OBJECTIVE To provide reference for medical institutions to establish the record management mode and review rules of off-label use of 5-aminolevulinic acid （ALA） in photodynamic therapy based on the level of evidence. METHODS All ALA-containing outpatient prescriptions in the rational drug use system in our hospital from January 1， 2024 to December 31， 2025 were retrospectively collected. Based on the drug instructions， the current status of off-label use of ALA in photodynamic therapy was identified . The relevant studies in Micromedex， PubMed， CNKI， Wanfang Data and other databases were systematically searched as the relevant evidence-based evidence of ALA off-label use. According to the Off-label Drug Use Filing Standard of the hospital，the evidence-based evaluation method was used to evaluate the evidence-based evidence of ALA off-label use and carry out hierarchical management. RESULTS A total of 1 803 effective prescriptions were included， of which 676 （37.49%） were off-label use， distributed in the dermatology department （564 prescriptions，83.43%） and the plastic surgery department （112 prescriptions，16.57%）. All 676 prescriptions were off-indications medication， involving ten types of skin diseases， primarily including moderate to severe acne （39.94%）， skin warts （25.44%）， Bowen’s disease （11.98%）， and others. According to evidence-based evidence，off-label uses such as moderate to severe acne， actinic keratosis， and Bowen’s disease were managed according to the evidence categoryⅠ orⅡ.The uses of extramammary Paget’s disease and rosacea were managed according to the evidence category Ⅲ.The uses of lichen sclerosus and keloids were managed according to the evidence category Ⅳ.The results of evidence-based evaluation showed that 92.01% of off-label use in our hospital had high-level evidence-based support （ evidence category was gradeⅠ-Ⅱ）. CONCLUSIONS Off-label uses supported by high-level evidence， such as moderate to severe acne， skin warts， and Bowen’s disease， can be managed under filing category Ⅰ or Ⅱ. For the use of lichen sclerosus and keloids， evidence-based evidence is insufficient and should be strictly restricted.The vast majority of ALA off-label use in our hospital has sufficient evidence-based basis.

Objective To explore the value of three-dimensional automated right ventricular quantification(3D Auto RV)for predicting right ventricular function dysfunction in patients with severe aortic stenosis(AS).Methods Eighty severe AS patients were retrospectively enrolled.Based on right ventricular ejection fraction(RVEF)obtained with 3D Auto RV,the patients were classified into right ventricular compensation group(RVEF≥45%,compensation group,n=56)and right ventricular function decompensation(RVEF＜45%,decompensation group,n=24)group.Ultrasonic parameters related to right ventricular structure and function were compared between groups.Univariable analysis and multivariable logistic regression were performed to observe ultrasound parameters related to right ventricular function,so as to screen out the independent predictors of right ventricular functional decompensation(dysfunction)in patients with severe AS.Results Compared with those in compensation group,right ventricular end diastolic volume and right ventricular end systolic volume of decompensation group increased,while right ventricular fractional area change,tricuspid annular plane systolic excursion,right ventricular free wall longitudinal strain(RVFWLS),septal longitudinal strain(SLS),right ventricular stroke volume and RVEF all decreased(all P＜0.05).Valvulo-arterial impedance(OR=2.337),left ventricular ejection fraction(OR=0.751)and RVFWLS/pulmonary artery systolic pressure(right ventricle-pulmonary artery coupling)(OR=0.653)were all independent predictors of right ventricular dysfunction in patients with severe AS(all P＜0.05).Conclusion 3D Auto RV could be used to effectively predict right ventricular dysfunction in patients with severe AS.

