Aim To explore the mechanism of Yangxin decoction in the treatment of chronic heart failure(CHF)based on network pharmacology and animal ex-periments.Methods The database was used to screen Yangxin decoction,a network of"drug-compo-nent-disease-target"was established,and the obtained targets were enriched and analyzed.The CHF model of rats was replicated by abdominal aortic ligation.After the administration,the general condition,body weight and heart weight of the rats were observed,and the he-modynamic changes,echocardiography indicators and left ventricular mass index were measured.HE staining was used to observe the morphological changes of myo-cardial tissue.Serum IL-1 β,IL-18,TNF-α and BNP were detected by ELISA.The expressions of NLRP3,caspase-1,ASC and NF-κB p65 proteinswere detected by Western blot.Results Enrichment analysis showed that the potential regulatory pathways of Yangx-in decoction in the treatment of CHF involved NOD-like signaling pathway,NF-κB signaling pathway,etc.The results of animal experiments showed that the body weight,left ventricular diastolic diameter and left ven-tricular systolic diameter of the rats in the administra-tion group decreased(P＜0.05),the left ventricular mass index,ejection fraction and short axis narrowing rate increased(P＜0.05),the pathological morphology of myocardial tissue was reduced,and the levels of IL-1 β,IL-18,TNF-α,BNP,NLRP3,caspase-1,ASC and NF-κB p65 decreased(P＜0.05).Conclusions The mechanism of Yangxin decoction in the treatment of CHF rats may be related to inhibiting the activation of NLRP3 inflammasome signaling pathway and reduc-ing the inflammatory response.

Objective:To evaluate the cumulative live birth rate (CLBR) and cost-effectiveness of fixed versus adjusted follicle-stimulation hormone (FSH) dosages in infertile women with different ovarian responses during their first assisted reproductive technology (ART) cycle.Methods:A retrospective real-world cohort study was conducted on 5 419 infertile women who underwent their first ART treatment at the Department of Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2017. All patients received an individualized starting dosage of gonadotropin. Based on whether FSH dosages were adjusted during controlled ovarian stimulation (COS), patients were divided into fixed-dosage group ( n=2 061) and adjusted-dosage group ( n=3 358). Clinical outcomes and FSH cost-effectiveness were compared between the two groups across different ovarian response groups, with CLBR as the primary outcome. Propensity score matching (PSM) and multivariable logistic regression were used to adjust for potential confounders. Results:FSH dosage adjustments were found in 62.0% (3 358/5 419) of cycles during COS. After PSM, baseline characteristics were comparable between the two groups (all P>0.05). After adjusting for confounders using multivariable logistic regression, FSH dosage adjustment was not significantly associated with CLBR ( OR=1.06, 95% CI: 0.94-1.20, P=0.332). Compared with the adjusted-dosage group, the fixed-dosage group showed no significant differences in CLBR in poor-, normal-, and high-responder groups (all P>0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) did not differ significantly between the two groups ( P>0.05). In poor-, normal-, and high-responder groups, the total FSH dosages in the fixed-dose group [1 350 (375, 1 825) U, 1 200 (375, 1 500) U and 525 (375, 1 128) U, respectively] were significantly lower than those in the adjusted-dose group [1 875 (1 425, 2 294) U, P=0.001; 1 425 (450, 1 875) U, P<0.001; 600 (375, 1 425) U, P=0.020]. Similarly, average FSH costs in different ovarian response groups in the fixed-dosage group [4 725.0 (1 312.5, 6 387.5) yuan, 4 200.0 (1 312.5, 5 250.0) yuan and 1 837.5 (1 312.5, 3 947.3) yuan, respectively] were significantly lower than those in the adjusted-dosage group [6 562.5 (4 987.5, 8 028.1) yuan, P=0.001; 4 987.5 (1 575.0, 6 562.5) yuan, P<0.001; 2 100.0 (1 312.5, 4 987.5) yuan, P=0.020]. For normal-responders, the FSH cost per high-quality embryo in the fixed-dosage group [1 365.0 (875.0, 2 537.5) yuan] was significantly lower than that in the adjusted-dosage group [2 056.3 (1 268.8, 3 412.5) yuan, P<0.001]. Conclusion:FSH dosage adjustment during COS is not associated with CLBR or the incidence of OHSS. However, the fixed-dose group exhibited lower total FSH dosages and costs across different ovarian response populations. In the context of ART being covered by medical insurance, fixed FSH dosage may represent a more cost-effective ovarian stimulation protocol.

