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Research progress on the mechanisms of Shengxian Decoction and its active components against doxorubicin-induced cardiotoxicity
MAO Shuyun, HUANG Doudou, TANG Pengyue, CHEN Lan, WU Yueyi, PANG Tao, SUN Lianna
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202607001
Abstract(213) HTML(113) PDF (2172KB)(3)
Abstract:
Doxorubicin(DOX), a widely used anthracycline chemotherapeutic agent, faces significant clinical limitations due to its severe dose-dependent cardiotoxicity. The pathophysiology of DOX-induced cardiotoxicity involves a complex, interconnected network of signaling pathways, including topoisomerase IIβ-mediated DNA damage, mitochondrial dysfunction, oxidative stress, ferroptosis, and inflammation, which collectively form a self-amplifying cascade. Shengxian Decoction, a classic formulation originally developed by the early 20th-century physician Zhang Xichun, exerts therapeutic effects in “tonifying Qi and elevating Yang”, and activating blood circulation. Notably, these efficacies are directed at core pathological features of DOX cardiotoxicity, like mitochondrial impairment and oxidative injury, positioning the decoction as a promising “multi-target, multi-pathway” holistic intervention. This review systematically delineates the pathological network underlying DOX-induced cardiotoxicity and elucidates the molecular mechanisms by which its key bioactive components, including astragaloside IV, calycosin, and mangiferin, and so on. These mechanisms encompass mitigating oxidative stress, inhibiting ferroptosis, restoring energy metabolism, modulating autophagy, and suppressing apoptosis. Furthermore, we explore the synergistic potential of these components and evaluate the prospects for clinical translation. This synthesis aims to provide insights for future investigations into the pharmacodynamic material basis and precise clinical application of Shengxian Decoction.
Advances in research on the antimicrobial resistance mechanisms of carbapenem-resistant pseudomonas aeruginosa
GAO Zhe, ZHAO Jingming
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202602016
Abstract(742) HTML(645) PDF (991KB)(20)
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Pseudomonas aeruginosa (PA) is a Gram-negative opportunistic pathogen widely distributed in natural ecosystems and clinical settings. Leveraging its robust environmental adaptability and genomic plasticity, PA has emerged as a major predominant pathogen responsible for hospital-acquired infections. Individuals in high-risk groups, including intensive care unit (ICU) patients, burn victims, and immunocompromised populations, face a markedly elevated risk of PA infection, which can trigger a range of severe infectious diseases such as pneumonia, bloodstream infections, and urinary tract infections. Carbapenem antibiotics (e.g., imipenem, meropenem) were once regarded as the core last line of defense for clinical treatment of multidrug-resistant PA infections, attributed to their broad antimicrobial spectrum and high stability against β-lactamases. However, with the extensive clinical utilization of these agents, the global detection rate of carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been steadily increasing. As one of the ESKAPE pathogens prioritized highest for prevention and control by the World Health Organization (WHO), CRPA not only poses formidable challenges to clinical anti-infective therapy, but also markedly elevates patient mortality rates and imposes a substantial burden on healthcare systems. To clarify the molecular mechanisms underlying PA resistance, this review systematically summarizes the recent research advances in the intrinsic, acquired, and adaptive resistance mechanisms of PA, aiming to provide theoretical support and references for the clinical prevention and control, early diagnosis, and development of novel therapeutic regimens against CRPA.
Meta-analysis of the efficacy and safety of treatment of urticaria with topical ointments of traditional Chinese medicine
PENG Jiahui, YAN Xinwei, CHEN Yin, GAO Wenya, XU Youqi, FENG Shuyi, ZHU Guangwei, SI Nan
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202605002
Abstract(1424) HTML(1124) PDF (2027KB)(18)
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  Objective  To systematically evaluate the efficacy of topical traditional Chinese medicine (TCM) ointments in treating urticaria and to analyze their Therapeutic value.   Methods  Computerized searches were conducted in Chinese and English databases such as CNKI, Wanfang, VIP, PubMed, Cochrane Library, and EMbase. Relevant randomized controlled trials (RCTs) were manually extracted. The search period was from the establishment of the databases to December 2025. Two researchers independently screened the literature, extracted data, and used the Cochrane RoB 2.0 tool to assess the risk of bias in the included studies. The GRADE system was used for evaluating the quality of evidence. Meta-analysis was performed using RevMan 5.4 software.   Results  A total of 9 RCTs were included, involving 828 patients, predominantly pediatric patients with papular urticaria. The meta-analysis results showed that compared with conventional treatment interventions, the topical TCM ointment had significant advantages in improving the cure rate [RR=1.33, 95% CI(1.17, 1.51), P < 0.01], total effective rate [RR=1.09, 95% CI(1.04, 1.14), P<0.01], and the incidence of adverse reactions [RR=0.29, 95% CI(0.11, 0.76), P=0.01] of patients with urticaria. Subgroup analysis showed that this advantage existed in different intervention combinations and control formulations. The adverse reactions reported in the included studies were mild and transient, and some studies did not report obvious adverse reactions.   Conclusion  Based on the current evidence, the topical TCM ointment for treating urticaria shows significant advantages over conventional treatment interventions in improving the clinical improvement rate and cure rate, and has good safety. This supports the important position and application prospects of this Chinese herbal formulation in the treatment of pediatric papular urticaria, providing evidence-based references for rational and effective clinical medication and the development of topical preparations.
