OBJECTIVE To investigate the stability and compatibility of butorphanol， nicardipine， urapidil， and tirofiban. METHODS A micro-infusion pump was used to simulate the infusion process. Samples were collected in real time from the needle tip at 0， 2， 4， 6， and 8 h after mixing of the four drugs. The appearance， pH， and number of insoluble particles were examined. The contents of butorphanol， nicardipine， urapidil， and tirofiban were determined using the ultra-high-performance liquid chromatography method. RESULTS Within 8 hours， all mixed solutions remained clear and transparent， with no visible turbidity， precipitation， color change， or gas generation. The pH fluctuation ranged from 0.02 to 0.09， both within 0.1 pH units. The number of insoluble particles ≥10 μm in size in each compatibility solution was ≤9， and the number of insoluble particles ≥25 μm was ≤2， meeting the requirements of the 2025 edition of the Chinese Pharmacopoeia （Volume Ⅳ）. The relative percentage contents of butorphanol， nicardipine， urapidil， and tirofiban at 8 hours after compatibility mixing ranged from 92.38% to 113.40%. CONCLUSIONS Within 8 hours under simulated clinical micro-infusion pump infusion conditions， the stability and compatibility of the mixed solution containing butorphanol， nicardipine， urapidil， and tirofiban were satisfactory.

OBJECTIVE To quantitatively assess the compatibility risk of commonly used intravenous drugs in intensive care unit （ICU） patients with severe pneumonia， and provide a reference for reducing the incidence of adverse events caused by incompatibility. METHODS The PASS clinical pharmacy management system was used to retrospectively collect the data of patients diagnosed with “severe pneumonia” in the ICU of Hebei General Hospital from January 2023 to June 2025， and the commonly used intravenous drugs and medication frequency were extracted. Based on authoritative databases such as Micromedex and Stabilis as well as relevant literature， the compatibility data of commonly used intravenous drugs with 0.9% Sodium chloride injection and 5% Glucose injection were summarized. The theoretical and actual compatibility risk values were calculated using formulas， and high-risk drugs were screened and the compatibility query table was drawn. RESULTS A total of 158 ICU patients with severe pneumonia were treated with 89 intravenous drugs， and 24 drugs with high compatibility risk were identified. The drug with the highest theoretical compatibility risk value was Amphotericin B for injection （risk value 146）， and the drug with the highest actual compatibility risk value was Propofol medium and long chain fat emulsion injection （risk value 8 740）. Among the 24 high-risk drugs， six drugs， namely Esomeprazole sodium for injection， Ambroxol hydrochloride injection， Midazolam injection， Methylprednisolone sodium succinate for injection， Furosemide injection， and Cefoperazone sodium and sulbactam sodium for injection， simultaneously ranked among the top 15 in both theoretical and actual compatibility risk rankings. Among 650 pairwise compatibility combinations of the 24 drugs， 24.62% were compatible， 11.23% were incompatible， 6.77% had conflicting evidence， and 57.38% had missing evidence. CONCLUSIONS This study quantitatively analyzed the medication safety of commonly used intravenous drugs in ICU patients with severe pneumonia， identified 24 drugs with high compatibility risk， and established a compatibility query table for high-risk drugs， which helps reduce the risk of ICU compatibility adverse events.

Objective In order to provide a better reference and basis for the selection of reasonable hypoglycemic drugs for clinical treatment,the study conducted a comprehensive clinical evaluation of the innovator sodium-glucose transporters 2(SGLT-2)inhibitors,based on A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition).Methods The real-world studies,randomized controlled trials,Meta-analysis/systematic review,drug clinical use guidelines,expert consensus and drug description evaluation evidence were collected,and the included drugs were assigned and evaluated from five dimensions:pharmaceutical characteristics,efficacy,safety,economy and other attributes.Results All SGLT-2 inhibitors had evaluation scores above 75,with dagaglifloztin tablets having the highest score of 84.6,and canaglifloztin having the lowest score of 75.1.Conclusions All five original SGLT-2 inhibitors showed good clinical utility,the difference is that the participating original drugs have different advantageous intervals in clinical use.The results show that dagliflozin has the most ideal clinical utility,and its clinical use should be safer and more effective.Due to the short time on the market and insufficient evidence-based reasons,the advantages of clinical use of proline hemegliflozin are not obvious compared with other evaluated drugs.

