ObjectiveTo explore the regulatory effect of Ganluqingwen prescription on inflammation and immunity by observing the clinical efficacy of Ganluqingwen prescription in the treatment of community-acquired pneumonia （CAP）， so as to provide a clinical basis for the treatment of CAP by traditional Chinese medicine （TCM）. MethodsA randomized controlled trial was conducted by selecting patients who were diagnosed with CAP and identified as wind-heat attacking lungs in Xinjiang Uygur Autonomous Region Hospital of TCM from January 2024 to May 2024 and assigning the patients to a control group （treated by western medicine treatment） or an experimental group （treated by Ganluqingwen prescription combined with western medicine）. The data of the enrolled patients before treatment， for three-day treatment， for seven-day treatment， and for 14-day treatment were collected， including basic information， medical history， pneumonia severity index （PSI） classification， and distribution and difference of laboratory and imaging information indexes. The peripheral blood specimens were collected from the patients. and the changes of inflammatory factors in peripheral blood were detected by using enzyme-linked immunosorbent assay （ELISA） reagent kits and flow-type multifactor microarrays to evaluate the clinical safety and efficacy of Ganluqingwen prescription in CAP. ResultsCompared with those in the groups before treatment， the total scores of TCM syndromes significantly decreased in both groups （P<0.05）. Compared with those in the control group after treatment， the total scores of TCM syndromes decreased more significantly in the experimental group （P<0.05）. Compared with the control group after treatment， the experimental group displayed a significantly reduced number of days of fever in patients （P<0.05）. Compared with those in the groups before treatment， the leukocyte， neutrophil counts， C-reactive protein （CRP）， procalcitonin （PCT）， interleukin （IL）-6， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， creatinine （Cr）， creatine kinase （CK）， and creatine kinase isoenzymes （CK-MB） in both groups decreased （P<0.05） after treatment. Compared with that in the control group after treatment， the decrease of leukocyte， neutrophil counts， CRP， PCT， IL-6， ALT， AST， Cr， CK， and CK-MB was more pronounced in the experimental group （P<0.05）. Compared with those in the group before treatment， the partial pressure of carbon dioxide increased in the experimental group for 3 d of treatment （P<0.05）， and the standard alkali residual， actual alkali residual， standard bicarbonate concentration， and actual bicarbonate concentration increased in the experimental group for 7 d of treatment （P<0.05）. Compared with that in the group before treatment， D-dimer decreased in the control group for 7 d of treatment （P<0.05）. D-dimer and activated partial thromboplastin time （APTT） decreased in the experimental group for 3 d of treatment （P<0.05）， and D-dimer， fibrinogen （FIB）， and APTI significantly decreased in the group for 7 d of treatment （P<0.05）. Compared with the group for 3 d of treatment， the experimental group for 7 d of treatment showed decreased FIB （P<0.05）. Compared with those in the groups before treatment， the levels of inflammatory factors IL-4， IL-10， and IL-13 were elevated in the peripheral blood of the two groups after treatment， and the levels of B lymphocyte chemoattractant （BLC）， interferon gamma-induced protein 10 （IP-10）， tumor necrosis factor-alpha （TNF-α）， interferon-gamma （IFN-γ）， monocyte chemoattractant protein-1 （MCP-1）， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 were significantly reduced （P<0.01）. Compared with the control group after treatment， the experimental group exhibited more significant improvement in indexes above （P<0.01）. ConclusionThe group treated by Ganluqingwen prescription combined with western medicine shows more significant effects on reducing total scores of TCM syndromes， lowering the ability of leukocyte and neutrophil counts， decreasing BLC， IP-10， TNF-α， IFN-γ， MCP-1， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 in the peripheral blood of the patients， and elevating levels of IL-4， IL-10， and IL-13 than the group treated by western drugs alone.

