OBJECTIVE To investigate the application status of prescription pre-review systems in healthcare institutions of Yunnan province， evaluate their system functions and management capabilities， and provide a practical basis for promoting rational drug use. METHODS A questionnaire survey was conducted among public healthcare institutions at or above the secondary level in Yunnan province to investigate the deployment status of the systems. A capability maturity assessment framework was constructed， encompassing 6 dimensions and 39 indicators， including real-time prescription review， prescription correlation review， rule setting， evidence-based information support， prescription authority management， and system operation management. This framework was then used to evaluate the institutions that had implemented the pre-review systems. RESULTS A total of 100 valid questionnaires were collected， with 37 institutions having adopted prescription pre-review systems， mainly tertiary hospitals. The system predominantly adopted a modular architecture and was embedded into the hospital information system through application programming interfaces and middleware， providing certain capabilities for real-time prescription risk identification. Evaluation results indicated that basic functions such as reviewing indications， contraindications， and drug compatibility performed well， while deficiencies remained in functions related to parenteral nutrition prescription， review of drug dosage for specific diseases， individual patient characteristic recognition， and rule setting. Moreover， the construction of review centers and establishment of management systems were also not well-developed. CONCLUSIONS The overall application rate of prescription pre-review systems in Yunnan province remains low. System functions and management mechanisms require further improvement. It is recommended to enhance information infrastructure in lower-level institutions and explore regionally unified review models to promote standardized and intelligent development of prescription review practices.

Objective To investigate the characteristics of epilepsy onset based on the theory of five circuits and six qi in traditional Chinese medicine(TCM).Methods A total of 8 389 epilepsy patients from a community-based natural population cohort study from UK Biobank were included.Frequency and constituent ratio analyses were performed to describe the distribution of epilepsy onset in relation to the five circuits and six qi elements,and statistical inferences were made using chi-square tests.Results The analysis revealed statistically significant differences existed in epilepsy onset across different heavenly stems,earthly branches,recombinant yearly circuit,celestial control and terrestrial effect,and dominant qi(all P＜0.05).From the perspective of circuits,the highest incidence occurred in years corresponding to the"Ji"and"Hai"years,while the lowest incidence was observed in"Bing"and"Mao"years.Years dominated by wood circuit and wind manifestations exhibited the highest incidence,whereas years with cold manifestations showed the lowest incidence,suggesting the liver as the primary pathological site in epilepsy.From the perspective of qi,the third dominant qi was most frequently associated with onset.Regarding presiding and subordinate qi,years with taiyin damp earth presiding and taiyang cold water subordinate had the highest incidence,while years with yangming dry metal presiding and shaoyang monarch fire subordinate had the lowest incidence,indicating that cold-damp years and midsummer periods are potential triggers for epilepsy.Conclusion There is a certain regularity in the epilepsy onset correlated with the features of five circuits and six qi,which can guide prevention and clinical diagnosis and treatment of epilepsy.

[Objective]Through case analysis,to illustrate the importance of the three methods"open pores","cleaning organs"and"loosen stools"in the treatment of immune-mediated dermatoses.[Methods]Three cases of immune-mediated dermatoses treated by LI Zhengfu were compiled.The etiology,pathogenesis and clinical medication rules at different stages of the disease were analyzed,and the clinical experiences of applying the methods"open pores","clean organs"and"loosen stools"from Neijing were summarized.[Results]The initial pathogenesis of immune-mediated dermatoses involves the stagnation of pathogenic factors on the surface,closure of pores and disharmonious Yingwei.The treatment focus is on the"open pores"method,which involves opening the lung Qi to dispel evil.During the course of the disease,pathological products such as phlegm dampness,water retention and blood stasis may be developed.The treatment focus shifts to the"clean organs"and"loosen stools"methods,aiming to resolve dampness,promote urination and activate blood circulation to eliminate pathogenic factors.Case one was addiction rash(wind cold restricting superficial),treated by dispelling wind and dispersing cold,solving the superficial wet,with Mahuang Xinren Yiyi Gancao Decoction and Guizhi Mahuang Half-Half Decoction;Case two was muscle numbness(triple-Jiao dampness and heat),treated by clearing heat and dampness,relieving triple-Jiao,with revised Haoqin Qingdan Decoction and Sanren Decoction;Case three was psoriasis(hot and toxic blood stasis),treated by clearing heat and cooling blood,dispelling wind and smoothing collateral,with revised Simiao Yong'an Decoction.Three medical cases respectively validated the significant efficacy of the three methods.[Conclusion]The etiology and pathogenesis of immune-mediated dermatoses in traditional Chinese medicine are complex,and the disease course is prolonged.Clinically,flexible application of the three methods"open pores""clean organs"and"loosen stools"for syndrome differentiation and treatment is recommended.

