Objective To provide a reference for the application of Polygonum cuspidatum polysaccharides. Methods This study reviewed literature to summarize the research progress on the isolation and purification, physicochemical properties, structural identification, and hypoglycemic activity of Polygonum cuspidatum polysaccharides. Conclusion The extraction process of Polygonum cuspidatum polysaccharides requires further optimization. The physicochemical properties and structural identification methods have been well-established, demonstrating promising hypoglycemic activity.

Polygonati Rhizoma is a Traditional Chinese Medicine (TCM). The Chinese Pharmacopoeia (2020 edition) contains three medicinal source species of Polygonatum sibiricum Red., Polygonatum kingianum Coll.et Hemsl, Polygonatum cyrtonema Hua, and the main medicinal part is its rhizome. Polygonati Rhizoma have sweet and mild property, rich in polysaccharides, saponins, flavonoids, alkaloids and other active ingredients. The content of active ingredients is the determining factor for the normal efficacy of TCM, and the active ingredient extraction process applied to Polygonati Rhizoma is continuously optimized along with the innovation of the extraction technology of TCM ingredients, and the active ingredient extraction methods and process conditions applicable to medicinal and edible Polygonati Rhizoma are different. Therefore, it is very important to choose the correct and effective extraction method to improve the yield of active ingredients according to their characteristics and purposes. This paper reviewed the various extraction methods for the active components of Polygonati Rhizoma, including the principles, advantages and disadvantages, and the current application status of the extraction process, with a view to providing a theoretical basis for the selection of the optimal extraction process of the active components of Polygonati Rhizoma for different applications.

Objective The basic sources of A.erubescens in “Pharmacopoeia of the People's Republic of China” include Arisaema erubescens(wall.) Schott. Arisaema.heterophyllum Blume and Arisaema.amurense Maxim, which is most widely distributed in Liaoning, Sichuan and Yunnan provinces of China.The chemical constituents of A.erubescens are complex, but the reports of its main pharmacological and pharmacodynamic chemical constituents are not perfect; And it is impossible to identify the difference between A.erubescens from different sources. At present, there are few studies on the exclusive HPLC fingerprint of A.erubescens for identification and control of genuine and counterfeit products. Therefore, the separation and purification of lipid components in this paper is helpful to establish the exclusive HPLC fingerprint of A.erubescens and provide a basis for the identification of the quality of different basic A.erubescens and its decoction pieces. Methods:This method describes a complete process for the extraction and isolation of compounds from the tubers of *Arisaema heterophyllum*. First, the sliced medicinal material was subjected to reflux extraction with 95% ethanol, followed by concentration to obtain a total extract. The extract was then roughly separated by silica gel column chromatography using a gradient elution with dichloromethane-methanol and ethyl acetate-methanol solvent systems in varying ratios. The fractions were monitored by thin-layer chromatography (TLC), and those with similar compositions were combined to yield 11 fractions. Fraction III was further separated by Sephadex LH-20 gel column chromatography with 70% methanol as the eluent. The subfractions were monitored by polyamide TLC and combined to obtain four subfractions. Finally, after analysis by liquid chromatography, the target subfraction was purified using semi-preparative liquid chromatography to obtain a relatively pure sample. Results Two monomers were isolated and identified as terpineol and (E)-p-Coumaryl Alcohol by combining NMR and physicochemical properties. Conclusion:Pine alcohol and (E)-p-Coumaryl Alcohol were isolated from A.erubescens for the first time.It is suggested that the content of phenylpropanoids in fat-soluble components of A.erubescens may be higher.

