OBJECTIVE To establish a full-cycle management model for type 2 diabetes mellitus （T2DM） patients led by clinical pharmacists. METHODS Based on literature research， a basic framework and items of full-cycle management model led by clinical pharmacists were initially formulated. The Delphi method was adopted to conduct questionnaire inquiries among 26 experts to determine the specific implementation items of the model. The analytic hierarchy process （AHP） method was used to determine the weight values of items at all levels， and the reliability and validity of the model items were analyzed. RESULTS The recovery rates of the two rounds of expert consultation questionnaires were 86.67% and 100%， respectively， and the expert authority coefficient was 0.88. Kendall’s concordance coefficients of the tertiary-level items were 0.064 and 0.084， respectively， and the P values from the χ 2 tests were all less than 0.05； the consistent ratios of the judgment matrices for all levels of AHP model were all less than 0.1. The established full-cycle management led by clinical pharmacists comprised three primary-level items （pharmacy service pathway for T2DM patients during hospitalization， pharmacy management pathway for hypoglycemia in T2DM inpatients， and the pharmacy follow-up pathway for T2DM discharged patients， with weights of 0.098， 0.568 and 0.334， respectively）， twelve secondary-level items （e.g. pharmaceutical care during hospitalization for 1 to 2 days， admission assessment and education， with weights ranging from 0.143 to 0.333） and thirty-seven tertiary-level items （e.g. assessment of medication compliance， verification of the medication plan for discharge， with weights ranging from 0.068 to 0.750）. Cronbach’s α coefficients for primary-level items and the overall questionnaire were 0.762， 0.879， 0.928 and 0.951， respectively. The item-level and scale-level content validity indexes were 0.967 and 0.808， respectively. CONCLUSIONS A full-cycle management model for T2DM patients led by clinical pharmacists has been constructed successfully， demonstrating high scientificity and reliability.

Nasopharyngeal carcinoma （NPC） is a malignant tumor originating from the mucosal epithelium of the nasopharynx. In recent years， its incidence and mortality rates have shown a continuous upward trend， and there is still a lack of therapeutic regimens with both favorable efficacy and safety in clinical practice. Mitogen-activated protein kinase （MAPK） signaling pathway plays a key regulatory role in biological processes such as cell proliferation， differentiation， apoptosis and invasion. It is widely involved in the occurrence and progression of NPC， and serves as an important target in the research field of anti-NPC therapy. This article systematically elaborates on the mechanism of action of the MAPK signaling pathway in NPC， and reviews the research status regarding the anti-NPC effect of active components of traditional Chinese medicine （TCM） and TCM compound prescriptions by regulating this signaling pathway. The results show that TCM active components， including flavonoids （luteolin， maackiain， baicalein， etc.）， alkaloids （picrasidine Ⅰ， tetrandrine， etc.）， terpenoids （bakuchiol， cantharidic acid）， as well as traditional Chinese medicine compound formulas （such as Biyan jiedu capsules and Yiqi jiedu formula） can exert effects including inducing autophagy and apoptosis of NPC cells， promoting pyroptosis， reversing drug resistance， blocking epithelial-mesenchymal transition， weakening cell stemness and arresting cell cycle progression by regulating the MAPK signaling pathway， thereby inhibiting the occurrence and development of NPC through multiple pathways.

Objective To investigate the characteristics of executive function impairment in patients with chronic insomnia disorder and its correlation with Objective sleep structure parameters. Methods A total of 92 patients who met the DSM-5 diagnostic criteria for chronic insomnia disorder were enrolled as chronic insomnia disorder group， and 45 healthy controls were enrolled as healthy control group. All subjects underwent assessments for anxiety and depression， overnight polysomnography， and executive function， and the two groups were compared in terms of sleep parameters （including sleep latency， sleep efficiency， total sleep time， sleep stages， and the proportion of each stage） and executive function （Stroop Color-Word Test， digit span test， and trail making test）， as well as the correlation between these parameters. Results Compared with the healthy control group， the chronic insomnia disorder group had significant increases in Stroop Card C completion time， Stroop interference effect， trail making test-B completion time， and trail making test B-A time difference and significant reductions in the score of digit span backward task and the total score of digit span test （P<0.05）. The correlation analysis showed that total sleep time， sleep efficiency， NREM stage 3 duration， and the proportion of NREM stage 3 were negatively correlated with Stroop Card C completion time， Stroop interference effect， trail making test-B completion time， and trail making test B-A time difference and were positively correlated with the score of digit span backward task and the total score of digit span test （P<0.05）. Conversely， NREM stage 1 duration and the proportion of NREM stage 1 were positively correlated with Stroop Card C completion time， Stroop interference effect， trail making test-B completion time， and trail making test B-A time difference and were negatively correlated with the score of digit span backward task （P<0.05）. Conclusion Patients with chronic insomnia disorder exhibit executive function impairment in multiple dimensions including inhibitory control， working memory， and cognitive flexibility， which are associated with the reductions in sleep efficiency and deep sleep.

