OBJECTIVE To establish management index system for rational drug use of key monitoring drugs， and provide reference for the management of key monitoring drugs in the hospitals. METHODS First， the management index system for rational drug use of key monitoring drugs was drafted by collecting the evidence from related medical literature. Next， using a modified Delphi method， twenty experienced experts from the fields of pharmacy， medical practice， healthcare insurance， and finance were selected to participate in two rounds of questionnaire consultations. Based on the expert enthusiasm coefficient， authority coefficient， degree of opinion concentration， and degree of coordination， the final indicators were determined to establish a management index system for rational drug use of key monitored drugs in medical institutions. RESULTS The expert enthusiasm coefficients reached 100% in both rounds of consultation. In first-level， second-level and third-level indicators， the authority coefficients of experts were 0.89， 0.86 and 0.87， and coordination coefficients of the experts in importance score were 0.300 （P＜ 0.05）， 0.125 （P＜0.05） and 0.139 （P＜0.05）， respectively. The average score for the importance of all indicators reached over 3.5， in which the full score ratio ranged from 35% to 100%. Except that the variation coefficient of a third-level indicator “number of specifications purchased for key monitored drugs” was 0.26， the variation coefficients of rest indicators were less than or equal to 0.25. Based on the results of expert consultation， final version of the management index system established in this study， including two first-level indicators （drug procurement and use， and rational drug use）， five second-level indicators （such as the accessibility， cost-effectiveness） and twenty third-level indicators （such as the number of specifications purchased for key monitored drugs， the increase in the cost of key monitored drugs）. CONCLUSIONS The management index system established in this study possesses high reliability and strong operability， and may provide a reference for the management of key monitoring drugs in the hospitals.

Alzheimer's disease (AD) is a common neurodegenerative disorder among the elderly, and BuChE has emerged as a potential therapeutic target. In this study, we reported the development of compound 8e, a selective reversible BuChE inhibitor (eqBuChE IC₅₀ = 0.049 μmol/L, huBuChE IC₅₀ = 0.066 μmol/L), identified through extensive virtual screening and lead optimization. Compound 8e demonstrated favorable blood-brain barrier permeability, good drug-likeness property and pronounced neuroprotective efficacy. Additionally, 8e exhibited significant therapeutic effects in zebrafish AD models and scopolamine-induced cognitive impairments in mice. Further, 8e significantly improved cognitive function in APP/PS1 transgenic mice. Proteomics analysis demonstrated that 8e markedly elevated the expression levels of very low-density lipoprotein receptor (VLDLR), offering valuable insights into its potential modulation of the Reelin-mediated signaling pathway. Thus, compound 8e emerges as a novel and potent BuChE inhibitor for the treatment of AD, with significant implications for further exploration into its mechanisms of action and therapeutic applications.

Objective To explore the expression and diagnostic value of circulating microRNA(miR)-126-3p in non-small cell lung cancer(NSCLC).Methods Multi-centred miR chips and sequencing data were col-lected to investigate the differential expression of circulating miR-126-3p in NSCLC.In order to evaluate the comprehensive expression level of circulating miR-126-3p in the cycle,the standardized mean difference(SMD)and summary receiver operating characteristic(sROC)curve were calculated,and the area under curve(AUC)of sROC curve was analyzed.Sensitivity,specificity,positive negative likelihood ratio were ex-plored,and the expression of circulating miR-126-3p was further comprehensively analyzed in combination with tissue.By using miRDB,starBase v2.0,and TargetScan 7.1,combined with up-regulated differentially expressed genes in NSCLC,potential target genes of circulating miR-126-3p were screened using complemen-tary sequence method.Results Based on six circulating miR datasets,the expression level of circulating miR-126-3p was higher than that of the control group,and the difference was statistically significant(P＜0.05).The receiver operating characteristic curves showed that circulating miR-126-3p had strong diagnostic efficacy(AUC＞0.5),and the comprehensive expression of circulating miR-126-3p was lower in 199 cases of NSCLC group than in the control group(SMD=-1.46).The sROC curve showed that circulating miR-126-3p distin-guished the NSCLC group from the control group with high accuracy(AUC=0.91),Egger's test showed no publication bias(P＞0.05),with sensitivity and specificity 0.80,and positive likelihood ratio and negative likelihood ratio were 5.37 and 0.18,respectively.In addition,a comprehensive analysis of the circulation and tissue of 1 320 NSCLC samples from 26 datasets showed that circulating miR-126-3p expression was lower in NSCLC group than in the control group(SMD=-2.07).The sROC curve showed that low-expression circu-lating miR-126-3p had high accuracy in distinguishing between the NSCLC group and the control group(AUC=0.97).In addition,potential target genes ADAM9 and SLC7A5 were screened for circulating miR-126-3p,and their expression in NSCLC group was higher than that in the control group.Conclusion Low ex-pression of circulating miR-126-3p in the circulation may be an important biomarker for high-precision screen-ing of NSCLC.