Optimization of rutin nanosuspension by response surface methodology and its intestinal absorption behavior
MA Yazhong, XUE Kailin, DENG Xiang, WANG Yini, XUE Yuye, YANG Zhihui
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202602009
Abstract(736) HTML(560) PDF (3647KB)(8)
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  Objective   Rutin nanosuspension (Ru-NS) was prepared in order to increase the solubility and improve its intestinal absorption behavior.   Methods   Ru-NS was prepared by wet media milling, and the effects of milling time, zirconia dosage and milling speed were investigated on the basis of a one-way test using particle size, polydispersity index (PDI) as the indexes, and Box-Behnken design-response surface method. Ru-NS was characterized and investigated by scanning electron microscope (SEM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR) and its saturation solubility was investigated, and then the in vitro dissolution of Ru-NS was investigated by the dialysis bag method. The absorption of the drug from different parts of the intestinal segments of the duodenum, jejunum, ileum and colon was investigated by in vivo unidirectional intestinal perfusion experiments in rats.   Results   The average particle size of the prepared Ru-NS was (138.47±6.33) nm, with a PDI of 0.1401±0.0704 and a zeta potential of (−43.72±1.86) mV. Ru-NS showed a rod-like structure with a decreased degree of crystallinity as compared to that of the raw material. The saturated solubility of Ru-NS was elevated by 52.45%, and the cumulative release within 48 h was up to 81.17%. In vivo unidirectional intestinal perfusion showed that the Ka and Papp of Ru and Ru-NS in different intestinal segments were duodenum > ileum > jejunum > colon, and the absorption of Ru-NS was significantly higher in duodenum, ileum, and jejunum (P<0.05).   Conclusion   The formation of Ru-NS in Ru had a significant promotion effect on its absorption in the small intestine of rats, which proved that Ru-NS could effectively improve the oral bioavailability of Ru.
Causal association between meningioma and asthma: a two-sample bidirectional Mendelian randomization study
LIU Liyan, CHANG Zheng, SUN Chuanduo, WANG Lingling, KONG Xianghui, YU Kefu
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202603035
Abstract(1969) HTML(1036) PDF (1928KB)(20)
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  Objective  To systematically evaluate the causal association between meningioma and asthma using a two-sample bidirectional Mendelian randomization (MR) approach.   Methods  Genome-wide association study (GWAS) data were used to select single nucleotide polymorphisms (SNPs) associated with meningioma and asthma as instrumental variables, respectively. The inverse variance weighted (IVW) method was applied as the primary analytical approach. Causal effects were quantified using odds ratios (OR) and 95% confidence intervals (95%CI). Heterogeneity among instrumental variables was assessed by Cochran's Q test, horizontal pleiotropy was examined using the MR-Egger regression intercept test, and sensitivity analyses were performed using leave-one-out validation. A funnel plot was used to visually evaluate the symmetry of effect estimates across SNPs.   Results  IVW analysis indicated a positive causal effect of meningioma on the risk of asthma (OR= 1.15,95%CI:1.10–1.20, P<0.05). Heterogeneity tests showed no significant heterogeneity among the selected SNPs (IVW Q-test P = 0.34; MR-Egger Q-test P = 0.82). The MR-Egger intercept test revealed no horizontal pleiotropy (P>0.05). Leave-one-out sensitivity analysis suggested that no single SNP substantially influenced the overall estimate, and the funnel plot showed symmetric distribution of SNP effects, supporting robust and reliable results. Reverse-direction MR found no statistically significant causal effect of asthma on meningioma risk (OR= 0.93, 95%CI: 0.80–1.09, P=0.36).   Conclusion  This two-sample bidirectional MR study provides evidence that meningioma may be an independent causal risk factor for an increased risk of asthma, whereas asthma shows no significant causal effect on meningioma risk, thus not supporting the existence of a reverse causal relationship.
