OBJECTIVE To conduct a clinical comprehensive evaluation of five marketed thrombopoietin receptor agonists （TPO-RA） approved in China， providing quantitative evidence for drug selection and therapeutic decision-making in medical institutions. METHODS Relevant data on Romiplostim for injection， Eltrombopag olamine tablets， Herombopag olamine tablets， Avatrombopag maleate tablets， and Lusutrombopag tablets were collected. Based on the Chinese Rapid Guide for Drug Evaluation and Selection in Medical Institutions （Second Edition）， 12 formulations of these five TPO-RA were scored quantitatively and comparatively across five dimensions： pharmacological characteristics， efficacy， safety， cost-effectiveness， and other attributes. RESULTS The comprehensive scores of the 12 formulations ranged from 62.56 to 75.50 points， with most scoring ≥70 points. Using the highest-scoring formulation for each generic name as a representative， the overall rankings of the five TPO-RA were as follows： Lusutrombopag tablets （75.50 points）， Eltrombopag olamine tablets （75.10 points）， Avatrombopag maleate tablets （70.40 points）， Romiplostim for injection （63.93 points）， and Herombopag olamine tablets （63.52 points）. Lusutrombopag tablets scored relatively high in pharmacological characteristics， safety， and cost-effectiveness， while Eltrombopag olamine tablets performed well in efficacy and cost-effectiveness. The other formulations showed varying scores across evaluation dimensions. CONCLUSIONS The five TPO-RA demonstrate favorable overall clinical value， with Lusutrombopag tablets and Eltrombopag olamine tablets ranking higher in comprehensive scores， these two drugs should be prioritized in drug selection and formula optimization by medical institutions.

Objective To assess the current status of microbial and parasitic quality control for laboratory animals in Jiangxi Province by analyzing microbiological and parasitic test results from production facilities between 2020 and 2024, and to provide a basis for enhancing quality control measures. MethodsIn accordance with the current national standards for laboratory animals at the time of testing, the Jiangxi Provincial Laboratory Animal Quality Inspection Station (affiliated to Institute of Occupational Medicine of Jiangxi) conducted microbial and parasitic testing on 451 laboratory animals of 4 species from 6 laboratory animal production units in Jiangxi Province between 2020 and 2024, and analyzed the quality status of laboratory animals in the province. ResultsPasteurella pneumotropica was detected in one mouse sample in 2020, with a detection rate of 5.00%. Pseudomonas aeruginosa was detected in one mouse sample and mouse hepatitis virus antibody was detected in another mouse sample in 2023, with a detection rate of 2.78%, respectively. No microorganisms or parasites that should be excluded from SPF grade mice as specified in the national standards were detected in 2021, 2022, or 2024, with a qualification rate of 100.00%. Pasteurella pneumotropica was detected in four rat samples in 2020, with a detection rate of 20.00%. Pseudomonas aeruginosa was detected in two rat samples in 2021, with a detection rate of 10.00%, and Tyzzer's disease agent antibody was detected in four rat samples in 2024, with a detection rate of 10.00%. No microorganisms or parasites that should be excluded from SPF grade rats as specified in the national standards were detected in 2022 or 2023, with a qualification rate of 100.00%. For rabbits and guinea pigs, no microorganisms or parasites required to be tested for conventional grade rabbits and guinea pigs as specified in the national standards were detected from 2020 to 2024, with the qualification rate of both species reaching 100.00%. ConclusionBased on the microbial and parasitic testing results, the quality of rabbits and guinea pigs in Jiangxi Province is satisfactory. However, some issues persist with rats and mice. It is recommended to enhance the quality of experimental animals in Jiangxi Province by increasing the frequency of random inspections by quality testing units or by improving the self-inspection capabilities of production and user facilities.

Epilepsy is a chronic neurological disease characterized by abnormal synchronous discharges of brain neurons. The mutation of GRIN1， a key gene encoding the essential GluN1 subunit of N-methyl-D-aspartate （NMDA） receptors， is closely associated with the pathogenesis and progression of epilepsy. This review summarizes research advances in GRIN1 mutation-related epilepsy， with a focus on its molecular mechanisms， clinical phenotypes， factors influencing phenotypic heterogeneity， and treatment strategies. In terms of molecular mechanisms， GRIN1 mutations affect NMDA receptor function through gain-of-function and loss-of-function mechanisms. Clinical phenotypes show significant heterogeneity， including seizure types， age of onset， and comorbid neurodevelopmental disorders. This heterogeneity may be related to the domain where the mutation is located， the mutation type， and the degree of impact on receptor function. Regarding treatment， gain-of-function mutations can be managed with NMDA receptor antagonists， while loss-of-function mutations may be treated with positive allosteric modulators. The ketogenic diet has also demonstrated potential therapeutic effects. This review aims to provide references for basic research and clinical translation in GRIN1 mutation-related epilepsy， and to promote the development of precision diagnosis and treatment.

