Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163),angiopoietin-like protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group,and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission,60 patients were divided into mild group (n=10),moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis,patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA),and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group,the levels of serum sCD163 (687.55±86.43 ng/ml vs 411.07±58.24 ng/ml) and ANGPTL3 (60.28±10.55 mg/L vs 25.34±5.93 mg/L) in ACI group were significantly increased,and the differences were significant (t=20.549,22.363,all P<0.05). The levels of serum sCD163 (551.65±69.66 ng/ml,668.92±81.12 ng/ml,859.79±117.24 ng/ml) and ANGPTL3 (44.52±8.12 mg/L,58.67±10.37 mg/L,75.34±13.12 mg/L) in mild,moderate and severe groups were gradually increased,and the differences were significant (F=36.011,23.007,all P<0.05). Compared with the good prognosis group,the proportion of time from onset to thrombolysis≥ 3 h,the proportion of NIHSS score>10 at admission,and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group,and the differences were statistically significant (t/x2=5.644,4.775,8.982,10.866,10.293,9.702,all P<0.05). ROC results showed that the area under the curves(95％ confidence intervals)[AUC(95％CI)]of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711～0.915) and 0.783 (0.658～0.879),and their sensitivity and specificity were 72.22％ and 85.71％,77.78％ and 85.71％,respectively. The AUC(95％CI)of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients[0.950(0.861～0.990)]was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378,2.109,P=0.017,0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients,and are related to their severity and prognosis.

Objective To investigate the association of endometrial thickness(EMT)with obstetric and neonatal outcomes of monoparous pregnancy in fresh cleavage embryos transfer.Methods A total of 1 845 patients of monoparous pregnancy after fresh cleavage embryos transfer cycles from Jan 2016 to Mar 2022 at Shanghai First Maternity and Infant Hospital,Tongji Universtiy were analyzed retrospectively.Patients were categorized into three groups by EMT on transferation day:≤8 mm(group A),8-14 mm(group B)and≥14 mm(group C).The primary outcomes were preterm birth(PTB),birth weight and birth weight z-score,small-for-gestation age,large-for-gestation age,very low birth weight,low birth weight and macrosomia.The second outcomes were pregnancy and perinatal complications.The relationship between EMT and adverse neonatal outcomes was estimated by Logistic regression analysis.Results The rate of ectopic pregnancy was increased significantly in group A.No significant differences were found among the three groups in gestation age,birth weight,birth weight z-score,PTB,small for gestation age,large for gestation age,low birth weight,very low birth weight and macrosomia.Compared with group B,the odds of adverse neonatal outcomes did not show significant differences before and after adjustment in both group A and group C by Logistic regression analysis.Conclusion Thinner EMT in fresh cleavage embryos transfer is associated with higher rate of ectopic pregnancy,while it is not independently associated with adverse perinatal outcomes.

Objective:To construct a key item checklist for the Mini-HTA report specification,providing scientific guidance for drafting each section of Mini-HTA research reports,enhancing their standardization,scientific rigor,and completeness,thereby improving the efficiency and quality of health decision-making.Methods:Based on preliminary literature review and qualitative systematic review,a pool of problem items for the Mini-HTA report specification was formed.Delphi questionnaires were distributed,and the Delphi technique was employed through two rounds of expert consultation to optimize and select key items.Results:Through two rounds of Delphi expert consultation,the initial Mini-HTA report specification item checklist was screened,integrated,and supplemented.A finalized key item checklist was constructed,comprising 8 first-level items(Title,Abstract,Introduction,Methods,Results,Discussion,Conclusion,and Other Relevant Information)and 48 second-level items.Conclusion:The constructed key item checklist for the Mini-HTA report specification provides scientific guidance for drafting Mini-HTA research reports.It helps enhance the standardization and transparency of the assessment process and the reliability of results,thereby optimizing the efficiency and quality of health decision-making.

