Central retinal vein occlusion(CRVO)is a retinal vascular disorder that significantly impairs vision, with its underlying mechanisms involving complex interactions across multiple biological systems. This article provides a systematic review of the pathological mechanisms associated with CRVO, emphasizing critical factors such as endothelial dysfunction, arteriosclerosis, thrombophilia, inflammation, and oxidative stress. The pathological mechanisms of CRVO are characterized by arteriosclerosis, which obstructs venous return through a dual mechanism involving mechanical compression and endothelin-1-mediated contraction; endothelial dysfunction, which exacerbates disturbances in blood flow; genetic and acquired coagulation abnormalities that disrupt hemostatic balance and promote thrombosis; and the synergistic effects of inflammation and oxidative stress that activate cytokines, thereby aggravating ischemia and vascular leakage. Innovatively, this review explores emerging mechanisms such as miRNA-mediated vascular regulation via exosomes, gut microbiota-retina crosstalk through the “gut-eye axis,” and systemic metabolic interactions that link local retinal lesions to broader dysregulation of CRVO. These insights underscore the importance of integrated eye-system interventions and provide a theoretical foundation for advancing early biomarker discovery, multitarget therapeutics, and personalized treatment paradigms. By bridging localized pathology and systemic mechanisms, this work promotes a transformative shift toward an integrative medicine model in the diagnosis and management of CRVO.

OBJECTIVE To summarize and analyze the profile of the implementation of pharmaceutical service by community pharmacists for patients with chronic diseases in China. METHODS Literature was searched from CNKI， Wanfang database， PubMed （Medline）， Embase， and Scopus to collect studies about community pharmacists providing pharmaceutical services for patients with chronic diseases. The ways and contents of the implementation of pharmaceutical services for chronic diseases by community pharmacists were summarized descriptively. RESULTS A total of 75 studies were included， involving 49 trial studies and 26 cross-sectional studies. The study sites were mainly located in the developed regions of China， and the types of disease involved in the studies were mainly diabetes mellitus （n＝30） and hypertension （n＝28）； most studies used the following indexes to evaluate pharmaceutical services， such as changes in disease symptoms and related indicators（n＝35）， improvement of patient compliance（n＝34）， and the occurrence of adverse drug reactions （irrational drug use） （n＝25）. The pharmaceutical service provided by community pharmacists included medication education （84.0%）， monitoring and follow-up （64.0%）， and identifying and solving medication-related problems （58.7%）. Thirty-eight studies mentioned that pharmaceutical services were achieved through teamwork， 16 of which mentioned healthcare alliances. A few studies investigated stratified healthcare systems （n＝15） and internet-based pharmaceutical services （n＝10）. CONCLUSIONS In China， pharmaceutical services provided by community pharmacies for patients with chronic diseases are still mainly confined to economically developed areas， and the scope of services is limited to a few diseases and basic pharmaceutical practices. In the future， the implementation of precise pharmaceutical services for different diseases and patients’ disease status， the establishment of medical alliances， and the development of internet-based pharmaceutical services should become the focus of pharmaceutical services.

With the wide application of artemisinin and its derivatives,its safety has become particularly important.Previous studies have shown that artemisinin and its derivatives have adverse reactions such as nausea,vomiting and diarrhea in clinical use,but they are all within the controllable range.In animal experiments,it has toxic effects on kidney,liver,heart,nerve,blood,embryo and DNA at a high dose.Toxicity and adverse reactions can be alleviated or eliminated by combining medication or changing the drug administration mode,solvent and preparation type.This article mainly discusses the drug safety,toxicity mechanism and attenuation countermeasures of artemisinin and its derivatives,in order to improve the understanding of the potential toxicity of artemisinin and its derivatives and provide reference for the safe use of the drug in clinic.

Objective This paper summarizes the research progress of biosynthesis and pharmacological effects of podophyllotoxin drugs,in order to provide reference for the wide application of these drugs.Methods The plant source,chemical structure,action mechanism and synthesis pathway of podophyllotoxin drugs were summarized.The pharmacological and toxicological characteristics and mechanisms of these drugs were discussed,and the research progress of new dosage forms of podophyllotoxin drugs was reviewed.Results Podophyllotoxin and its derivatives are important chemical constituents in the plants of the podophyllum,such as Dysosma versipellis,Diphylleia sinensis,Sinopodophyllum hexandrum.This kind of drug has few natural sources and can be artificially produced through chemical and biosynthetic pathways.Podophyllotoxin drugs have pharmacological effects such as anti-inflammatory,anti-tumor and anti-virus,but their toxic effects need to be paid attention to.Drugs can be transported by carriers to reduce toxicity and increase effect.Conclusion Podophyllotoxin drugs have broad clinical application prospects,and will be further studied and applied in the fields of anti-inflammatory,anti-tumor and anti-virus in the future.

