Stroke is the leading cause of death and disability among adults in China， and its common complications include digestive system abnormalities， cognitive impairment， depression， stroke-associated pneumonia， and hemiplegia. The combination of traditional Chinese and Western medicine has great potential in treating post-stroke complications. Xinglou Chengqitang （XLCQT） is a representative prescription of alleviating the disease in the upper part by treating the lower part. It has definite therapeutic effect and high safety. Clinically， XLCQT is often used to treat stroke and its complications. However， the quantity and quality of clinical trials of XLCQT in treating post-stroke complications need to be improved. Additionally， since the basic research is weak， the material basis and multi-target mechanism for the efficacy of this prescription are unknown. This article reviews XLCQT in terms of the pharmacodynamic basis， medicinal properties， safety evaluation， and progress in clinical research and mechanisms in treating post-stroke complications. This article summarizes 22 key active ingredients of XLCQT in treating acute stroke complicated with syndrome of phlegm heat and fu-organ excess. Among these key active ingredients， resveratrol， kaempferol， luteolin， chrysoeriol， apigenin， （+）-catechin， and adenosine have good pharmacokinetic properties and high bioavailability. The mechanisms of XLCQT in treating post-stroke complications are complex， including inflammatory response， brain-gut axis， hypothalamic-pituitary-adrenal （HPA） axis， intestinal flora， neurotrophic factors， autophagy， oxidative stress， and free radical damage. This review helps to deeply understand the pharmacodynamic basis and mechanisms of XLCQT in treating post-stroke complications and provides a theoretical basis for the clinical application of XLCQT against post-stroke complications and the development of drugs.

Stroke is the main cause of death and disability among adults in China and is characterized by high incidence， disability， mortality， and recurrence rates. The combination of traditional Chinese and Western medicine has great potential in treating stroke and its sequelae. The classic traditional Chinese medicine prescription Da Chengqitang （DCQT） has a long history and proven efficacy in treating stroke. Clinically， DCQT is often used to treat stroke and its sequelae. However， the number and quality of clinical trials of DCQT in treating stroke need to be improved. Because of the insufficient basic research， the active ingredients and multi-target mechanism of action of DCQT remain unclear. Our research group has previously confirmed that DCQT can effectively reverse neurological damage， reduce iron deposition， and downregulate the levels of pro-inflammatory cytokines in the rat model of hemorrhagic stroke. The treatment mechanism is related to the nuclear factor erythroid 2-related factor 2 （Nrf2）-mediated signaling pathway and p38 mitogen-activated protein kinase （MAPK） signaling-mediated microglia activation. To clarify the pharmacodynamic basis and anti-stroke mechanism of DCQT， this article reviews the research progress in the treatment of stroke with DCQT in terms of clinical trials， pharmacodynamic material basis， safety evaluation， and mechanisms of absorbed components. This article summarizes 45 major phytochemical components of DCQT， 11 of which are currently confirmed absorbed components. Among them， emodin， rhein， chrysophanol， aloe-emodin， synephrine， hesperidin， naringin， magnolol， and honokiol can be used as quality markers （Q-markers） of DCQT. The mechanism of DCQT in treating stroke is complex， involving regulation of inflammatory responses， neuronal damage， oxidative stress， blood-brain barrier， brain-derived neurotrophic factor， and anti-platelet aggregation. This article helps to deeply understand the pharmacodynamic basis and mechanism of DCQT in treating stroke and provides a theoretical basis for the clinical application of DCQT in treating stroke and the development of stroke drugs.

Background: To enhance perioperative outcomes, a perioperative registry that integrates high-quality real-world data throughout the perioperative period is essential. Singapore General Hospital established the Perioperative and Anesthesia Subject Area Registry (PASAR) to unify data from the preoperative, intraoperative, and postoperative stages. This study presents the methodology employed to create this database. Methods: Since 2016, data from surgical patients have been collected from the hospital electronic medical record systems, de-identified, and stored securely in compliance with privacy and data protection laws. As a representative sample, data from initiation in 2016 to December 2022 were collected. Results: As of December 2022, PASAR data comprise 26 tables, encompassing 153,312 patient admissions and 168,977 operation sessions. For this period, the median age of the patients was 60.0 years, sex distribution was balanced, and the majority were Chinese. Hypertension and cardiovascular comorbidities were also prevalent. Information including operation type and time, intensive care unit (ICU) length of stay, and 30-day and 1-year mortality rates were collected. Emergency surgeries resulted in longer ICU stays, but shorter operation times than elective surgeries. Conclusions The PASAR provides a comprehensive and automated approach to gathering high-quality perioperative patient data.

