Latest ArticlesSepsis-induced cardiomyopathy is a common cardiovascular complication among septic patients, which significantly increases mortality rates. Ferroptosis is an iron-dependent form of regulated cell death characterized by increased lipid reactive oxygen species (ROS), which causes lipid peroxidation and cell membrane damage. Increasing evidence has highlighted a significant link between ferroptosis and sepsis-induced cardiomyopathy, in which traditional Chinese medicine (TCM) exhibits promising therapeutic potential. This article reviews the mechanism of ferroptosis and current advances in the use of TCM active ingredients and formulated preparations to target ferroptosis in treating sepsis-induced cardiomyopathy, aiming to offer new perspectives for clinical management.
As a multi-target tyrosine kinase inhibitor, sorafenib is the core therapeutic drug for advanced hepatocellular carcinoma, renal cell carcinoma and differentiated thyroid cancer. However, its cardiotoxicity significantly limits clinical application, mainly manifests in hypertension, myocardial ischemia, heart failure, arrhythmia, and thrombosis/hemorrhage events, which seriously affect the patient’s prognosis. This paper deeply explores the molecular mechanisms of sorafenib inducing cardiotoxicity, including key pathways such as oxidative stress and mitochondrial dysfunction, autophagy imbalance, ribonucleic acid binding motif protein 20 (RBM20) mediated gene splicing abnormalities, calcium homeostasis imbalance and myocardial electrophysiological abnormalities; at the same time, a systematic summary of clinical prevention and treatment strategies, covering monitoring and intervention measures for adverse reactions such as hypertension and heart failure, as well as research progress in experimental therapeutic drugs.
The high-altitude environment is characterized by hypoxia, low temperatures, strong radiation, and low humidity, with hypoxia exerting profound effects on human physiological functions. Cardiovascular disease, a prevalent chronic condition in plateau regions, poses a serious threat to health. While pharmacotherapy is the primary intervention, the hypoxic environment significantly alters the pharmacokinetic processes of cardiovascular drugs in vivo, thereby compromising their safety and efficacy. Consequently, investigating the pharmacokinetic characteristics of cardiovascular drugs under high-altitude hypoxia is crucial. Given the current scarcity of research in this area, this review summarizes the impact of high-altitude hypoxia on key pharmacokinetic parameters of cardiovascular drugs and explores potential mechanisms of action, aiming to provide a theoretical basis for the rational clinical use of these drugs in plateau areas.
Elderly patients with hip fracture have a high incidence of perioperative neurocognitive disorders (PND), poor prognosis and high resource consumption. Remazolam has the pharmacokinetic advantages of esterase metabolism, predictable recovery and hemodynamic friendliness, and can be quickly reversed by flumazenil, making it suitable for people with advanced age, insufficient organ reserve or high risk of cognitive complications. Recent studies have shown that remazolam can reduce the level of postoperative inflammatory markers, improve early cognitive function and reduce the incidence of delirium, while retaining good hemodynamic stability and controllable recovery characteristics. The underlying mechanism involves the inhibition of excessive activation of microglia and neuroinflammatory response, reduction of systemic inflammatory response, reduction of stress and pain intensity, and reduction of cerebral hypoperfusion events and other pathways to produce neuroprotective effects. Therefore, this paper integrates the latest evidence of the molecular mechanism, pharmacological characteristics and clinical application of remazolam in the prevention and treatment of perioperative neurocognitive disorders in elderly patients with hip fracture, and emphasizes its potential value in optimizing perioperative anesthesia management of elderly hip fracture. It is expected to provide a theoretical basis for future high-quality, multi-center, long-term follow-up clinical research, and provide reference for individualized perioperative strategy formulation and PND prevention and treatment.
Polymyxin’s clinical application is limited by its significant nephrotoxicity, complex pharmacokinetic and pharmacodynamic characteristics, and the growing issue of bacterial resistance. This systematic review summarizes research progress on three novel polymyxin derivatives: SPR206, QPX9003, and MRX-8. Through structural design, these compounds retain potent antimicrobial activity while reducing nephrotoxicity and improving PK/PD profiles. Preclinical studies and preliminary clinical trials demonstrate broad-spectrum antimicrobial activity against multidrug-resistant Gram-negative bacteria, along with promising efficacy in models such as pulmonary infections. Although these candidate drugs are still undergoing clinical trials, they show potential to become alternatives to existing polymyxin therapies.