[Objective]Based on the theory of five movements and six Qi,to construct the systematic classification framework of combined diseases and complicated diseases in Shanghan Lun(Treatise on Febrile Diseases)and clarify the disease location category,transmission rule and syndrome characteristics.[Methods]Based on the temporal basis of the explanation system of the six meridians and diseases in Shanghan Lun,combined with TIAN Helu's academic thought of"three parts and six meridians",through the pathogenesis diagram and literature mutual reference,the theory of seven categories of combined diseases and complicated diseases Qi was analyzed hierarchically.the systematic classification framework of combined diseases and complicated diseases in Shanghan Lun was constructed,and the disease location category,transmission law and syndrome characteristics were expounded.[Results]The complex diseases described in Shanghan Lun can be classified into seven major categories:Taiyang-Yangming complex disease,Taiyang-Shaoyang complex disease,Yangming-Shaoyang complex disease,triple Yang complex disease,Taiyang-Taiyin complex disease,Taiyang-Shaoyin complex disease and Taiyang-Jueyin complex disease.The first four categories pertain to disorders within the exterior system,while the latter three involve conditions that progress from exterior to interior patterns.The Taiyang-Yangming syndrome can be further divided into three types:cold pathogenic disease(treated with Mahuang Decoction),warm disease(managed with Gegen Decoction),and complex diseases(addressed with Guizhi Decoction for mild exterior Yang deficiency and Dachengqi Decoction for solid interior syndromes).For Taiyang-Shaoyang combined disease,warm disease is treated with Huangqin Decoction to clear heat and nourish Yin,while wind-cold comorbidity is managed through acupuncture at points such as Dazhui(GV14)and Feishu(BL13).Yangming-Shaoyang combined disease involves the use of Xiaochengqi Decoction for mild purgation to resolve interior heat.Triple Yang combined disease is treated with Baihu Decoction to clear Qi-level heat,and Jinshui(fluid)injury is addressed with ginseng to support Yin and Qi.In Taiyang-Taiyin complex disease,surface syndromes accompanied with internal deficiency are treated with Guizhi Renshen Decoction,internal Yin deficiency with Guizhi plus Shaoyao Decoction,and interior excess with Guizhi plus Huangqin Decoction.Renshen For Taiyang-Shaoyin combined disease,cold pathogenic disease is managed with Mahuang Fuzi Xixing Decoction to warm Yang,while warm disease is treated with Huanglian Ejiao Decoction to clear heat and nourish Yin.Lastly,Taiyang-Jueyin complex disease presents with mixed patterns of cold-heat and deficiency-excess,and is treated with Mahuang Shengma Decoction to resolve both exterior and interior symptoms.[Conclusion]The system of TIAN's"three parts and six meridians"integrates the theory of the six meridians to explain the seasons and the five movements and six Qi,and reveals that the nature of diseases and diseases combination in Shanghan Lun is a unified model of space-time disease location.It provides a paradigm of"cause,location and method"for clinical differentiation and treatment,and deepens the practical connotation of the theory of"correspondence between nature and human"in traditional Chinese medicine.

