To clarify the effects of betulinic acid on autophagic flux and apoptosis in RPMI-8226 multiple myeloma cells, and to explore the underlying mechanisms.

The apoptosis rate and morphological changes were detected by TUNEL and Hoechst 33258 staining methods; the activities of Caspase-3 and Caspase-8 were measured using the Caspase activity assay kits. The expression of various indicator proteins in cells was detected by Western blotting.

Betulinic acid induced apoptosis and morphological changes in RPMI-8226 cells. Z-VAD-FMK inhibited the pro-apoptotic effect of betulinic acid, while Z-DEVD-FMK further enhanced the pro-apoptotic effect of betulinic acid. Additionally, betulinic acid increased the accumulation of autophagy-related proteins LC3B and P62, promote the activation and protein expression of Caspase-8, and subsequently increase the release of AIF. Z-VAD-FMK antagonized the effects of betulinic acid on LC3B, P62, Caspase-8 and AIF, whereas Z-DEVD-FMK synergized with betulinic acid to enhance its effects on LC3B, P62, Caspase-8 and AIF.

Betulinic acid can directly activate Caspase-3 in RPMI-8226 cells. After acting on RPMI-8226 cells, it can also activate Caspase-8 by blocking autophagic flux, increase mitochondrial membrane permeability, and thereby enhance the release of AIF, thereby mediating an apoptotic process independent of Caspase-3 activation.

To observe the effect of ginkgo biloba extract on myocardial apoptosis after myocardial infarction and its influence on the expression of signaling pathway proteins by regulating the Wnt/β-catenin signaling pathway.

Thirty-five SD rats were selected as the experimental subjects and divided into the blank control group, the model group, the captopril group, and the low-dose and high-dose groups of ginkgo biloba extract. After 24 hours of modeling, continuous intervention was performed for 6 weeks. Cardiac function indicators of rats were detected, and pathological changes of rat myocardial tissue were observed. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum CK-MB, cTnT levels, and collagen Ⅰ and collagen Ⅲ levels in myocardial tissue. Western blot (WB) was used to detect the protein expression levels of β-catenin, Wnt5a, and cleaved caspase-3 in rat myocardial tissue. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to detect the mRNA expression levels of β-catenin and MMP-9.

Compared with the blank control group, the levels of LVESD and LVEDD in the model group rats were increased, while the levels of LVEF and LVFS were decreased. The expression levels of serum CK-MB, cTnT, and collagen I and collagen III in myocardial tissue were increased. The mRNA expression of β-catenin and MMP-9 mRNA in myocardial tissue was increased. and the protein expression of β-catenin, Wnt5a, and cleaved-caspase-3 proteins was also increased. Compared with the model group, the treatment groups showed decreased levels of LVESD and LVEDD, and increased levels of LVEF and LVFS. The serum indicators and collagen content of rats in each treatment group were reduced. The expression of β-catenin and MMP-9 mRNA in myocardial tissue was reduced. And the expression of β-catenin, Wnt5a, and cleaved-caspase-3 proteins were significantly reduced. Compared with the captopril group, the low-dose ginkgo biloba extract group showed improved cardiac function indicators, and the high-dose group exhibited more significant improvement than the low-dose group. The serum indicators and collagen content in both low-dose and high-dose ginkgo biloba extract groups were decreased. The mRNA expression was decreased in the low-dose group, while there was no statistically significant difference in the high-dose group cmRNA expression in the high-dose group. The protein expression levels in both low-dose and high-dose groups were increased compared with the captopril group.

Ginkgo biloba extract improves myocardial injury in rats with myocardial infarction by inhibiting the Wnt/β-catenin signaling pathway, improving cardiac function related indicators, reducing the degree of myocardial injury, and ultimately improving rat cardiac function.

To establish a method for the simultaneous determination of catechin, epicatechin, isoquercitrin, quercetin, madecassic acid, asiatic acid, corosolic acid, oleanolic acid, ursolic acid, β-sitosterol, ethanol-soluble extractive, total ash and acid-insoluble ash in Actinidiae chinensis Radix (Radix Actinidiae Chinensis, Tengligen), and explore the application of chemometrics and weighted TOPSIS in the quality evaluation of Actinidiae chinensis radix.

An HPLC method was adopted with acetonitrile-0.2% phosphoric acid solution as the mobile phase under gradient elution.The detection wavelengths were set at 280 nm and 210 nm. Chemometric analysis (principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA)) was performed on the multi-index content results, and a weighted TOPSIS model was established to comprehensively evaluate the overall quality of Actinidiae chinensis radix.