Objective In this paper,the harmful effects and mechanisms induced by traditional Chinese medicine were expounded by combining the mechanism of programmed cell death and inflammatory reaction.It is expected to provide data support and theoretical reference for the rational use of traditional Chinese medicine and toxicology research.Methods By systematically analyzing the correlation between cell death and inflammatory response,the molecular mechanisms of pyroptosis,programmed cell necrosis and ferroptosis at home and abroad were summarized,and the harmful outcomes induced by traditional Chinese medicine were further discussed.Results Different toxic traditional Chinese medicines and their active ingredients have different tolerances to biological organisms.Programmed cell death is an important molecular mechanism for the toxicity of traditional Chinese medicines.Its signaling pathways are complex and diverse and are often accompanied by inflammatory reactions.Both of them have a certain effect on the toxic effects of traditional Chinese medicine.Conclusion Traditional Chinese medicine can provide inflammatory mediators for inflammatory response pathways through cell death or change the physiological balance of cells,thereby inducing inflammatory cascade reactions and promoting harmful outcomes in various systems of the body under the dual effects of cell death and inflammatory response.

Objective To summarize the preliminary application results of ultrasound-guided biliary drainage tube replacement, present the corresponding technical points, and discuss the operation strategy and clinical application value. Methods The clinical data of 60 patients who underwent ultrasound-guided biliary drainage tube replacement in Qilu Hospital of Shandong University between August 2014 and August 2020 were retrospectively analyzed. The operation procedure, clinical applications, and postoperative complications were summarized and analyzed. Results Fifty-eight of the 60 patients (96.67%) were successfully replaced with drainage tubes along the original sinus. Among them, dilated sinus tracts of 47 patients were placed with coarse-grade drainage tubes, and dilated sinus tracts of the remaining 11 patients were placed with the original type of drainage tubes, with the mean operation time of 15.8(12.0-19.0) min under local anesthesia. In total, bile was drained from 28 patients receiving PTCD drainage, 23 patients receiving gallbladder drainage, and 9 patients receiving T-tube drainage. The post-operation evaluation revealed that the drainage situation has improved, with a 100% effective rate. No obvious abnormality was found in the postoperative follow-up visit. Conclusion The replacement of drainage tube under ultrasound guidance is simple, safe and feasible, and it provides further promotion in clinical practice with sufficient data support.

Objective:To investigate the diagnostic and prognostic value of the growth differentiation factor 15 (GDF15) and the procalcitonin (PCT) in sepsis.Methods:A total number of 137 patients with sepsis (considered as the sepsis group) and 59 patients with inflammatory infection but not diagnosed as sepsis (the non-sepsis group) received treatment in intensive care unit of Renming Hospital of Wuhan University were collected from July 2020 to January 2021, and 62 cases of healthy physical examination (control group) were simultaneously chosen as control. Sepsis patients were divided into two groups (death group [ n=48] and survival group [ n=89]) according to their 28-day′s survival. The serum levels of GDF15, PCT, C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10) were examined, and the levels of each index, was dynamically monitored on the 1st, 3rd and 7th day after admission. The differences of the two indicators between different groups were compared by non-parametric test. The correlation between GDF15 and PCT was analyzed by Spearman correlation test. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic and prognostic value of the two indicators for sepsis. Results:The levels of GDF15 in the sepsis group, non-sepsis group and control group were 3.22 (1.39, 6.31) μg/L, 0.84 (0.21, 1.66) μg/L and 0.11 (0.09, 0.13) μg/L, respectively. The levels of PCT were 13.10 (1.99, 50.25) μg/L, 0.24 (0.13, 0.68) μg/L and 0.05 (0.03, 0.10) μg/L, respectively. The levels of CRP were 115.80 (26.40, 184.07) mg/L, 24.20 (11.30, 53.20) mg/L and 0.50 (0.50, 2.76) mg/L, respectively. The levels of IL-6 were 68.26 (21.59, 255.46) ng/L, 33.20 (10.81, 89.27) ng/L and 8.82 (7.33, 11.23) ng/L, respectively. The levels of IL-10 were 11.30 (5.88, 25.50) ng/L, 9.34 (5.65, 16.90) ng/L and 4.94 (4.31, 5.31) ng/L, respectively. The GDF15, PCT, CRP and IL-6 of the sepsis group were significantly higher than those of the non-sepsis group (The U values were 67.681, 86.034, 44.164 and 38.934, respectively, with P values less than 0.05) and the control group (The U values were 136.475, 138.667, 120.701 and 100.886, respectively, with P values less than 0.001). There was no significant difference in IL-10 between sepsis group and nonsepsis group, but it was higher than that of control group ( U=80.221, P<0.001). There was a positive correlation between GDF15 and PCT in patients with sepsis, and the spearman correlation coefficient was 0.234 ( P=0.006). The GDF15 of the death group and the survival group were 5.49 (3.60, 8.25) μg/L and 2.03 (1.06, 3.69) μg/L, and the PCT levels were 26.45 (11.23, 94.25) μg/L and 9.08 (1.33, 22.75) μg/L, respectively. GDF15 and PCT in the death group were significantly higher than those in the survival group ( U values were 3 305.500 and 3 060.000, respectively, and P values were both less than 0.001). The GDF15 and PCT levels in the death group were higher than those in the survival group on the 1st, 3rd and 7th day of dynamic monitoring ( P<0.05), however, the level of CRP and IL-10 were not significantly different ( P>0.05). The level of IL-6 in the death group was not significantly different from that of the death group on 1st day, but was higher than that of the survival group on the 3rd and 7th day ( P<0.05). The area under the curve (AUC) of GDF15, PCT, CRP, IL-6 and IL-10 alone and in the combined diagnosis of sepsis were 0.899, 0.938, 0.874, 0.789, 0.698 and 0.962, respectively. The combined detection of AUC was better than a single index; the GDF15, PCT, CRP, IL-6 and IL-10 alone and combined detection of sepsis prognosis AUC were 0.774, 0.716, 0.522, 0.623, 0.520 and 0.839, respectively, the combined detection of AUC is also better than single index. Conclusions:GDF15 and PCT have good clinical reference value in the differential diagnosis and prognosis of sepsis. The combination of indicators has a higher clinical value. GDF15 may become a biomarker for the diagnosis and prognosis of sepsis.