Objective In order to provide a better reference and basis for the selection of reasonable hypoglycemic drugs for clinical treatment,the study conducted a comprehensive clinical evaluation of the innovator sodium-glucose transporters 2(SGLT-2)inhibitors,based on A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition).Methods The real-world studies,randomized controlled trials,Meta-analysis/systematic review,drug clinical use guidelines,expert consensus and drug description evaluation evidence were collected,and the included drugs were assigned and evaluated from five dimensions:pharmaceutical characteristics,efficacy,safety,economy and other attributes.Results All SGLT-2 inhibitors had evaluation scores above 75,with dagaglifloztin tablets having the highest score of 84.6,and canaglifloztin having the lowest score of 75.1.Conclusions All five original SGLT-2 inhibitors showed good clinical utility,the difference is that the participating original drugs have different advantageous intervals in clinical use.The results show that dagliflozin has the most ideal clinical utility,and its clinical use should be safer and more effective.Due to the short time on the market and insufficient evidence-based reasons,the advantages of clinical use of proline hemegliflozin are not obvious compared with other evaluated drugs.

Emerging research suggests a potential association of progression of Alzheimer's disease(AD)with al-terations in synaptic currents and mitochondrial dynamics.However,the specific associations between these pathological changes remain unclear.In this study,we utilized Aβ42-induced AD rats and primary neural cells as in vivo and in vitro models.The investigations included behavioural tests,brain magnetic resonance imaging(MRI),liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)analysis,Nissl staining,thioflavin-S staining,enzyme-linked immunosorbent assay,Golgi-Cox staining,trans-mission electron microscopy(TEM),immunofluorescence staining,proteomics,adenosine triphosphate(ATP)detection,mitochondrial membrane potential(MMP)and reactive oxygen species(ROS)assess-ment,mitochondrial morphology analysis,electrophysiological studies,Western blotting,and molecular docking.The results revealed changes in synaptic currents,mitophagy,and mitochondrial dynamics in the AD models.Remarkably,intervention with Dengzhan Shengmai(DZSM)capsules emerged as a pivotal element in this investigation.Aβ42-induced synaptic dysfunction was significantly mitigated by DZSM intervention,which notably amplified the frequency and amplitude of synaptic transmission.The cognitive impairment observed in AD rats was ameliorated and accompanied by robust protection against structural damage in key brain regions,including the hippocampal CA3,primary cingular cortex,prelimbic system,and dysgranular insular cortex.DZSM intervention led to increased IDE levels,augmented long-term potential(LTP)amplitude,and enhanced dendritic spine density and length.Moreover,DZSM intervention led to favourable changes in mitochondrial parameters,including ROS expression,MMP and ATP contents,and mitochondrial morphology.In conclusion,our findings delved into the realm of altered synaptic currents,mitophagy,and mitochondrial dynamics in AD,concurrently highlighting the therapeutic potential of DZSM intervention.

Objective We aimed to observe the clinical efficacy and safety of Compound Congrong Yizhi Capsule in subjects with mild to moderate Alzheimer's disease (AD). Methods A total of 65 subjects with mild to moderate AD who visited the Affiliated Hospital of Qingdao University and Xuanwu Hospital of Capital Medical University from February 2023 to February 2024 were selected and divided into the Compound Congrong Yizhi Capsule group (40 cases) and the Donepezil Hydrochloride group (25 cases) for a 6-month treatment. The primary outcome measures included the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog) score and Auditory Verbal Learning Test (AVLT) score. Secondary outcome measures included the Mini-Mental State Examination (MMSE),Activities of Daily Living (ADL),Rey-Osterrieth Complex Figure Test (ROCFT),Trail Making Test (TMT),Verbal Fluency Test (VFT),Symbol Digit Modalities Test (SDMT),Digital Span Test (DST),Clock Drawing Test (CDT),and Boston Naming Test (BNT) scores,as well as clinical biochemical indicators including blood lipids,blood glucose,liver and kidney function. Results Compared with the Donepezil Hydrochloride group after treatment,subjects in the Compound Congrong Yizhi Capsule group showed an increase in ADAS-Cog and AVLT-total scores,and a decrease in MMSE,Rey-Osterrieth Complex Figure Copy Test,and CDT scores (P<0.05). Additionally,there was an increase in alanine aminotransferase (ALT),blood urea nitrogen(BUN),and total bilirubin (TBIL) levels,and a decrease in indirect bilirubin (IBIL) levels (P<0.05).Conclusion Compound Congrong Yizhi Capsule exerts a regulatory effect on cognitive function in subjects with AD,especially in the cognitive domains of episodic memory and visual-spatial processing ability. It also improves certain clinical indicators such as ALT,BUN,TBIL,and IBIL. This suggests that the early intervention with Compound Congrong Yizhi Capsule in AD can effectively improve symptoms,delay disease progression,and fully embody the concept of traditional Chinese medicine's preventive approach to illness.