Dystrophic epidermolysis bullosa (DEB) is a mechanobullous disorder caused by mutations in the COL7A1 gene encoding type VII collagen. It has been included in China’s Rare Disease List, with clinical management primarily focused on preventing mechanical trauma and infections. In recent years, significant progress has been made in the development of advanced therapy medicinal products (ATMPs) for DEB, with two products already approved for marketing and multiple others undergoing clinical trials. This article reviews the fundamental characteristics of both approved and investigational ATMPs for DEB and discusses key considerations in clinical trial design, aiming to provide valuable insights for the clinical development of advanced therapies for this condition.
As a representative of the new generation of nucleic acid vaccine technology, messenger ribonucleic acid (mRNA) vaccines have demonstrated advantages such as rapid manufacture, high efficacy, and good safety since Coronavirus Disease 2019(COVID-19), becoming an important direction in global vaccine research and development. Many mRNA vaccines have been approved or in clinical trials. This article systematically reviews and summarizes the current research and development of mRNA vaccines, discussing the current state of mRNA vaccine development and evaluation strategies in China, with the aim of providing scientific basis for the development of mRNA vaccines.
To examine issues in sample management within drug clinical trials, their implications on subject rights, data integrity, and propose targeted enhancements.
A retrospective analysis was conducted on 69 clinical trial projects, encompassing bioequivalence and innovative drug phase I-IV trials, processed by the phase I clinical trial laboratory at our institution from April 2018 to December 2024. Problems in biological sample management were identified through monitoring records maintained by quality control professionals, institutional quality control personnel, and clinical research monitors. The distribution patterns of issues were analyzed, and non-standard problems were assessed and categorized using the protocol deviation (PD) evaluation system.
A total of 68 issues were identified in biological sample management, primarily centered around sample collection (27.94%), processing (19.12%), and preservation (36.76%). PD evaluations indicated that deficiencies in operational processes (e.g., non-compliance with standard operating procedures), insufficient personnel training, and irregular documentation were the primary underlying causes.
Comprehensive standardized management strategies, including enhancing standardized procedures in critical stages, improving personnel training, quality control frameworks, and implementing intelligent information systems, are essential to ensure the provision of dependable sample support for high-caliber clinical research.
To analyze the species distribution and antimicrobial resistance profiles of Acinetobacter baumannii complex (ABC) isolates from a Grade A tertiary hospital in Beijing (2017-2024), providing evidence for clinical microbiological identification and antimicrobial therapy.
ABC isolates were collected from the hospital’s antimicrobial resistance surveillance network. Species identification was performed by mass sectrometry and susceptibility testing was analyzed using WHONET 5.6. Statistical comparisons of resistance rates were performed with SPSS 26.0 (chi-square test).
Among 2 752 non-repetitive ABC isolates,Acinetobacter baumannii (ABA) accounted for 91.75%, followed by Acinetobacter pittii (APT, 6.90%) and Acinetobacter nosocomialis (ANO, 1.31%). Sputum and urine were the predominant specimen types, with ABA and APT frequently isolated from bloodstream infections. The resistance profile varied statistically significantly defferences across the bacterial species for all 12 common antimicrobials (all P<0.05). Among these, ABA demonstrated the highest resistance rates, ANO showed an intermediate profile, and APT was the most susceptible. Specifically, ABA exhibited resistance rates exceeding 80% to β-lactam antibiotics, including piperacillin/tazobactam, ceftazidime, imipenem and meropenem. In contrast, ANO showed resistance rates of 30%-50%, and APT only 10%-30% to the same agents. Resistance profiles between ABA and ANO differed statistically significantly except for trimethoprim-sulfamethoxazole and minocycline (all P>0.05). The single Acinetobacter calcoaceticus isolate was only resistant to doxycycline and trimethoprim-sulfamethoxazole, while remaining susceptible to all other β-lactam and fluoroquinolone agents tested.