Hepatic venous pressure gradient measurement via jugular vein catheterization is still currently the gold standard for evaluating portal hypertension. However, how to accurately and reproducibly assess whether there is portal hypertension has always been a concern in patients with liver cirrhosis. In recent years, imaging methods have made significant progress in the non-invasive diagnosis of portal hypertension. This paper reviews the current different diagnostic value of imaging methods and related research progress in an attempt to evaluate patients with cirrhotic portal hypertension.

Objective? To analyze the bias of dimension measurement results of penis and testis by the self-design cylinder boy penis and testicles measurement (hereinafter called cylinder ruler) and it influencing factors. Methods? From June to December 2018, we selected 152 children of Department of Urinary Surgery in Hu'nan Children's Hospital as subjects by case sampling. Children's penis and testicles dimension were measured repeatedly by their patients and nurses with the self-designed cylinder ruler and three kinds of common clinical measurement tools (vernier caliper+tape measure+testis measurer, vernier caliper+straightedge, vernier caliper+round head probe), and the bias were counted based on medical reference value. Results? Measurement bias of length and diameter of penis in a resting state, length of penis in a traction state, length and width of testis in group of cylinder ruler were lower than those in other groups with statistical differences (P＜0.05) which not influenced by boys' ages and measurement time (P＞ 0.05). Bias of length of penis in a traction state, length and width of testis measured by nurses were lower than those by children's patients with statistical differences (P＜ 0.05). Interaction effect analysis showed that there were no statistical differences in dimension of penis and testis measured by different measurers with the cylinder ruler (P＞0.05); however, there were statistical differences in dimension of penis and testis measured with the cylinder ruler by different measurers at different times of a day (P＜0.05). The differences of interaction effects between measurement time and measurers were statistical (P＜0.05). Conclusions? Compared with other measurements, the self-designed cylinder ruler for measurement of penis and testis in boys has higher accuracy. The main influencing factors of bias of dimension of boys' penis and testis are ages of boys and measurement time. Bias of length of penis in a traction state, length and width of testis measured by nurses are lower than those by children's patients. Measurers and measurement time are not suggested as independent factors when analyzing the influencing factors of dimensions measurement bias of penis and testis. Dimensions of penis and testis are measured with the cylinder ruler at different times which have certain changes.

This paper aimed at investigating the effects of Xinfukang Oral Liquid on mitochondrial proteomic alterations in rats with heart failure after myocardial infarction and exploring its possible mechanisms. Heart failure models were established by ligating the left anterior descending coronary artery of SD rats. Rats were randomly divided into sham group, model group, Xinfukang group. 8 weeks after drug intervention, the mitochondrial proteomic alterations of myocardial tissue were detected by two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) . Furthermore, expression levels of part of the differently expressed proteins were verified by western blot. Compared with model group, 20 differentially expressed protein spots were detected in Xinfukang group, 13 of which showed increased protein expression and 7 decreased; 13 differentially expressed protein spots were successfully identified by MALDI-TOF-MS. Bioinformatics analysis showed that these differential proteins were mainly associated with energy metabolism, stress reaction, oxidative damage, cyto-skeleton, cell differentiation and proliferation. Western blot results showed that the expression of Stress-70 protein and Nucleophosmin increased and the expression of ATP-αdecreased in model group. The expression of Stress-70 protein and Nucleophosmin decreased and the expression of ATP-αincreased in Xinfukang group, which shows the same results in proteomics. Xinfukang Oral Liquid can partly adjust proteomic alterations of myocardial mitochondrial in HF rats, and its intervention mechanism may involve improving energy metabolism, reliving stress reaction and oxidative damage, as well as regulating cell differentiation and proliferation. The results of comparative proteomic analysis performed by using2-DE and MALDI-TOF-MS are acurate, stable and reliable.