Objective:To construct a key item checklist for the Mini-HTA report specification,providing scientific guidance for drafting each section of Mini-HTA research reports,enhancing their standardization,scientific rigor,and completeness,thereby improving the efficiency and quality of health decision-making.Methods:Based on preliminary literature review and qualitative systematic review,a pool of problem items for the Mini-HTA report specification was formed.Delphi questionnaires were distributed,and the Delphi technique was employed through two rounds of expert consultation to optimize and select key items.Results:Through two rounds of Delphi expert consultation,the initial Mini-HTA report specification item checklist was screened,integrated,and supplemented.A finalized key item checklist was constructed,comprising 8 first-level items(Title,Abstract,Introduction,Methods,Results,Discussion,Conclusion,and Other Relevant Information)and 48 second-level items.Conclusion:The constructed key item checklist for the Mini-HTA report specification provides scientific guidance for drafting Mini-HTA research reports.It helps enhance the standardization and transparency of the assessment process and the reliability of results,thereby optimizing the efficiency and quality of health decision-making.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163),angiopoietin-like protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group,and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission,60 patients were divided into mild group (n=10),moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis,patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA),and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group,the levels of serum sCD163 (687.55±86.43 ng/ml vs 411.07±58.24 ng/ml) and ANGPTL3 (60.28±10.55 mg/L vs 25.34±5.93 mg/L) in ACI group were significantly increased,and the differences were significant (t=20.549,22.363,all P<0.05). The levels of serum sCD163 (551.65±69.66 ng/ml,668.92±81.12 ng/ml,859.79±117.24 ng/ml) and ANGPTL3 (44.52±8.12 mg/L,58.67±10.37 mg/L,75.34±13.12 mg/L) in mild,moderate and severe groups were gradually increased,and the differences were significant (F=36.011,23.007,all P<0.05). Compared with the good prognosis group,the proportion of time from onset to thrombolysis≥ 3 h,the proportion of NIHSS score>10 at admission,and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group,and the differences were statistically significant (t/x2=5.644,4.775,8.982,10.866,10.293,9.702,all P<0.05). ROC results showed that the area under the curves(95％ confidence intervals)[AUC(95％CI)]of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711～0.915) and 0.783 (0.658～0.879),and their sensitivity and specificity were 72.22％ and 85.71％,77.78％ and 85.71％,respectively. The AUC(95％CI)of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients[0.950(0.861～0.990)]was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378,2.109,P=0.017,0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients,and are related to their severity and prognosis.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder affecting multiple systems, characterized by the development of harmful autoantibodies and immune complexes that lead to damage in organs and tissues. Chinese medicine (CM) plays a role in mitigating complications, enhancing treatment effectiveness, and reducing toxicity of concurrent medications, and ensuring a safe pregnancy. However, CM mainly solves the disease comprehensively through multi-target and multi-channel regulation process, therefore, its treatment mechanism is often complicated, involving many molecular links. This review introduces the research progress of pathogenesis of SLE from the aspects of genetics, epigenetics, innate immunity and acquired immunity, and then discusses the molecular mechanism and target of single Chinese herbal medicine and prescription that are commonly used and effective in clinic to treat SLE.
Lupus Erythematosus, Systemic/immunology* ; Humans ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/pharmacology* ; Animals

OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Ischemic stroke (IS) is a globally life-threatening disease. Presently, few therapeutic medicines are available for treating IS, and rt-PA is the only drug approved by the US Food and Drug Administration (FDA) in the US. In fact, many agents showing excellent neuroprotection but no blood flow-improving activity in animals have not achieved ideal clinical efficacy, while thrombolytic drugs only improving blood flow without neuroprotection have limited their wider application. To address these challenges and meet the huge unmet clinical need, we have designed and identified a novel compound AAPB with dual effects of neuroprotection and cerebral blood flow improvement. AAPB significantly reduced cerebral infarction and neural function deficit in tMCAO rats, pMCAO rats, and IS rhesus monkeys, as well as displayed exceptional safety profiles and excellent pharmacokinetic properties in rats and dogs. AAPB has now entered phase I of clinical trials fighting IS in China.