Chronic refractory wound （CRW） presents significant clinical treatment challenges due to pathological characteristics such as persistent inflammation， bacterial infection， oxidative stress and inadequate angiogenesis. Astragali Radix， a traditional Chinese medicinal herb， exerts multi-target pharmacological effects on CRW through its active components， including Astragalus polysaccharides， flavonoids， and astragaloside Ⅳ， etc. Fundamental studies indicate that these components promote CRW healing by modulating inflammatory responses， inhibiting pathogen growth， improving antioxidant capacity and stimulating neovascularization. Network pharmacology and bioinformatics studies have revealed that active components of Astragali Radix target and modulate key signaling nodes such as nuclear factor-κB， phosphatidylinositol 3-kinase/Akt， AMP-activated protein kinase， and vascular endothelial growth factor receptor， as well as inflammation-angiogenesis-related pathways， thereby synergistically exerting anti-inflammatory and pro-angiogenic effect. Clinical applications have demonstrated that oral formulations （e.g.， Huangqi guizhi decoction， Danggui huangqi decoction， etc.） reduce healing time of CRW and lower inflammatory marker levels， while topical preparations （e.g.， Zizhu ointment， Huangqi shengji ointment， electrostatically spun Astragalus polysaccharide composite nanofibre dressings， etc.） significantly improve healing rates of CRW and minimize complications.

Objective:This article analyzed the current situation, similarities and differences and main problems of the registration and management systems of innovative medical devices in China and the United States.Methods:This article summarized the requirements and policies for the registration management of innovative medical devices in China and the United States, as well as the development and differences of the registration of innovative medical devices in China and the United States, and the main problems in the registration management of innovative medical devices in China.Results:At present, the development level of medical device industry in China and the United States was different, facing different development problems, and there were differences in the access standards and management methods of innovative medical devices. The registration management system established for innovative medical devices in China was gradually improving, and to a certain extent, it had promoted the enthusiasm of innovative product research and development and registration applications, but there were also problems such as unclear innovation evaluation scales, insufficient early intervention of review resources, and insufficient utilization of post-marketing data.Conclusions:Drawing on the beneficial experience of breakthrough device registration management in the United States, we will improve the registration management system for innovative products and shorten the review and approval cycle by clarifying the identification criteria for innovative medical devices, promoting the placement of review resources in the R&D stage, and further strengthening the use of post-marketing data and regulatory scientific research.

Objective Based on the framework of"quantitative analysis of supporting policies",this study focuses on the formulation and implementation of supporting policies for pharmaceutical science and technology innovative enterprises in China,so as to provide a certain reference for the implementation and improvement of policies for pharmaceutical science and technology innovative enterprises in China.Methods This study used Roy Rothwell and Walter Zegveld's innovative policy tools as the basis for analysis,and combined with the dimension of policy type,the policy was quantitatively analyzed.Results A total of 47 effective policy documents were selected,including 22 issued by the state and 25 issued by Beijing municipal government.A total of 104 policy instruments were included through the dismantling of policy provisions.Specifically,environment-based policy tools accounted for the highest proportion(60.58%),while demand-based and supply-based policy tools were relatively few.From the perspective of policy types,there were more planning policy documents(25 articles),while there were relatively few specific implementation policies(22 articles).Conclusion It is necessary to focus on optimizing the formulation stage of support policies and improving the use of supply-oriented and demand-oriented policy tools to better meet the needs of pharmaceutical science and technology innovative enterprises.