Aim To study the effect of p-benzoyl sali-droside(pOBz)on angiogenesis after ischemic stroke and to explore the underlying mechanism.Methods The MCAO model was prepared by suture method.Rats were divided into four groups:sham,MCAO,pOBz administration,and edaravone positive control,treated for seven days.The mNSS was used to assess the neurological impairment.Western blotting was em-ployed to detect CD31,NICD,and Hes-1 protein ex-pression,while immunofluorescence staining was ap-plies to quantify CD31-positive cells in ischemic brain tissue.In vitro an OGD/R model was established in HUVECs.Following treatment with varying pOBz con-centrations(0.01,0.1,1 μmol·L-1),the CCK-8 as-say was uses to measure cell viability,and in vitro tube formation assay was utilized to evaluate angiogenesis.Western blotting was employed again to assess CD31,NICD and Hes-1 protein levels.To further elucidate the mechanism,HUVEC were treated with the Notch inhibitor DAPT prior to grouping and pOBz administra-tion,and the same parameters were evaluated.Results pOBz significantly reduced the mNSS score of MCAO rats,increased CD31-positive cell counts,and upregu-lated CD31,NICD,and Hes-1 protein expression(P＜0.01).In vitro results further showed that pOBz could dose-dependently increase the survival rate and angio-genesis ability of HUVEC induced by OGD/R,and promote CD31,NICD and Hes-1 proteins(P＜0.01),and Notch inhibitor DAPT could reverse the above effects of pOBz.Conclusion pOBz promotes angio-genesis in HUVEC,and its mechanism involves activa-tion of the Notch signaling pathway.

Aim To evaluate the role of the glucose transporter protein 1(GLUT1)-dependent glycolytic in the attenuation of oxygen-glucose deprivation-reoxygen-ation(OGD/R)injury in HK-2 cells by dexmedetomi-dine(Dex).Methods C57/BL6 mice were random-ly divided into three groups(n=6),namely,sham operation group(Sham group),renal ischemia reper-fusion group(I/R group)and Dex group(I/R+Dex group).Serum creatinine(Cr)and urea nitrogen(BUN)were measured,while the levels of key glyco-lytic enzymes HK2,PFKFB3 and GLUT1 were meas-ured.HK-2 cells were cultured and randomised into seven groups(n=6),which was treated with OGD/R,overexpression or interference with GLUT1,Dex and glycolysis inhibitor 2-DG.CCK-8 and LDH activi-ty were used to detect cellular damage.Glycolysis lev-els were detected by lactate and ECAR.The inflamma-tory level was reflected by qRT-PCR for IL-6 and TNF-α.qRT-PCR and Western blot were performed to de-tect the levels of GLUT1,HK2,and PFKFB3.Results Dex significantly ameliorated kidney injury and HK-2 cell injury(P＜0.05).Dex inhibited the OGD/R-induced rise in lactate and extracellular acidification rate(ECAR),as evidenced by suppression of the ex-pression of GLUT1,HK2 and PFKFB3(P＜0.05).In vitro experiments showed that GLUT1 knockdown sig-nificantly improved OGD/R-induced cellular damage.Lactate,ECAR,glycolysis-related mRNAs and pro-teins were inhibited by GLUT1 knockdown(P＜0.05).Significantly,there were no significant differ-ences in above indexes after Dex treatment based on GLUT1 knockdown.Overexpression of GLUT1 abroga-ted the protective effects of Dex,while reversing the inhibitory effects of Dex on the expression of GLUT1,HK2,and PFKFB3(P＜0.05).Conclusions Dexmedetomidine attenuates OGD/R induced injury in HK-2 cells by inhibiting GLUT1-dependent glycolysis.