The methodological validation results of the external standard method for HPLC simultaneous determination were consistent with the requirements of the Chinese Pharmacopoeia (ChP). The results of chemometrics analysis showed that 18 batches of Actinidiae chinensis radix were clustered into three categories, and epicatechin, β-sitosterol, asiatic acid, ursolic acid, quercetin and catechin were the main potential quality markers affecting the quality of Actinidiae chinensis radix.The Euclidean closeness degree (C_i) of the weighted TOPSIS method ranged from 0.143 8 to 0.763 4, indicating a certain degree of batch-to-batch variation in Actinidiae chinensis radix.

The multi-index quantitative evaluation method combined with chemometrics and weighted TOPSIS method of Actinidiae chinensis radix is efficient and accurate, with good repeatability and stability, which can be used for the quality evaluation of Actinidiae chinensis radix.

This study aims to utilize the FAERS database to identify and evaluate the adverse event signals of zuranolone after its market launch in the real world, so as to provide real-world evidence for its safe clinical application.

Collect the reports from the FAERS database for the fourth quarter of 2023 to the third quarter of 2025. Data is stored in MySQL, Medical Dictionary for Regulatory Activities (MedDRA) version 28.0 standardizes and systematically classifies adverse event terms, and Python is used for data cleaning and analysis. The Proportional Reporting Ratio (PRR) method and Bayesian Confidence Propagation Neural Network (BCPNN) method are used simultaneously to detect signals, thereby improving the accuracy of positive signals.

There were a total of 883 reports where zuranolone was identified as the primary suspected drug. 70 positive signals were identified, involving 7 system organ classes (SOCs). The SOC with the highest number of positive signals was psychiatric disorders, followed by neurological disorders. The number of positive signals for these two categories accounted for 80% of the total positive signals. The top three adverse events in terms of signal intensity were neonatal drowsiness, perinatal depression, and intoxication.

The adverse drug events (ADEs) of zuranolone mainly include mental disorders and neurological diseases. It may aggravate depressive symptoms and even induce suicidal behavior; during medication, it may impair the ability to operate precision instruments; it is necessary to strengthen the warning about infant exposure to zuranolone.

To investigate the early laboratory and clinical manifestations of thyroid dysfunction induced by immune checkpoint inhibitors (ICIs) in the treatment of malignant tumors.

A retrospective analysis was conducted on malignant tumor patients who received ICIs treatment during hospitalization between January 1, 2020, and December 31, 2021. Data collected included patients'general information, ICIs treatment regimens, and thyroid function indicators, including the initial onset time of treatment-related thyroid dysfunction, patterns of abnormal manifestations, and thyroid imaging findings.

Among 156 enrolled patients, the five most frequently used ICIs were sintilimab (n =40), camrelizumab (n =38), tislelizumab (n = 32), toripalimab (n =25), and pembrolizumab (n =14). The overall incidence of thyroid dysfunction was 55.13% (86/156). The median time to initial thyroid laboratory function abnormality was 104 days (14.86 weeks), with the shortest being 4 days and the longest 2.4 years. The most frequent onset period of initial thyroid index abnormality was >112 days (16 weeks), accounting for 47.89%. Thyroid laboratory index abnormality presented in various forms, with one or more indices being elevated or decreased. In terms of the number of abnormal indicators, single indicator abnormality was the most common (72.09%), among which hyroid-stimulating hormone (TSH) abnormality (including elevation and reduction) was the most prevalent, accounting for 41.86%. In terms of TSH change patterns, elevated TSH accounted for the highest proportion (44.19%), followed by normal TSH (33.72%), and low TSH (20.93%). After ICIs treatment, 16.28% of patients had conversion of thyroid autoantibodies to positive. Thyroid B-ultrasound findings were abnormal in four patients, mainly presenting as diffuse thyroid changes (n =2), bilateral thyroid volume reduction (n =1), and bilateral thyroid echo hanges (n=1), all of whom had abnormal thyroid antibodies. The thyroid function abnormalities included in this study were all Grade 1 or 2, and most patients had no obvious clinical symptoms. Finally, only three patients continued to take levothyroxine half a year after the end of immunotherapy.

Thyroid dysfunction caused by ICIs often presents as atypical clinical symptoms and mainly manifests as abnormal laboratory tests. Initial thyroid index abnormalities present various manifestations, with TSH abnormalities being the most common. Understanding the early manifestations of thyroid dysfunction caused by ICIs is helpful for oncologists in the diagnosis and treatment of this adverse reaction.

To analyze the risk factors for early low tacrolimus blood concentration in lung transplant patients and to develop and evaluate a risk prediction model.