Objective This study aims to explore the potential mechanism of Datura stramonium in treating psoriasis using network pharmacology.Methods In this study, high-throughput retrieval of active components of Datura metel was first performed based on the Traditional Chinese Medicine Systems Pharmacology Analysis Platform combined with the PubChem chemoinformatics database. Subsequently, the Swiss Target Prediction system was used to conduct target spectrum analysis on candidate active compounds. Simultaneously, psoriasis-related targets were systematically captured through the OMIM disease genomics database and GeneCards gene annotation knowledge base. Finally, the Venny 2.1.0 bioinformatics visualization tool was employed for topological analysis of the drug-disease target network, and core action target groups of Datura metel in treating psoriasis were revealed through multi-dimensional validation mechanisms. The protein-protein interaction (PPI) network was constructed using the STRING database, and the core genes of PPI were screened plugin of Cytoscape software. The "drug-component-target-disease" network diagrams were constructed using Cytoscape software. The DAVID database was used to conduct gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis on the above intersection target sites to obtain the biological mechanism of Datura stramonium in treating psoriasis.Results Through database analysis, 310 target sites of Datura stramonium were screened out, 4466 psoriasis-related target sites were obtained, and 224 common target sites were identified. 49 key target sites were screened out from the PPI network. GO functional enrichment analysis shows that the biological processes and functions of Datura metel are concentrated on protein- and adenosine triphosphate (ATP)-related functions, plasma membrane and membrane structures in cellular components, and protein phosphorylation and chromatin remodeling activity in molecular functions, etc. KEGG pathway enrichment showed that the treatment of psoriasis by Datura stramonium mainly involved pathways in cancer, endocrine resistance, AGE-RAGE signaling pathway in diabetic complications, prostate cancer, etc.Conclusion Based on the network pharmacology research method, this study found that the pharmacological basis of Datura stramonium in treating psoriasis lies in its multiple active components that can exert effects through a multi-target and multi-pathway synergistic regulatory network. The research results provide important theoretical support for further in-depth exploration of the mechanism of Datura stramonium in treating psoriasis and its clinical application. 

Objective Pyrazolone and hydroxyindole structures are two very important pharmacophore, which occupy a very important position in medicinal chemistry. Among them, pyrazolone is a kind of five membered heterocyclic compounds containing N-N bond. It has become one of the most important nitrogen heterocycles in heterocycles due to its wide application in medicinal chemistry and functional materials. At the same time, hydroxyindole derivatives have unique physiological anticancer activity and analgesic effects due to their unique chemical structure. Isatin is an oxidation product of indigo, found in plants of the genus Isatis, and is a metabolic derivative of adrenaline in the human body. In view of the importance of pharmacophore combination strategy in drug research and development, the organic combination of these two pharmacophore will lay an important molecular foundation for drug research and development. Methods Considering the important application of SNV reaction in C-C bond coupling, in this paper, starting from the 4-position monosubstituted pyrazolone, a variety of chiral alkenylpyrazolone adduct were obtained through the SNV reaction between it and the isatin-derived nitroalkenes. The optimal reaction conditions were determined by screening factors such as catalysts, solvents, and temperature. Under the optimal reaction conditions, substrate expansion of structurally diverse pyrazolone compounds was achieved, and the resulting products were characterized and analyzed by 1H NMR, 13C NMR, HRMS, and other methods to determine their structures. Results This synthesis strategy constructs a series of chiral alkenyls containing a tetrasubstituted stereoisomeric center with a hydroxyindole moiety, which have high yields (excellent regioselectivity (E: Z >20:1) and good enantioselectivity (up to 86% ee). Conclusion These new alkenylpyrazolone adduct are expected to provide material support for the search for new lead compound.

Objective To investigate the preventive effect of stevia rebaudiana polysaccharide (SRP) on non-alcoholic fatty liver disease (NAFLD) and its therapeutic effect on cell fat accumulation. Methods Cultivation of LO2 cells and measurement of their proliferative activity, treatment of LO2 cells with stevia rebaudiana root polysaccharides at different concentrations to determine whether stevia rebaudiana cells have toxicity to LO2 cells, induction of LO2 cells with oleic acid (OA), development of a cell model of NAFLD in vitro, Use of cck8 to measure cell activity, and with oil red O staining to observe fat accumulation.Treatment with oleic acid (OA) in different concentrations of Stevia Rebaudiana polysaccharide induced LO2 cells and oily red O staining was performed to observe the improvement of Stevia Rebaudiana polysaccharide on LO2 fat accumulation. Results After SRP treatment, SRP significantly reduced the accumulation of fat around LO2 cells. Conclusion Stevia rebaudiana polysaccharide can prevent non-alcoholic fatty liver disease (NAFLD) by regulating lipid metabolism disorders and reducing the accumulation of fat around cells.Therefore, stevia root polysaccharide plays an important role in the prevention and treatment of NAFLD.