In recent years， the field of network pharmacology （NP） has developed rapidly， but the flawed and routine workflow has seriously affected the scientificity and reliability of NP analysis results. For complex diseases caused by environmental and genetic factors， symptomatic treatment or drugs targeting a single pathophysiological process cannot prevent or delay the progression of the disease， so the drug development fails or withdraws from the market. Therefore， there is an urgent need to develop new ideas for NP analysis that combines multiple pathophysiological processes. The key pathophysiological process is an important and complete set of pathological changes in the process of the occurrence， development， and outcome of the disease， which represents the current comprehensive and profound understanding of the nature of the disease. In order to improve the quality of NP research and promote the healthy development of the NP field， this paper proposes a new idea of NP analysis based on key pathophysiological processes. Based on the long-term clinical practice of traditional Chinese medicine and the key pathophysiological process of the disease， the method comprehensively analyzes the pharmacological mechanism and active ingredients of traditional Chinese medicine compound from the perspective of key pathophysiological process， which increases the scientifically， reliability， and repeatability of the analysis results. This paper takes Alzheimer's disease （AD） as an example to illustrate the necessity， feasibility， main workflow， advantages， and disadvantages of this method， and it is expected to screen disease-modifying drugs that prevent or reverse the course of the disease and promote the clinical transformation of research results.

Nasopharyngeal carcinoma is one of the most common malignant head and neck tumors, and radiotherapy is the main treatment. However, radio-resistance is a key cause of local recurrence of nasopharyngeal carcinoma. Therefore, overcoming the radio-resistance of nasopharyngeal carcinoma and enhancing the radiosensitivity have become urgent problems in the treatment of nasopharyngeal carcinoma, which also play a key role in improving the overall survival rate of patients. In this article, recent studies on DNA, non-coding RNA (ncRNA), protein and cell behaviors related to radio-resistance of nasopharyngeal carcinoma were reviewed, aiming to provide valuable ideas for clinical treatment of nasopharyngeal carcinoma.

Objective To study the protective effect and mechanism of adenosine A2a receptor(A2aR)activation in the pathogenesis of systemic sclerosis associated interstitial lung disease(SSc-ILD).Methods A total of 24 healthy female Balb/c mice were randomly divided into three groups:wild normal control(WN)group,wild model(WM)group,WM with CGS21680(WMC)group.Two weeks after the end of injections,the lung samples and serum of mice were collected.A part of lung tissues were obtained for hematoxylin eosinstaining,Masson staining and determination of hydroxyprolineto observe the degree of inflammation and fibrosis.Enzyme linked immunosorbent assay(ELISA)was used to detect advanced oxidative protein products in mouse serum and lung tissue,reduced glutathione in lung tissue,and oxidative stress levels in serum and lung tissue.Results①Underhematoxylin eosinstaining and Masson staining,the lungs of mice in WM group showed inflammation infiltration and fibrosis,while mice in WMC group showed a reduction compared to mice in WM group;②The content of hydroxyproline in lung tissue,serum and late stage oxidative protein products in lung tissue of WM group mice increased compared to WN group mice(P<0.01),while the content of WMC group mice decreased compared to WM group mice(P<0.01);③The reduced glutathione content in lung tissue of WM group mice was lower than that of WN group mice(P<0.01),while WMC group mice were higher than WM group mice(P<0.05).Conclusion The activation of A2aR ameliorated the degree of inflammation and fibrosis in SSc-ILD,possibly through the antioxidant mechanism.