Objective:To analyze the etiological composition and clinical characteristics of infant hypertension，and provide reference for its diagnosis and treatment.Methods:This is a retrospective case-control study.Retrospective investigation and analysis were conducted on the clinical data of infants discharged from Beijing Children's Hospital Affiliated to Capital Medical University with a diagnosis of "hypertension" from June 1，2016 to September 30，2021，including clinical manifestations，auxiliary examinations，treatment plans，and prognosis.Results:A total of 74 eligible children were collected，including 42 male infants（56.8%）and 32 female infants（43.2%）.A total of 67 cases（90.5%）had clear secondary factors，including 35 cases of kidney disease（47.3%），12 cases of connective tissue disease（16.2%），and 9 cases of hematological tumor disease（12.2%）.At the beginning of the disease，cardiac ultrasound showed that 54 cases（73.0%）had ventricular wall thickening，including mild thickening in 31 cases（57.4%），moderate thickening in 11 cases（20.3%），and severe thickening in 12 cases（22.2%）.After grouping by etiology，the incidence of proteinuria and severe hypertension in the renal hypertension group，as well as those receiving multiple antihypertensive drugs，was significantly higher than that in the non-renal hypertension group（ χ 2=28.493， P<0.001； χ 2=17.283， P<0.001； χ 2=17.358， P<0.001）；Renal disease was risk factor for severe hypertension in infants according to univariate and multivariate logistic regression analysis respectively（ OR=11.176，95% CI：2.882~43.339， P<0.001； OR=11.669，95% CI：2.921~46.624， P<0.001）.Thirty-one children had follow-up records for 6 months or more，and 13（41.9%）still required antihypertensive treatment，of whom 26（83.9%）were no longer recorded as having elevated blood pressure. Conclusion:Infant hypertension is mainly secondary，with a high proportion of renal factors and predisposition to severe hypertension，which requires multiple antihypertensive drugs for control.Active antihypertensive treatment and removal of secondary factors during the acute phase are helpful for controlling hypertension in infants，but further research is needed on treatment options and long-term prognosis.

Objective:To explore the medication thinking and compatibility rules of TCM for the treatment of diabetic nephropathy (DN).Methods:Relevant journal literature of TCM for the treatment of DN was retrieved from CNKI, Wanfang Data, VIP, and CBM from January 1, 2000 to December 31, 2023, and a database was established through Excel 2016. Python 3.10 and the ancient and modern medical record cloud platform 2.3.5 were used to conduct Latent Dirichlet Allocation (LDA) topic modeling and association rule analysis to explore the thinking and compatibility rules of TCM prescriptions in the literature.Results:A total of 474 articles were included in the study, including 474 prescriptions, involving 260 kinds of Chinese materia medica, of which 40 kinds of Chinese materia medica with a frequency of ≥ 30, mainly Astragali Radix, Salviae Miltiorrhizae Radix et Rhizoma, Dioscoreae Rhizoma, Poria, and Corni Fructus, etc. The LDA topic model identified three groups of prescriptions, including four classic prescriptions: Liuwei Dihuang Pills, Taohong Siwu Decoction, Erzhi Pills, and Wuling Powder. The commonly used drug combinations extracted by association rules were: Rhizoma Alismatis - Poria, Cortex Moutan Radicis-Fructus Corni and Cortex Moutan Radicis - Rhizoma Dioscoreae.Conclusions:The main therapeutic principle of TCM in treating DN is to nourish the yin and tonify the kidney, supplemented by drugs that promoting blood circulation for removing blood stasis as well as promoting urination and draining dampness. In clinical application, modern doctors tend to use classic prescriptions such as Liuwei Dihuang Pills, Erzhi Pills, Taohong Siwu Decoction, and Wuling Powder as the basis, and modify them according to the specific conditions of patients. The LDA topic model can extract valuable prescription information from a large number of modern TCM literature, providing new perspectives and ideas for the study of clinical medication rules in TCM.