Evaluating the consistency of herb injectable formulations could improve their product quality and clinical safety, particularly concerning the composition and content levels of trace ingredients. Panax notoginseng Saponins Injection (PNSI), widely used in China for treating acute cardiovascular diseases, contains low-abundance (10%-25%) and trace saponins in addition to its five main constituents (notoginsenoside R₁, ginsenoside Rg₁, ginsenoside Re, ginsenoside Rb₁, and ginsenoside Rd). This study aimed to establish a robust analytical method and assess the variability in trace saponin levels within PNSI from different vendors and formulation types. To achieve this, a liquid chromatography-triple quadrupole mass spectrometry (LC-MS/MS) method employing multiple ions monitoring (MIM) was developed. A "post-column valve switching" strategy was implemented to eliminate highly abundant peaks (NR₁, Rg₁, and Re) at 26 min. A total of 51 saponins in PNSI were quantified or relatively quantified using 18 saponin standards, with digoxin as the internal standard. This study evaluated 119 batches of PNSI from seven vendors, revealing significant variability in trace saponin levels among different vendors and formulation types. These findings highlight the importance of consistent content in low-abundance and trace saponins to ensure product control and clinical safety. Standardization of these ingredients is crucial for maintaining the quality and effectiveness of PNSI in treating acute cardiovascular diseases.
Ginsenosides ; Saponins ; Chemometrics ; Panax notoginseng ; Cardiovascular Diseases ; Chromatography, Liquid ; Tandem Mass Spectrometry

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism.Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects,who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acu-points,apart from conventional rehabilitation training 30 cases in each group.The cognitive function,developmental status,and parental quality of life before and after the treatment were compared between the two groups,and so were the language function and safety.Results There were no significant differences in the scores by Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS),adaptability scores,language scores,and individual-social interaction scores between the conventional group and the combination group before the treatment(P>0.05).After the treatment,the scores by ABC and CARS were significantly decreased in both groups,and the scores of the combination group were significantly lower than those in the conventional group(P<0.05);The adaptability scores,language,individual-social interaction scores were significantly increased in both groups,and the scores of the combined group were significantly higher than those of the conventional group(P<0.05).The abnormal rates of symbolic expression,language comprehension,action-oriented subjects,and language development delay in the combined group were all significantly lower than those in the conventional group(P<0.05).There was no significant difference in the scores by the QL-Index between the conventional group and the combined group before the treatment(P>0.05),but after the treatment,the QL-Index scores of the conventional group and the combination group were increased,and the score of the combination group was significantly higher than that of the conventional group(P<0.05).The results of blood routine,urine routine,stool routine,liver function,and kidney function in both groups were not significantly abnormal.There was one case of mild swelling and pain at the acupunctured site in the combination group,which was improved without intervention.Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function,cognitive function,and development of autis-tic children.In addition,it can enhance parental quality of life and have a high level of safety.

