Objective To rapidly evaluate the effectiveness,safety and economy of edaravone in treating acute ischemic stroke(AIS),and to provide the evidence-based basis for clinical decision-making.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI and WanFang Data databases and the official website of health technology assessment(HTA)agency were electronically searched to collect HTA reports,systematic reviews/Meta-analysis and pharmacoeconomic studies of edaravone in the treatment of AIS from the inception to October 1,2024.Two reviewers independently screened the literature,extracted data,evaluated the quality,summarized the results,and qualitatively described and analyzed the results.Results A total of 12 literature were included,involving 9 systematic reviews/Meta-analysis and 3 pharmacoeconomic studies.In terms of efficacy,edaravone alone or in combination with conventional therapy(alteplase,ozagrel)increased efficiency,improved short-term neurological deficit scores and improved patients'ability to perform activities of daily living compared with placebo or conventional therapy(alteplase,ozagrel)(P＜0.05).There was no significant difference in the incidence of adverse reactions between edaravone and placebo,routine treatment,or other neuroprotectants(P＞0.05).Combined with alteplase,it could reduce the incidence of intracranial hemorrhage compared to alteplase alone(P＜0.05),with no statistically significant difference in all-cause mortality(P＜0.05).Pharmacoeconomic studies showed that,edaravone does not have a cost-effectiveness advantage in the short term,but it may have a cost-effectiveness advantage from limited long-term studies.Conclusion Edaravone is effective and safe in the treatment of AIS,but there is limited research evidence and the conclusion still needs to be confirmed by further studies and clinical trials,and the economics need to be further evaluated.

Heart failure is a severe manifestation or advanced stage of various heart diseases,with high mortality and readmission rates.The 2024 guidelines for the diagnosis and treatment of heart failure,which are on the 2018 guidelines,combined with new evidence and China's national conditions,provide a comprehensive and systematic description and recommendation on the classification,diagnosis,prevention,treatment,comorbidity,and management of heart failure.This article reviewed the update of the therapeutic drugs section.

Methods: Radiological parameters were extracted from the whole lateral radiographs. Patients were divided into two groups: the ASD group (segmental kyphosis of ≥10º, and/or a ≥50% loss of disc height, and/or ≥3 mm of anteroposterior translation) and the non-ASD group. Results: All 112 included patients underwent PLIF for lumbar degenerative diseases. The minimum follow-up period was 2 years, with an average follow-up time of 63.6 months. Fifty-two patients (46.4%) were classified into the ASD group and of these, 13 required reoperation due to failure of conservative treatment. Patients with ASD exhibited significantly more caudal and posterior inflection vertebrae (IV), while the lumbar apical vertebra was significantly more caudal immediately after surgery. The IV position was identified as a significant risk factor for ASD, and the ASD incidence was significantly higher in the group where IV ≤5 (L1 vertebral body) than in the group where IV ≥5.5 (T12–L1 disc) (69.0% vs. 38.6%). Conclusions The IV position is a significant risk factor for ASD development. Although it is difficult to control intraoperative IV levels, we note a high risk of ASD in patients with IV lower than T12–L1.

Objective To rapidly evaluate the efficacy,safety and economics of empagliflozin in the treatment of type 2 diabetes mellitus(T2DM)and to provide evidence-based medical evidence for clinical decision.Methods PubMed,Embase,the Cochrane Library,CNKI,Wangfang,VIP database and major health technology assessment(HTA)websites were searched from the construction of the databases to Nov 30th,2022.Two researchers independently screened,extracted the data,evaluated the quality and analyzed the results according to inclusion and exclusion criteria.Results A total of 23 literatures were included,including 3 HTA reports,10 systematic review/Meta-analyses and 10 pharmacoeconomic studies.The results of efficacy showed that empagliflozin reduced HbA1c,blood pressure,body weight and all-cause mortality compared with the control group.Safety studies showed that empagliflozin was generally well tolerated,and significantly reduced MACEs and the relative risk of the renal primary outcomes,but increased the risk of genital infections and electrolyte abnormality compared with placebo and other oral antidiabetic drugs.The economic evaluation results showed that empagliflozin was more cost-effective in high risk patients with comorbid cardiovascular or kidney disease.Conclusion Empagliflozin is effective and safe in the treatment of T2DM,but the pharmacoeconomic studies focusing on chinese populations are urgently needed.