ABC species exhibit distinct clinical distributions and resistance patterns, emphasizing the need for accurate species identification and ongoing resistance surveillance to guide appropriate empirical therapy.
To explore the clinical efficacy and safety of different doses of buspirone hydrochloride tablets combined with venlafaxine hydrochloride sustained-release tablets in the treatment of elderly patients with generalized anxiety disorder (GAD) accompanied by depression.
Elderly patients with GAD accompanied by depression were taken as the research subjects. The control group was given oral treatment with venlafaxine hydrochloride sustained-release tablets (75 mg·d-1, once daily) and buspirone hydrochloride tablets (the initial dose was 5 mg each time, and it was increased by 5 to 10 mg every 2 to 3 days according to the patient’s tolerance, and then increased to 10 mg each time, twice daily after 2 weeks). The treatment group was treated with venlafaxine hydrochloride sustained-release tablets on the basis of the control group. Different doses of buspirone hydrochloride tablets were given orally for treatment (the initial dose was 5 mg each time, and it was increased by 5 to 10 mg every 2 to 3 days according to the patient’s tolerance, and then increased to 20 mg each time, twice a day after 2 weeks). Both groups were treated continuously for 8 weeks. The clinical efficacy, Hamilton anxiety scale (HAMA) scores, anxiety and depression scores, sleep conditions, levels of neurotransmitters for mood regulation, neurological function levels and endocrine metabolic levels of the two groups of patients were compared, and the safety was evaluated.
A total of 100 cases were screened, and 95 cases were enrolled, including 49 cases in the control group and 46 cases in the treatment group. In the control group, 3 cases dropped out due to loss to follow-up, and eventually 46 cases were included in the statistical analysis. There were no patients with dropout in the treatment group. Eventually, 46 cases were included in the statistical analysis. After 8 weeks of treatment, the HAMA scores of the treatment group and the control group were (17.93±2.85) and (19.51±2.96) points, respectively; the Hamilton depression scale scores were (18.85±3.11) and (20.37±3.08) points, respectively; the scores of the Beck despair scale were (4.64±1.44) and (5.37±1.53) points, respectively; the scores of the Chinese version of the self-rating scale for constrained neurosis were (25.63±4.17) and (27.73±4.31) points, respectively; the scores of melatonin were (38.83±5.78) and (36.24±5.27) pg·mL-1, respectively; the cortisol levels were (109.36±11.92) and (115.41±12.17) ng·mL-1, respectively; and the Pittsburgh sleep quality index scores were (8.28±2.35) and (9.48±2.46) points, respectively; the values of substance P were (112.17±10.66) and (117.61±11.37) ng·L-1, respectively; and those of γ -aminobutyric acid were (5.65±0.65) and (5.31±0.67) μmol·L-1, respectively; the glutamic acid were (25.02±3.22) and (26.75±3.28) mg·L-1, respectively; the brain-derived neurotrophic factor were (14.33±1.56) and (13.54±1.46) ng·mL-1, respectively; the glial cell-derived neurotrophic factor were (556.41±62.12) and (525.57±64.72) pg·mL-1, respectively; and the glial fibrillary acidic protein were (2.51±0.28) and (2.67±0.35) ng·mL-1, respectively; the free thyroxine were (13.33±1.96) and (12.41±1.85) pmol·L-1, respectively; and the 25-hydroxyvitamin D3 was (33.46±4.39) and (31.57±3.14) ng·mL-1, respectively; the prolactin levels were (22.56±3.94) and (24.59±3.78) ng·mL-1, respectively. The differences in the above indicators of the treatment group were statistically significant with control group (all P<0.05). Two groups of patients experienced adverse drug reactions such as dizziness, headache, nausea and vomiting, constipation and dry mouth. The total effective rates of the treatment group and the control group were 82.61% and 73.91%, respectively, and the total incidences of adverse drug reactions were 15.22% and 13.04%, respectively. There were no statistically significant differences between the two group (all P>0.05).
The application of 20 mg buconspirone tablets combined with venlafaxine tablets in the treatment of elderly patients with GAD and depression can improve sleep conditions and clinical symptoms, regulate neurological function and endocrine metabolism, and has certain safety.
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