OBJECTIVE To systematically review the status on pharmacist competency assessment tools both domestically and internationally， providing a theoretical basis for constructing scientific and applicable pharmacist competency assessment tools in China. METHODS Through literature review and comparative analysis， 15 representative domestic and international pharmacist competency assessment tools were systematically summarized， and their theoretical foundations， core dimensions， methodological characteristics and practical applications were compared and implications were given. RESULTS &CONCLUSIONS International research has established relatively mature evaluation systems. Represented by those developed from the United Kingdom， the United States， and the International Pharmaceutical Federation， these assessment tools demonstrate scientific structure， wide application， and dynamic and international applicability. While domestic research has progressed in sub-specialties such as clinical pharmacists， licensed pharmacists and pediatric pharmacists， it still faces challenges including insufficient standardization， inadequate validation， delayed updates， and limitations in practical application. The reasons for the disparities in assessment tools between China and other countries include differences in pharmaceutical care models， varying pharmacist training systems， cultural and social background factors， as well as differences in industry management and international influence. Based on this， the author suggests promoting the development and research of assessment tools for pharmacist job competency in China from four aspects： mechanism construction， system refinement， standardization development， and practical implementation.

“Inflammation-cancer” transformation of chronic atrophic gastritis （CAG） refers to the process in which the gastric mucosa， in the context of CAG， progresses through stages of precancerous lesions of gastric cancer （PLGC）， such as intestinal metaplasia and dysplasia， and eventually develops into gastric cancer （GC）. In China， the incidence and mortality rates of GC rank among the highest in the world， and the proportion of GC cases caused by gastric mucosal infection and inflammation has been increasing. Modern medical treatments for CAG and PLGC mainly rely on drug therapy， endoscopic resection， and regular surveillance. Although these disease management strategies are relatively mature， they present limitations in early lesion prevention and recurrence risk control. Therefore， it is imperative to identify therapeutic approaches for CAG and PLGC that offer preventive， reversible， and recurrence-reducing benefits. With advances in research on the mechanisms underlying inflammation-cancer transformation and the integration of traditional Chinese and Western medicine， the advantages of TCM in preventing and even reversing early-stage CAG and PLGC have gradually become apparent. This review explored the mechanisms of inflammation-cancer transformation in CAG from five aspects： inflammatory microenvironment， autophagy， glycolysis， bile acids， and ferroptosis. In conjunction with TCM theory and a deeper understanding of the distinct mechanisms involved in the inflammation-cancer transformation of CAG， this review further discussed the specific mechanisms through which TCM intervened in treating CAG and PLGC， with the aim of providing theoretical support and therapeutic insights for future clinical applications.

“Inflammation-cancer” transformation of chronic atrophic gastritis （CAG） refers to the process in which the gastric mucosa， in the context of CAG， progresses through stages of precancerous lesions of gastric cancer （PLGC）， such as intestinal metaplasia and dysplasia， and eventually develops into gastric cancer （GC）. In China， the incidence and mortality rates of GC rank among the highest in the world， and the proportion of GC cases caused by gastric mucosal infection and inflammation has been increasing. Modern medical treatments for CAG and PLGC mainly rely on drug therapy， endoscopic resection， and regular surveillance. Although these disease management strategies are relatively mature， they present limitations in early lesion prevention and recurrence risk control. Therefore， it is imperative to identify therapeutic approaches for CAG and PLGC that offer preventive， reversible， and recurrence-reducing benefits. With advances in research on the mechanisms underlying inflammation-cancer transformation and the integration of traditional Chinese and Western medicine， the advantages of TCM in preventing and even reversing early-stage CAG and PLGC have gradually become apparent. This review explored the mechanisms of inflammation-cancer transformation in CAG from five aspects： inflammatory microenvironment， autophagy， glycolysis， bile acids， and ferroptosis. In conjunction with TCM theory and a deeper understanding of the distinct mechanisms involved in the inflammation-cancer transformation of CAG， this review further discussed the specific mechanisms through which TCM intervened in treating CAG and PLGC， with the aim of providing theoretical support and therapeutic insights for future clinical applications.

Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

Background: Inhalation-based combination therapy has gained increasing attention for local treatments. However, a key challenge remains in ensuring the sustained pulmonary release of multiple active ingredients, particularly in traditional Chinese medicine (TCM) formulations. Objective: This study investigates a novel PulmoSphere-based inhalable carrier designed for the sustained pulmonary release of multiple active ingredients, using Shuang-Huang-Lian as a model TCM formulation containing three chemical markers. Materials and methods: The carrier was developed using PulmoSphere technology, incorporating phospholipid complexes of the chemical markers and hyaluronic acid (HA) into spray-dried microparticles. The aerodynamic properties, release characteristics, pulmonary distribution, and anti-inflammatory efficacy of different formulations were evaluated in vitro and in mice. Results: The microparticles retained the excellent aerodynamic properties of conventional PulmoSphere particles, with a mass median aerodynamic diameter of approximately 3.1 μm and a fine particle fraction of approximately 55%. Compared to free Shuang-Huang-Lian or phospholipid complex-loaded PulmoSphere particles, the HA-containing particles prolonged the retention of chemical markers in the lung epithelial lining fluid, demonstrating sustained release in vivo. Additionally, the HA-containing formulation enhanced the exposure of the three chemical markers to immune cells and lung tissues, leading to improved and prolonged anti-inflammatory effects, even at decreased doses. Conclusion: This novel inhalable particle system represents a promising approach for sustained pulmonary co-delivery of multiple active ingredients, offering enhanced and extended local therapeutic efficacy.