Study on the improvement mechanisms of vascular cognitive impairment from Polygonatum based on network pharmacology and molecular docking techniques
LIU Yun, SHAO Wei, WEI Dan, WANG Feng
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202512029
Abstract(1162) HTML(745) PDF (3444KB)(1)
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  Objective  To explore the potential mechanism of Polygonatum in improving VCI based on network pharmacology and molecular docking techniques.   Methods  The active components of Polygonatum were screened from the TCMSP database, and corresponding targets were predicted by the SwissTargetPrediction database. VCI-related targets were obtained from the GeneCards and OMIM databases. Intersection targets between Polygonatum and VCI were identified as potential therapeutic targets. A “herb-component-target-pathway” network was constructed using Cytoscape. PPI network was established via the STRING database to screen core targets. GO functional enrichment and KEGG pathway analyses were performed using R language. Molecular docking was conducted using AutoDock to validate the binding affinity between core components and core targets.   Results  A total of 12 active components of Polygonatum were identified, corresponding to 352 targets. A total of 3,515 VCI-related targets were retrieved, yielding 177 intersection targets. PPI network analysis suggested that STAT3, SRC, EGFR, BCL2, and HIF1A might be the core targets. GO and KEGG enrichment analyses indicated that Polygonatum might exert its effects by modulating the AGE-RAGE, PI3K-Akt, lipid and atherosclerosis signaling pathways, involving biological processes such as neuroinflammation, oxidative stress, and apoptosis. Molecular docking results showed that core active components(liquiritigenin, wogonin)had good binding affinity with core targets EGFR, BCL2, SR.   Conclusion  Polygonatum exerts a protective effect against VCI through a multi-component, multi-target, and multi-pathway mechanism. Its underlying mechanism may be closely associated with the regulation of core targets such as STAT3, BCL2, and HIF1A, as well as key signaling pathways including AGE-RAGE and PI3K-Akt. This study provided an important theoretical basis for the rational clinical application of Polygonatum and the in-depth elucidation of its anti-VCI molecular mechanism.
The impact of medication therapy management on medication adherence and medication cognition in patients with coronary heart disease
LIU Yanping
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202510037
Abstract(1591) HTML(1024) PDF (851KB)(226)
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  Objective  To explore the impact of medication therapy management (MTM) on medication adherence, medication knowledge, and incidence of adverse drug reactions (ADRs) in patients with coronary heart disease (CHD).   Methods  The Morisky Medication Adherence Scale and the Medication Knowledge Assessment Scale were established. Sixty patients with CHD who received pharmaceutical outpatient services from October 2023 to March 2025 were selected and divided into the MTM group and the control group using a random number table method, with 30 patients in each group. The control group received routine pharmaceutical outpatient counseling and conventional treatment, the MTM group received clinical pharmacist-led MTM services in addition to routine pharmaceutical outpatient counseling and conventional treatment. Analyze the medication adherence, medication cognition, and incidence of adverse reactions of the two groups of patients before and after the intervention at 0 months, 1 month, and 6 months, respectively.   Results  After 6 months, the medication adherence and medication knowledge in the MTM group were 7.20±0.43, 17.92±0.73 respectively, which were significantly higher than those in the control group (4.83±0.83, 11.20±1.55, respectively). The incidence of ADRs in the MTM group was 16.67%, which was significantly lower than those in the control group(43.33%). The differences were statistically significant (P<0.05).   Conclusion  MTM could significantly improve medication adherence and medication knowledge in patients with CHD, reduce the incidence of ADRs, and enhance the safety and efficacy of medication use for patients.
Study on the quality standard of Xiaozhong Zhiyang Granules
LU Yan, LI Yan, LIU Wenjing, XIE Fan, SHI Yanhong, LI Wenyan
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202505028
Abstract(887) HTML(679) PDF (3051KB)(7)
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  Objective  To establish a quality standard for Xiaozhong Zhiyang Granules(XZG ) .   Methods  Qualitative identification of each composed single herbs such as Radix Sophorae Flavescentis, Granati Pericarpium, Radix Sanguisorbae, and Cortex Ailanthi in XZG was performed using thin-layer chromatography (TLC). Owing to the different chemical properties of key quality bio-markers in XZG, two analytical methods were developed: Gallic acid, ellagic acid, ziyuglycoside I, and canthin-6-one were simultaneously quantified by ultra-performance liquid chromatography (UPLC), whereas matrine and oxymatrine were analyzed by high-performance liquid chromatography (HPLC).   Results  The optimized TLC identification methods were accurate and specific, and TLC spots of each composed raw materials were clear and well separated, and there was no interference with the negative control samples. The quantitative methods demonstrated excellent precision, stability, and repeatability, with relative standard deviations (RSD) below 3.0 % for all six analytes. Mean recoveries ranged from 97.47 % to 101.13 %.   Conclusion  The method was stable, reliable, simple, proprietary and reproducible, which could be used for the quality control of the hospital preparation of the XZG.