Objective:To investigate the effect of myogenic differentiation protein 1(Myod1)on the proliferation inhibition and apoptosis of the SH-SY5Y cells induced by oxygen-glucose deprivation(OGD),and to elucidate its mechanism.Methods:Real-time quantitative fluorescence PCR(RT-qPCR)method was used to detect the mRNA levels of Myod1 and long non-coding RNA(lncRNA)small nucleolar RNA host gene 15(SNHG15)in peripheral blood of the subjects in normal group and the patients in ischemic cerebral infarction group as well as the normal cultured SH-SY5Y cells(control group)and the cells in OGD model(OGD group).After transfecting SH-SY5Y cells with si-Myod1,pcDNA3.0-Myod1,si-SNHG15,pcDNA3.0-SNHG15、si-NC,Vector,miR-NC,and miR-24-3p mimics,the cells were treated with OGD,and then the SH-SY5Y cells were divided into control group,OGD group,OGD+Vector group,OGD+Myod1 group,OGD+si-NC group,OGD+si-Myod1 group,OGD+si-SNHG15 group,OGD+si-SNHG15+Vector group,OGD+si-SNHG15+Myod1 group,OGD+miR-NC group,OGD+miR-mimics group,OGD+miR-mimics+Vector group,and OGD+miR-mimics+SNHG15 group.CCK-8 method was used to detect the cell activities in various groups;5-ethynyl-2'-deoxyuridine(EdU)staining was used to detect the rates of EDU positive cells in various groups;the rates of TdT-mediated dUTP nick end labeling(TUNEL)positive cells in various groups were detected by TUNEL staining;Western blotting method was used to detect the expression levels of cleaved caspase-3,cleaved caspase-9,B-cell lymphoma 2(Bcl-2)and Bcl-2 associated X protein(Bax)proteins in the cells in various groups;the association between Myod1 and SNHG15 was evaluated by chromatin immunoprecipitate(CHIP);dual luciferase reporter gene experiment was used to evaluate the targeting relationships between Myod1 and SNHG15 as well as SNHG15 and miR-24-3p.Results:Compared with normal control group,the expression levels of Myod1 and SNHG15 mRNA in peripheral blood of the patients in ischemic cerebral infarction group were significantly increased(P＜0.05).Compared with control group,the expression levels of Myod1 and SNHG15 mRNA in the SH-SY5Y cells in OGD group were significantly increased(P＜0.05).Compared with OGD group,the cell activities and rates of EdU positive cells in OGD+Myod1 group at 48 and 72 h were decreased(P＜0.01),and the rates of TUNEL positive cells were increased(P＜0.05);the cell activities and rates of EdU positive cells in OGD+si-Myod1 group were increased(P＜0.05),while the rates of TUNEL positive cells were decreased(P＜0.01).Myod1 binded to the promoter sequence of SNHG15.SNHG15 could absorb miR-24-3p,and there were target relatronships between Myod1 and SNHG15 as well as SNHG15 and miR-24-3p.After SNHG15 knockdown,compared with OGD group,the cell activities and rates of EdU positive cells in OGD+si-SNHG15 group at 48 and 72 h were increased(P＜0.01),and the rates of TUNEL positive cells were decreased(P＜0.01),the expression levels of Bax,cleaved caspase-3 and cleaved caspase-9 proteins were decreased(P＜0.01),and the expression levels of Bcl-2 protein were increased(P＜0.01).Compared with OGD+si-SNHG15 group,the cell activities and rates of EdU positive cells in OGD+si-SNHG15+Myod1 group at 48 and 72 h were decreased(P＜0.05),the rates of TUNEL positive cells were(P＜0.05),the expression levels of Bax,cleaved caspase-3,and cleaved caspase-9 proteins were increased(P＜0.05),and the expression levels of Bcl-2 were decreased(P＜0.05).After over-expression of miR-24-3p and SNHG15,compared with OGD group,the cell activities and rates of EdU positive cells in OGD+miR-mimics group at 48 and 72 h were increased(P＜0.01),the rates of TUNEL positive cells were significantly decreased(P＜0.01),the protein expression levels of Bax,cleaved caspase-3 and cleaved caspase-9 were decreased(P＜0.05),and the expression levels of Bcl-2 were increased(P＜0.01).Compared with OGD+miR-mimics group,the cell activities and rates of EdU positive cells in OGD+miR-mimics+SNHG15 group at 48 and 72 h were decreased(P＜0.05),and the rates of TUNEL positive cells were increased(P＜0.05),the expression levels of Bax,cleaved caspase-3 and cleaved caspase-9 proteins were increased(P＜0.05),and the expression levels of Bcl-2 protein were decreased(P＜0.05).Conclusion:Myod1 can promote the proliferation inhibition and apoptosis of OGD-induced SH-SY5Y cells by binding to the SNHG15 promoter region and then absorbing miRNA-24.