The clinical data of a child with WAGR syndrome combined with end-stage renal disease admitted to the Department of Nephrology, Beijing Children′s Hospital, Capital Medical University in April 2023 was retrospectively analyzed.After a review of domestic and foreign literatures, the long-term renal function of children with WAGR syndrome was summarized.A boy, aged 11 years and 11 months, presented with a poor appetite as the initial symptom, and had markedly elevated creatinine and an estimated glomerular filtration rate of 14.96 mL/(min·1.73m 2).The inquiry about the medical history showed that the child was born with aniridia, had a history of nephroblastoma, and was mentally retarded.Gene sequencing revealed a copy number deletion of approximately 5.38 Mb in the short arm of chromosome 11, 11p14.2p13, which led to the diagnosis of WAGR syndrome.There is currently no cure for WAGR syndrome, while the detection rate of the disease has further increased with an improved understanding of the disease and extensive use of genetic testing.However, there is a lack of data on long-term renal function in children with WAGR syndrome in China.This report is the first instance of a child with WAGR syndrome progressing to end-stage renal failure in China, highlighting the significance of early identification and prompt molecular diagnosis of suspected WAGR syndrome in infancy and childhood and the importance of monitoring renal function and metabolism index of the diagnosed child from prepuberty to adulthood.In addition, the life-cycle management of children with WAGR syndrome is suggested.

Onconephrology is a new subject field that has emerged in the past decade.On the one hand, tumors can cause renal injury.On the other hand, as the research on the pathogenesis of tumors has brought unprecedented progress in tumor treatment, more treatment-related renal damage has occurred.Tumor-associated acute kidney injury is common in pediatrics.Therefore, early diagnosis and treatment are crucial for the protection and prognosis of kidney in children.This article reviews the epidemiological characteristics of pediatric cancer and the concept and pathogenesis of tumor-associated renal injury, so as to better promote the development of the field of pediatric onconephrology.

Objective This paper aims to investigate and analyze the baseline conformity rate of bacterial culture exami-nation records in a tertiary specialized hospital.By doing this,this paper seeks to understand the current situation of medical re-cord writing of bacterial culture examination and explore the improvement path and relevant measures for enhancing the conformity rate of bacterial culture examination records.Methods According to the requirements of"Quality Control Index of Medical Re-cord Management(2021 Edition)",a retrospective analysis was conducted on 6 317 medical records that underwent bacterial culture examination in 2022.Results The execution rate of medical orders was 100.00％,the completeness rate of the report sheet was 100.00％,the record rate of medical records was 81.05％,the analysis rate of results was 33.07％,and the conformi-ty rate of bacterial culture examination records was 33.07％.Conclusion It is imperative to enhance the conformity rate of bac-terial culture examination records and improve the quality of medical records in terms of content.

Objective:To observe the efficacy of vitrectomy combined with subretinal injection of tissue plasminogen activator (t-PA) in the treatment of macular hemorrhage (SMH).Method:An observational case series study was performed.Twelve eyes of 12 SMH patients diagnosed in Tianjin Medical University Eye Hospital were included from February 2022 to November 2022, including 11 eyes of polypoid choroidal vascular disease (PCV) and 1 eye of retinal artery aneurysm.There were 5 males and 7 females, aged 56 to 78 years old, with an average age of (65.67±8.09) years.Two eyes had intraocular lenses and 10 eyes were with cataracts.Nine cases had hypertension and 2 cases had diabetes.The duration of SMH was 2 to 25 days, with an average of (14.67±8.03) days.Vitrectomy combined with subretinal injection of t-PA was performed in the 12 eyes.All affected eyes underwent best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscopy, indirect ophthalmoscopy, optical coherence tomography (OCT), and ultra-wide-filed imaging examinations before and 1, 3, 6 months after surgery.The central retinal thickness (CRT) was examined using an OCT instrument.The postoperative ocular conditions and the occurrence of adverse effects were observed.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2022JS-05).Written informed consent was obtained from each patient before surgery.Results:The preoperative, 1-, 3-, and 6-month postoperative average BCVA (LogMAR) of the affected eye was 1.58±0.63, 1.12±0.49, 1.07±0.44, and 0.59±0.19, respectively, showing a statistically significant overall difference ( F=14.435, P<0.001).The BCVA at 6 months after surgery was significantly better than that before surgery ( P<0.001).The preoperative, 1-, 3-, and 6-month postoperative average CRT of the affected eye was (606.25±204.67), (379.83±92.05), (313.75±60.87), and (267.75±73.07)μm, respectively, showing a statistically significant overall difference ( F=27.720, P<0.001).The CRT at 1, 3, 6 months after surgery were significantly thinner than that before surgery (all at P<0.001).One eye had suprachoroidal hemorrhage 3 months after surgery, and 6 eyes received intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs due to recurrent PCV during follow-up, with a total of 16 injections.The average number of anti-VEGF injections at 1, 3, and 6 months after surgery was (0.3±0.5), (1.3±1.4), and (2.7±2.0) times, respectively. Conclusions:In the treatment of SMH, vitrectomy combined with subretinal injection of t-PA can improve BCVA, reduce CRT, reduce retinal damage from blood clots, and promote early postoperative visual recovery.It is a safe and effective surgical procedure.