Objective:To establish a radioresistant nasopharyngeal carcinoma cell line in vitro and provide experimental basis for further research of the molecular mechanism of radioresistance. Methods:A radioresistant cell line 5-8F-IR was established by dose gradient irradiation. Cell morphological changes were observed by optical microscope. The formation of colony was detected by colony formation assay. Cell viability was detected by CCK-8 assay. Cell proliferation was assessed by 5-ethynyl-2'-deoxyuridine (EdU) assay. DNA damage repair ability was measured by immunofluorescence staining and comet assay. Cell apoptosis and cycle were detected by flow cytometry. The expression levels of DNA damage related protein γH2AX and apoptosis related protein Caspase-3 were measured by Western blot.Results:The 5-8F-IR cells became longer than that of parental generation 5-8F cells after dose gradient irradiation. The colony formation ability ( P<0.01), cell viability ( P<0.001), cell proliferation ability ( P<0.05) and DNA damage repair ability ( P<0.05) of 5-8F-IR cells were significantly stronger than those of parental generation 5-8F cells. The apoptosis rate of 5-8F-IR cells after irradiation was significantly lower than that of parental generation 5-8F cells ( P<0.01). The 5-8F-IR cells showed higher percentage of cells in S phase without irradiation, and obvious G 2/M phase arrest after irradiation ( P<0.01). Western blot showed that the expression levels of γH2AX ( P<0.001) and Caspase-3 ( P<0.05) in 5-8F-IR cells after irradiation were significantly lower compared with those of parental generation 5-8F cells. Conclusion:5-8F-IR cells induced by dose gradient irradiation of human nasopharyngeal carcinoma cell line 5-8F cells exhibit radioresistance and exhibit different biological characteristics compared to their parental 5-8F cells, providing a research tool for exploring radioresistance mechanism of nasopharyngeal carcinoma.

Objective To identify the influence factors and construct a predicted model for liver, lung, bone, or brain metastasis among patients with left or right colorectal cancer. Methods Patients with colorectal cancer with information on liver, lung, bone, and brain metastasis were retrospectively filtered and analyzed from 2010 to 2018 from the SEER database. These patients were divided into three groups based on their primary tumor location. Multivariate logistic regression analysis was conducted to identify the influence factors on metastasis. A nomogram that could predict metastasis was established and further validated by the AUC of ROC curves. Results A total of 49335 eligible patients were chosen from the SEER database. N stage and CEA were identified as risk factors for all metastases, which were unrelated to primary tumor location. By contrast, race had varying effects on liver metastasis between different groups (P < 0.05). The nomogram model predicting liver metastasis was successfully established, and the AUCs based on the three groups were 0.821 (95%CI: 0.813-0.830), 0.841 (95%CI: 0.833-0.848), and 0.796 (95%CI: 0.782-0.811), respectively. Conclusion The influence factors and predictive models on liver metastasis were different in patients with colorectal cancer and different primary tumor locations.

Objective:To study the effect of in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) on ovarian responsiveness during ovulation induction and pregnancy outcome in elderly patients with polycystic ovary syndrome (PCOS). Methods:A retrospective cohort study was conducted, and 201 elderly women with PCOS who underwent IVF/ICSI for the first time in the Reproductive Medical Center of Peking University Third Hospital from January 1, 2016 to December 31, 2018 were selected as PCOS group. According to the 1∶1 matching principle, selected 201 elderly patients with non-PCOS menstrual regularity who entered the cycle at the same time as the elderly PCOS patients and underwent IVF/ICSI for the first time due to tubal factors alone named control group. The first three thawing cycles of this egg retrieval cycle were selected. Due to the higher incidence of ovarian hyperstimulation syndrome and the number of aging PCOS patients undergoing embryo freezing, the thawing cycles of the elderly PCOS patients were more than those of control group. A total of 215 cycles in PCOS group and 124 cycles in control group were used to analyze the clinical data and IVF/ICSI laboratory data.Results:1) Between PCOS group and control group, anti-Müllerian hormone (AMH) and antral follicle count (AFC) were significantly different [(7.66±4.62) μg/L vs. (1.89±1.44) μg/L, P=0.005; 26.44±8.06 vs. 9.33±4.05, P<0.001]; the rate of high-quality embryos in PCOS group was higher than that in control group [58.04% (1281/2207) vs. 57.20% (743/1299), P=0.005]. 2) The dosage of gonadotropin (Gn) used during ovulation induction in PCOS group was less than that in control group [(2 090.17±909.74) U vs. (2 969.14±1 101.79) U, P=0.009], but the number of oocytes retrieval was more than that in control group (15.17±8.35 vs. 9.51±5.83, P<0.001). The clinical pregnancy rate, the miscarriage rate, the ectopic pregnancy rate and the cumulative live birth rate of PCOS group were not significantly different from those of control group (all P>0.05). 3) Age, body mass index (BMI), testosterone level, ovulation stimulation program and the number of transferred embryos were the independent influencing factors of the clinical pregnancy rate ( P=0.028, P=0.004, P=0.027, P=0.014, P<0.001); BMI and the number of transferred embryos were the independent influencing factors of the live birth rate ( P=0.008, P<0.001). Conclusion:1) Elderly PCOS patients have higher follicle reserve. 2) The cumulative live birth rate can more truly reflect the fertility window of elderly PCOS patients. The cumulative live birth rate of elderly PCOS patients is significantly better than that of control group with the increase of age; the reproductive window of PCOS patients is longer than that of non-PCOS patients. 3) For elderly patients, the laboratory results should be improved as soon as possible, the waiting time in the early stage of the IVF/ICSI cycle should be shortened as much as possible, and assisted reproductive treatment should be performed as soon as possible to obtain better pregnancy outcomes.

