OBJECTIVE To systematically evaluate the effects of oral non-peptidic thrombopoietin receptor agonists （TPO-RAs） on hepatic enzyme in adult patients with immune thrombocytopenia. METHODS A comprehensive literature search was conducted in PubMed， Web of Science， CNKI， Wanfang database and the Chinese Medical Association Journal Full-Text Database to collect randomized controlled trials （RCTs） comparing oral non-peptidic TPO-RAs （intervention group） with placebo or conventional therapy （control group）. All databases were searched from their inception to June 2025. After literature screening， data extraction and quality assessment of the included studies， meta-analysis was conducted using RevMan 5.4.1 software. RESULTS Twelve RCTs comprising 1 388 patients were included， with 971 in the intervention group and 417 in the control group. Meta-analysis results showed that there were no significant differences between the two groups in terms of the incidence of hepatic enzyme elevation[OR＝1.24， 95%CI （0.77， 1.99）， P ＝0.37 ] ， the incidence of hepatic enzyme elevation in patients treated for ≥6 weeks[OR＝1.21， 95%CI （0.73， 1.99）， P ＝0.46 ] ， and the incidence of severe hepatic enzyme elevation[OR＝1.39， 95%CI（0.46， 4.20）， P ＝0.55 ] . Subgroup analysis showed that there were no significant differences in the incidence of hepatic enzyme elevation between the intervention group and control group among patients using eltrombopag[OR＝1.57，95%CI（0.85，2.87）， P ＝0.15 ] ， avatrombopag[OR＝0.88，95%CI （0.09，8.46）， P ＝0.91 ] ， and hetrombopag[OR＝1.04，95%CI（0.30，3.65）， P ＝0.95 ] ， respectively. CONCLUSIONS Oral non-peptidic TPO-RAs do not significantly increase the risk of hepatic enzyme elevation in adult patients with immune thrombocytopenia， and show an overall favorable hepatic safety profile.

ObjectiveTo evaluate the clinical efficacy of Shenqi Yangxin decoction in the treatment of ischemic cardiomyopathy （ICM） with Qi and Yin deficiency and blood stasis syndrome and its effect on serum hydrogen sulfide （H₂S） and calcium ion （Ca²⁺）. MethodsA total of 64 ICM patients with Qi and Yin deficiency and blood stasis syndrome who met the inclusion criteria were randomly divided into a control group （n=32） and a treatment group （n=32）. All patients received conventional Western medicine treatment. The treatment group was additionally given Shenqi Yangxin decoction. The TCM syndrome score， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， 6-minute walk test （6MWT）， New York Heart Association （NYHA） cardiac function classification， and serum H₂S and Ca²⁺ levels were compared between the two groups pre- and post-treatment. ResultsTwo cases dropped out from each group during the study. Finally， 30 patients in each group were included in the analysis. There were no significant differences in age， gender， course of coronary heart disease， underlying diseases， and laboratory tests between the two groups. Compared with baseline， the TCM syndrome score， MLHFQ score， and NT-proBNP in both treatment group and control group decreased significantly （P<0.01）， LVEF， 6MWT， and H₂S increased significantly （P<0.01）， and serum Ca²⁺ increased （P<0.05）. Compared with the control group after treatment， the MLHFQ score and NT-proBNP in the treatment group decreased （P<0.05）， the TCM syndrome score decreased significantly （P<0.01）， LVEF， 6MWT， and serum Ca²⁺ increased （P<0.05）， and H₂S increased significantly （P<0.01）. The improvement degree of the NYHA cardiac function classification in the treatment group was higher than that in the control group， but there was no significant difference. ConclusionShenqi Yangxin decoction is effective in treating ICM patients with Qi and Yin deficiency and blood stasis， which could significantly improve cardiac function and quality of life， and its therapeutic effect may be related to the regulation of serum H₂S and Ca²⁺ levels.

Chronic obstructive pulmonary disease(COPD),as a global health challenge,brings heavy economic and psychological burdens to patients and their families.Accurately identifying the risk factors for COPD and excluding false associations are crucial for understanding its pathogenesis and formulating prevention strategies.Mendelian randomization(MR),as a supplementary method,has shown great potential in reducing the interference of confounding factors,lowering the cost of experimental research,and avoiding experimental ethical issues.This article focuses on MR and its main derivative methods,discusses their basic principles and applicable conditions,and analyzes their application effects and limitations in COPD research in combination with specific cases,enabling MR to be more widely applied in the study of influencing factors of COPD.