The efficacy and safety of once-a-week tirzepatide in adults with obesity: A Meta-analysis
LUAN Zenghui, YAN Meixing, LV Fuyun, LIU Bensheng, LIU Chang
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202512033
Abstract(4713) HTML(2278) PDF (2190KB)(25)
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  Objective  To systematically evaluate the efficacy of once-weekly tirzepatide in participants with obesity.   Methods  We searched PubMed, Cochrane Library, Embase, and The ClinicalTrails.gov identify randomized controlled trials comparing the efficacy and safety of Tirzepatide with placebo in adults with obesity, and searched the databases up to July, 2025. The quality of literature was evaluated after they were screened according to inclusion and exclusion criteria. The Meta-analysis analyses were conducted by using RevMan 5.3 and R 4.4.2 software, and analyzed the efficacy with different dose.   Results  This study included 11 articles, with 7570 obesity participants. The Meta-analysis results showed that with the dose growing up, tirzepatide is more effective in weight loss, waist circumference loss, body mass index loss, achievement of ≥5%, ≥10% and ≥15% weight loss comparing with placebo. Gastrointestinal side effects were common but generally mild.   Conclusion  Once-a-week tirzepatide appears to be effective and generally well-tolerated in adults with overweight or obesity.
Research progress on the application potential and mechanism of elemental sulfur in the treatment of skin diseases
KOU Erwen, ZHANG Xiaobei, WANG Bo, ZHU Yuanjie
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202509041
Abstract(3775) HTML(2074) PDF (910KB)(37)
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As a traditional Chinese medicine, elemental sulfur has long been used for the treatment of scabies and tinea. In recent years, with the in-depth study of the biological function of elemental sulfur, its function has been extended to the treatment of acne, eczema, rosacea and other skin diseases, and the various mechanisms of elemental sulfur involved in the prevention and treatment of skin diseases are gradually being elucidated: the dual regulatory effect of elemental sulfur on skin keratinization, anti-inflammatory effect, antibacterial effect, and insecticide-killing effect. However, the therapeutic effects and specific mechanisms of action of this drug vary in different diseases, and the related research still need to be improved. In addition, the effects of elemental sulfur on pharmacokinetics and skin healing need to be further explored. The application status and mechanism of elemental sulfur in common skin diseases were systematically reviewed in this paper, which and provided a new perspective for the future development of elemental sulfur in the prevention and treatment of skin diseases.
Progress in drug research for Alzheimer’s disease and application of cellular metabolomics
CAO Xiuyu¹, JIN Mengying, SHEN Shuqi, WANG Hui, HONG Zhanying
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202509026
Abstract(2643) HTML(1166) PDF (1114KB)(16)
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Alzheimer’s disease (AD) is a typical neurodegenerative disorder, and its pathogenic mechanism remains to be fully elucidated. Currently, there are limited drugs available for the clinical treatment of AD, and many of these drugs are associated with numerous adverse effects. Traditional Chinese medicine (TCM), featuring multi-component and multi-target properties, possesses unique advantages and potential in the prevention and treatment of AD. AD cell models enable in-depth investigations into the pathogenesis of AD and the mechanisms underlying drug-based prevention and treatment. Cell metabolomics studies changes in intracellular metabolites to accurately capture dynamic variations in metabolite types, contents, and metabolic pathways of cells under different physiological states; this approach holds promise for revealing the complex regulatory mechanisms of cellular metabolic networks, identifying AD-specific biomarkers, and providing support for research on the mechanisms of AD. This article reviews the drugs used for AD prevention and treatment, as well as recent progress in the application of cellular metabolomics in AD research, aiming to provide a reference for studies on AD mechanisms, clinical diagnosis and treatment, and drug development.