Objective Platycodon grandiflorus (Jacq.) A.DC. contains a lot of triterpenoid saponins, volatile oil, flavonoids, polysaccharides and amino acids, which have some effects on the germination and growth of plant seeds.In this experiment, the effect of aqueous extracts from different parts of Platycodon grandiflorus (Jacq.) A.DC. on wheat seed germination was studied by using culture dish filter paper method. In the experiment, different parts of Platycodon grandiflorus (Jacq.) A.DC. were extracted by water, 2 g powder of different parts of Platycodon grandiflorus (Jacq.) A.DC. were extracted by water bath with 100 mL ultra-pure water at 65 °C for 1 h, and mother liquor was obtained, then diluted to the appropriate concentration of extract solution, then we made the medium to culture the wheat seeds, through observing the germination of the wheat seeds on the medium of the blank control group and the water extract of different parts of Platycodon grandiflorus (Jacq.) A.DC., to analyze the effect of aqueous extracts from different parts of Platycodon grandiflorus (Jacq.) A.DC. on the germination of wheat seeds, the germination percentage and germination potential of wheat seeds were measured at different time.The results showed that the aqueous extract from roots and stems of Platycodon grandiflorus (Jacq.) A.DC. had a certain effect on the germination of wheat seeds, and the effect of the aqueous extract from stems was better than that of roots, but at the same concentration, the aqueous extract of leaves of Platycodon grandiflorus (Jacq.) A.DC. showed almost inhibitory effect on wheat seed germination.

Objective A randomized, multicenter, open-label, phase III trial (IMforte) demonstrated that lurbinectedin combined with atezolizumab significantly prolonged overall survival and progression-free survival in patients with extensive-stage small cell lung cancer (ES-SCLC) compared with atezolizumab alone. This study aimed to evaluate the cost-effectiveness of lurbinectedin combined with atezolizumab as first-line treatment for ES-SCLC from the perspective of the United States. Methods Based on the IMforte trial, a Markov model was developed to simulate the disease progression of ES-SCLC, including three health states: progression-free survival (PFS), disease progression (PD), and death. The model simulation period was 10 years with a 3-week cycle. The model used cost and quality-adjusted life years (QALYs) as output indicators, and the incremental cost-effectiveness ratio (ICER) was calculated through cost-effectiveness analysis to assess the economic feasibility of lurbinectedin combined with atezolizumab compared with atezolizumab alone. Sensitivity analysis and scenario analysis were conducted to test the robustness of the model. Results Compared with atezolizumab alone, the lurbinectedin combined with atezolizumab group had an additional cost of $85,854.15 and an incremental benefit of 0.2 QALYs. The lurbinectedin combined with atezolizumab group was not cost-effective compared with the atezolizumab group, with an ICER of $429,270.75/QALY, exceeding the willingness-to-pay threshold of $150,000. The model was most sensitive to the cost and PFS utility value of the lurbinectedin combined with atezolizumab group. Conclusion From the perspective of US payers, lurbinectedin combined with atezolizumab is not a cost-effective option for first-line treatment of ES-SCLC.