ObjectiveTo explore the regulatory effect of Ganluqingwen prescription on inflammation and immunity by observing the clinical efficacy of Ganluqingwen prescription in the treatment of community-acquired pneumonia （CAP）， so as to provide a clinical basis for the treatment of CAP by traditional Chinese medicine （TCM）. MethodsA randomized controlled trial was conducted by selecting patients who were diagnosed with CAP and identified as wind-heat attacking lungs in Xinjiang Uygur Autonomous Region Hospital of TCM from January 2024 to May 2024 and assigning the patients to a control group （treated by western medicine treatment） or an experimental group （treated by Ganluqingwen prescription combined with western medicine）. The data of the enrolled patients before treatment， for three-day treatment， for seven-day treatment， and for 14-day treatment were collected， including basic information， medical history， pneumonia severity index （PSI） classification， and distribution and difference of laboratory and imaging information indexes. The peripheral blood specimens were collected from the patients. and the changes of inflammatory factors in peripheral blood were detected by using enzyme-linked immunosorbent assay （ELISA） reagent kits and flow-type multifactor microarrays to evaluate the clinical safety and efficacy of Ganluqingwen prescription in CAP. ResultsCompared with those in the groups before treatment， the total scores of TCM syndromes significantly decreased in both groups （P<0.05）. Compared with those in the control group after treatment， the total scores of TCM syndromes decreased more significantly in the experimental group （P<0.05）. Compared with the control group after treatment， the experimental group displayed a significantly reduced number of days of fever in patients （P<0.05）. Compared with those in the groups before treatment， the leukocyte， neutrophil counts， C-reactive protein （CRP）， procalcitonin （PCT）， interleukin （IL）-6， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， creatinine （Cr）， creatine kinase （CK）， and creatine kinase isoenzymes （CK-MB） in both groups decreased （P<0.05） after treatment. Compared with that in the control group after treatment， the decrease of leukocyte， neutrophil counts， CRP， PCT， IL-6， ALT， AST， Cr， CK， and CK-MB was more pronounced in the experimental group （P<0.05）. Compared with those in the group before treatment， the partial pressure of carbon dioxide increased in the experimental group for 3 d of treatment （P<0.05）， and the standard alkali residual， actual alkali residual， standard bicarbonate concentration， and actual bicarbonate concentration increased in the experimental group for 7 d of treatment （P<0.05）. Compared with that in the group before treatment， D-dimer decreased in the control group for 7 d of treatment （P<0.05）. D-dimer and activated partial thromboplastin time （APTT） decreased in the experimental group for 3 d of treatment （P<0.05）， and D-dimer， fibrinogen （FIB）， and APTI significantly decreased in the group for 7 d of treatment （P<0.05）. Compared with the group for 3 d of treatment， the experimental group for 7 d of treatment showed decreased FIB （P<0.05）. Compared with those in the groups before treatment， the levels of inflammatory factors IL-4， IL-10， and IL-13 were elevated in the peripheral blood of the two groups after treatment， and the levels of B lymphocyte chemoattractant （BLC）， interferon gamma-induced protein 10 （IP-10）， tumor necrosis factor-alpha （TNF-α）， interferon-gamma （IFN-γ）， monocyte chemoattractant protein-1 （MCP-1）， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 were significantly reduced （P<0.01）. Compared with the control group after treatment， the experimental group exhibited more significant improvement in indexes above （P<0.01）. ConclusionThe group treated by Ganluqingwen prescription combined with western medicine shows more significant effects on reducing total scores of TCM syndromes， lowering the ability of leukocyte and neutrophil counts， decreasing BLC， IP-10， TNF-α， IFN-γ， MCP-1， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 in the peripheral blood of the patients， and elevating levels of IL-4， IL-10， and IL-13 than the group treated by western drugs alone.

Objective To analyze the occurrence and clinical characteristics of bleeding adverse reactions induced by apixaban,and to provide reference for clinical therapy.Methods From the marking of apixaban to May 2024,cases of adverse reactions to hemorrhage caused by apixaban were searched in the database of CNKI,Wanfang,VIP,PubMed and Web of Science.Statistical analysis was performed on the collected data.Results A total of thirty-nine cases of hemorrhagic adverse reactions induced by apixaban were documented.Therewere thirty-three patients(84.62%)over 60 years old.Twenty-two patients had bleeding within 30 days of treatment(56.41%).Intracranial hemorrhage occurred in nine patients(23.08%).Twenty-two patients improved after conventional treatment(56.41%).Twenty-three patients(58.97%)stopped bleeding within 30 days,and two patients(5.13%)died,all of whom died within 1 month after taking apixaban.Conclusions Physician and pharmacists should pay close attention to the adverse reactions of hemorrhage caused by apixaban,and do a good job in drug monitoring and patient education to ensure the safety of clinical medication.

Objective To address the issue of information silos in inpatient pharmaceutical logistics,and to achieve real-time monitoring of hospital-wide pharmaceutical logistics,thereby reducing labor and time costs.Methods This study utilized the Hospital Information System(HIS)and barcode scanning technology to record and upload pharmaceutical logistics information.A questionnaire survey method was employed to collect data on clinical department satisfaction,and the number of drug circulation consultation calls as research subjects.The study evaluated the inpatient pharmaceutical comprehensive tracking service platform from the number of calls for drug circulation information and clinical department satisfaction.Results The inpatient pharmaceutical full-process tracking service platform allowed pharmacists and clinical departments to grasp pharmaceutical logistics information more.There was a significant decrease in the proportion of calls for drug circulation information to the pharmacy and pharmacy intravenous admixture service before and after the platform's implementation.The proportion of calls for drug circulation information was significantly reduced.Additionally,the satisfaction of clinical departments increased by 40.35％after the platform's implementation,indicating a significant improvement in satisfaction.Conclusion The inpatient pharmaceutical full-process tracking service platform(IPTP)has significantly enhanced the level of pharmaceutical informatization and raised the satisfaction rate of clinical departments.

