higher integrity of retinal function recovery, and enable patients to obtain better postoperative visual function.

Ischemic stroke (IS) ranks as a leading cause of death and disability globally. The blood-brain barrier (BBB) poses significant challenges for effective drug delivery to brain tissues. Recent decades have seen the development of targeted nanomedicine and biomimetic technologies, sparking substantial interest in biomimetic drug delivery systems for treating IS. These systems are devised by utilizing or replicating natural cells and their derivatives, offering promising new pathways for detection and transport across the BBB. Their multifunctionality and high biocompatibility make them effective treatment options for IS. In addition, the incorporation of engineering techniques has provided these biomimetic drug delivery systems with active targeting capabilities, enhancing the accumulation of therapeutic agents in ischemic tissues and specific cell types. This improvement boosts drug transport and therapeutic efficacy. However, it is crucial to thoroughly understand the advantages and limitations of various engineering strategies employed in constructing biomimetic delivery systems. Selecting appropriate construction methods based on the characteristics of the disease is vital to achieving optimal treatment outcomes. This review summarizes recent advancements in three types of engineered biomimetic drug delivery systems, developed from natural cells and their derivatives, for treating IS. It also discusses their effectiveness in application and potential challenges in future clinical translation.
Humans ; Drug Delivery Systems/methods* ; Ischemic Stroke/drug therapy* ; Animals ; Blood-Brain Barrier/metabolism* ; Stroke/drug therapy*

Objective To comprehensively analyze the epidemiological characteristics and resistance mechanisms of New Delhi metallo-β-lactamase(NDM)-positive multidrug-resistant bacteria in China.Methods Relevant literatures on NDM-positive multidrug-resistant bacteria discovered in China were searched in the CNKI and PubMed databases(publications from January 1,2017 to December 31,2023).The epidemiological analysis was conducted on the types of NDM-positive bacterial strains,their regional distribution,infection sources,resistance profiles,and transfer mechanisms.Results A total of 118 eligible articles were collected,reporting 1627 NDM-positive bacterial strains.The number of reports increased annually from 2011 to 2019,but began to decline annually from 2020 onwards.NDM-1 and NDM-5 were the most commonly reported variants.The highest number of reports came from Eastern China,followed by Central China and North China.The primary pathogens were Klebsiella pneumoniae,Escherichia coli,and Enterobacter cloacae.The age distribution of patients with NDM-positive infections showed distinct patterns,with neonates and children accounting for 27.25％and patients over 50 years old accounting for 49.57％.The majority of positive bacterial infections came from sputum(38.28％),urine(28.94％),and blood(23.28％).The main departments reporting NDM-positive bacteria were the ICU(39.93％)and pediatrics(20.14％).These resistant bacteria exhibited resistance to more than 50.00％of antibiotics,with lower resistance to colistin and tigecycline(below 30.00％).The predominant plasmid type carrying the blaNDMwas IncX3,and the insertion sequences upstream and downstream of the blaNDM showed diversity.Conclusion NDM-positive multidrug-resistant bacteria are widely prevalent across regions in China,exhibiting multidrug-resistance.This poses significant challenges to clinical antibiotic selection and necessitates the development of effective countermeasures.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Scutellariae Radix， Coptidis Rhizoma， and Phellodendri Chinensis Cortex are three commonly used Chinese herbal medicines， and their application in classic famous prescriptions cannot be fully explained by the triple energizer classification method. This study reviewed the ancient materia medica works and elaborated on the functions of the three herbal medicines before the Song dynasty and after the Jin dynasty. The works before the Song dynasty mainly introduced the diseases treated by the three herbal medicines according to the Shennong's Classic of Materia Medica（《神农本草经》）， and the works after the Jin dynasty mainly expounded the indications of the three medicines in the Shennong's Classic of Materia Medica according to the new medical theory. Although all the three herbal medicines can treat heat syndrome， digestive system diseases， skin and mucosa diseases， they act on different targets. Scutellariae Radix can regulate Qi stagnation and reverse caused by the fire syndrome. Coptidis Rhizoma can treat excess fire and purulent bloody stool caused by the deficiency of Zang-fu organs. Phellodendri Chinensis Cortex mainly treats the diseases of the intestine and reproductive system and can kill parasites. In addition， this paper summarized the descriptions about the functions of Scutellariae Radix in eliminating blood blockage， Coptidis Rhizoma in protecting the intestine， and Phellodendri Chinensis Cortex in clearing the liver in ancient books. According to the sentences in the Treatise on Febrile and Miscellaneous Diseases（《伤寒杂病论》）， the application of Scutellariae Radix in Chaihu prescriptions， Coptidis Rhizoma in Baitouweng Decoction， and Phellodendri Chinensis Cortex in Zhizi Baipi Decoction confirms to the indications of the three medicines in the materia medica works before the Song Dynasty. The existing clinical and pharmacological research results confirm the indications of the three herbal medicines in the ancient works. The clinical application of the three medicines should refer to the materia medicia works before the Song dynasty， so as to achieve precise medication.