OBJECTIVE To sum marize the pro cedure and informatization construction of centralized volume-based procurement（VBP）in our hospital ，in order to give references for normal development of centralized VBP. METHODS The standardized workflow system was established ，including using flow chart method to establish standardized workflow ，carrying out procedure training and inspection of procedure implementation ， and continuously conducting procedure optimization. The information system was developed for the task links that needed a lot of calculation to improve the automation level of information processing. RESULTS & CONCLUSIONS Eight specific work procedures were established in our hospital ，including the work procedures of submitting the demand data of centralized VBP and the implementation of centralized VBP ，and has taken measures such as procedure training ，establishing supervision and inspection system and using auxiliary means to promote the implementation of the procedure ，so as to optimize the procedure and work form. An informatization platform for the clinical task allocation of the agreed purchase quantity of centralized VBP and a supervision platform for the daily use of VBP were also established in our hospital，then the two tasks with a large amount of calculation could be finished. Standardized workflow system and informatization platform construction has improved the operation and supervision efficiency of centralized VBP in our hospital ，ensured the completion of centralized purchase tasks and saved human resources ，which has a certain promotion value.

Centralized drug procurement in large quantities is a major step to deepen the medical and healthcare system reform, to improve the mechanism of drug price formation, and to give full play to the role of medical insurance in guiding drug prices in China. Combined with the practice of centralized drug purchasing in public hospitals, the authors sorted out the practical problems and causes from four aspects which affected the implementation of centralized drug purchasing policy in public hospitals: selection on centrally purchased drugs, procurement and supply, clinical use, and hospital financial operation. On this basis, suggestions were put forward to provide reference for the normalization of centralized drug procurement work, such as coordinating national and regional drug collection policies, reasonably setting distribution costs, extending the agreed procurement period, and carrying out special evaluation for drug collection.

DNA methylation is a prevalent epigenetic modification in vertebrates, and it has been shown to be involved the regulation of gene expression and embryo development. However, it remains unclear how DNA methylation regulates sexual development, especially in species without sex chromosomes. To determine this, we utilized zebrafish to investigate DNA methylation reprogramming during juvenile germ cell development and adult female-to-male sex transition. We reveal that primordial germ cells (PGCs) undergo significant DNA methylation reprogramming during germ cell development, and the methylome of PGCs is reset to an oocyte/ovary-like pattern at 9 days post fertilization (9 dpf). When DNA methyltransferase (DNMT) activity in juveniles was blocked after 9 dpf, the zebrafish developed into females. We also show that Tet3 is involved in PGC development. Notably, we find that DNA methylome reprogramming during adult zebrafish sex transition is similar to the reprogramming during the sex differentiation from 9 dpf PGCs to sperm. Furthermore, inhibiting DNMT activity can prevent the female-to-male sex transition, sug-gesting that methylation reprogramming is required for zebrafish sex transition. In summary, DNA methylation plays important roles in zebrafish germ cell development and sexual plasticity.

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.
Age Factors ; Aged ; COVID-19/therapy* ; China ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Odds Ratio ; Propensity Score ; Retrospective Studies ; Survival Rate

Objective:To investigate and analyze the influencing factors in the implementation of essential drugs in the medical in-stitutions in Hubei in order to provide reference for promoting the implementation of national essential drugs. Methods: The medical staff participating in the training class of clinical application guidelines and formulary of national essential drugs in Hubei (2014) was surveyed by a questionnaire to analyze and evaluate the statistical influencing factors in essential drugs implementation. Results: A-mong the factors affecting the implementation of essential drugs, the score of rational use was the highest (3. 86) followed by that of medicine quality, rational varieties of essential drugs, affordability and management system, and the factors with score below 3. 0 were pharmacy trusteeship and income of essential drugs in medical institutions. Conclusion: Based on the investigation and evaluation of influencing factors, the corresponding measures should be adopted, which can further improve the basic drug system and enhance the use effects of essential drugs.

To study and compare the protective effects of Cordyceps sinensis from different habitats on acute injury of hepatic tissue induced by carbon tetrachloride ( CCl4 ) . Methods:The rat model of acute injury of hepatic tissue induced by CCl4 was established. The biochemical indicators of alanine aminotranferease ( ALT) and aspartate aminotransferease ( AST) in the serum and superoxide dismutase ( SOD) and L-glutathione( GSH) in the liver tissue were detected, and the liver tissue HE staining was used for the histopathology determination. Results:Compared with those in the model group, the levels of AST and ALT in the serum were sig-nificantly reduced, the levels of SOD and GSH in the liver tissue were notably increased, and the necrosis of liver cells was improved in Cordyceps sinensis groups at low, medium and high dose from different habitats (P<0. 05), however, the differences between the two different habitats were not significant (P>0. 05). Conclusion: Cordyceps sinensis from Qinghai and Tibet shows some positive differences in the protective effect on the acute chemical liver injury induced by CCl4 in rats,however, the differences are not remarka-ble.