Objective:To study the effect of in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) on ovarian responsiveness during ovulation induction and pregnancy outcome in elderly patients with polycystic ovary syndrome (PCOS). Methods:A retrospective cohort study was conducted, and 201 elderly women with PCOS who underwent IVF/ICSI for the first time in the Reproductive Medical Center of Peking University Third Hospital from January 1, 2016 to December 31, 2018 were selected as PCOS group. According to the 1∶1 matching principle, selected 201 elderly patients with non-PCOS menstrual regularity who entered the cycle at the same time as the elderly PCOS patients and underwent IVF/ICSI for the first time due to tubal factors alone named control group. The first three thawing cycles of this egg retrieval cycle were selected. Due to the higher incidence of ovarian hyperstimulation syndrome and the number of aging PCOS patients undergoing embryo freezing, the thawing cycles of the elderly PCOS patients were more than those of control group. A total of 215 cycles in PCOS group and 124 cycles in control group were used to analyze the clinical data and IVF/ICSI laboratory data.Results:1) Between PCOS group and control group, anti-Müllerian hormone (AMH) and antral follicle count (AFC) were significantly different [(7.66±4.62) μg/L vs. (1.89±1.44) μg/L, P=0.005; 26.44±8.06 vs. 9.33±4.05, P<0.001]; the rate of high-quality embryos in PCOS group was higher than that in control group [58.04% (1281/2207) vs. 57.20% (743/1299), P=0.005]. 2) The dosage of gonadotropin (Gn) used during ovulation induction in PCOS group was less than that in control group [(2 090.17±909.74) U vs. (2 969.14±1 101.79) U, P=0.009], but the number of oocytes retrieval was more than that in control group (15.17±8.35 vs. 9.51±5.83, P<0.001). The clinical pregnancy rate, the miscarriage rate, the ectopic pregnancy rate and the cumulative live birth rate of PCOS group were not significantly different from those of control group (all P>0.05). 3) Age, body mass index (BMI), testosterone level, ovulation stimulation program and the number of transferred embryos were the independent influencing factors of the clinical pregnancy rate ( P=0.028, P=0.004, P=0.027, P=0.014, P<0.001); BMI and the number of transferred embryos were the independent influencing factors of the live birth rate ( P=0.008, P<0.001). Conclusion:1) Elderly PCOS patients have higher follicle reserve. 2) The cumulative live birth rate can more truly reflect the fertility window of elderly PCOS patients. The cumulative live birth rate of elderly PCOS patients is significantly better than that of control group with the increase of age; the reproductive window of PCOS patients is longer than that of non-PCOS patients. 3) For elderly patients, the laboratory results should be improved as soon as possible, the waiting time in the early stage of the IVF/ICSI cycle should be shortened as much as possible, and assisted reproductive treatment should be performed as soon as possible to obtain better pregnancy outcomes.