This article reviews the progress of clinical research on abnormal sounds after ceramic-on-ceramic total hip arthroplasty, with a focus on analyzing the differences between the third-generation and fourth-generation ceramic prostheses. Abnormal sounds generally refer to high-pitched audible sounds (such as creaking, clicking, etc.) during hip joint movement after surgery, which are considered possible precursors to prosthesis fragmentation (for example, patients with abnormal sounds have more ceramic particles in the joint fluid, and some are accompanied by prosthesis fragmentation). The fundamental frequency of abnormal sounds in the third-generation ceramic prostheses ranges from 400 to 7 500 Hz (approximately 1 500 Hz in males and 2 500 Hz in females), while the acoustic characteristics of the fourth-generation ones remain unclear. The reported occurrence time of abnormal sounds varies significantly among different studies, with an average of 6.4 to 40 months after surgery. This variation may be influenced by patient characteristics, surgical technique, and prosthesis type. Abnormal sounds are considered a possible early indicator of prosthesis fragmentation; for instance, higher concentrations of ceramic particles have been detected in the synovial fluid of affected patients, and some cases have been accompanied by prosthesis fracture. The incidence of abnormal sounds with the fourth-generation prostheses ranges from 3.8% to 46.6% (with a follow-up period exceeding 10 years), while the third-generation shows rates of 0% to 19.7% with no difference between the two generations. Although the fourth-generation prostheses are superior to the third-generation in material toughness (flexural strength>1 380 MPa) and hardness, they still fail to solve the problem of abnormal sounds, and the incidence may increase with the extension of the follow-up time (for example, in some studies, the incidence at 10-year follow-up is higher than that at 5-year follow-up). Abnormal sounds are mostly associated with movements such as extreme flexion (e.g., squatting) and walking. Different sound properties (such as friction sound) correspond to specific inducing movements and locations, among which friction sound requires vigilance against the risk of prosthesis fragmentation. The risk factors include patient-related factors (height, weight, activity level, etc.), surgical factors (prosthesis position angle), and prosthesis-related factors (design, diameter, neck length, etc.). Proposed mechanisms include abnormal edge loading, stripe wear, femoral neck impingement, wear particle generation, and prosthesis mismatch. Adverse outcomes include decreased patient satisfaction with life, revision surgery (with an incidence of 0.2% to 4.65%), and prosthesis fragmentation. Currently, there are still controversies in research. Future studies need to focus on special patient groups, surgical techniques (such as robot-assisted surgery), and the optimization of prosthesis materials and designs (such as gradient structures and surface coatings) to reduce the incidence of abnormal sounds.

Cell death is a fundamental phenomenon for organisms to maintain their basic morphology.When a pathogen infects a cell,the process of programmed cell death is activated,the lysed cells carrying the pathogen ac-tivate the immune response of the organism in the process of removing infected cells,thus exerting immune de-fense.The molecular mechanisms of the 4 types of cell death modes apoptosis,pyroptosis,necroptosis and pan-apoptosis as well as their effects on innate immune defense against microbial infections were mainly elaborated in the article,the interactions among the different programmed cell death pathways were briefly interpreted so as to provide new ideas for further study of pathogenic mechanisms of infectious diseases.

Objective To preliminarily describe the current situation of chronic disease drug continuity between community hospitals and the Affiliated Hospital of Qingdao University in the medical alliance,to explore the key points for further improving the connection between upper and lower-level hospitals in the medical alliance,and to improve the drug supply guarantee and the ability of pharmaceutical services of primary medical institutions.Methods The nine community hospitals within the medical alliance centered on the Affiliated Hospital of Qingdao University were taken as the research subjects to investigate the medication continuity between the community hospitals and the core hospital in terms of cardiovascular diseases,diabetes,and respiratory system diseases before and after the medical alliance.Results Before the integration of medical alliances,the drug linkage rate for cardiovascular diseases,diabetes,and respiratory system diseases in community hospitals and core hospitals was relatively low.After the integration of medical alliances,the average drug linkage rate for the three chronic diseases significantly increased,all exceeding 60%.At the same time,the drug catalog in community hospitals was streamlined,reducing the phenomenon of one drug having multiple specifications.There is a significant difference in the number of drug varieties provided by different community hospitals for the three chronic diseases.Conclusion The medical alliance with the Affiliated Hospital of Qingdao University as the core promotes the up-down linkage of drug treatment in community hospitals,simplifies the drug catalog of primary medical structure,and facilitates the treatment and prescription of chronic patients.