[Objective]Through case analysis,to illustrate the importance of the three methods"open pores","cleaning organs"and"loosen stools"in the treatment of immune-mediated dermatoses.[Methods]Three cases of immune-mediated dermatoses treated by LI Zhengfu were compiled.The etiology,pathogenesis and clinical medication rules at different stages of the disease were analyzed,and the clinical experiences of applying the methods"open pores","clean organs"and"loosen stools"from Neijing were summarized.[Results]The initial pathogenesis of immune-mediated dermatoses involves the stagnation of pathogenic factors on the surface,closure of pores and disharmonious Yingwei.The treatment focus is on the"open pores"method,which involves opening the lung Qi to dispel evil.During the course of the disease,pathological products such as phlegm dampness,water retention and blood stasis may be developed.The treatment focus shifts to the"clean organs"and"loosen stools"methods,aiming to resolve dampness,promote urination and activate blood circulation to eliminate pathogenic factors.Case one was addiction rash(wind cold restricting superficial),treated by dispelling wind and dispersing cold,solving the superficial wet,with Mahuang Xinren Yiyi Gancao Decoction and Guizhi Mahuang Half-Half Decoction;Case two was muscle numbness(triple-Jiao dampness and heat),treated by clearing heat and dampness,relieving triple-Jiao,with revised Haoqin Qingdan Decoction and Sanren Decoction;Case three was psoriasis(hot and toxic blood stasis),treated by clearing heat and cooling blood,dispelling wind and smoothing collateral,with revised Simiao Yong'an Decoction.Three medical cases respectively validated the significant efficacy of the three methods.[Conclusion]The etiology and pathogenesis of immune-mediated dermatoses in traditional Chinese medicine are complex,and the disease course is prolonged.Clinically,flexible application of the three methods"open pores""clean organs"and"loosen stools"for syndrome differentiation and treatment is recommended.

[Objective]Based on the theory of five movements and six Qi,to construct the systematic classification framework of combined diseases and complicated diseases in Shanghan Lun(Treatise on Febrile Diseases)and clarify the disease location category,transmission rule and syndrome characteristics.[Methods]Based on the temporal basis of the explanation system of the six meridians and diseases in Shanghan Lun,combined with TIAN Helu's academic thought of"three parts and six meridians",through the pathogenesis diagram and literature mutual reference,the theory of seven categories of combined diseases and complicated diseases Qi was analyzed hierarchically.the systematic classification framework of combined diseases and complicated diseases in Shanghan Lun was constructed,and the disease location category,transmission law and syndrome characteristics were expounded.[Results]The complex diseases described in Shanghan Lun can be classified into seven major categories:Taiyang-Yangming complex disease,Taiyang-Shaoyang complex disease,Yangming-Shaoyang complex disease,triple Yang complex disease,Taiyang-Taiyin complex disease,Taiyang-Shaoyin complex disease and Taiyang-Jueyin complex disease.The first four categories pertain to disorders within the exterior system,while the latter three involve conditions that progress from exterior to interior patterns.The Taiyang-Yangming syndrome can be further divided into three types:cold pathogenic disease(treated with Mahuang Decoction),warm disease(managed with Gegen Decoction),and complex diseases(addressed with Guizhi Decoction for mild exterior Yang deficiency and Dachengqi Decoction for solid interior syndromes).For Taiyang-Shaoyang combined disease,warm disease is treated with Huangqin Decoction to clear heat and nourish Yin,while wind-cold comorbidity is managed through acupuncture at points such as Dazhui(GV14)and Feishu(BL13).Yangming-Shaoyang combined disease involves the use of Xiaochengqi Decoction for mild purgation to resolve interior heat.Triple Yang combined disease is treated with Baihu Decoction to clear Qi-level heat,and Jinshui(fluid)injury is addressed with ginseng to support Yin and Qi.In Taiyang-Taiyin complex disease,surface syndromes accompanied with internal deficiency are treated with Guizhi Renshen Decoction,internal Yin deficiency with Guizhi plus Shaoyao Decoction,and interior excess with Guizhi plus Huangqin Decoction.Renshen For Taiyang-Shaoyin combined disease,cold pathogenic disease is managed with Mahuang Fuzi Xixing Decoction to warm Yang,while warm disease is treated with Huanglian Ejiao Decoction to clear heat and nourish Yin.Lastly,Taiyang-Jueyin complex disease presents with mixed patterns of cold-heat and deficiency-excess,and is treated with Mahuang Shengma Decoction to resolve both exterior and interior symptoms.[Conclusion]The system of TIAN's"three parts and six meridians"integrates the theory of the six meridians to explain the seasons and the five movements and six Qi,and reveals that the nature of diseases and diseases combination in Shanghan Lun is a unified model of space-time disease location.It provides a paradigm of"cause,location and method"for clinical differentiation and treatment,and deepens the practical connotation of the theory of"correspondence between nature and human"in traditional Chinese medicine.