Objective Based on network pharmacology, to explore the therapeutic effect of Simo Decoction on Functional Constipation (FC). Methods TCMSP, DisGeNET, Gene cards, OMIM, and SwissTarget Prediction reverse molecular docking server were used to predict the possible effective components in Simo Decoction and their potential targets in the treatment of FC. With the help of STRING database, PPI network is constructed to identify the core target. Subsequently, these core targets are imported into Cytoscape software, and the mutual graph of PPI network is drawn. In addition, the functional classification of Gene Ontology, GO) and the enrichment analysis of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were carried out on these effective targets by using David bioinformatics resources. Results Simo Decoction has 40 active components and 575 action targets, and 211 action targets related to the pathogenesis of FC. Through topological analysis, 41 key therapeutic targets were obtained. According to the degree value, AKTI, TNF, SRC, BCL2 and EGFR were selected, and boldine, quercetin, kaempferol and 6,7-dimethoxy -2 -(2-phenylethyl) were selected. 1245 GO function items and 178 signal paths were obtained by enrichment analysis. Conclusion Simotang can comprehensively regulate key biological processes such as anti-inflammatory reaction and cell cycle regulation through its compound components and multi-target mechanism. These comprehensive effects are helpful to improve the peristalsis ability of the intestine, and then have a therapeutic effect on functional constipation.

Objective To investigate the molecular mechanism of Sansheng Hehuan Yin in treating lipid metabolism-related depression based on network pharmacology. Methods Target genes of Sansheng Hehuan Yin and those related to lipid metabolism-related depression were screened from databases. A “Chinese herbal compound-active ingredient-key target” network and a protein-protein interaction network were constructed, followed by GO and KEGG enrichment analyses. Results A total of 911 target genes of Sansheng Hehuan Yin and 9,017 disease-related target genes were identified, yielding 724 overlapping targets. Twenty-one core genes, including PTGS2, HSP90AA1, and ESR1, were screened from the PPI network. A total of 11,307 GO entries were enriched, involving biological processes such as protein phosphorylation and cellular response to lipid, cellular components such as membrane raft and dendrite, and molecular functions such as protein kinase activity. KEGG enrichment analysis identified 313 signaling pathways, including pathways in cancer, lipid and atherosclerosis, among others. Conclusion Sansheng Hehuan Yin may exert its therapeutic effects on lipid metabolism-related depression through multiple targets, components, and signaling pathways.

Objective To systematically analyze the key issues such as drug resistance, safety and irrational drug use faced by quinolone antibacterial drugs in clinical application in the past five years, and to explore the corresponding solutions. Methods systematically retrieved and sorted out domestic and international research, guidelines, monitoring reports and real-world data on quinolone antibacterial drugs from 2018 to 2023, with a focus on including evidence in areas such as plasmid-mediated resistance, serious adverse reactions, medication in special populations and antibacterial drug management. Results The detection rate of plasmid-mediated quinolone resistance (PMQR) genes has shown a rapid upward trend in China, and the quinolone resistance rate of multi-drug resistant bacteria generally exceeds 85%. Fluoroquinolone drugs carry serious black box warning risks such as aortic dissection and tendon rupture, and the problems of unindicated clinical use and non-standard dosage and treatment courses are prominent. New quinolones (such as nerofloxacin) remain effective against some drug-resistant bacteria. Conclusion The resistance situation of quinolone antibacterial drugs is severe, the safety risks need to be highly vigilant, and irrational drug use is widespread. In the future, it is necessary to strengthen the management of antibacterial drugs, promote individualized medication based on PK/PD, and accelerate the research and development of new drugs.Key words: Quinolone antibacterial drugs Plasmid-mediated drug resistance Drug safety; Medication for children Management of antibacterial drugs Therapeutic drug monitoring