Objective To evaluate the effects of fasting and high-fat diet on the pharmacokinetics of rabeprazole sodium enteric-coated tablets in healthy Chinese subjects.Methods A single-center,randomized,open,two-agent,two-sequence,four-cycle,fully repeated crossover,single-dose trial design was used in this study,healthy subjects were assigned to receive single dose of rabeprazole sodium enteric-coated tablets 0.1 g in either fasting or high-fat diet state,and blood samples were taken at different time points,respectively.The concentrations of rabeprazole sodium enteric-coated in plasma were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS),the model method of the non-compartmental was used to calculate the pharmacokinetic parameters by Phoenix WinNonlin 8.2.Results The main pharmacokinetic parameters of rabeprazole sodium enteric-coated tablets in fasting state and high-fat diet state were as follows:Cmax were(339.63±156.47)and(318.86±132.13)ng·mL-1;t1/2 were(2.34±0.68)and(3.60±2.40)h;AUC0_t were(556.62±251.65)and(528.50±201.78)ng·mL-1·h;AUC0-∞ were(563.39±255.69)and(535.15±203.24)ng·mL-1·h;tmax were 3.65 and 6.99 h.After high-fat diet,the Cmax and AUC of rapeprazole sodium after high-fat and high-calorie diet decreased,Cmax decreased by 6.12％,AUC0-t decreased by 5.05％,AUC0-∞ decreased by 5.01％,andtmaxwas delayed by about 3.34 h.Cmax,AUC0-t and AUC0-∞ 90％confidence interval were 73.13％-115.10％,83.22％-112.28％and 83.40％-112.13％,respectively.Neither was between 85.00％-125.00％.Conclusion High-fat diet affects the absorption rate and degree of rabeprazole sodium enteric-coated,so it is suitable to be administered on an empty stomach.

Objective:To establish risk warning model for intraoperative hypothermia in patients undergoing laparoscopic myomectomy based on the nomogram model.Methods:127 patients undergoing laparoscopic myomectomy were divided into non-hypothermia group(86 cases)and hypothermia group(41 cases)according to whether intraoperative hypothermia occurred.Multivariate Logistic regression was used to analyze the influencing factors of intraoperative hypothermia in patients,and Nomogram prediction model was constructed and verified according to the influencing factors.Results:The intraoperative irrigation volume and intravenous input volume in the hypothermia group were higher than those in the non-hypothermia group,the basal body temperature at admission,intraoperative infusion temperature,and the proportion of intraoperative warmth were lower than those in the non-hypothermia group,the operation time and anesthesia time were longer than that in the non-hypothermia group(all P＜0.05).Multivariate logistic regression analysis showed that,excessive intraoperative irrigation volume,low basal body temperature and excessive intravenous input volume were risk factors for intraoperative hypothermia in patients undergoing laparoscopic myomectomy(P＜0.05),while intraoperative warmth was protective factor(P＜0.05).A nomogram prediction model was constructed based on influencing factors,and it was verified that the model had good discrimination(area under the curve was 0.881,P＜0.05),calibration degree(C-index=0.852,mean absolute error=0.002)and clinical applicability.Conclusion:Intraoperative irrigation volume,basal body temperature,intravenous input volume,and intraoperative warmth are the influence factors that intraoperative hypothermia in patients undergoing laparoscopic myomectomy,this Nomogram model based on these factors has a good predictive efficacy and clinical value for the prediction of intraoperative hypothermia in patients undergoing laparoscopic myomectomy.

Objective:To establish risk warning model for intraoperative hypothermia in patients undergoing laparoscopic myomectomy based on the nomogram model.Methods:127 patients undergoing laparoscopic myomectomy were divided into non-hypothermia group(86 cases)and hypothermia group(41 cases)according to whether intraoperative hypothermia occurred.Multivariate Logistic regression was used to analyze the influencing factors of intraoperative hypothermia in patients,and Nomogram prediction model was constructed and verified according to the influencing factors.Results:The intraoperative irrigation volume and intravenous input volume in the hypothermia group were higher than those in the non-hypothermia group,the basal body temperature at admission,intraoperative infusion temperature,and the proportion of intraoperative warmth were lower than those in the non-hypothermia group,the operation time and anesthesia time were longer than that in the non-hypothermia group(all P＜0.05).Multivariate logistic regression analysis showed that,excessive intraoperative irrigation volume,low basal body temperature and excessive intravenous input volume were risk factors for intraoperative hypothermia in patients undergoing laparoscopic myomectomy(P＜0.05),while intraoperative warmth was protective factor(P＜0.05).A nomogram prediction model was constructed based on influencing factors,and it was verified that the model had good discrimination(area under the curve was 0.881,P＜0.05),calibration degree(C-index=0.852,mean absolute error=0.002)and clinical applicability.Conclusion:Intraoperative irrigation volume,basal body temperature,intravenous input volume,and intraoperative warmth are the influence factors that intraoperative hypothermia in patients undergoing laparoscopic myomectomy,this Nomogram model based on these factors has a good predictive efficacy and clinical value for the prediction of intraoperative hypothermia in patients undergoing laparoscopic myomectomy.