This paper reported a case of severe COVID-19 in the recovery stage with acute lymphoblastic leukemia treated by integrated traditional Chinese and western medicine， with the intention of shedding light on the clinical diagnosis and treatment of similar conditions. The patient， who had acute lymphoblastic leukemia， developed COVID-19 infection during the bone marrow suppression period after chemotherapy. Treatment with western medicine was mainly anti-infection， symptomatic management， and supportive care. During the recovery stage， considering the patient's chemotherapy history and disease progression， the overall syndrome was identified as deficiency of both qi and yin and binding of phlegm and blood. Based on the “state-target” combined treatment strategy， herbal prescriptions were selected and modified to address the “deficiency state”， “disease target”， and “symptom target”. In addition to western medicine， the patient was administered with Shengmai Powder （生脉散） and Compound Zhebei Granules （复方浙贝颗粒） in its modifications to boost qi， nourish yin， and reinforce healthy qi， nourish and cool the blood， ultimately achieving satisfactory therapeutic effects.

Objective:To investigate the effects of total-body PET/CT imaging with short acquisition time on image quality and lesion detectability in lungs and parenchymal organs.Methods:Sixty patients (31 males, 29 females, age (61.1±11.8) years) with pulmonary nodules (PN) and 53 patients (29 males, 24 females, age (56.7±17.2) years) with parenchymal organ lesions (POL) who underwent total-body PET/CT imaging in the First Affiliated Hospital of Shandong First Medical University between October 2021 and April 2022 were retrospectively analyzed. The acquisition time with PET was 600 s, and the reconstructed images were divided into 6 groups based on different duration (30, 60, 120, 180, 300 and 600 s), namely G30, G60, G120, G180, G300 and G600 groups. The subjective analysis was carried out with the 5-point Likert scale in 3 aspects: the overall impression of image quality, noise, and lesion conspicuity. The objective analysis indicators included the SUV mean of the mediastinal blood pool (MBP); the SUV mean, standard deviation (SD) and signal-to-noise ratio (SNR) of the liver; SUV max and target-to-background ratio (TBR) of the lesions. Differences of the indicators among 6 groups were analyzed by Friedman test with Bonferroni correction. G600 served as the reference for the other 5 groups to test their lesion detectability. Results:The subjective image quality of different groups for PN and that of G120, G180, G300 groups for POL could meet the needs of clinical diagnosis in terms of the overall image quality, noise, and lesion conspicuity (all scores>3). There was no significant difference in the SUV mean of MBP among different time groups (median for PN: 1.52-1.56, median for POL: 1.35-1.47; χ2 values: 10.23, 11.02, both P>0.05). Difference was not found in SUV mean of the liver either (median for PN: 2.51-2.56, median for POL: 2.33-2.40; χ2 values: 8.35, 8.93, both P>0.05). The liver SD significantly increased along with the shortened acquisition time ( χ2 values: 400.99, 400.00, both P<0.001; z values: from -16.90 to -3.15, all P<0.003). The SNR significantly decreased along with the shortened acquisition time ( χ2 values: 397.32, 400.00, both P<0.001; z values: 2.98-16.90, all P<0.003). The SUV max (median for PN: 3.55-4.01, median for POL: 5.77-6.08; χ2 values: 8.58, 3.02, both P>0.05) and TBR (median for PN: 2.42-2.81, median for POL: 2.36-2.45; χ2 values: 9.83, 3.69, both P>0.05) of lesion were not significantly different among 6 groups. Taking G600 group as a reference, the lesion detection rates were 100% in G30 group and other 4 groups for PN (81/81) and in G120, G180, G300 groups for POL (80/80). Conclusion:Total-body PET/CT imaging with acquisition time of 30 s for lungs and that with acquisition time of 120 s for parenchymal organs are feasible for clinical use, with the PET image quality and lesion detectability maintained.