Objective To describe the significance of the pretreatment inflammatory indicators in predicting the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after undergoing radical radiotherapy. Methods The data of 246 ESCC patients who underwent radical radiotherapy were retrospectively collected. Receiver operating characteristic (ROC) curves were drawn to determine the optimal cutoff values for platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII). The Kaplan-Meier method was used for survival analysis. We conducted univariate and multivariate analyses by using the Cox proportional risk regression model. Software R (version 4.2.0) was used to create the nomogram of prognostic factors. Results The results of the ROC curve analysis showed that the optimal cutoff values of PLR, NLR, and SII were 146.06, 2.67, and 493.97, respectively. The overall response rates were 77.6% and 64.5% in the low and high NLR groups, respectively (P<0.05). The results of the Kaplan-Meier survival analysis revealed that the prognosis of patients in the low PLR, NLR, and SII group was better than that of patients in the high PLR, NLR, and SII group (all P<0.05). The results of the multivariate Cox regression analysis showed that gender, treatment modalities, T stage, and NLR were independent factors affecting the overall survival (OS). In addition, T stage and NLR were independent factors affecting the progression-free survival (PFS) (all P<0.05). The nomogram models of OS and PFS prediction were established based on multivariate analysis. The C-index values were 0.703 and 0.668. The calibration curves showed excellent consistency between the predicted and observed OS and PFS. Conclusion The pretreatment values of PLR, NLR, and SII are correlated with the prognosis of patients with ESCC who underwent radical radiotherapy. Moreover, NLR is an independent factor affecting the OS and PFS of ESCC patients. The NLR-based nomogram model has a good predictive ability.

Objective To explore the medicinal mechanism of Actinidia Chinensis Planch Radix(ACPR)in the treatment of colorectal cancer(CRC)by network pharmacology and molecular docking technology.Methods The genes involved in the effects of the main chemical components and disease genes of ACPR were screened from the TCM database and disease database.The main genes were analyzed through protein interaction network analysis,and molecular docking was performed on the main chemical components and key targets.The effects of the drug on tumor cells were measured,and the levels of key proteins in the signaling pathway were detected.Results The primary components of ACPR for treating CRC include quercetin,β-sitosterol,aloe baicalin,and catechin.It targets 144 protein interaction sites and were involved in the protein interaction network,with key genes including AKT1,TP53,MAPK1,JUN,and TNF.The recognition network includes five modules that were involved in various biological processes and signaling pathways.The main components exhibited excellent or good activity when interacting with these targets.At a certain concentration,the drug could inhibit the proliferation,invasion,and migration of colorectal cancer cells and affect the PI3K/AKT signaling pathway.Conclusion ACPR has been used to treat colorectal cancer through multiple pathways and multiple targets,among which the PI3K/AKT signaling pathway may be the mechanism.

Objective:To explore the feasibility and safety of laparoscopic combined with colonoscopic transanal total mesorectal resection (laparoscopic combined with colonoscopic taTME) in the treatment of rectal cancer.Methods:The descriptive case series analysis method was adopted. From October 2023 to February 2024, the Department of Colorectal Surgery of Li Huili Hospital, Ningbo Medical Center, performed laparoscopic combined with colonoscopic taTME on 8 patients with rectal cancer. Among the 8 patients, there were 5 males and 3 females, aged from 56 to 74 years old, with a body mass index (BMI) of 20.3-26.7 kg/m2. All patients were pathologically diagnosed with rectal adenocarcinoma. The long diameter of the tumors was 2.0-6.5 cm, the lower edge of the tumors was 3-5 cm away from the anal verge. In terms of tumor TNM staging, there were 2 cases in stage I, 3 cases in stage II, and 3 cases in stage III. The surgical conditions, postoperative curative effects, and the occurrence of complications were observed.Results:All 8 patients successfully completed laparoscopic combined with colonscopic taTME, and there was no conversion to laparotomy. The operative time was 260 to 335 minutes, the intraoperative blood loss was 50 to 100 milliliters, and the distance from the tumor to the anal margin was 0.8 to 2.0 centimeters. All patients in the group underwent protective end ileostomy, and none of them underwent permanent enterostomy. Specimens were removed from the right lower abdomen in 7 cases and through the anus in 1 case. There was no residual cancer cells at the pathological resection margins postoperatively. All patients ambulated on the first day after the operation, and began to eat on the 2nd to 3rd day after the operation. Anastomotic leakage occurred in 1 patient after the operation, and the condition improved after conservative treatment. The length of hospital stay was 21 days. The other 7 patients were discharged from the hospital 8 to 12 days after the operation. Two patients completed the ileostomy closure surgery 3 months after the operation and recovered well. The patients were followed up until April 2024, during which there were no cases of tumor recurrence or death.Conclusion:For appropriate cases, laparoscopic combined with colonoscopic taTME is safe and feasible.