As people’s attention to health continues to increase, the market demand for traditional Chinese medicine (TCM) is growing steadily. The quality and safety of Chinese medicinal materials have attracted unprecedented social attention. In particular, the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society. The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM. This not only reflects China’s high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision. Basis on this study, by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detection standards in the Chinese Pharmacopoeia 2025 Edition, deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition. Moreover, it interprets the future development directions of the detection of exogenous residues in TCM, aiming to provide a reference for the formulation of TCM safety supervision policies.

Objective To investigate the clinical manifestations of traditional Chinese medicine(TCM)and their associations with TCM constitutions in individuals who have migrated to plateau areas,and to provide a scientific basis for plateau health management.Methods Migrants living in areas above 3000 m were selected as research subjects.Data were collected by using TCM symptom assessment scales and constitution assessment scales.Descriptive statistical analysis was conducted to determine the incidence and severity of symptoms among individuals with different migration durations,and core symptoms were identified.Factor analysis was performed by using SPSS software to extract symptom clusters and explore the correlation between core symptoms and TCM constitutions.Results Among individuals who migrated to plateau areas,the incidence of discomfort symptoms was 83.44％.The five most common symptoms were dry skin(67.94％),forgetfulness(56.03％),dry mouth(52.06％),yellow urine(48.73％),and insomnia(47.14％).In the top 10 symptoms with the highest increase in incidence,yellow urine(33.51％)and forgetfulness(26.33％)were both present in the top 10 symptoms across different migration durations.Factor analysis extracted 5,2,4,and 6 symptom clusters from the overall population,individuals who migrated within 1 year,those who migrated for 1-2 years,and those who migrated over 2 years,respectively.Qi-deficiency constitution(QDC),blood stasis constitution(BSC),qi stagnation constitution(QSC),phlegm-dampness constitution(PDC),and dampness-heat constitution(DHC)were significantly positively correlated with forgetfulness.Conclusion Migrating to plateau areas can induce discomfort symptoms,and both the number and incidence of symptoms increase with longer migration durations.The number and incidence of high-frequency symptoms(incidence≥30％)increase with prolonged migration time.There are differences in the composition and severity of symptom clusters across different migration durations.QDC,BSC,QSC,PDC,and DHC are closely related to forgetfulness and can be considered risk constitutions for forgetfulness.Timely attention to changes in symptom clusters and constitutions can help prevent and mitigate the occurrence and development of symptoms.

As people's attention to health continues to increase,the market demand for traditional Chinese medi-cine(TCM)is growing steadily.The quality and safety of Chinese medicinal materials have attracted unprecedent-ed social attention.In particular,the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society.The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM .This not only reflects China's high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision.Basis on this study,by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detec-tion standards in the Chinese Pharmacopoeia 2025 Edition,deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition.Moreo-ver,it interprets the future development directions of the detection of exogenous residues in TCM ,aiming to provide a reference for the formulation of TCM safety supervision policies.

Objective:To understand healthcare professionals' perceptions and experiences of early rehabilitation exercise for extracorporeal membrane oxygenation (ECMO) patients, explore existing problems in the implementation of early rehabilitation exercise, and provide reference for constructing safe and effective early rehabilitation exercise programs for ECMO patients.Methods:This study was a qualitative study. Using purposeful sampling method, 13 ICU healthcare professionals (including doctors, rehabilitation therapists, and nurses) from three Class Ⅲ Grade A hospitals in Zhejiang Province that have implemented early rehabilitation exercise for ECMO patients were selected for semi-structured interviews from March to May 2024, and the interview data were collated and analyzed using the Colaizzi 7-step analysis method.Results:The perceptions and experiential perspectives of healthcare professionals on early rehabilitation exercise for ECMO patients can be summarized into three themes and 10 subthemes. The three themes were: healthcare professionals affirm the role of early rehabilitation exercise; lack of unified operational guidelines for early rehabilitation exercise; and patients and their families show high enthusiasm for participating in early rehabilitation exercise.Conclusions:Hospitals should regularly conduct related training on early rehabilitation exercise to enhance the practical skills of healthcare professionals. At the same time, healthcare professionals should focus on utilizing the positive role of patients and their families in the process of early rehabilitation exercise to improve the quality of ECMO patient rehabilitation care.