Objective To analyze the clinical characteristics and changes of serum tumor markers in lung cancer patients with different smoking status in Hanzhong area. Methods A retrospective analysis was performed on 642 hospitalized lung cancer patients in Hanzhong area from March 2017 to March 2019. According to their smoking status, they were divided into observation group (smoking history, n=404) and control group (no smoking history, n=238). Age, sex, place of residence, basic information of the disease including pathological stage, pathological type, short-term efficacy, survival and serum tumor marker level were analyzed retrospectively. Results The proportion of male in observation group (67.08%) was significantly higher(57.56%) (χ²=5.855,P<0.05). Observed a group of 50 or more patients (80.94%) were significantly higher (73.53%) (χ²=4.824 , P<0.05); There was no significant difference between the two groups (χ²=2.110 , P<0.05). The proportion of adenocarcinoma in the control group (49.16%) was the highest, and that of small cell lung cancer in the observation group (41.34%) was the highest (χ²=15.291, P <0.05). Comparison of pathological stages between the two groups showed that stage IIIB (32.77%) was the highest in the control group, followed by stage IV (23.53%), Stage IIIA (20.59%), Stage II (13.03%) and stage I (10.08%). The observation group had the highest proportion in stage IIIA (35.40%), followed by Stage IIIB (25.00%), stage IV (16.09%), Stage IIIA (16.09%), stage II (15.10%) and stage I (8.42%). The difference between the two groups was statistically significant (χ²=10.817,P<0.05). Before treatment, serum CEA, CA125 and CA199 levels in observation group were significantly higher (P<0.05). After treatment, the levels of serum tumor markers in both groups were significantly decreased (P<0.05); The serum CEA, CA125 and CA199 levels in observation group were significantly higher (P<0.05). After treatment, THE ORR of the observation group (48.76%) was lower than that of the control group (53.78%), but the difference was not statistically significant (χ²=2.051, P>0.05). The 1-year survival rate of the observation group (64.85%) was significantly lower than that of the control group (73.95%) (χ²=5.255, P<0.05). Conclusion Middle-aged and elderly male smokers in Hanzhong area have a high incidence of lung cancer, multiple stage Ⅲ squamous cell carcinoma, and the level of tumor markers in serum is higher than that of non-smokers. The prognosis is not good, so we should encourage patients to quit smoking, which can improve the survival rate of patients.