Objective To investigate the effects of five-element music on depressive behaviors and intestinal flora in offspring of fear-stress rats during pregnancy.Methods Thirty-six 0.5-day pregnant Wistar rats were divided randomly into a control group,fear-stress group,and five-element music group,and the subsequent litters continued the maternal grouping.Pregnant rats in the fear-stress and five-element music groups were modeled on days 1～19 of gestation using the bystander electric method,while the five-element music group was also exposed to Feather Tune five-element music intervention.The fear behavior and serum glucocorticoid(GC)levels in pregnant rats were assessed on day 20 of pregnancy by open field test and enzyme-linked immunosorbent assay,respectively,to evaluate the effectiveness of the model.Depression in 3-week-old offspring was evaluated by open field,tail suspension,and sucrose preference tests.Norepinephrine(NE),dopamine(DA),and 5-hydroxytryptamine(5-HT)levels in the hippocampus of the offspring were measured by high-performance liquid chromatography.Changes in the intestinal flora of the offspring were analyzed by 16S rRNA sequencing.Expression levels of the proximal colonic proteins claudin1,occludin,and ZO1 in the offspring were measured by Western blot assay.Results Pregnant rats in the fear-stress group stayed longer in the area around the open field(P＜0.05),had fewer entries into the central area(P＜0.001),and had higher serum GC levels compared with those in the blank group(P＜0.001).In contrast,five-element music exposure reversed these behavioral changes(P＜0.05)and serum GC levels(P＜0.001)in the fear-stress group.Offspring in the fear-stress group exhibited decreased open-field crossing frequency(P＜0.01),reduced sucrose preference index,and longer immobility time in the tail suspension test(P＜0.05),compared with those in the blank group,together with significantly decreased NE,DA,and 5-HT levels in the hippocampus(P＜0.05).Rats in the fear-stress group showed decreased diversity of the intestinal flora(P＜0.01)and significant alterations in flora structure,including higher abundance of Proteobacteria,Enterobacteriaceae,Enterococcus,and Escherichia(P＜0.05),and lower abundance of Spirochaetes,Spirochaetaceae,Lachnospiraceae,Ruminococcaceae,Treponema,Prevotella,Coprococcus,Allobaculum,Ruminococcus,and Dorea(P＜0.05).The proximal colonic proteins Claudin1,Occludin,and ZO1 were significantly downregulated(P＜0.05).The open-field crossing frequency,sucrose preference index,and duration of tail suspension immobilization were improved in the five-element music group compared with those in the fear-stress group(P＜0.05),while DA and 5-HT levels were significantly restored in the hippocampus(P＜0.05),species diversity of the intestinal flora increased(P＜0.01)and changes in the abundance of the flora were reversed,and the proximal colonic proteins Occludin and ZO1 expression were significantly upregulated(P＜0.05).Conclusions Five-element music intervention during pregnancy can ameliorate fear-stress-induced depression behaviors and intestinal flora disorders in the offspring.

Stem-leaf saponins from Panax notoginseng (SLSP) comprise numerous PPD-type saponins with diverse pharmacological properties; however, their role in Parkinson's disease (PD), characterized by microglia-mediated neuroinflammation, remains unclear. This study evaluated the effects of SLSP on suppressing microglia-driven neuroinflammation in experimental PD models, including the 1-methyl-4-phenylpyridinium (MPTP)-induced mouse model and lipopolysaccharide (LPS)-stimulated BV-2 microglia. Our findings revealed that SLSP mitigated behavioral impairments and excessive microglial activation in models of PD, including MPTP-treated mice. Additionally, SLSP inhibited the upregulation of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX2) and attenuated the phosphorylation of PI3K, protein kinase B (AKT), nuclear factor-κB (NFκB), and inhibitor of NFκB protein α (IκBα) both in vivo and in vitro. Moreover, SLSP suppressed the production of inflammatory markers such as interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) in LPS-stimulated BV-2 cells. Notably, the P2Y2R agonist partially reversed the inhibitory effects of SLSP in LPS-treated BV-2 cells. These results suggest that SLSP inhibit microglia-mediated neuroinflammation in experimental PD models, likely through the P2Y2R/PI3K/AKT/NFκB signaling pathway. These novel findings indicate that SLSP may offer therapeutic potential for PD by attenuating microglia-mediated neuroinflammation.
Animals ; Panax notoginseng/chemistry* ; Saponins/pharmacology* ; Microglia/immunology* ; Mice ; NF-kappa B/immunology* ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/immunology* ; Phosphatidylinositol 3-Kinases/genetics* ; Male ; Parkinson Disease/immunology* ; Mice, Inbred C57BL ; Disease Models, Animal ; Plant Leaves/chemistry* ; Neuroinflammatory Diseases/drug therapy* ; Humans