The efficacy of aerobic exercise combined with sertraline in the treatment of elderly patients with post-stroke depression, and its effect on cognitive function and inflammatory cytokine
ZHU Laiyun, WANG Nuan, SUN Lingchen, ZHAO Chao
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.202508024
Abstract(5913) HTML(2651) PDF (1074KB)(39)
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  Objective  To investigate the efficacy of aerobic exercise combined with sertraline in the treatment of post-stroke depression (PSD) in elderly patients and its effects on cognitive function and inflammatory cytokines.   Methods  70 elderly PSD patients admitted to the Xuzhou Municipal Hospital affiliated with Xuzhou Medical University from June 2022 to December 2024 were selected as study objects. Patients were randomly divided into control group treated with sertraline and study group treated with aerobic exercise combined with sertraline. The treatment duration was 8 weeks. The Hamilton Depression Rating Scale (HAMD) scores, the clinical efficacy, cognitive function [Mini Mental State Examination (MMSE)], and the levels of inflammatory cytokines (IL-1β, IL-6, TNF-α) were compared before and after treatment.   Results  No significant differences in baseline data were observed between the two groups before treatment. After 4 and 8 weeks of treatment, HAMD scores were significantly decreased compared to baseline in both groups (all P<0.05). The study group showed significantly lower HAMD scores than the control group at both 4 and 8 weeks (all P<0.05). The overall clinical effective rate was significantly higher in the study group (94.29%) than in the control group (77.14%)(P<0.05). MMSE scores were significantly increased compared to baseline in both groups at 4 and 8 weeks(all P<0.05), and the study group demonstrated significantly higher MMSE scores than the control group at both time points (all P<0.05). Similarly, serum levels of IL-1β, IL-6, and TNF-α were significantly reduced from baseline in both groups at 4 and 8 weeks (all P<0.05). The reductions in these inflammatory cytokine levels were significantly greater in the study group compared to the control group (all P<0.05). The incidence of adverse reactions was 8.57% in the control group and 5.71% in the study group, with no statistically significant difference (P>0.05).   Conclusion  The combination of aerobic exercise and sertraline is a safe and reliable therapeutic strategy for elderly PSD patients, alleviating depressive symptoms, improving cognitive function, and reducing systemic inflammation.
The Evolutionary Pattern of Meaning in Life Among University Students and Its Association with Depressive Symptoms
YU Yongju, HE Min
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.20240380
Abstract(9706) HTML(3617) PDF (985KB)(34)
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This study aimed to clarify the causal relationship between meaning in life and depression symptoms, explore the evolutionary patterns of meaning in life, and assess its impact on the incidence of depressive symptoms. A two-wave longitudinal study with a 12-month interval was conducted among 896 university students recruited from one university. The meaning in life questionnaire and the depression symptom screening questionnaire were administered. The findings showed that: 1)Meaning in life at T1 negatively predicted depression symptoms at T2. Conversely, depression symptoms at T1 did not significantly predict meaning in life at T2. 2)The evolutionary patterns of meaning in life from T1 to T2 could be categorized into four groups: sustained low meaning, meaning improvement, meaning reduction, and sustained high meaning. The incidence of depressive symptoms in these four groups was 13.00%, 5.00%, 12.00%, and 4.00%, respectively. 3)The evolutionary patterns of meaning in life significantly impacted the incidence of depressive symptoms. Compared to the sustained high meaning group, both the sustained low meaning group and the meaning reduction group exhibited significantly higher rates of depression symptoms. The results suggest that psychological health education in universities should focus on individuals with sustained low meaning or meaning reduction, and that enhancing meaning in life serves as an effective intervention approach to reducing the incidence of depression symptoms among university students.
Accepted Manuscript  doi: 10.12206/j.issn.2097-2024.
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Cover Catalogue
Reviews
Therapeutic heterogeneity and research advances of colchicine in cardiovascular diseases
RUAN Xiaobao, QIU Jinghui, PENG Cheng, XIE Hehui
2026, 44(10): 491-495, 501.   doi: 10.12206/j.issn.2097-2024.202505038
Abstract(2603) HTML(1291) PDF (1299KB)(24)
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Colchicine, a classic anti-inflammatory agent, has been long used for the prevention and treatment of gouty arthritis and familial Mediterranean fever. Given the pivotal role of inflammation in the development and progression of cardiovascular diseases, the clinical value of colchicine in the secondary prevention of cardiovascular diseases has attracted significant attention. Diabetes mellitus (DM) leads to severe and irreversible vascular complications, and cardiovascular diseases are the leading cause of death in patients with DM. However, existing research indicated heterogeneity in the therapeutic efficacy of colchicine among patients with cardiovascular diseases and those with diabetes complicated by cardiovascular conditions. The heterogeneity manifests as differences in efficacy across various disease stages, patient baseline characteristics, specific cardiovascular event types, endpoint definitions, and treatment regimens. The current domestic and international research findings on colchicine in relation to cardiovascular events—both in patients with CVD and in those with diabetes—were reviewed, with the aim of elucidating the underlying causes of this efficacy heterogeneity and providing evidence-based guidance for identifying patients likely to benefit and optimizing individualized treatment strategies in clinical practice.