Objective:To investigate the efficacy and safety of hypofractionated radiotherapy combined with temozolomide and bevacizumab in the treatment of primary glioblastoma.Methods:A total of 48 patients who received radiotherapy in Chongqing University Cancer Hospital from Jan. 2020 to Dec. 2023 were enrolled. According to the principle of voluntary participation of patients,research group: hypofractionated radiotherapy+temozolomide+bevacizumab, control group: radiotherapy+temozolomide. The research group received bevacizumab at a dose of 7.5mg/kg, q2w, 1 week before radiotherapy. Hypofractionated radiotherapy (60Gy/20F) was administered with bevacizumab (7.5mg/kg, q2w) combined with temozolomide (75mg/m 2), D1-D42, once a day. Patients would rest for 4 weeks after radiotherapy, and be given bevacizumab (10mg/kg q3w) for 6 cycles until cancer progression and combined with temozolomide (150-200mg/m 2, d1-d5, q28) for 6 cycles. Control group: radiotherapy (60Gy/30F), combined with temozolomide (75mg/m 2) once a day, D1-D42. Patients would rest for 4 weeks after radiotherapy, and be given temozolomide (150-200mg/m 2, d1-d5, q28) for 6 cycles. Both groups were treated until the disease progression or intolerant toxicity. Clinical efficacy evaluation based on neurooncological response evaluation criteria. Results:The total response rate (ORR) in the control group and research group were 37.50% (9 cases/24 cases) and 54.17% (13 cases/24 cases) ; The disease control rate (DCR) ratio was 79.17% (19 cases/24 cases) and 91.67% (22 cases/24 cases) respectively. There were significant differences in ORR and DCR rates between the two groups (all P<0.05). The median OS of patients in the control group and research group were 12.4 months (95% CI: 5.8-9.6) and 18.2 months (95% CI: 8.2-12.4). The median PFS of patients in the control group and research group were 8.9 months (95% CI: 3.8-7.2) and 13.2 months (95% CI: 6.4-10.2). The differences between the two groups were statistically significant ( P<0.05). The incidence of adverse drug reactions in both group was 50.00%, with no statistically difference ( P>0.05) . Conclusion:The newly diagnosed glioblastoma treated with hypofractionated radiotherapy+temozolomide+bevacizumab showed significant advantages compared with conventional radiotherapy in PFS, OS, ORR and DCR.

Aim To explore the mechanism of Yangxin decoction in the treatment of chronic heart failure(CHF)based on network pharmacology and animal ex-periments.Methods The database was used to screen Yangxin decoction,a network of"drug-compo-nent-disease-target"was established,and the obtained targets were enriched and analyzed.The CHF model of rats was replicated by abdominal aortic ligation.After the administration,the general condition,body weight and heart weight of the rats were observed,and the he-modynamic changes,echocardiography indicators and left ventricular mass index were measured.HE staining was used to observe the morphological changes of myo-cardial tissue.Serum IL-1 β,IL-18,TNF-α and BNP were detected by ELISA.The expressions of NLRP3,caspase-1,ASC and NF-κB p65 proteinswere detected by Western blot.Results Enrichment analysis showed that the potential regulatory pathways of Yangx-in decoction in the treatment of CHF involved NOD-like signaling pathway,NF-κB signaling pathway,etc.The results of animal experiments showed that the body weight,left ventricular diastolic diameter and left ven-tricular systolic diameter of the rats in the administra-tion group decreased(P＜0.05),the left ventricular mass index,ejection fraction and short axis narrowing rate increased(P＜0.05),the pathological morphology of myocardial tissue was reduced,and the levels of IL-1 β,IL-18,TNF-α,BNP,NLRP3,caspase-1,ASC and NF-κB p65 decreased(P＜0.05).Conclusions The mechanism of Yangxin decoction in the treatment of CHF rats may be related to inhibiting the activation of NLRP3 inflammasome signaling pathway and reduc-ing the inflammatory response.