Chronic kidney disease (CKD) is a serious health problem worldwide, whereas there is still no efficient cure. The gut microbiota plays a crucial role in maintaining human health and disease resistance, and multiple studies have confirmed that the gut microbiota is closely related to the occurrence and development of CKD. Starting from the "gut-kidney axis" theory, this article provides a systematic review of the changes in gut microbiota composition and function in patients with CKD, such as a decrease in the abundance of butyrate-producing bacteria Roseburia and Faecalibacterium prausnitzii. Besides that, the article explores the mechanisms by which the gut microbiota affects CKD progression, such as inflammation and immunity, and also describes the application methods of using the gut microbiota as a therapeutic target for CKD, such as fecal microbiota transplantation, microecologics, and dietary therapy, in order to provide microbial- based targets for the clinical diagnosis and treatment of CKD.

Objective:To observe the effect of mechanical vibration on the expression of microRNA-214-3p and serum interleukin-1β (IL-1β) in the broken ends of fractured bones in ovariectomized rats.Methods:Thirty 3-month-old female Wistar rats were randomly divided into a control group, a model group, and a vibration group, each of 10. An operation of ovariotomy was performed in those of the model and vibration groups to establish osteoporosis model. Five months later a model of mid femur fracture was made with animals in all the groups. Five days after their fracture, the vibration group received 20 minutes of whole-body vibration treatment at 35Hz for 5 days a week, while the control group and the model group received natural rearing without any additional intervention At 2 and 6 weeks after the operation, the Lane-Sandhu X-ray scoring system was used to evaluate the quality of fracture healing, and reverse-transcription polymerase chain reactions and enzyme-linked immunosorbent assays were used to detect miR-214-3p in the fractured bones and the serum levels of IL-1β.Results:At 2 weeks and 6 weeks after the operation the average growth score of the broken ends in the model group was significantly lower than that of the control group, while that of the vibration group was significantly higher than the model group′s average. Compared with the control group at the same time point, the average miR-214-3p content of the model and vibration groups was significantly higher 2 and 6 weeks after the surgery. Compared with the model group, the average level of miR-214-3p of the fractured ends of the vibration group was significantly lower at 6 weeks. Two and six weeks after the surgery, the average IL-1β of the model group was significantly higher than the control group′s average, and that of the vibration group was significantly lower.Conclusion:Mechanical vibration can promote osteoporotic fracture healing by inhibiting the expression of miR-214-3p and reducing the level of IL-1β at the broken ends of fractured bones.

Objective:To explore the application of peritoneal dialysis routine examination in reducing the incidence of peritonitis associated with peritoneal dialysis.Methods:From July 2018 to June 2019, 191 patients with peritoneal dialysis who were followed up regularly in the nephrology department were selected as the study subjects.Using convenient sampling method, outpatient follow-up on Tuesday were selected as control group(95 cases) and fixed outpatient follow-up on Thursday were selected as observation group(96 cases). Routine follow-up was performed in the control group, and routine examination of peritonitis was performed in the observation group during the follow-up.Intervention was given immediately when the problems were found to the naked eye and the examination results were abnormal.The incidence of peritonitis in the two groups was compared.Results:Peritonitis occurred in 24 cases in the control group(25.26%), and 9 cases in the observation group(9.38%). The incidence of peritonitis in the observation group was lower than that in the control group, and the difference was statistically significant(χ 2=5.972, P<0.05). Conclusion:The occurrence of peritoneal dialysis-related peritonitis is related to a variety of factors.Paying attention to the routine examination of peritonitis and observing the color of peritonitis, strengthening the aseptic fluid exchange operation, and following up the patients can effectively reduce the occurrence of peritonitis and improve the quality of dialysis.