Current status and research progress of therapeutic drug monitoring technologies
LOU Sheng, LI Dan, ZHANG Linfeng, LI Zeyao, LYU Diya, CHAI Yifeng
2026, 44(10): 496-501.   doi: 10.12206/j.issn.2097-2024.202507003
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Therapeutic drug monitoring (TDM) is the core approach for individualized precision medication in clinical practice. Based on pharmacokinetics, it quantitatively measures in vivo drug concentrations using modern analytical techniques, mainly applied to drugs with a narrow therapeutic window, significant adverse reactions, and large interindividual pharmacokinetic variability across multiple categories. TDM plays an irreplaceable role in optimizing therapeutic regimens, reducing drug toxicity, and enhancing rational clinical drug use. TDM-applicable drugs were systematically reviewed in this paper, focusing on the working principles, clinical applications, advantages and limitations of mainstream analytical techniques (immunoassay, liquid chromatography tandem mass spectrometry, LC-MS/MS) and emerging ones (surface plasmon resonance and biolayer interferometry), which provided a valuable reference for the standardized clinical application of TDM, rational selection of analytical methods, and subsequent technological research and development.
Original articles
The preventive and therapeutic effects of three ethanol extracts derived from three sources of Stellera chamaejasme L. on imiquimod-induced psoriasis in mice
PENG Ying, LIU Xin, NIE Yiwen, WANG Xinhe, NIAN Hua, ZHU Jianyong
2026, 44(10): 502-507.   doi: 10.12206/j.issn.2097-2024.202406029
Abstract(17863) HTML(5542) PDF (7668KB)(62)
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  Objective  To investigate the preventive and therapeutic effects of ethanol extracts derived from three sources of traditional Chinese medicine: Stellera chamaejasme L., Euphorbia fischeriana Steud. and Euphorbia kansuensis Prokh., on imiquimod (IMQ)-induced psoriasis in mice.   Methods  Thirty-six male BALB/c mice were randomly divided into the following 6 groups with 6 mice in each group: blank control, model, Stellera chamaejasme, Euphorbia fischeriana, Euphorbia kansuensis, and calcipotriol. Psoriasis area and severity index(PASI) scores were used to record the changes of skin lesions in every group; Hematoxylin-eosin(HE) staining was used to observe the pathological morphology of skin and measure the thickness of the epidermis. Immunohistochemistry was used to detect the expression of nuclear antigen Ki67 in the skin tissues of mice.   Results  Compared with the model group, the three kinds of ethanol extracts could reduce the PASI score, inhibit epidermal thickening, and decrease expression of Ki67 in the psoriasis mice. Among them, the therapeutic effect of Stellera chamaejasme was the most significant and it was better than the commonly used topical drug calcipotriol.   Conclusion  The ethanol extract of Stellera chamaejasme had good anti-psoriatic activity, which could inhibit the abnormal proliferation of keratinocytes, reduce the expression of Ki67, and significantly improve psoriasis-like skin lesions.
Protective effect of Indigo Naturalis on cerebral ischemia-reperfusion injury in mice
GUO Yuchen, LI Junchi, YANG Guoling, ZHANG Yuefan, LI Tiejun, SUN Lili
2026, 44(10): 508-514, 533.   doi: 10.12206/j.issn.2097-2024.202510044
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  Objective  To investigate the protective effect of Indigo Naturalis on cerebral ischemia-reperfusion injury in mice.   Methods  The mouse model of middle cerebral artery occlusion/reperfusion (MCAO/R) was established using the filament ligation method. Mice were randomly divided into five groups: sham surgery, model, positive drug control, low-dose Indigo Naturalis, and high-dose Indigo Naturalis. After 7 d of drug administration, the relevant experiments were performed. Neurological function was assessed via behavioral scoring, balance beam test, forelimb grip strength, and tail lift test. Brain infarct volume was quantified using 2,3,5-triphenyl tetrazolium chloride (TTC) staining. Histopathological changes and neuronal apoptosis were systematically analyzed through hematoxylin-eosin (HE) staining, Nissl staining, and TUNEL staining. Finally, polymerase chain reaction (PCR) was employed to detect mRNA expression levels of inflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and microglial polarization markers (CD32, CD206) in the mouse cerebral cortex.   Results  Compared with the model group, the neurological function scores of mice in the high-dose Indigo Naturalis group showed significant improvement, and the motor ability recovery in each drug-administration group was remarkable (P<0.05, P<0.01). The cerebral infarct volume in the high-dose Indigo Naturalis group was significantly reduced (P<0.05). Histological results revealed that Indigo Naturalis could alleviate pathological damage in brain tissue and reduce neuronal apoptosis (P<0.01). PCR results demonstrated that after treatment with Indigo Naturalis, the expression of inflammatory factors and CD32 was significantly downregulated (P<0.05, P<0.01), while the expression of CD206 was significantly upregulated (P<0.05).   Conclusion  Indigo Naturalis could improve motor function in mice with cerebral ischemia-reperfusion injury, and its effects might be related to regulating inflammatory responses and reducing neuronal damage.
