OBJECTIVE To investigate the implementation effects of the national centralized drug volume-based procurement policy （abbreviated as “national centralized procurement policy”） in Guangxi Zhuang Autonomous Region prefecture， and to provide a reference for the future centralized drug procurement work of the medical institution. METHODS Drug procurement data before and after policy implementation were included in the study. The six secondary indicators （such as availability， affordability， and drug safety） and eighteen third-level indicators （such as completion rate of agreed purchase volume， affordability level， drug revenue proportion） were introduced， guided by the policy objectives and issues of concern to policy beneficiaries. Descriptive statistics was adopted to analyze the data before and after policy implementation （in 2019 and 2020） in terms of differences and change trends. RESULTS In terms of accessibility， the participation rate of medical institutions in Guangxi Zhuang Autonomous Region was 92.55%， the proportion of diseases involved and median completed procurement rate were 40.16%， and 287.82% respectively， and the total centralized delivery rate was 97.20%. In terms of affordability， the total reduction amplitude in drug price was 74.80% from 2019 to 2022； the charge for medicine per capita in hospitalization， the proportion of medicine used for outpatient service and hospitalization， decreased by 17.61%， 10.22%， and 20.10% in order； the burden levels on medical fares for patients were all below 1 in addition to chronic diseases， and anti-tumor drugs. In terms of the impact on medicine， the ratio of adverse drug reaction event cases in 2022 was 66.00%， an increase of 1.29% compared to the previous； since the implementation of the policy， 12 drugs from local pharmaceutical enterprises from Guangxi Zhuang Autonomous Region had passed the consistency evaluation， and the market concentration rate of the top 8 pharmaceutical companies was less than 20.00%. In terms of the impact on healthcare and medical insurance， the public medical institutions achieved generic substitution for originator drugs mostly until 2022； about 9.12% of drugs that were non- centrally purchased in the same category were used； 63.39% of people under investigation did not show a need for a second dressing change； drug expenditure decreased by 2.459 billion yuan. CONCLUSIONS The national centralized procurement policy achieves a significant effect in Guangxi Zhuang Autonomous Region. On the other hand， attention should be paid to these suggestions as follows: expanding the category of drugs used in clinic， conducting clinically comprehensive evaluation of selected drugs， and improving reasonable allocation strategy， etc.

Objective To identify the characteristics of complementary and alternative therapies for cancer patients and investigate the effect on symptom clusters in cancer patients,in order to provide references in management of the symptom clusters.Methods A scoping review was conducted to search nine databases,namely PubMed,Cochrane Library,Web of Science,Embase,PsycINFO,CINAHL,CNKI,Wanfang Data,and VIP,for literatures published between January 2016 and January 2024.Results Twenty articles focusing on complementary and alternative therapies were included.Four themes were identified from the retrieved articles:cancer research subjects,characteristics of complementary alternative therapies,type of symptom cluster and effectiveness of complementary alternative therapies.Specifically,the cancer research subjects in relation to symptom cluster management included those of breast cancer,advanced cancer and the cancer under radio or chemotherapy.The most commonly used types of complementary and alternative therapies in managing the symptom clusters were exercise therapies,cognitive-behavioural interventions,traditional Chinese medicine therapies,multidisciplinary collaborative models and specific interventions.Interventions for symptom clusters predominantly targeted fatigue,mental status,pain,and gastrointestinal symptoms.Conclusion The interventions for symptom clusters in complementary and alternative therapies vary across different types of complementary and alternative therapies,so as the effectiveness.Some of the complementary and alternative therapies have unidentified effects and further investigations are required.The complementary and alternative therapies currently that have been used in managing the symptom clusters were found to have shortcomings.Further studies should focus on sentinel and core symptoms of symptom clusters and emphasize the development of standardised and individualised intervention plans based on symptom management theories,hence to improve the management of symptom clusters in cancer patients.

Talents are the main force for the development of traditional Chinese medicine（TCM）， and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present， we are still exploring and developing in the fields of the formulation， implementation and evaluation indicators of TCM talent evaluation system. However， there are shortcomings and difficulties. For instance， insufficient stratification in the evaluation， excessive emphasis on the quantity of achievements， neglecting the quality of the achievements and the actual contribution， imperfect assessment indicators， and the weak characteristics of TCM. Therefore， national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard， in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value， ability and contribution. For the evaluation of TCM clinical talents， China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM（CCCL-TCM）， which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry， and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.

After kidney transplantation,the recipients have been under long-term immunosuppression due to the use of immunosuppressive drugs,and they are high-risk population of Pneumocystis jirovecii pneumonia(PJP).The risk of PJP is the highest within 6 months after kidney transplantation and after intensified anti-rejection therapy.Fever,dry cough,progressive dyspnea and hypoxemia are common clinical manifestations of PJP after kidney transplantation.Trimethoprim-sulfamethoxazole(TMP-SMX)can effectively prevent and treat PJP,and significantly reduce the incidence rate and fatality of PJP.To standardize the diagnosis,treatment and prevention of PJP after kidney transplantation,Branch of Organ Transplantation of Chinese Medical Association organized relevant Chinese experts to formulate the"Guidelines for Clinical Diagnosis and Treatment of Pneumocystis Jirovecii Pneumonia After Kidney Transplantation in China"based on clinical concerns,aiming to provide guidance for the prevention and comprehensive clinical treatment of PJP after kidney transplantation.