Chronic obstructive pulmonary disease(COPD),as a global health challenge,brings heavy economic and psychological burdens to patients and their families.Accurately identifying the risk factors for COPD and excluding false associations are crucial for understanding its pathogenesis and formulating prevention strategies.Mendelian randomization(MR),as a supplementary method,has shown great potential in reducing the interference of confounding factors,lowering the cost of experimental research,and avoiding experimental ethical issues.This article focuses on MR and its main derivative methods,discusses their basic principles and applicable conditions,and analyzes their application effects and limitations in COPD research in combination with specific cases,enabling MR to be more widely applied in the study of influencing factors of COPD.

Objective:To understand healthcare professionals' perceptions and experiences of early rehabilitation exercise for extracorporeal membrane oxygenation (ECMO) patients, explore existing problems in the implementation of early rehabilitation exercise, and provide reference for constructing safe and effective early rehabilitation exercise programs for ECMO patients.Methods:This study was a qualitative study. Using purposeful sampling method, 13 ICU healthcare professionals (including doctors, rehabilitation therapists, and nurses) from three Class Ⅲ Grade A hospitals in Zhejiang Province that have implemented early rehabilitation exercise for ECMO patients were selected for semi-structured interviews from March to May 2024, and the interview data were collated and analyzed using the Colaizzi 7-step analysis method.Results:The perceptions and experiential perspectives of healthcare professionals on early rehabilitation exercise for ECMO patients can be summarized into three themes and 10 subthemes. The three themes were: healthcare professionals affirm the role of early rehabilitation exercise; lack of unified operational guidelines for early rehabilitation exercise; and patients and their families show high enthusiasm for participating in early rehabilitation exercise.Conclusions:Hospitals should regularly conduct related training on early rehabilitation exercise to enhance the practical skills of healthcare professionals. At the same time, healthcare professionals should focus on utilizing the positive role of patients and their families in the process of early rehabilitation exercise to improve the quality of ECMO patient rehabilitation care.

Objective To explore the effects of different phenotypes macrophages(Mφs)on the proliferation,mi-gration and osteogenic differentiation of periodontal ligament stem cells(PDLSCs).Methods PDLSCs were isola-ted and cultured by tissue block method.Tohoku Hospital Pediatrics-1(THP-1)cell line was stimulated to activate into unpolarized Mφs(M0),then induced to polarize into type Ⅰ Mφs(M1)and type Ⅱ Mφs(M2).Quantitative real-time PCR(qPCR)detected the inflammatory factors tumor necrosis factor α(TNF-α),interleukin(IL)-1 β,IL-6,IL-10 and transforming growth factor-β(TGF-β)mRNA expression level.After collecting culture superna-tants with different phenotypes,PDLSCs were stimulated,native control(NC)group did not receive the culture su-pernatant of Mφs.The effects of PDLSCs proliferation were assessed via Methylthiazolyldiphenyl-tetrazolium bro-mide(MTT)assay,while scratch assays were employed to evaluate their migration.Western blot was utilized to analyze the protein expression of Runt-related transcription factor 2(RUNX2)and alkaline phosphatase(ALP).Additionally,Alizarin Red staining was performed to investigate the deposition of calcified nodules in PDLSCs.Re-sults qPCR showed the relative expression of TNF-α,IL-1 β and IL-6 in M1 Mφs were higher than those in M0 and M2 Mφs(P＜0.05),and the relative expression of IL-10 and TGF-β in M2 Mφs were higher than those in M0 and M1 Mφs(P＜0.05);Western blot showed the expression of RUNX2 and ALP proteins in PDLSCs in M0 and M2 groups was higher than those in the NC group(P＜0.05),Alizarin Red staining showed increased calcified nodule deposition in PDLSCs in M0,M1 and M2 groups compared to the NC group;MTT assay showed the prolifer-ation of PDLSCs in the M0 and M1 groups was suppressed compared to the NC group(P＜0.05);and scratch ex-periment showed the migratory capacity of PDLSCs in the M1 and M2 groups was stronger than that in the NC group.Conclusion M0 and M1 Mφs inhibit PDLSCs proliferation,M1 and M2 Mφs promote PDLSCs migration,and all types of Mφs promote osteogenic differentiation of PDLSCs.