Medicine & Clinical
Efficacy and safety of EGFR-TKIs monotherapy versus combination therapy as first-line treatment for advanced non-small cell lung cancer: a network meta-analysis
CHEN Guanxu, SONG Yutong, GUO Xiuqiang, ZHANG Mi, LIU Zhihong, SONG Hongtao
2026, 44(10): 515-524.   doi: 10.12206/j.issn.2097-2024.202504044
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  Objective  To investigate the efficacy and safety of EGFR-TKIs monotherapy and its combination therapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations.   Methods  Databases such as PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were systematically searched to collect eligible phase Ⅱ/Ⅲ randomized controlled trials (RCTs), with the time range from the establishment of the databases to June 2023. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the studies. Outcome data, including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), grade 3 or higher adverse events (≥3 AEs), and serious adverse events (SAEs), were collected. A network meta-analysis was performed using R software (version 4.2.1) under the Bayesian theoretical framework. Subgroup analyses of survival outcomes (OS, PFS) were conducted based on different clinical and pathophysiological characteristics of the patients.   Results  A total of twenty-eight phase Ⅱ/Ⅲ RCTs were included in the study, involving a total of 7 460 patients and 18 first-line treatment regimens. The results showed that in terms of efficacy, gefitinib + pemetrexed-containing chemotherapy performed best in OS and ORR, while osimertinib + bevacizumab performed best in PFS. In terms of safety, furmonertinib had the lowest incidence of ≥3 grade AEs, and osimertinib had the lowest incidence of SAEs. Subgroup analysis results indicated that the efficacy and safety of various treatment regimens differed among patients with different clinical and pathological characteristics.   Conclusion  Monotherapy with third-generation EGFR-TKIs, represented by osimertinib, serves as the preferred therapeutic option considering both efficacy and safety profiles. While some combination therapies could enhance survival benefits, need to be vigilant about increased toxicity. Clinical decision-making should be tailored based on patients’ mutation subtypes, comorbidities, and tolerance.
Two cases of severe infusion-related reactions caused by cetuximab and preventive strategies
BAO Chunrong, LIU Xijun
2026, 44(10): 525-528.   doi: 10.12206/j.issn.2097-2024.202512005
Abstract(1888) HTML(922) PDF (820KB)(8)
Abstract:
  Objective  To explore the clinical characteristics and preventive strategies of severe infusion-related reactions (IRR) caused by cetuximab and provide reference for its safe clinical application.   Methods  The clinical data of two patients who experienced severe IRR following cetuximab treatment were retrospectively analyzed. With clinical data and relevant literature, the underlying reaction mechanisms were elucidated and corresponding preventive measures were formulated.   Results  Two patients with malignant tumors received cetuximab infusion after pretreatment, and both developed severe IRR abruptly within minutes of infusion. Symptoms were relieved after drug discontinuation and symptomatic treatment, and the patients were discharged in stable condition.   Conclusion   Cetuximab-induced severe IRR is acute in onset. Clinically, standardized pre-medication, enhanced monitoring during infusion and implementation of preventive strategies are essential to guarantee medication safety.
Pharmacy administration
Construction of medication error prediction model for intravenous medication dispensing center in a hospital from 2023 to 2024
ZHANG Yanqing, WANG Rutao, ZHAO Meina, SUN Dan, ZHAO Min, ZHOU Xiaoyan
2026, 44(10): 529-533.   doi: 10.12206/j.issn.2097-2024.202512047
Abstract(2291) HTML(826) PDF (963KB)(15)
Abstract:
  Objective  To explore the influencing factors of medication errors (ME) in the intravenous admixture service center of a tertiary hospital in Xi’an and construct a prediction model.   Methods   A retrospective cohort study design was adopted, with 200 cases of ME recorded in the hospital’s intravenous dispensing center from January 1, 2023 to December 31, 2024, as the ME group. 400 cases of routine medication records without ME were randomly selected as the ME group. Baseline data from two groups were collected and compared, the influencing factors of ME in the hospital’s static fitting center were analyzed, and a decision tree mode was constructed.   Results  There was a statistically significant difference (P<0.05) in incomplete medical order information, high-risk drugs, preparation time, and pharmacist training frequency between the ME group and the non ME group. However, there was no statistically significant difference (P>0.05) in other data between the groups; Through logistics regression analysis, it was found that incomplete medical order information, high-risk drugs, preparation time, and pharmacist training frequency were all influencing factors for ME occurrence in hospital intravenous dispensing centers (OR>1, P<0.05); The constructed decision tree model selected a total of four explanatory variables, among which the configuration time was the important root node variable. The AUC of the decision tree model was 0.808 (95% CI: 0.774−0.842), the sensitivity was 0.840, the specificity was 0.635, and the Youden index was 0.475.   Conclusion  The occurrence of ME in the hospital's static dispensing center from 2023 to 2024 was related to incomplete medical order information, high-risk drugs, preparation time, and pharmacist training frequency. The decision tree model constructed based on the above indicators had certain predictive value for ME in the static dispensing center.