A retrospective analysis of medical records of hospitalized lung transplant patients who had their tacrolimus blood concentrations monitored within three months post-transplantation.Univariate and multivariate Logistic regression analysis were used to screen the risk factors for tacrolimus plasma concentration below the lower limit in the early postoperative period of lung transplantation patients. A nomogram model was developed using R software.

Logistic regression analysis identified age, sex, azole antifungal agents, and carbapenem antibiotics as independent risk factors for subtherapeutic tacrolimus blood concentrations (P <0.05). Based on these factors, a nomogram model was established.Model evaluation showed an area under the curve (AUC) of 0.919, and bootstrap validation demonstrated the good model fit with a mean absolute error of 0.022. The decision curve analysis (DCA) showed that when the threshold probability ranged from 0.1-0.91, the curve lay between the 'all events' and 'no events' curves, indicating the model achieved a high net benefit.

This study developed a risk prediction model for low tacrolimus blood concentrations in lung transplant recipients in the early stages, which can help guide individualized clinical dosing regimens.

To explore the correlation between Case Mix Index (CMI) and Antimicrobial Usage Density (AUD), construct a tiered management model for AUD, optimize the management of antimicrobial agents in the entire hospital, and improve the quality of antimicrobial management.

Data on CMI, AUD, and other antimicrobial usage-related indicators from 41 clinical departments of a tertiary general hospital in 2023 were collected. Linear regression models and multivariate regression analysis were used to investigate the relationship between CMI and AUD and other antimicrobial usage indicators. The optimal model was determined using the Rank Sum Ratio (RSR), and tiered management of AUD was implemented based on the this optimal model.

The fitting coefficient (R₂) of the CMI×Antimicrobial Usage Rate×AUD model was 0.522, which was significantly higher than that of other AUD linear regression models (P <0.05), indicating a superior fit. Using this model, the RSR was calculated, and a linear regression equation was established:y =0.120 3x-0.102 6, with R₂=0.899. Analysis of variance showed F =357.112 and P < 0.001, indicating that the regression equation constructed with the RSR based on this model was well-established and statistically significant. After adjusting AUD with CMI and antimicrobial usage rate, the tiered results of 10 departments (24.40%) changed, with 5 departments being upgraded and 5 downgraded in management level. Following the implementation of tiered AUD management, the overall antimicrobial usage intensity in the hospital decreased by 4.22% in 2024 compared to 2023. The 8 strictly controlled departments showed an average AUD reduction of 5.89%, indicating a satisfactory overall management effect.

Adjusting AUD with CMI and antimicrobial usage rate can enhance the accuracy of antimicrobial usage evaluation and provide a scientific basis for hospital antimicrobial management.

To explore the impact of pharmacist-led comprehensive pharmaceutical care on clinical symptoms, medication adherence, and quality of life in chronic obstructive pulmonary disease (COPD) patients.

A total of 70 COPD patients admitted to a hospital between January and December 2022 were selected as subjects and randomly divided into a study group and a control group using a random number table, with 35 patients in each group. The control group received conventional treatment and nursing care, while the study group received individualized, comprehensive pharmaceutical care led by clinical pharmacists in addition to conventional treatment.The intervention duration covered the hospitalization period and 6 months after discharge.Clinical efficacy, Clinical Asthma Test (CAT) scores, mMRC scores, Morisky medication adherence scores, inhaled preparation use scores, and EQ-5D-5 L quality of life scores were compared between the two groups before and after the intervention.

The total effective rate in the study group was 94.29%, significantly higher than the 71.43% in the control group (χ₂ =6.437, P =0.011). At the end of the observation period, CAT scores, mMRC scores, Morisky scores, EQ-5D-5 L scores, and inhaler technique scores in both groups were improved compared to those before intervention, and all scores in the study group were significantly superior to the corresponding scores in the control group (all P < 0.05).

Individualized, comprehensive pharmaceutical care can effectively alleviate clinical symptoms, improve medication adherence and quality of life in COPD patients, and has significant clinical promotion value.

This study evaluates and compares tools for pharmaceutical clinical comprehensive evaluation, so as to preliminarily identify a suitable method for the "Hong Kong and Macao Medicine and Equipment Connect" and lay a foundation for the development of subsequent evaluation models.

Systematic literature retrieval, policy research, and comparative analysis were adopted to discuss domestic and international frameworks for drug value assessment.

Existing foreign frameworks cannot be directly applied due to differences in pharmaceutical systems and assumptions.In contrast, the MCDA framework has certain advantages because of its openness and flexibility and its compatibility with the requirements of China's pharmaceutical clinical comprehensive evaluation.

The MCDA framework can be adjusted to fit for the "Hong Kong and Macao Medicine and Equipment Connect" program, making it a suitable foundational model.