Objective:To evaluate the cumulative live birth rate (CLBR) and cost-effectiveness of fixed versus adjusted follicle-stimulation hormone (FSH) dosages in infertile women with different ovarian responses during their first assisted reproductive technology (ART) cycle.Methods:A retrospective real-world cohort study was conducted on 5 419 infertile women who underwent their first ART treatment at the Department of Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2017. All patients received an individualized starting dosage of gonadotropin. Based on whether FSH dosages were adjusted during controlled ovarian stimulation (COS), patients were divided into fixed-dosage group ( n=2 061) and adjusted-dosage group ( n=3 358). Clinical outcomes and FSH cost-effectiveness were compared between the two groups across different ovarian response groups, with CLBR as the primary outcome. Propensity score matching (PSM) and multivariable logistic regression were used to adjust for potential confounders. Results:FSH dosage adjustments were found in 62.0% (3 358/5 419) of cycles during COS. After PSM, baseline characteristics were comparable between the two groups (all P>0.05). After adjusting for confounders using multivariable logistic regression, FSH dosage adjustment was not significantly associated with CLBR ( OR=1.06, 95% CI: 0.94-1.20, P=0.332). Compared with the adjusted-dosage group, the fixed-dosage group showed no significant differences in CLBR in poor-, normal-, and high-responder groups (all P>0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) did not differ significantly between the two groups ( P>0.05). In poor-, normal-, and high-responder groups, the total FSH dosages in the fixed-dose group [1 350 (375, 1 825) U, 1 200 (375, 1 500) U and 525 (375, 1 128) U, respectively] were significantly lower than those in the adjusted-dose group [1 875 (1 425, 2 294) U, P=0.001; 1 425 (450, 1 875) U, P<0.001; 600 (375, 1 425) U, P=0.020]. Similarly, average FSH costs in different ovarian response groups in the fixed-dosage group [4 725.0 (1 312.5, 6 387.5) yuan, 4 200.0 (1 312.5, 5 250.0) yuan and 1 837.5 (1 312.5, 3 947.3) yuan, respectively] were significantly lower than those in the adjusted-dosage group [6 562.5 (4 987.5, 8 028.1) yuan, P=0.001; 4 987.5 (1 575.0, 6 562.5) yuan, P<0.001; 2 100.0 (1 312.5, 4 987.5) yuan, P=0.020]. For normal-responders, the FSH cost per high-quality embryo in the fixed-dosage group [1 365.0 (875.0, 2 537.5) yuan] was significantly lower than that in the adjusted-dosage group [2 056.3 (1 268.8, 3 412.5) yuan, P<0.001]. Conclusion:FSH dosage adjustment during COS is not associated with CLBR or the incidence of OHSS. However, the fixed-dose group exhibited lower total FSH dosages and costs across different ovarian response populations. In the context of ART being covered by medical insurance, fixed FSH dosage may represent a more cost-effective ovarian stimulation protocol.

Objective:To investigate the efficacy and safety of hypofractionated radiotherapy combined with temozolomide and bevacizumab in the treatment of primary glioblastoma.Methods:A total of 48 patients who received radiotherapy in Chongqing University Cancer Hospital from Jan. 2020 to Dec. 2023 were enrolled. According to the principle of voluntary participation of patients,research group: hypofractionated radiotherapy+temozolomide+bevacizumab, control group: radiotherapy+temozolomide. The research group received bevacizumab at a dose of 7.5mg/kg, q2w, 1 week before radiotherapy. Hypofractionated radiotherapy (60Gy/20F) was administered with bevacizumab (7.5mg/kg, q2w) combined with temozolomide (75mg/m 2), D1-D42, once a day. Patients would rest for 4 weeks after radiotherapy, and be given bevacizumab (10mg/kg q3w) for 6 cycles until cancer progression and combined with temozolomide (150-200mg/m 2, d1-d5, q28) for 6 cycles. Control group: radiotherapy (60Gy/30F), combined with temozolomide (75mg/m 2) once a day, D1-D42. Patients would rest for 4 weeks after radiotherapy, and be given temozolomide (150-200mg/m 2, d1-d5, q28) for 6 cycles. Both groups were treated until the disease progression or intolerant toxicity. Clinical efficacy evaluation based on neurooncological response evaluation criteria. Results:The total response rate (ORR) in the control group and research group were 37.50% (9 cases/24 cases) and 54.17% (13 cases/24 cases) ; The disease control rate (DCR) ratio was 79.17% (19 cases/24 cases) and 91.67% (22 cases/24 cases) respectively. There were significant differences in ORR and DCR rates between the two groups (all P<0.05). The median OS of patients in the control group and research group were 12.4 months (95% CI: 5.8-9.6) and 18.2 months (95% CI: 8.2-12.4). The median PFS of patients in the control group and research group were 8.9 months (95% CI: 3.8-7.2) and 13.2 months (95% CI: 6.4-10.2). The differences between the two groups were statistically significant ( P<0.05). The incidence of adverse drug reactions in both group was 50.00%, with no statistically difference ( P>0.05) . Conclusion:The newly diagnosed glioblastoma treated with hypofractionated radiotherapy+temozolomide+bevacizumab showed significant advantages compared with conventional radiotherapy in PFS, OS, ORR and DCR.

Objective:To analyze the association between standardized management of clinical research, initiated by investigators and guided by clinical research management policies in healthcare institutions, and changes in the research behavior of graduate students.Methods:Theses related to cardiovascular health published by graduate students in the Sichuan-Chongqing region of China between January 2019 and June 2024 were retrieved from the China National Knowledge Infrastructure database. Multilevel models were used to analyze changes in ethical compliance awareness, research methodology standardization, and academic collaboration of graduate students before and after policy implementation. Using Shapiro Wilk test and percentage representation.Results:Among the 712 theses included in this study, the proportion of studies with ethical review reports increased from 44.50% to 55.32% following the implementation of standardized management [odds ratio ( OR)=1.80, P=0.017]. Standardized management significantly improved the quality scores of cross-sectional studies and randomized controlled trials ( P<0.001), as well as significantly increased the frequencies of multi-center collaboration ( OR=2.84, P=0.001) and intra-provincial collaboration ( OR=2.80, P=0.001). Conclusions:Standardized clinical research management shows significant association with positive changes in the research behavior of graduate students. Further optimization of management measures is recommended to comprehensively enhance the clinical research capabilities of graduate students.