A randomized controlled trial of a smart pillbox to improve medication adherence among middle-aged and older adults with polypharmacy
YU Fei, ZHANG Hongjun, LIU Zhaoyuan
2026, 44(10): 534-538.   doi: 10.12206/j.issn.2097-2024.202604008
Abstract(1150) HTML(744) PDF (881KB)(21)
Abstract:
  Objective  To evaluate the effect of smart medication boxes on medication adherence among middle-aged and older patients with polypharmacy in real world.   Methods  A single-center randomized controlled trial was conducted in 147 middle-aged and older patients with polypharmacy under long-term follow-up management at a tertiary hospital from June, 2020 to May, 2023. Participants were randomly assigned to the intervention group (n=73) or the control group (n=74). The intervention group received smart medication box-based reminders and monitoring, while the control group received routine medication guidance. Follow-up assessments were performed in baseline, 6 months, and 12 months. Medication adherence was evaluated by self-report and pill count, and the composite endpoint of death and rehospitalization was recorded. Repeated-measures analysis was used to compare changes in adherence between groups, and logistic regression was used to analyze the primary outcome.   Results  At 6 months, pill count-based adherence was significantly higher in the intervention group than in the control group [94.6% (95% CI: 92.8%-96.7%) vs 90.3% (95% CI: 88.5%-92.3%), P=0.002]. At 12 months, pill count-based adherence remained higher in the intervention group [95.3%(95% CI: 93.9%-97.0%)vs 88.4%(95% CI: 87.2%-90.8%), P=0.001]. Self-reported adherence was also significantly higher in the intervention group at 12 months (P=0.019). After adjustment for nursing level and health-related quality of life, no significant difference was observed between groups in the composite endpoint of death and rehospitalization.  Conclusion  Smart medication boxes could effectively improve objective medication adherence in middle-aged and older patients with polypharmacy and might help optimize long-term medication management. Their effect on major clinical outcomes still requires further validation.
Efficacy and risk of cardiotoxicity associated with ibrutinib anti-tumor treatment
HU Qin, ZHANG Hongyu
2026, 44(10): 539-544.   doi: 10.12206/j.issn.2097-2024.202607004
Abstract(340) HTML(198) PDF (1287KB)(3)
Abstract:
  Objective  To evaluate the efficacy of ibrutinib in patients with mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), and assess the risk of cardiovascular adverse events.   Methods  PubMed, the Cochrane Library, Web of Science, and ClinicalTrials.gov were searched for studies on ibrutinib in lymphoma till December 2025. Hazard ratios (HRs) with 95% confidence intervals (CIs), relative risks (RRs), or odds ratios (ORs) with 95% CIs were used to compare progression-free survival (PFS) and overall survival (OS) between the ibrutinib group and the control group and evaluate the risk of ibrutinib-related adverse events, including hypertension and atrial fibrillation.   Results  A total of 10 studies involving 3 190 patients were included, with 1 620 patients in ibrutinib group and 1 570 patients in control group. Compared with the ibrutinib group, the control group had a significantly higher risk of PFS events (HR=2.93, 95% CI 2.36-3.64, P<0.01) and OS events (HR=1.64, 95% CI 1.41-1.90, P<0.01), indicating that PFS and OS were significantly better in the ibrutinib group than in the control group. The objective response rate (ORR) was significantly higher in the ibrutinib group than in the control group (RR=3.68, 95% CI 1.61-8.40, P=0.002). In addition, the ibrutinib group had a higher risk of hypertension (RR=2.29, 95% CI 1.69-3.10, P<0.01) and atrial fibrillation (RR=4.92, 95% CI 3.10-7.80, P<0.01).   Conclusion  Ibrutinib significantly improved prognosis in patients with MCL and CLL/SLL, but it was associated with significantly increased risks of hypertension and atrial fibrillation.
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Chief Editor: LI Jie Wei

Publication Number:

ISSN 2097-2024   CN  31-2185/R

Website: www.yxsjzz.cn or yxsj.smmu.edu.cn

Email: yxsjzzs@163.com

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