Objective To explore the value of three-dimensional automated right ventricular quantification(3D Auto RV)for predicting right ventricular function dysfunction in patients with severe aortic stenosis(AS).Methods Eighty severe AS patients were retrospectively enrolled.Based on right ventricular ejection fraction(RVEF)obtained with 3D Auto RV,the patients were classified into right ventricular compensation group(RVEF≥45%,compensation group,n=56)and right ventricular function decompensation(RVEF＜45%,decompensation group,n=24)group.Ultrasonic parameters related to right ventricular structure and function were compared between groups.Univariable analysis and multivariable logistic regression were performed to observe ultrasound parameters related to right ventricular function,so as to screen out the independent predictors of right ventricular functional decompensation(dysfunction)in patients with severe AS.Results Compared with those in compensation group,right ventricular end diastolic volume and right ventricular end systolic volume of decompensation group increased,while right ventricular fractional area change,tricuspid annular plane systolic excursion,right ventricular free wall longitudinal strain(RVFWLS),septal longitudinal strain(SLS),right ventricular stroke volume and RVEF all decreased(all P＜0.05).Valvulo-arterial impedance(OR=2.337),left ventricular ejection fraction(OR=0.751)and RVFWLS/pulmonary artery systolic pressure(right ventricle-pulmonary artery coupling)(OR=0.653)were all independent predictors of right ventricular dysfunction in patients with severe AS(all P＜0.05).Conclusion 3D Auto RV could be used to effectively predict right ventricular dysfunction in patients with severe AS.

Aim To study the mechanism of salidro-side combined with rosavin in rats with ischemic stroke.Methods The MCAO rats was established by using thread-embolic method.The rats were divided into the sham group,MCAO group,salidroside com-bined with rosavin group,and positive control group;the drug was given continuously for seven days.Western blot was used to detect apoptosis indicators.Proteomics was used to analyse differential proteins(DEPs).STEP receptor inhibitor was injected into the lateral ventricles,the rats were administered for seven days,then the apoptosis indicators were detected.Re-sults Salidroside combined with rosavin could reduce neurological function scores in MCAO rats and inhibit cell apoptosis.Quantitative proteomics identified 496 DEPs in brain tissue and discovered core proteins STEP,p38,and CRTC1.Salidroside combined with rosavin could promote the STEP and CRTC1 while in-hibiting p38 protein.After treatment with STEP inhibi-tor,those effects were reversed.Conclusion Salidro-side combined with rosavin can inhibit cell apoptosis in MCAO rats,which is closely related to the regulation of the STEP/p38/CRTC1 signaling pathway.

Aim To study the mechanism of salidro-side combined with rosavin in rats with ischemic stroke.Methods The MCAO rats was established by using thread-embolic method.The rats were divided into the sham group,MCAO group,salidroside com-bined with rosavin group,and positive control group;the drug was given continuously for seven days.Western blot was used to detect apoptosis indicators.Proteomics was used to analyse differential proteins(DEPs).STEP receptor inhibitor was injected into the lateral ventricles,the rats were administered for seven days,then the apoptosis indicators were detected.Re-sults Salidroside combined with rosavin could reduce neurological function scores in MCAO rats and inhibit cell apoptosis.Quantitative proteomics identified 496 DEPs in brain tissue and discovered core proteins STEP,p38,and CRTC1.Salidroside combined with rosavin could promote the STEP and CRTC1 while in-hibiting p38 protein.After treatment with STEP inhibi-tor,those effects were reversed.Conclusion Salidro-side combined with rosavin can inhibit cell apoptosis in MCAO rats,which is closely related to the regulation of the STEP/p38/CRTC1 signaling pathway.