Currently, the quality control of traditional Chinese medicine (TCM) encounters substantial technical challenges, necessitating the urgent development of innovative evaluation methods for key quality attributes. This study proposes the construction of a quality assurance system centered on key quality attributes, with systems biology and chemical biology serving as its core components: utilizing multi-omics technologies to systematically analyze the core functional modules of TCM, integrating pharmacological approaches to precisely identify key bioactive components; applying chemical biology to elucidate the interaction mechanisms between components and their targets, while screening for quality markers associated with specific functions and clinical indications; establishing an integrated quality control system based on quality markers and biological potency to ensure comprehensive quality management from raw herb materials through to finished products. Additionally, it emphasizes the formulation of compatibility rules grounded in TCM theory, integrates clinical practice and multi-dimensional value assessments, and establishes a novel quality evaluation model with distinct TCM characteristics.This offers a comprehensive and systematic approach to ensuring the safety and efficacy of TCM while facilitating the high-quality development of the TCM industry.

Objective: To analyze the incidence trend of colorectal cancer in Xiaoshan District, Hangzhou City from 2010 to 2024, and predict the incidence of colorectal cancer from 2025 to 2027, so as to provide the evidence for improving the prevention and control strategies of colorectal cancer. Methods: Colorectal cancer incidence data from 2010 to 2024 in Xiaoshan District were collected through the Hangzhou Municipal Chronic Disease Monitoring Management System. The crude incidence of colorectal cancer was calculated, and standardized using the data from the Sixth National Population Census in 2010 (Chinese standardized rate) and the Segi's world standard population (world standardized rate). The trend of colorectal cancer incidence from 2010 to 2024 was analyzed using the average annual percent change (AAPC). An exponential smoothing state space model with trigonometric seasonality, box-cox transformation, ARMA errors, trend and seasonal components (TBATS) was established to forecast the crude incidence of colorectal cancer from 2025 to 2027. Results: There were 10 726 new cases of colorectal cancer in Xiaoshan District from 2010 to 2024. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer were 59.25/100 000, 38.62/100 000 and 29.50/100 000, respectively. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer in males were 70.56/100 000, 44.44/100 000and 35.58/100 000, respectively, while those in females were 48.37/100 000, 32.69/100 000 and 23.70/100 000, respectively. The Chinese standardized rate of colorectal cancer was significantly higher in males than in females (P<0.05). The crude incidence of colorectal cancer in males, females and the whole population showed upward trends from 2010 to 2024 (AAPC=4.916%, 3.795% and 4.442%, all P<0.05). The crude incidence of colorectal cancer in the groups of 0-<35, 35-<50, 50-<75 and ≥75 years were 1.75/100 000, 19.86/100 000, 112.28/100 000 and 272.99/100 000, respectively, showing an increasing trend with age (P<0.05). From 2010 to 2024, the crude incidence of colorectal cancer in the ≥75 years group showed an increasing trend (AAPC=4.470%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). TBATS model demonstrated good fitting (predictive) performance, indicating a year-by-year increase in the crude incidence of colorectal cancer across the whole population from 2025 to 2027, with an estimated rate reaching 70.45/100 000 in 2027. Conclusions The crude incidence of colorectal cancer in Xiaoshan District showed an increasing trend from 2010 to 2024, and it is predicted to continue to increase from 2025 to 2027. Males and the elderly are the key populations for colorectal cancer prevention and control.

Ferroptosis, an iron-dependent programmed cell death process driven by reactive oxygen species-mediated lipid peroxidation, is regulated by several metabolic processes, including iron metabolism, lipid metabolism, and redox system. Macrophages are a group of innate immune cells that are widely distributed throughout the body, and play pivotal roles in maintaining metabolic balance by its phagocytic and efferocytotic effects. There is a profound association between the biological functions of macrophage and ferroptosis. Therefore, this review aims to elucidate three key aspects of the unique relationship between macrophages and ferroptosis, including macrophage metabolism and their regulation of cellular ferroptosis; ferroptotic stress that modulates functions of macrophage and promotion of inflammation; and the effects of macrophage ferroptosis and its role in diseases. Finally, we also summarize the possible mechanisms of macrophages in regulating the ferroptosis process at the global and local levels, as well as the role of ferroptosis in the macrophage-mediated inflammatory process, to provide new therapeutic insights for a variety of diseases.
Ferroptosis/physiology* ; Macrophages/metabolism* ; Humans ; Animals ; Iron/metabolism* ; Reactive Oxygen Species/metabolism* ; Lipid Peroxidation/physiology* ; Inflammation/metabolism*