Objective This study was conducted to systematically analyze the epidemic status, core co-morbidities patterns and influencing factors of chronic diseases among elderly people aged 65 and above in FQ town in East China, so as to reveal the health burden characteristics and co-morbidities trends of the elderly population in this area, and provide empirical evidence for formulating precise prevention and control strategies and management programs for chronic diseases in accordance with the characteristics of grass-roots villages and towns. Methods A cross-sectional study design was adopted to collect health examination data of 12,028 elderly people aged 65 and above in FQ town in 2024. Prevalence and comorbidity of 8 common chronic diseases such as hypertension, diabetes mellitus and stroke were analyzed. Disease counting method was used to describe comorbidity combinations, and Apriori association rule algorithm was used to mine strong association patterns among diseases. Based on the health ecology model framework, single factor and multiple factor Logistic regression analysis were used to explore the influencing factors of chronic disease comorbidity from multiple aspects such as congenital traits, individual behavior, interpersonal network and living conditions. Results In FQ town, 64.9% of the elderly were included in chronic disease management, and the overall prevalence of chronic diseases was 20.2%. Hypertension had the highest prevalence Association rule analysis showed that the binary comorbidity pattern presented a highly concentrated feature,"diabetes→ hypertension"(Confidence 95.89%), Stroke→Hypertension (93.93% confidence) and "coronary heart disease→hypertension" There was age and gender heterogeneity in the co-morbid pattern: the co-morbid driving core shifted from metabolic diseases to "myocardial infarction→hypertension" and "chronic bronchitis→hypertension" in the age group of 75-79; the association of "chronic bronchitis→hypertension" appeared in the elderly women. Multivariate analysis showed that old age and overweight/obesity were independent risk factors for comorbidity, and obesity was the highest risk factor (OR=21.7). Conclusion Although the burden of chronic diseases in FQ town was lower than that reported in China, the metabolic and cardiovascular diseases co-morbidities pattern with hypertension as the core was very prominent and the correlation intensity was amazing. The study suggests that prevention and control of chronic diseases at the grass-roots level should break through the single-disease diagnosis and treatment thinking, implement synchronous blood pressure management for patients with diabetes and stroke, and formulate stratified and accurate health management and education strategies according to age and gender differences.

Objective From the perspective of China's health system, to evaluate the cost-effectiveness of cetuximab β combined with FOLFIRI (irinotecan + calcium folinate + fluorouracil) compared to single-agent FOLFIRI as first-line treatment for RAS/BRAF wild-type metastatic colorectal cancer, providing economic evidence for clinical decision-making and medical insurance policy formulation. Method Based on a phase III clinical trial of cetuximab β combined with FOLFIRI, a three-state Markov model was constructed. The simulation cycle is 2 weeks (matching the FOLFIRI dosing regimen), and the simulation time range is 10 years (ensuring that 99% of cohort patients reach the death state). Output indicators include total cost and Quality-Adjusted Life Years (QALYs), to calculate the Incremental Cost Effectiveness Ratio (ICER); model robustness is verified through univariate sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis. Cost data is calculated based on the per capita GDP in 2024 at 95,700 yuan/person, with both cost and utility discount rates set at 5%. Results The basic analysis showed that the total cost of the cetuximab β + FOLFIRI group was 162,791 yuan, with a cumulative gain of 1.08 QALYs; the total cost of the FOLFIRI group alone was 47,846 yuan, with a cumulative gain of 0.91 QALYs. Compared to the FOLFIRI group alone, the incremental cost of the combination therapy group was 114,945 yuan, and the incremental QALYs were 0.17, with an ICER of 676,147 yuan/QALY, which is higher than three times the per capita GDP of China in 2024. Sensitivity analysis showed that scenario analysis and sensitivity analysis demonstrated the robustness of the model. In 99.9% of simulations, the incremental cost for each QALY gained by the cetuximab β combined with FOLFIRI group was above 287,100 yuan. Conclusion At a threshold of three times the per capita GDP in China, cetuximab β combined with FOLFIRI as first-line treatment for RAS/BRAF wild-type mCRC patients in China is not cost-effective compared to FOLFIRI alone.

 Objective This paper aims to systematically review the clinical application value and development pathways of Guizhou Miao medicine in the field of rehabilitation. Methods Through literature review and problem analysis, the current practice status of Miao medicine in rehabilitation fields such as orthopedics, neurology, and chronic diseases was summarized, and the development bottlenecks were analyzed from aspects including theory, standards, research, talent, and industry. Results Miao medicine shows significant potential in pain management, functional recovery, and chronic disease adjustment, but it faces challenges such as insufficient modernization of theory, lack of standards, weak evidence-based support, and shortage of talents. Conclusion Measures such as theoretical innovation, standardization and evidence-based research, industrial integration, and talent cultivation should be taken to promote the scientific integration of Miao medicine into rehabilitation medicine, and to support the inheritance of ethnic medicine and the development of the health and wellness industry.