Radiotherapy-induced late effects(RILE)or delayed reactions have significant impacts on patients'long-term quality of life.However,current understanding of their developmental mechanisms remains limited,with a lack of effective risk prediction models and preventive interventions.Radiobiological studies and radiation-induced senescence models have revealed that radiotherapy can alter the epigenetic characteristics in late-responding tissue cells,leading to derepression of retrotransposable elements(particularly endogenous retroviral elements),subsequent activation of cytoplasmic nucleic acid sensor systems(cGAS-STING,MDA5/RIG-I-MAVS)and type Ⅰ interferon-mediated immune-inflammatory responses.This review summarized relevant research findings,proposing that the autoimmune-like inflammatory response induced by the'radiotherapy-epigenetic alteration-retrotransposable element activation'cascade is an underinvestigated mechanistic basis in the development of RILE.Constructing risk prediction models for late effects based on epigenetic signatures,cell type,and radiation dose,along with developing strategies to epigenetically suppress retrotransposable element expression,holds promise for preventing or mitigating RILE.

Radiotherapy-induced late effects(RILE)or delayed reactions have significant impacts on patients'long-term quality of life.However,current understanding of their developmental mechanisms remains limited,with a lack of effective risk prediction models and preventive interventions.Radiobiological studies and radiation-induced senescence models have revealed that radiotherapy can alter the epigenetic characteristics in late-responding tissue cells,leading to derepression of retrotransposable elements(particularly endogenous retroviral elements),subsequent activation of cytoplasmic nucleic acid sensor systems(cGAS-STING,MDA5/RIG-I-MAVS)and type Ⅰ interferon-mediated immune-inflammatory responses.This review summarized relevant research findings,proposing that the autoimmune-like inflammatory response induced by the'radiotherapy-epigenetic alteration-retrotransposable element activation'cascade is an underinvestigated mechanistic basis in the development of RILE.Constructing risk prediction models for late effects based on epigenetic signatures,cell type,and radiation dose,along with developing strategies to epigenetically suppress retrotransposable element expression,holds promise for preventing or mitigating RILE.

Objective To evaluate the short-term outcomes of robot-assisted partial nephrectomy(RAPN)in the treatment of renal cell carcinoma(RCC)involving segmental renal vein invasion,and to summarize relevant diagnostic experience and surgical techniques.Methods A retrospective analysis was conducted on the clinicopathological data of 23 RCC patients who were found to have segmental renal vein invasion during RAPN at Sun Yat-sen University Cancer Center during 2022 and 2024.All procedures were performed by the same experienced urologic surgeon(＞1000 robotic cases).Preoperative computed tomography(CT)scans of all patients failed to reveal segmental renal vein invasion.Two experienced radiologists re-evaluated the imaging postoperatively.The clinical and pathological data of patients were analyzed to preliminarily explore the short-term efficacy,imaging,intraoperative findings and pathological characteristics.Results All surgeries were completed successfully via the transperitoneal approach with renal preservation.The median operation time was 151.0(125.5,182.0)min,and median blood loss was 180.0(100.0,300.0)mL;2 patients(8.7％)required intraoperative transfusion;3(13.0％)experienced postoperative complications,all of which were minor(Clavien-Dindo grade 1-2).Postoperative pathology confirmed venous invasion in 2 patients.The diagnostic rates of segmental renal vein invasion by the two radiologists were 47.8％(11/23)and 21.7％(5/23),respectively,with concordance in only 3 cases.During a mean follow-up of 9.1 months,1 patient developed iliac lymph node metastasis without local recurrence 12.4 months after surgery.After reoperation to remove the metastatic focus,the patient was treated with Axitinib combined with Toripalimab and has survived to date.The remaining patients were followed up for an average of 8.9 months,with no recurrence or metastasis observed.Conclusion Preoperative detection of segmental renal vein invasion in RCC is challenging,and pathological confirmation is often inconsistent with intraoperative findings.For RCC patients with intraoperatively identified segmental renal vein invasion,RAPN performed by experienced surgeons is feasible and safe on the premise of ensuring complete tumor resection,with favorable short-term oncologic outcomes.Long-term results require further follow-up.