ObjectiveTo analyze the incidence rate and mortality of acute myocardial infarction (AMI) and their changing trends among the registered residents in Xiaoshan District, Hangzhou City from 2017 to 2023, so as to provide references for formulating policies related to AMI prevention. MethodsThe morbidity and mortality data of AMI among the registered residents in Xiaoshan District from 2017 to 2023 were collected through the Hangzhou Chronic Disease and Death Cause Monitoring System. Software such as Excel 2019, SPSS 25.0 and Joinpoint 4.9.1.0 were used to calculate the incidence rate, mortality, and average annual percentage change (AAPC) of AMI. ResultsFrom 2017 to 2023, the average annual crude incidence rate, age-standardized incidence rate using China standard population (ASIRC), and the age-standardized incidence rate using World standard population (ASIRW) of AMI in Xiaoshan District were 48.25/100 000, 29.14/100 000, and 21.64/100 000, respectively, and, from which the AAPCs were 5.495%, 6.010%, and 6.533%, respectively, all showing an upward trend. The average annual crude mortality rate, the age-standardized mortality rate using China standard population (ASMRC), and the age-standardized mortality rate using World standard population (ASMRW) were 11.76/100 000, 6.52/100 000, and 4.71/100 000, respectively, from which the AAPCs were -9.669%, -10.433% and -9.615%, respectively, all showing a downward trend. The average annual crude incidence rate of AMI was higher in males (65.87/100 000) than that in females (31.31/100 000). Moreover, the average annual crude mortality rate of AMI was higher in males (14.08/100 000) than that in females (9.52/100 000), and the difference was statistically significant (all P<0.001) .After age grouping, the crude incidence rate of AMI among the residents aged 35-, 45-, 55-, and 65- years in Xiaoshan District from 2017 to 2023 showed an upward trend over time, with AAPCs of 16.993%, 17.149%, 8.523%, and 5.002%, respectively. While the crude mortality rate in residents aged 35-, 75-, and 85-102 years showed an decreasing trend over time, with AAPCs of -23.977%, -15.467%, and -17.415%, respectively, but there was no statistically significant difference in the trends in incidence rate and mortality of other age groups (all P>0.05). ConclusionThe situation of AMI prevention and control among the registered residents in Xiaoshan District is not optimistic, and targeted measures should be strengthened for the male residents aged ≥35 years old.

To investigate the correlation between hepatic lipid accumulation and the metabolic profiles of free fatty acids(FFAs), tricarboxylic acid (TCA) cycle, and ketone body in alcoholic fatty liver disease (AFLD), a chronic plus acute alcohol feeding model (Gao-Binge model) was employed using C57BL/6N mice to simulate different stages of AFLD. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed to measure the levels of FFAs, TCA cycle intermediates, and ketone bodies in mouse liver tissue and plasma, followed by Pearson correlation analysis. The study revealed that both acute and chronic models showed significant increases in total FFAs, saturated FFAs and short-chain FFAs, as well as β-hydroxybutyric acid(HDBT) in plasma and liver, indicating FFA metabolic profile disturbances in the Gao-Binge model. Moreover, in both models, acetic acid (AA), 2-Methylbutyric acid (2-meBA), and HDBT displayed strong positive correlations with hepatic injury markers in plasma and liver samples (for instance, in the acute model plasma data, r = 0.834, 0.699, 0.818, P<0.05), while pyruvic acid (PRA) showed a strong negative correlation (r = −0.66, P<0.05). These findings suggest that FFAs, TCA cycle, and ketone body metabolism are disrupted in the alcoholic liver disease in mice model, and metabolites such as AA, 2-meBA, HDBT and PRA may serve as potential biomarkers for AFLD, which would be helpful in the diagnosis and treatment of this disease.

Shengma Gegentang is one of the classic formulas in the Catalogue of Ancient Classic Prescriptions （Second Batch）. This study reviewed ancient and modern literature and used literature tracing and bibliometric methods to analyze the historical evolution， efficacy， indications， dosage decoctions， and modern clinical disease spectrum of Shengma Gegentang. The results indicated that the earliest record of Shengma Gegentang can be found in the Taiping Huimin Heji Jufang of the Song dynasty， but its origin can be traced back to the Shaoyao Siwu Jiejitang in the Beiji Qianjin Yaofang of the Tang dynasty. The composition dosage of Shengma Gegentang is 413 g of Cimicifugae Rhizoma， 619.5 g of Puerariae Lobatae Radix， 413 g of Paeoniae Radix Alba， and 413 g of Glycyrrhizae Radix et Rhizoma， which are ground into coarse powder. Each dose is 12.39 g， and the amount of water added is 300 mL. 100 mL of solution is decocted and taken at the right time. The four drugs in the formula play the role of relieving exterior syndrome， penetrating pathogenic factors， and detoxicating together. Its indications are widely involved in internal medicine， pediatrics， surgery， ophthalmology and otorhinolaryngology， obstetrics and gynecology， sexually transmitted diseases， and other diseases， such as measles， sores， acne， spots， surgical gangrene， red eyes， toothache， chancre， and fetal poison. The epidemic diseases treated by Shengma Gegentang are complicated， including rash， pox， macula， numbness， summer diarrhea， dysentery， sha disease， febrile symptoms， spring warmth， winter warmth， and cold pestilence. At the same time， it is a plague prevention formula. Although Shengma Gegentang has a wide range of indications， it cannot be separated from the pathogenic mechanism of evil Qi blocking the muscle surface and heat in the lungs and stomach. The modern clinical disease spectrum of Shengma Gegentang involves the ophthalmology and otorhinolaryngology system， nervous system， pediatric-related diseases and syndromes， skin system， hepatobiliary system， and digestive system. It plays a key role in the treatment of epidemic diseases such as measles， chronic hepatitis B， dysentery， and tetanus.