Aim To investigate the protective effect of Shengmai Yin on myocardial ischemia/reperfusion in-jury(MI/RI)in vitro and in vivo and to unravel the underlying mechanism.Methods SD rats were divid-ed into the sham group,model group,and Shengmai Yin group(SM).Rat MI/RI model was established.Cardiac function,infarct area,pathological changes,cardiomyocyte apoptosis,macrophage infiltration,and serum cTnT and CK-MB levels were measured.The mRNA and protein expressions of Calpain-1 and Cal-pain-2 were assessed.The hypoxia/reoxygenation(H/R)model was constructed in H9c2 cells.The active ingredients of Shengmai Yin were screened using net-work pharmacology and verified by CCK-8.In the car-diomyocytes H/R model,Fluo-4 AM staining was used to detect the changes of Ca2+levels.Results Com-pared with model group,LVEF and LVFS of Shengmai Yin-treated rats increased,myocardial infarction area was reduced,while myocardial tissue injury was allevi-ated.Myocardial apoptosis rate and the number of macrophages were reduced.Similarly,cTnT and CK-MB levels decreased.In addition,the expression lev-els of Calpain-1 and Calpain-2 mRNA and protein de-creased in the SM treatment group.Under the H/R model,all the active ingredients of Shengmai decoction had protective effects on cardiomyocytes,and the treat-ment could reduce the level of Ca2+in cardiomyocytes.Conclusions Shengmai Yin has protective effects on MI/RI in rats.This effect may be related to the de-crease in Ca2+levels,as well as Calpain-1 and Calap-in-2 mRNA and protein expression.

Objective:To explore the biodistribution characteristics of mixed activated killer (MAK) immune cells in immunodeficient mice after administration.Methods:Ninety-six immune immunodeficient (NOG) mice (half male and half female) were equally divided into MAK cell group and solvent control group. The MAK cell group mice were injected with DiR-labeled MAK cells via the tail vein, while those in the solvent control group were injected with an equal amount of solvent via the tail vein. The number of MAK cells in the peripheral blood of mice was detected using a flow cytometry at 11 time points from 15 minutes to 84 days after administration. The distribution of MAK cells in mice was measured using in vivo bioluminescence imaging at 18 time points from 5 minutes to 84 days after administration. And at 8 time points from 3 hours to 84 days after administration, the heart, liver, spleen, lungs, kidneys, brain, stomach, duodenum, colon, bone marrow, fat, skeletal muscle, testes/uterus, epididymis/ovary, and blood were collected from corresponding mice. The DNA levels of MAK cells in blood and various organs of these mice were detected using fluorescence real-time quantitative polymerase chain reaction (qPCR) method.Results:The flow cytometry results showed that MAK cells could be detected in the peripheral blood of mice 15 minutes after administration, and the highest number of MAK cells in blood appeared during 3 hours to 1 day. By 14 days after administration, MAK cells were almost undetectable in peripheral blood of mice. In vivo bioluminescence imaging results showed that the fluorescence intensity of MAK cells in mice was strongest on days 1 and 2 after administration, and MAK cells were mostly distributed in the liver, spleen, lung, and leg bone of mouse. The qPCR detection results showed that MAK cells were mainly distributed in the spleen and lungs. High levels of MAK cell DNA amplification were observed in organs such as the spleen and lungs 28-56 days after administration, and a certain amount of MAK cell DNA could still be detected in organs of mice such as the spleen at 84 days.Conclusions:After administration, MAK cells were mainly distributed in the spleen, lung, liver and other organs of NOG mice. From 28 to 56 days after administration, MAK cells are significantly activated and proliferate, and a certain amount of MAK cell DNA can still be detected in the spleen and other organs after 84 days in mice.

The Hazardous Drug Exposure Management: Information for Healthcare Settings (2023 Edition) released by the National Institute for Occupational Safety and Health (NIOSH) of US provided detailed protection recommendations for medical personnel to mitigate the risks of occupational exposure to hazardous drugs. This study reviewed the literature in terms of hazard identification, occupational exposure assessment, risk assessment, risk management planning, and waste and spill control. It also explored the precautions for each step of hazardous drug handling, aiming to raise medical personnel's awareness of hazardous drug protection and improve their self-protection skills. The findings provided valuable references for medical institutions to develop hazardous drug disposal plans and reduce employees' exposure to hazardous drugs and occupational injuries.