Objective:Iron accumulation is related to the occurrence of postmenopausal osteoporosis. Meanwhile, autophagy abnormality of bone marrow hematopoietic cells is observed in hip osteoporotic fracture. This study is performed to investigate correlation between iron accumulation induced bone loss and hematopoietic autophagy dysfunction to explore the new risk factor of osteoporosis.Methods:Male iron accumulation mice model was established by intraperitoneally injecting ferric ammonium citrate. Serum ferritin and osteogenic indicator P1NP were tested by ELISA. Bone mineral density was measured by micro-CT. Femur and tibia bone marrows were collected for hematopoietic stem and progenitor cells proportion and cell apoptosis analysis. Autolysosome formation was measured by image flow cytometry. We used conditional mouse model Atg7 flox/flox; Vav-Cre(Atg7 -/-) in which Atg7 had been genetically deleted in the hematopoietic system. Bone marrow hematopoietic stem and progenitor cells were collected for RNA sequence. micro-CT scan was conducted for Atg7 -/- femur. Results:Ferritin level of iron accumulation mice was significantly higher than control group( P<0.05). Iron accumulation inhibited P1NP and induced decreased bone mineral density( P<0.05). Iron accumulation bone marrow displayed enhanced hematopoietic stem and progenitor cells proportion( P<0.05), with more cell apoptosis( P<0.05). Hematopoietic autophagy was deteriorated in iron accumulation bone marrow. Transcriptomic profiling showed up-regulation of iron activity in Atg7 -/- mice, with increased iron homeostasis and iron membrane transporter genes, including Lcn2, Tfr2, Slc40a1(Fpn1), Steap3, and Cpox. micro-CT revealed severe bone loss and decreased bone mineral density in Atg7 -/- mice( P<0.05). Conclusion:Iron accumulation induced bone loss is related to inhibition of hematopoietic cells. Hematopoietic autophagy dysfunction is associated with bone loss.

Objective:To study the risk factors of hemodynamically significant patent ductus arteriosus (hsPDA) in extremely preterm infants (EPI).Method:From July 2017 to April 2020, EPI (gestational age <28 weeks) admitted to the Department of Neonatology of our hospital were included and analyzed retrospectively. According to whether hsPDA existed or not, the infants were assigned into non-hsPDA group and hsPDA group. Demographic findings and possible risk factors of hsPDA were collected.The cumulative fluid overload (FO) within 3 days after birth was calculated. Univariate and multivariate analysis were used to determine the risk factors of hsPDA.Result:A total of 79 infants with gestational age of (27.0±0.9) weeks and birth weight of (987±173)g were enrolled, including 23 cases in non-hsPDA group and 56 cases in hsPDA group. Univariate analysis showed that thrombocytopenia ( P=0.044), respiratory distress syndrome (RDS) treated with pulmonary surfactant (PS) ( P=0.006) and high FO level ( P=0.002) were associated with hsPDA. Multivariate analysis showed that RDS treated with PS ( OR=5.933, 95% CI 1.360~25.883, P=0.018) and high FO level ( OR=1.261, 95% CI 1.063~1.496, P=0.008) were independent risk factors for hsPDA in EPIs. ROC curve analysis showed that the cut-off value of FO was -0.2%, with 85.7% sensitivity and 56.5% specificity distinguishing the presence of hsPDA (AUC=0.712, Youden index=0.422). Conclusion:High level of FO within the first 3 days of life and RDS treated with PS are independent risk factors for hsPDA in EPI. After PS treatment, hemodynamic changes of infants with RDS should be monitored closely. During early fluid management of EPI, FO should be strictly monitored to avoid high FO level.

Adiponectin is a kind of cytokines secreted by adipose tissue, which has the functions of regulating glucose and lipid metabolism, protecting vascular endothelium, promoting angiogenesis, and anti-inflammatory. Recent studies have shown that there is a certain correlation between adiponectin and vascular cognitive impairment and its risk factors. This article reviews the relationship between adiponectin and vascular cognitive impairment, especially its risk factors.

Objective To evaluate the scientific research performance of a third-grade maternal and child health hospital in Guangxi from 2007 to 2016,and to understand the situation of scientific research in past 10 years,and provide decision-making basis for strengthening the scientific research management of hospitals.Methods According to the statistical reports of the hospital's scientific research data,7 indexes were used to evaluate the quality of the scientific research performance of the hospital,and the close value method was used to evaluate the quality of the scientific research during 2007-2016.Results According to the Close-value method analysis,the overall quality of the scientific research performance showed a upward trend in recent ten years;according to the ranked order of the Close-value,the research performance of the institute in 2016 was the smallest while the quality of scientific research was the best.In 2009,the Institute's scientific research performance was the closest,however,the scientific research performance was the worst.Conclusions The result of comprehensive evaluation of Close-value method is consistent with the actual situation of scientific research in this hospital.It has reference significance for the evaluation of hospital scientific research quality.