Objective:To investigate the significance of plasma pentraxin 3 (PTX3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods:Plasma PTX3 levels were tested by ELISA in 48 newly diagnosed sHLH patients, 18 healthy volunteers and 9 lymphoma controls in the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2019. Clinical parameters were collected, and the correlations with PTX3 levels were analyzed.Results:PTX3 level in newly diagnosed group was significantly higher than that of healthy control group [16.29(1.17-66.00) vs. 0.76(0.01-7.86) μg/L, P<0.01]. Patients with lymphoma-associated HLH(LHLH) had higher plasma level of PTX3 than Fhose with infection-associated HLH (IHLH) [24.29(3.36-66.00) vs. 9.56(1.17-36.50)μg/L, P<0.05]. Plasma PTX3 levels in 48 sHLH patients were positively correlated with serum ferritin ( P<0.05). Receiver operating characteristic (ROC) curve for plasma PTX3 levels of sHLH and healthy controls produced a cutoff value at 3.9 μg/L, with its 86.7% sensitivity and 94.4% specificity. And ROC analysis showed that PTX3 17.5 μg/L was the critical value for diagnosis of LHLH from non-LHLH group, that the sensitivity and specificity were 63.0% and 76.2% respectively. The 1-year overall survival (OS) rate in patients with PTX3≥17.5 μg/L was significantly lower in those with PTX3<17.5 μg/L (18.5% vs. 75.8%, P<0.01). Conclusion:These results indicate the potential of PTX3 as a biomarker for diagnosis and prognosis in patients with sHLH.

OBJECTIVE：To study the e ffects of stilbene glycoside c（TSG）on phosphorylation of Thr 205，Ser404 sites of Tau protein in Aizheimer ’s disease （AD）model mice ，and to investigate the potential anti-AD mechanism of TSG. METHODS ：APP/ PS1/Tau three transgenes （3×Tg-AD）mice were randomly divided into model group ，positive control group （huperzine，0.15 mg/kg），TSG low-dose ，medium-dose and high-dose groups （0.033，0.1，0.3 g/kg），with 6 mice in each group. In addition ，6 C57BL/6J mice were chosen as normal control group. Administration groups were given relevant medicine intragastrically. Model group and normal control group were given equal volume of normal saline intragastrically ，once a day ，for consecutive 60 days. After last medication ，immunofluorescence staining was used to detect Tau protein and phosphorylated Tau protein （Thr205， Ser404 sites） distribution and expression in brain tissue of mice in each group. Western blotting assay was used to detect phosphorylated Tau protein （Thr205，Ser404 sites）expression level in brain tissue of mice in each group. RESULTS ：Compared with normal control group ，the expression of Tau protein，phosphorylated Tau protein （Thr205，Ser404 sites）in 729011126@qq.com the brain tissue of mice were increased in model group ，which were easy to aggregate and distributed more widely ；theirrelative expression were increased significantly （P＜0.01）. Results of Western blotting assay showed that the expression levels of phosphorylat ed Tau protein （Thr205，Ser404 sites）were increased significantly （P＜0.01）. Compared with model group ，the expression of Tau protein ，phosphorylated Tau protein （Thr205，Ser404 sites） in the brain tissue of mice were decreased in positive control group and TSG groups ；aggregation decreased，distribution narrowed and their relative expression were decreased significantly （P＜0.01）. Results of Western blotting assay showed that the expression levels of phosphorylated Tau protein （Thr205，Ser404 sites）were decreased significantly （P＜ 0.01）. Compared with positive control group ，There was no significant difference in the distribution of Tau protein ，phosphorylated Tau protein （Thr205，Ser404 sites）in the brain tissue of mice in TSG groups ；the relative expression were not statistically significant（P＞0.05）；but Western blotting assay showed the expression levels of phosphorylated Tau protein （Thr205 site）in TSG medium-dose and high-dose groups as well as the expression levels of phosphorylated Tau protein （Ser404 site）in TSG groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：TSG can play an anti-AD effect on AD model mice by down-regulating the expression of phosphorylated Tau protein （Thr205，Ser404 sites）in brain tissue.