OBJECTIVE To evaluate the cost-effectiveness of rezivertinib versus gefitinib as first-line treatment for epidermal growth factor receptor （EGFR） mutation-positive advanced non-small cell lung cancer （NSCLC） from the perspective of the Chinese healthcare system. METHODS A Markov model was constructed based on the REZOR trial data， with a cycle length of 3 weeks and a study duration of 5 years. Both costs and health outcomes were discounted at an annual rate of 5%. A cost-utility analysis was conducted using 3 times China’s 2024 per capita gross domestic product as the willingness-to-pay （WTP） threshold. The economic differences between the rezivertinib regimen versus the gefitinib regimen were evaluated using the incremental cost- effectiveness ratio （ICER） and incremental net monetary benefit （INMB）. Sensitivity and scenario analyses were performed to verify the robustness of the model. RESULTS Compared to the gefitinib regimen， the rezivertinib regimen saved 225 310.47 yuan and gained an additional 0.57 quality- adjusted life years （QALYs）， resulting in an ICER of －395 562.80 yuan/QALY， which was much lower than the WTP threshold of this study， indicating that rezivertinib had an absolute economic advantage. The INMB analysis （389 041.26 yuan） further validated this conclusion. One-way and probabilistic sensitivity analyses confirmed the robustness of the model. Scenario analysis， incorporating a 15% reduction in drug prices and adjustments to the utility values for progression free survival and progression disease， yielded consistent results with the base case analysis. CONCLUSIONS Compared to gefitinib， rezivertinib as a first-line treatment for EGFR mutation-positive advanced NSCLC has an absolute economic advantage.

Given the increasing concern regarding antibacterial resistance, the antimicrobial properties of naphthoquinones have recently attracted significant attention. While 1,4-naphthoquinone and its derivatives have been extensively studied, the antibacterial properties of 5,8-dihydroxy-1,4-naphthoquinone derivatives remain relatively unexplored. This study presents a comprehensive in vitro and in vivo analysis of the antibacterial activity of 35 naturally sourced and chemically synthesized derivatives of 5,8-dihydroxy-1,4-naphthoquinone. Kirby-Bauer antibiotic testing identified three compounds with activity against methicillin-resistant Staphylococcus aureus (MRSA), with one compound (PNP-02) demonstrating activity comparable to vancomycin in minimum inhibitory concentration, minimum bactericidal concentration (MBC), and time-kill assays. Microscopic and biochemical analyses revealed that PNP-02 adversely affects the cell wall and cell membrane of MRSA. Mechanistic investigations, including proteomic sequencing analyses, Western blotting, and RT-qPCR assays, indicated that PNP-02 compromises cell membrane integrity by inhibiting arginine biosynthesis and pyrimidine metabolism pathways, thereby increasing membrane permeability and inducing bacterial death. In an in vivo mouse model of skin wound healing, PNP-02 exhibited antibacterial efficacy similar to vancomycin. The compound demonstrated low toxicity to cultured human cells and in hemolysis assays and remained stable during serum incubation. These findings suggest that PNP-02 possesses promising bioactivity against MRSA and represents a potential novel antibacterial agent.
Methicillin-Resistant Staphylococcus aureus/genetics* ; Anti-Bacterial Agents/chemistry* ; Naphthoquinones/administration & dosage* ; Animals ; Microbial Sensitivity Tests ; Mice ; Humans ; Staphylococcal Infections/microbiology* ; Molecular Structure

Objective:To evaluate the effect of Jianpi-Huatan Decoction combined with routine western medicine of COPD patients with lung and spleen deficiency. Methods:A total of 102 patients who met the inclusion criteria from February 2017 to February 2018 were divided into two groups according to random number table method, with 51 in each group. The control group was treated with routine western medicine and the study group was treated with Jianpi-Huatan Decoction on the basis of the control group. Two groups were treated continuously for 3 months. Before and after the treatment, TCM symptoms like cough, expectoration, chest distress, wheezing, asthenia, abnormal stool and abnormal food intake were scored. Then measured FEV1 and FVC by pulmonary function instrument, calculated the value of FEV1/FVC, measured TNF-α;, IL-6 and IL-8 levels in sputum by ELISA, and evaluated its clinical effectd. Results:The total effective rate of the study group was 82.4% (42/51) and the control group was 62.8% (32/51). The difference between the two groups was statistically significant ( χ2=4.923, P=0.027). After the treatment, the scores of cough, expectoration, chest distress, wheezing, asthenia, abnormal stool and abnormal food intake in the study group were significantly lower than those in the control group ( t value were 8.705, 6.969, 9.844, 9.140, 15.540, 11.941 and 5.968, respectively, all Ps<0.01). After the treatment, FEV1 (1.97 ± 0.50 L vs. 1.58 ± 0.43 L, t=4.223), FVC (2.57 ± 0.47 L vs. 2.13 ± 0.45 L, t=4.829), value of FEV1/FVC (76.65 ± 4.11 vs. 74.18 ± 4.33, t=2.955) in the study group was significantly higher than those in the control group ( P<0.01). The levels of TNF-α, IL-6 and IL-8 in sputum of the study group were significantly lower than those in the control group ( t value were 3.917, 5.598 and 8.846, respectively, all Ps<0.01). Conclusions:Jianpi-Huatan Decoction combined with routine western medicine has a significant curative effect in treating COPD of stable period with lung and spleen deficiency, which can significantly reduce clinical symptoms, improve lung function, inhibit airway inflammation with safty.