Objective To investigate the effects of acute sleep deprivation on the behavior and synaptic protein expression of rats.Methods Seventy healthy male Wistar rats were randomly divided into seven groups,a Control group and sleep deprivation groups(24,48,72,96,120 and 144 hours).The sleep deprivation rat model was established by the modified multiplatform water environment sleep deprivation method.Spatial learning and memory were assessed by the Morris water maze.Anxiety was assessed by the open field test.The morphology and quantity of hippocampal neurons were observed by Nissl staining.Western blot and Real-time PCR were used to determine the expression of synaptophysin(SYN),post-synaptic density protein-95(PSD-95),and brain-derived neurotrophic factor(BDNF)in rats.Results Compared with the Control group,the numbers of standing and modification were significantly increased by prolongation of the sleep deprivation time(P＜0.05).The escape latency and path length were significantly increased in 120 and 144 h groups(P＜0.05),whereas the number of platform crossings and the percentage of the target quadrant time were significantly decreased(P＜0.01)and negatively correlated to the sleep deprivation time.The expression levels of BDNF,SYN,and PSD-95 were significantly decreased with the prolongation of sleep deprivation time(P＜0.01).Conclusions With the increase in sleep deprivation time,cognitive dysfunction and anxiety gradually deteriorated,which may be related to decreases in the expression of synaptic biomarkers.

Objective To investigate the current situation of preoperative nursing trust in total knee replacement patients and analyze the influencing factors.Methods Using convenience sampling method,138 patients who underwent total knee ar-throplasty in our department from October 2020 to September 2021 were selected as the research objects.The patients were inves-tigated by general information questionnaire,nurse-patient relationship trust scale(NPTs),self-rating Anxiety Scale(SAS)and knee American Special Surgery scale(HSS),to explore the current situation and influencing factors of patient-nurse trust in pa-tients undergoing total knee arthroplasty.Results The total score of preoperative trust of patients(136.75±7.93);Pearson correlation analysis showed a negative correlation with total anxiety score(r =-0.419,P＜0.01)and no correlation with knee function score(r=0.063,P＞0.05).The results of the multiple linear regression analysis showed that the educational level,previous experience of hospitalization,and preoperative anxiety entered the regression equation(P＜0.05)explained 66.9% of the total variation.Conclusion In this group,the trust between nurses and patients in patients undergoing total knee arthroplas-ty is at the upper middle level,and is affected by education level,previous hospitalization experience and preoperative anxiety.Nurses should focus on patients with low education level,no previous hospitalization experience and high anxiety level,and carry out targeted intervention for theme,so as to reduce postoperative anxiety and improve postoperative function,Promote doctor-pa-tient relationship,reduce medical disputes and help patients recover as soon as possible.

In non-small cell lung cancer(NSCLC),as an improtant oncogenic driver gene,epidermal growth factor receptor exon 20 insertion(EGFR ex20ins)has a unique protein structure and is primarily drug-resistant to tradi-tional EGFR-tyrosine kinase inhibitors(EGFR-TKIs).In recent years,exploration of targeted therapy for EGFR ex20ins has never stopped.Firstly Mobocertinib and Amivantamab obtained approval from U.S.Food and Drug Administration(FDA)for EGFR ex20ins mutant NSCLC patients,then other drugs,such as Sunvozertinib,made breakthroughs and combination therapies also obtained gains.Multi-pronged measures are hopeful to overcome EGFR ex20ins drug resistance.As men-tioned above,it's definitely important to gain deeper understanding of molecular mechanism of EGFR ex20ins and assess ef-fect and difference between novel drugs.This review is devoted to make a summary about newest achievement so to provide valuable reference about precise therapy for patients with EGFR ex20ins.