Objective:To conduct a scoping review on self-transcendence in cancer patients, analyze and summarize the current status of self-transcendence in cancer patients, so as to provide a reference for its future development in cancer.Methods:The relevant research was systematically searched on China National Knowledge Infrastructure, WanFang Data, VIP, PubMed, Web of Science, Embase, Cochrane Library, and CINAHL, with a search period from database establishment to September 5, 2023. The included literature was summarized and analyzed.Results:A total of 43 articles were included, consisting of 16 cross-sectional surveys, 8 qualitative studies, and 19 intervention studies. Five aspects were elaborated and summarized, namely theoretical evolution and development, evaluation tools, current situation and influencing factors, implementation approaches, and intervention program characteristics.Conclusions:The research on self-transcendence in cancer patients is in the ascendant. In the future, it is necessary to strengthen the development of self-transcendence assessment tools for cancer patients, adopt various research methods to comprehensively understand the changes in self-transcendence level and psychological experience of cancer patients, and improve the scientific and rigorous nature of self-transcendence intervention program for cancer patients.

Objective To assess short-and long-term changes in the upper airway,natural head position and hyoid bone position in skeletal Class Ⅲ patients after bimaxillary surgery.Methods In this retrospective study,the cone-beam computed tomography(CBCT)of skeletal Class Ⅲ patients was taken before surgery(T0),3 months after surgery(T1)and 2 years after surgery(T2).Three-dimensional images were created to assess postoperative changes and the correlation between the upper airway,natural head posi-tion and hyoid bone was analyzed.Results Thirty skeletal Class Ⅲ patients(13 men and 17 women)who underwent bimaxillary sur-gery with a mean(SD)age of 21 years(a range of 17-30 years)were evaluated.A significant decrease was observed in the volume of palatopharynx,glossopharynx and total airway after T1 and T2.There was a significant correlation between changes in the position of the mandible and changes in the volume of the upper airway(P＜0.05).The NSL/OPT angle and the NSL/CVT angle were greater after Tl and T2.The change in the NSL/CVT angle was positively correlated with the change in palatopharyngeal and glossopharyngeal volume(P＜0.05).Conclusion Bimaxillary surgery may cause a decrease in upper airway volume,an increase in the cranio-cervical angle,and a downward and backward movement of the hyoid bone.Changes in the cranio-cervical angle may cause changes in the upper air-way.

Objective To analyze the application characteristics of acupuncture and moxibustion in the treatment of postherpetic neuralgia(PHN)using complex networks;To provide clinical acupuncture and moxibustion treatment with application basis for acupoint selection,acupuncture and moxibustion,and treatment ideas.Methods The clinical research literature on acupuncture and moxibustion treatment for PHN was retrieved from CNKI,Wanfang Data,VIP,PubMed and Web of Science.The literature was screened according to the inclusion and exclusion criteria,and Excel 2019 was used to establish an acupuncture and moxibustion treatment PHN database.SPSS Modeler 18.0 software was used for modeling and association rule analysis,and Gephi 0.10.1 software was used for complex network analysis.Results Totally 237 articles were included,and 262 acupuncture and moxibustion prescriptions data were extracted,involving a total of 115 acupoints,with a total use frequency of 1 432 times.The top 10 most frequently used acupoints were Ashi acupoint(214 times)and Jiaji acupoint(198 times),Zusanli(74 times),Taichong(74 times),Sanyinjiao(66 times),Hegu(65 times),Yanglingquan(62 times),Xuehai(60 times),Zhigou(53 times),and Quchi(52 times).The association rule analysis showed that the acupoint combination with the highest correlation was Ashi acupoint-Jiaji acupoint.K-core hierarchical analysis and community analysis on the complex network of the acupoint prescriptions obtained two core acupoint groups.Therapy analysis showed that filiform needle acupuncture was the most commonly used intervention for acupuncture treatment of PHN;syndrome type-acupoint analysis showed that the syndrome types with the highest frequency of PHN were liver meridian heat stagnation,blood stasis and collaterals obstruction,and spleen meridian damp-heat;tonic and diarrhea-acupoint analysis showed that the main operating techniques were neutral-tonifying and neutral-discharging.Conclusion Acupuncture and moxibustion treatment for PHN mainly selects local acupoints,Ashi acupoint and Jiaji acupoint are often selected,and focusing on the cooperation with distal acupoints.The external and internal meridians are mostly selected according to different syndrome types.The operation is performed using neutral-tonifying and neutral-discharging techniques.Commonly used filiform acupuncture combined with electro-acupuncture,pricking,cupping and other therapies.The application characteristics can provide clinical reference for the treatment of PHN.