Objective:To investigate the diagnostic value of CT-guided puncture biopsy combined with serum gamma-glutamyltransferase (GGT) and abnormal prothrombin (PIVKA-Ⅱ) in serum alpha-fetoprotein(AFP) negative primary liver cancer (PHC).Methods:Eighty patients with AFP negative PHC treatment in Fuyang Women and Children′s Hospital from January 2018 to March 2021 were selected as AFP negative PHC group, and another 85 patients diagnosed with benign liver tumor during the same period were selected as the control group retrospectively. The patients of the two groups underwent CT-guided biopsy and the levels of GGT and PIVKA-Ⅱ were detected. The single diagnostic value and combined diagnostic value of AFP negative PHC were analyzed by receiver operating characteristic (ROC) curve.Results:Seventy-five of the 80 patients in the AFP negative PHC group were confirmed as liver malignant lesions by biopsy, with a coincidence of 93.75%, and 84 of the 85 patients in the control group were confirmed as liver benign lesions by biopsy, with a coincidence of 98.82%. The levels of AFP, GGT and PIVKA-Ⅱ in AFP negative PHC group were significantly higher than those in the control group: (175.67 ± 39.58) μg/L vs. (18.74 ± 7.42) μg/L, (1 245.37 ± 255.41) U/L vs. (486.63 ± 89.05) U/L, (385.49 ± 30.27) AU/L vs. (25.84 ± 7.66) AU/L, there were statistical differences ( P<0.05). Spearman correlation analysis showed that serum AFP was positively correlated with GGT and PIVKA-Ⅱ ( r = 0.858 and 0.429, P<0.05). The results of ROC curve showed that the area under curve of CT-guided biopsy combined with GGT and PIVKA-Ⅱ in the diagnosis of AFP negative PHC was 0.877, the sensitivity was 91.19%, the specificity was 87.34%. Conclusions:CT-guided biopsy combined with GGT and PIVKA-Ⅱ detection of AFP negative PHC can effectively improve the diagnostic value.

Objective:To investigate the effects of cyclic tensile stress on the function and degeneration of nucleus pulposus cells.Methods:The human primary nucleus pulposus cells were isolated and cultured. The cyclic tensile stress (100 000 μ?, 10% tensile strain, 0.1 Hz, 8 640 cycles) was loaded on the cells for 24 h. The proliferation of the cells was examined by MTT method. The cell cycle and apoptosis were detected through flow cytometry. Gene expression profile chip was used to detect the differentially expressed genes between the tensile stress group and control group. The function of these gene was analyzed by bioinformatics. The expression of inflammatory related factors, TGF-β, matrix degrading enzymes and extracellular matrix molecules were examined by qRT-PCR.Results:The cyclic tensile stress significantly promoted proliferation and cell cycle of nucleus pulposus cells. The cell percentage of S phase ( t=5.336, P<0.05) and G2/M phase ( t=7.288, P<0.01) was significantly different between the tensile stress group and control group. The cyclic tensile stress inhibited apoptosis of nucleus pulposus cells (8.56%±0.48% vs 10.63%±0.32%, t=4.474, P<0.05). A total of 866 differentially expressed genes were detected. Gene ontology analysis showed the roles of these genes in cells including focal adhesion, extractable matrix, membrane raft, condensed chrome kinetochore, cytoskeleton, etc. The cyclic tensile stress significantly affected the mRNA expression of inflammatory related factors, TGF-β genes, matrix proteinase and extracellular matrix molecules. Compared with the control group, the mRNA expression of inflammatory related factors IL15 ( t=5.379, P<0.05), IGF1 ( t=5.454, P<0.05) and IGFBP7 ( t=13.57, P<0.01) were significantly decreased in the tensile stress group; The mRNA expression of TGF-β genes TGFB1 ( t=6.931, P<0.05), TGFB2 ( t= 15.56, P<0.01) and TGFB3 ( t=7.744, P<0.05) were significantly increased in the tensile stress group; The mRNA expression of matrix proteinase ADAMTS3 ( t=5.241, P<0.05) and MMP19 ( t=24.72, P<0.01) were significantly decreased, and TIMP3 ( t=8.472, P<0.01) increased in the tensile stress group; The mRNA expression of extracellular matrix molecules COL2A1 ( t=5.871, P<0.05), FLRT2 ( t=5.216, P<0.05) and FN1 ( t=4.289, P<0.05) were significantly increased. Conclusion:The cyclic tensile stress promoted cell cycle and proliferation and inhibited apoptosis of nucleus pulposus cells. The cyclic tensile stress may affect the function and degeneration of nucleus pulposus cells by regulating the expression of inflammatory related factors, TGF-β, matrix degradation enzymes and ECM molecules.

Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease, and lupus nephritis (LN) is the most common and severe complication of systemic lupus erythematosus, and the diagnosis and treatment of LN is closely related to the prognosis of systemic lupus erythematosus. Recently, promising LN biomarkers have been discovered that will be expected to provide guidance for the diagnosis and treatment of lupus kidney.