Objective: To evaluate the efficacy and safety of PEG-rhG-CSF therapy in the primary and secondary prevention of chemo-therapy-induced neutropenia . Methods: This single-center, one-arm, and open-label clinical study involved 217 patients with non-my-eloid malignant tumors. These patients included 18 gynecologic oncology (3 endometrial and 15 ovarian cancer), 50 breast cancer, 30 bone tumor, and 119 lymphoma patients who underwent a total of 774 cycles of chemotherapy, comprising 146 primary and 71 sec-ondary prevention patients. The patients ≥45 kg and those <45 kg received a single subcutaneous injection of 6 mg and 3 mg PEG-rhG-CSF, respectively, 24-48 h after the chemotherapy was completed. All patients received only one dose of PEG-rhG-CSF admin-istration per chemotherapy cycle. Results: The overall incidence of febrile neutropenia (FN) was found to be 5.7%, with rates of 4.9% and 7.2% in the primary and secondary prevention groups, respectively. Univariate and multivariate Logistic regression analyses re-vealed that the longer PEG-rhG-CSF was sustained in the treatment cycle, the lower the incidence of FN was. The incidence of FN was significantly lower in the second cycle of the treatment than in the first in both the primary and secondary prevention groups (cycle 1 vs. cycle 2: 11.6% vs. 4.4%, respectively, P=0.039, in the primary group; 16.9% vs. 5.6%, respectively, P=0.034, in the secondary group). The overall incidence of gradeⅣneutropenia was 10.3% (80/774), with rates of 6.7% (34/510) and 17.4% (46/264) in the primary and secondary prevention groups, respectively (P<0.001). The incidence of gradeⅣneutropenia was significantly lower in the second cy-cle of the treatment than in the first (cycle 1 vs. cycle 2: 17.1% vs. 5.3%, respectively, P=0.004, in the primary group; 46.5% vs. 11.3%, respectively, P<0.001, in the secondary group). The treatment-induced toxicity mainly involved bone pain, with 3.7% (8/217) and 1.8% (4/217) incidence rates for grade 1-2 and 3-4 bone pain, respectively. Conclusions: PEG-rhG-CSF administration can effectively reduce the incidence of FN (5.7%) when prophylactically applied to patients with non-myeloid malignant tumors. Primary prevention can sig- nificantly reduce the risk of grade IV neutropenia in all chemotherapy cycles relative to the secondary prevention.

Objective To investigate the effect of the Notch signaling pathway on the proliferation and invasion of human SW982 synovial sarcoma cells. Methods SW982 cells and normal human synovial cells were routinely cultured, and the expression of proteins related to the Notch pathway was compared. The Notch signaling pathway was manipulated by NICD1 overexpression, CFB1 shRNA lentivirus, and the γ-secretase inhibitor, DAPT. CCK-8 and wound healing assays were carried out to investigate the role of the Notch signaling pathway in SW982 cells. Results The Notch signaling pathway clearly showed higher activity in human SW982 synovial sarcoma cells than in normal human synovial cells (P ＜ 0.05). The proliferation and invasion of SW982 cells were significantly upregulated by overexpressing NICD1; however, were suppressed by downregulating the Notch signaling pathway using CFB1 shRNA or DAPT (P ＜ 0.05). Conclusion Our findings demonstrate that the proliferation and invasion of human SW982 synovial sarcoma cells are dependent on Notch signaling pathway activity.

Objective: To investigate the efficacy and safety of anlotinib hydrochloride capsules for the treatment of advanced soft tissue sarcoma based on the data from Department of Bone and Soft Tissue Tumor, Peking University Cancer Hospital&Institute. Methods: Patients were randomized allocated at 2:1 ratio for the anlotinib treatment and placebo group. The treatment group received 12 mg/day of anlotinib for 14 consecutive days in a 21-day cycle. The primary end-point was progression-free survival (PFS), and the secondary end-points were disease control rate (DCR), overall survival (OS), and adverse event rate. Results: A total of 46 patients were enrolled in this study; 7 of them were excluded from per protocol set (PPS). Among the remaining 39 patients, 28 were included in the anlotinib group and 11 in the placebo group. In the anlotinib group, 4 patients had partial remission and 13 had stable disease (SD), whereas in the placebo group, 3 patients had SD. The difference in DCR between the 2 groups was statistically significant (60.7% vs . 27.3%, P=0.082). The DCR of the advanced soft tissue sarcoma in the anlotinib group was 78.6% (11/14). The median PFS in the anlotinib group was 12.4 (95% confidence interval [CI]: 7.6 to 17.2) months, which was significantly longer than 4 months in the placebo group (95% CI: 1.7 to 6.3 months, P=0.043); however, the difference in OS between the 2 groups was not significant (19.4 vs . 17.6 months, P=0.961). Regarding the safety, 2 patients had severe adverse events (7.14%) possibly related with treatment in the anlotinib group; one of them had pneumothorax. The other adverse events were grade 1 to 2. Conclusions: Soft tissue sarcoma is highly responsive to anlotinib, with prolonged PFS. Anlotinib is well tolerated and can be used as a treatment option for advanced soft tissue sarcoma.