To investigate the analgesic mechanism of the active constituents of Piper wallichii.

The core targets related to analgesia of Piper wallichii were screened by network pharmacology, and GO functional enrichment and KEGG pathway enrichment analyses were carried out by DAVID database. The cationic elution site of Shinan vine was eluted by a silica gel column with a gradient（95:5-50:50）of petroleum ether-ethyl acetate separation system system to isolate the wallwort alkaloids, and the purity was determined by HPLC. Selected ICR mice were randomly divided into a blank group, positive control（aspirin 120 mg·kg^-1）group, a model group, and low, medium, and high dose（150, 300, and 600 mg·kg^-1）pellitorine groups（all n=8）, and were administered continuously for 7 d. After the last administration, each group was injected intraperitoneally with 0.1 mL of 0.7% acetic acid for every 10 g of body weight except the blank group. The number of twisting responses and latency period in each group were examined. Serum levels of tumour necrosis factor（TNF）-α, interleukin（IL）-6 and IL-1β were detected by ELISA, and the concentrations of choline acetyltransferase（ChAT）, acetylcholine（ACh）, and acetylcholinesterase（AChE）were examined in brain tissues.

The network pharmacological results showed that Piper wallichii screened out the core components such as pellitorine and futoamide, and the key pathways such as nerve signalling pathway and cholinergic synaptic pathway. The purity of isolated pellitorine was 90.42%. Animal experiments showed that, compared with the model group, the number of twisting in the low, medium and high dose pellitorine groups was significantly reduced（P<0.05）, and the content of TNF-α,IL-6 and IL-1β in serum was significantly reduced（P<0.01）. ChAT in the brain tissues of the three dose pellitorine groups were significantly higher（P<0.01）, and the concentration of ACh in the medium and high dose pellitorine groups were significantly higher（P<0.01）, and the AChE concentration of low, middle and high dose pellitorine groups were significantly decreased（P<0.05）.

The key active constituent in the analgesic effect of Piper wallichii is pellitorine, which is involved in the cholinergic synaptic pathway by up-regulating the activities of ChAT and ACh, and down-regulating AChE,thus reducing pain.

To explore the current research progress, research status, and future development directions in the field of traditional Chinese medicine（TCM）innovation.

CiteSpace software was used to analyze the paper trends and keywords in domestic journal articles between 1999 and 2023, and keyword clustering analysis, drawing timeline mapping,and emergent word analysis were used to visualize the field of Chinese medicine innovation in China.

The number of TCM innovation-related publications showed a fluctuating upward trend year by year. The research is still dominated by the researchers’ respective teams and lacks relevant team cooperation. The development of TCM research has entered a rapid development stage, which has envolved from the traditional research direction such as prescription research and development,it has developed to the construction of TCM data platform and intelligent production in the industry.

Research in the field of TCM innovation in China is developing steadily and undergoing a transformation towards diversification,digitization, and intelligence.

To evaluate the rationality of irinotecan application based on weighted TOPSIS method.

Based on the drug label of irinotecan, combined with relevant guidelines and literatures, weighted TOPSIS method was used to establish the evaluation criteria for the rationality of irinotecan clinical application, with “indications,contraindications, application and dosage, solvent selection, baseline examination, pretreatment, administration sequence,blood routine monitoring, dosage adjustment and ADR monitoring” as evaluation indicators. The archived medical records of inpatients who had used irinotecan in Binhu Hospital of Hefei from January 1, 2022 to May 31, 2023 were evaluated for the rationary of irinotecan administration.

Among the 10 evaluation indicators, the highest relative weighted index was indication（0.133 1）, while the lowest was pretreatment（0.084 9）. Among the included 97 cases, 10 cases（10%）had relative proximity（C_i）≥0.8, with the evaluation result as rational drug application; 79 cases（81%）had 0.6≤ C_i< 0.8,with the evaluation result as basic rational drug application; 8 cases（8%）had 0.4≤C_i < 0.6, with the evaluation result as irrational drug application.

The weighted TOPSIS method can be used to evaluate the rational usage of irinotecan. In our hospital, the use of irinotecan is basically reasonable, however, there are still some problems about baseline examination, blood routine monitoring and unreasonable indications.

To investigate the effect of ultrasound-guided lateral quadratus lumborum block（QLB-1）on the median effective dosage（ED₅₀）of butorphanol by patient controlled intravenous analgesia（PCIA）performed after cesarean section under general anesthesia.

Parturients were scheduled for cesarean section under general anesthesia,gestation 37-42 weeks, ASA physical status Ⅱ were assigned into two groups, group Q（QLB-1 combined with butorphanol PCIA）and group C（butorphanol PCIA）. Each group was expected to have 35 cases. Both groups were administered general anesthesia with endotracheal intubation. The group Q: 0.3% ropivacaine with 25 mL were injected in the QLB-1 in each side respectively under ultrasound guidance before extubation at the end of the surgery. The group C: no nerve block.The two groups underwent PCIA after extubation. The scores of resting visual analogue scale（VAS）≤3 points or VAS of motion state ≤4 points within 48 hours after operation were used as the criteria of analgesia satisfaction. The initial dose of butorphanol with PCIA was 4 μg·kg^-1·h^-1, adjusted by the modified Dixon’s up-and-down method with a dose gradient of 0.25 μg·kg^-1·h^-1. Probit analysis was used for calculating ED₅₀ and 95% confidence interval（CI）of butorphanol PCIA for satisfactory analgesia.

The sample size included in group Q and group C were 31 and 28 cases, respectively.The ED₅₀ of butorphanol PCIA for satisfactory analgesia was 3.81 μg·kg^-1·h^-1 for the group C（95%CI: 2.87 to 4.25 μg·kg^-1·h^-1）and 2.45 μg·kg^-1·h^-1 for the group Q（95%CI: 2.16 to 2.70 μg·kg^-1·h^-1）. In the parturients with satisfactory analgesia of the two groups, the incidence of drowsiness, dizziness and nausea was higher in the group C than that in the group Q（P<0.05）.

The ED₅₀ of butorphanol PCIA combined with QLB-1 for satisfactory relieve postoperative analgesia after cesarean section under general anesthesia reduce butorphanol PCIA alone by 36% and reduce the incidence of adverse reactions.

To evaluate the efficacy and safety of anlotinib combined with gemcitabine + docetaxel as second-line or later therapy in patients with lung metastasis of osteosarcoma.

Case data of 23 patients with lung metastasis of osteosarcoma received anlotinib combined with gemcitabine + docetaxel as second-line or later therapy in the department of oncology of Shanghai Sixth People’s Hospital from January 2016 to December 2022 were analysed retrospectively. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate, disease control rate (DCR) and safety.

In the 23 patients with lung metastasis of osteosarcoma, 17 patients (74%)achieved stable disease and 6 patients (26%) achieved progress disease, with DCR 74%. Median PFS was 10.8 months (95% CI: 1.4 to 20.2 months). All 23 patients experienced adverse reactions. Grade 3 or 4 adverse reactions included thrombocytopenia (17%)，hypothyroidism (9%), hypertension (4%), hand-foot reaction (4%), fatigue (4%), diarrhea (4%), leukopenia (4%), and pneumothorax (4%).

Anlotinib combined with gemcitabine + docetaxel as second-line or later therapy can be used as an effective treatment with manageable toxicities for patients with lung metastasis of osteosarcoma.