Objective:To evaluate the effects of inhaling high concentration hydrogen on myocardial injury and mitochondrial biogenesis in septic mice.Methods:One hundred and twenty-eight clean-grade healthy male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=32 each) using a random number table method: sham operation group (group Sham), sham operation + hydrogen group (group Sham+ H), sepsis group (group Sep), and sepsis+ hydrogen group (group Sep+ H). The sepsis model was developed by cecal ligation and puncture in anesthetized animals. In Sham+ H and Sep+ H groups, 67% H 2 was inhaled for 1 h starting from 1 and 6 h after operation, respectively. Twenty mice in each group were randomly selected to observe the survival conditions at 7 days after operation. Blood samples were taken from the remaining mice at 24 h after operation for determination of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), cardiac troponin I (cTnI) and creatine kinase isoenzyme (CK-MB) (by enzyme-linked immunosorbent assay), for examination of the pathological changes of myocardial tissues (by HE staining), and for determination of the mitochondrial membrane potential (MMP) (by fluorescence spectrophotometry), ATP content (by luciferase assay), and expression of myocardial peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), nuclear respiratory factor 2 (NRF2) and mitochondrial transcription factor A (TFAM) (by Western blot). Results:Compared with Sham group, the survival rate was significantly decreased, the serum concentrations of TNF-α, IL-1β, cTnI and CK-MB and pathological score were increased, the MMP and content of ATP in myocardial mitochondria were decreased, and the expression of PGC-1α, NRF2 and TFAM in myocardial tissues was down-regulated in Sep group ( P<0.05), and no significant change was found in the parameters mentioned above in Sham+ H group ( P>0.05). Compared with group Sep, the survival rate was significantly increased, the serum concentrations of TNF-α, IL-1β, cTnI and CK-MB and pathological score were decreased, the MMP and content of ATP in myocardial mitochondria were increased, and the expression of PGC-1α, NRF2 and TFAM in myocardial tissues was up-regulated in group Sep+ H ( P<0.05). Conclusions:Inhaling high concentration hydrogen can attenuate sepsis-induced myocardial injury in mice, and the mechanism may be related to promotion of mitochondrial biosynthesis and improvement in mitochondrial function.

Objective:To evaluate the effects of inhalation of high-concentration hydrogen on acute kidney injury (AKI) and mitochondrial dynamics in septic mice.Methods:One hundred and twenty-eight male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=32 each) using a random number table method: sham operation group (group Sham), sham operation + hydrogen group (group Sham+ H), sepsis AKI group, and sepsis AKI+ hydrogen group (group S-AKI+ H). A mouse model of sepsis-induced AKI was developed by cecal ligation and puncture in anesthetized animals. In Sham+ H and S-AKI+ H groups, 67% H 2+ 33% O 2 was inhaled for 1 h starting from 1 and 6 h after sham operation or developing the model, respectively. Twenty mice were selected to observe the survival at 7 days after developing the model. At 24 h after developing the model, blood samples were collected for determination of serum BUN and Cr concentrations (by colorimetric analysis), and renal tissues were obtained for determination of the contents of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and high mobility group protein B1 (HMGB1) (by enzyme-linked immunosorbent assay), activities of superoxide dismutase (SOD) and catalase (CAT) (by spectrophotometry) and expression of dynamin-related protein 1 (Drp1) and mitofusin 2 (Mfn2) (by Western blot). The damage to the renal tubules was scored after HE staining. Results:Compared with Sham group, the survival rate was significantly decreased, the serum BUN and Cr concentrations, renal tubular damage score and contents of TNF-α, IL-1β and HMGB1 were increased, the activities of SOD and CAT were decreased, the expression of Drp1 was up-regulated, and the expression of Mfn2 was down-regulated in S-AKI group ( P<0.05), and no significant change was found in the parameters mentioned above in Sham+ H group ( P>0.05). Compared with S-AKI group, the survival rate was significantly increased, the serum BUN and Cr concentrations, renal tubular injury score and contents of TNF-α, IL-1β and HMGB1 were decreased, the activities of SOD and CAT were increased, the expression of Drp1 was down-regulated, and the expression of Mfn2 was up-regulated in S-AKI+ H group ( P<0.05). Conclusions:Inhalation of high-concentration hydrogen can alleviate AKI in septic mice, and the mechanism may be related to inhibition of renal mitochondrial fission and promotion of mitochondrial fusion.

The risk of graft loss is relatively high in early stages after pancreatic transplantation so that some patients are placed back on a waiting list for pancreatic transplantation. This review summarized the experiences of two recipients of pancreatic re-transplantation after simultaneous pancreas-kidney transplantation. Both patients could successfully discontinue insulin dosing, blood sugar levels were maintained at a normal level and function of kidney graft improved obviously as compared to pre-transplant levels.