Chinese medical records recorded the whole activities during a syndrome differentiation and treatment of disease. With the characteristics of diversity and lively, the records have important values in establishing TCM therapeutic thoughts and abilities for students. Amount of medical records have been recorded in medical books since the Western Han dynasty. In order to provide the references for teaching prescription aided by medical records, this article discusses the choice and application of medical records to teach prescription by listing examples on the basis of outlining the development of TCM medical records.

Background: Pre-exam anxiety syndrome is a common condition occurring in pre-exam students and directly affects their examination performance and physical state. Wrist-ankle acupuncture has significant therapeutic effects in treating mental disorders and may also relieve the symptoms of pre-exam anxiety syndrome. Objective: To assess the therapeutic effect of wrist-ankle acupuncture on pre-exam anxiety syndrome. Design, setting, participants and interventions: A total of 60 students who met the inclusion criteria of pre-exam anxiety syndrome were enrolled from a university in Shanghai and they were randomly divided into treatment group and control group. There were 30 cases in each group, and no case failed to follow-up. In the treatment group, wrist-ankle acupuncture was adopted to point upper 1 bilaterally (impression between flexor carpi ulnaris tendon and ulnar margin), and there was no requirement for Deqi (arrival of qi). In the control group, sham acupuncture was adopted. The treatment was applied 3 times totally in both groups one week before the exam, once every other day, each time with the needles retained for 30 min. Main outcome measures: The therapeutic effects were compared between two groups. Before and after 3 treatments, Sarason Test Anxiety Scale (TAS) and Expectation and Treatment Credibility Scale (ETCS) were measured and evaluated. Results: The therapeutic effect experienced by the treatment group was better than that of the control group (P<0.05). There were no statistically significant differences in TAS and ETCS before treatment between the two groups. The scores of TAS after treatment in two groups were higher than those before treatment (P<0.05, P<0.01). There were statistical differences in TAS absolute difference and TAS relative difference between the two groups and the treatment group had better results (P<0.05, P<0.01). After treatment, patients in the treatment group had higher scores in ETCS than those in the control group (P<0.05, P<0.01). No adverse reaction was reported. Conclusion: Wrist-ankle acupuncture can relieve the symptoms of pre-exam anxiety syndrome significantly, and this therapy is highly safe.

【Objective】To observe the effect of Ma Xing Shi Gan Decoction(MXSGD)on metabolism of oxygen free radicals in mice with bronchial asthma.【Methods】Forty BALB/c mice were randomized into 4 groups:normal group,model group,low-dose MXSGD group(20?g?kg~(-1)?d~(-1))and high-dose MXSGD group (80?g?kg~(-1)?d~(-1)).Except the normal group,the mice in other 3 groups received sensitization by intraperitoneal injection of ovalbumin(OVA)and challenge by inhalation of OVA to induce bronchial asthma.Meanwhile,MXSGD groups were given the corresponding doses according to the experimental design by gastric gavage,and normal group and model group received the same volume of normal saline for 27 days.Twelve-four hours after last challenge,blood sample was taken and homogenate of lung tissue was prepared for the detection of superoxide dismutase(SOD),malondialdehyde(MDA)and glutathione peroxidase(GSH-Px)contents in the plasma and the lung tissue.【Results】High-and low-dose MXSGD increased SOD and GSH-Px contents and decrease MDA content in the lung tissue and plasma(P

Objective To report the treatment outcomes and repair methods for soft tissue defects at thumb using miniature flaps. Methods Six different kinds of surgical flaps were used for the repair on different thumb injuries. They were radial lateral thumb reverse island flap, dorsal ulnar thumb revers flap, first metacarpal dorsal reverse flap, first digital dorsal island flap, neurovessel pedicled V-Y advanced island flap, free nail flap first foot digital, and so on. The emergency repair using miniature flaps were studied on 132 different cases, all 137 flaps. Results The flaps survived expect 5 flaps had partial epidermis necorsis in the 137 flaps. But the 5 flaps survived too after disinfecting and changing dressing. The appearances and functions of thumbs were satisfactory for the 1 to 2 years post-operation follow-up. Conclusion It will gain better results if choosing appropriate emergency repair methods using miniature flaps on different cases.

[Objective] To observe the effect of Puji Xiaodu Decoction (PXD) on immune function in mice. [Methods] Thirty NIH mice were randomized into three groups. Group A was treated with normal saline, group B with 2.9 g/kg PXD and group C with 11.6 g/kg PXD for 7 days. After treatment, interleukin 2 (IL-2) production and natural killer cell (NK) activity in splenocytes and lymphocyte proliferation in the spleen were detected. [Results] PXD increased the NK activity and IL-2 production, and promoted the proliferation of splenic lymphocyte, the difference being significant as compared with group A ( P