Objective To evaluate the inhibitory effect of geniposide on the oxidative damage to in vitro cultured human melanocytes,and to explore the role of PI3K-Akt signaling pathway in this inhibitory effect.Methods Epidermal melanocytes were isolated from the circumcised foreskin of healthy adolescent males,and then subjected to culture.Melanocytes at passage 2-3 were divided to six groups:control group receiving no treatment,geniposide group treated with 125 μmol/L geniposide alone,LY294002 group treated with 5 μmol/L LY294002 alone,H2O2 group treated with 250 μmol/L H2O2 alone,geniposide + H2O2 group firstly treated with 125 μmol/L geniposide for 24 hours followed by 4-hour treatment with 250 μmol/L H2O2,and geniposide + LY294002 + H2O2 group treated with 125 μmol/L geniposide for 24 hours,then with 5 μmol/L LY294002 for 1 hour,followed by 4-hour treatment with 250 μmol/L H2O2.After the above treatment,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the cellular proliferative activity,Western blot analysis to determine the protein expression of Akt,phosphorylated Akt (p-Akt),heme oxygenase1 (HO-1) and glutathione peroxidase (GPx-1),and flow cytometry to detect the level of cellular reactive oxygen species (ROS),and biochemical methods were used to evaluate the activity of superoxide dismutase (SOD) and catalase (CAT).Statistical analysis was carried out by one-way analysis of variance (ANOVA) for intergroup comparison,and Student-Newman-Keuls-q (SNK-q) test for multiple com-parisons.Results Compared with the control group,the H2O2 group showed significantly decreased cellular proliferative activity (P ＜ 0.01),protein expression of p-Akt (P ＜ 0.01),HO-1 (P ＜ 0.01) and GPx-1 (P ＜ 0.05),SOD activity (P ＜ 0.01) and CAT activity (P ＜ 0.01),but significantly increased ROS level (P ＜ 0.01).Compared with the H2O2 group,the geniposide + H2O2 group showed significantly increased cellular proliferative activity (72.98％ ± 8.92％ vs.50.53％ ± 10.85％,P ＜ 0.05),up-regulated protein expression of p-Akt (P ＜ 0.05),HO-1 (P ＜ 0.01) and GPx-1 (P ＜ 0.01),increased SOD activity (6.82 ±1.03 U/mg vs.1.29 ± 0.43 U/mg,P ＜ 0.05) and CAT activity (46.08 ± 4.16 U/mg vs.18.71 ± 3.09 U/mg,P ＜0.05),but decreased ROS level (1 284.33 ± 110.64 vs.2 158.00 ± 222.75,P ＜ 0.01).The proliferative activity of melanocytes was significantly lower in the geniposide + LY294002 + H2O2 group (44.35％ ±14.85％) than in the geniposide + H2O2 group (P ＜ 0.05).In addition,the geniposide + LY294002 + H2O2 group showed significantly decreased protein expression of p-Akt (P ＜ 0.01),HO-1 (P ＜ 0.05) and GPx-1 (P ＜ 0.01),SOD (1.31 ± 0.65 U/mg,P ＜ 0.05) and CAT activity (23.25 ± 5.56 U/mg,P ＜ 0.05),but significantly increased ROS level (1 668.00 ± 62.03,P ＜ 0.05)compared with the geniposide + H2O2 group.Conclusion Through the PI3K-Akt pathway,geniposide can promote the protein expression of HO-1 and GPx-1 in melanocytes,enhance SOD and CAT activity,and antagonize the oxidative damage of melanocytes.