OBJECTIVE:To explore the methods of clinical pharmacists providing pharmaceutical care for a patient with N-methyl-D-aspartate receptor(NMDAR)encephalitis complicating with multiple organ infections. METHODS:Taking one clinical case as breakthrough point,the points of pharmaceutical care provided by clinical pharmacists for NMDAR encephalitis complicat-ing with multiple organ infections were analyzed,so as to put forward the suggestions in the field of antibiotics selection,medica-tion approach based on pharmacokinetics,ADR disposal and nutrition support. RESULTS:Clinical pharmacists applied pharmaceuti-cal care to resolve ADR as abnormal liver enzyme timely,and the symptom had been improved gradually. Then the patient was dis-charged from the hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care and screen the possible risk of drug use to avoid the occurrence of severe ADR.

AIM To establish an HPLC method for the simultaneous content determination of four constituents in Qingzhiyi Tablets (Puerariae lobatae Radix,Phyllanthi Fructus,Salviae miltiorrhizae Radix et Rhizoma,etc.).METHODS The analysis of 50％ methanol extract of this drug was performed on a 30 ℃ thermostatic Kromasil C18 column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of 0.1％ formic acid-methanol-acetonitrile flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 270 nm.RESULTS Gallic acid,puerarin,salvianolic acid B and tanshinone Ⅱ A showed good linear relationships within the ranges of 11.95-382.48,14.23-455.28,10.77-344.68 and 3.89-124.32 μg/mL,whose average recoveries were 99.96％,100.92％,98.87％ and 97.67％ with the RSDs of 1.09％,1.30％,1.11％ and 1.22％,respectively.CONCLUSION This sensitive,simple and accurate method can be used for the quality control of Qingzhiyi Tablets.

Objective To compare the excursion of blood glucose (BG) in the type 2 diabetes mellitus treated with oral antidiabetic drugs (OADs) plus glargine or human isophane insulin (HII). Methods A 1 : 1 randomization schedule assigned 30 type 2 diabetics inadequately controlled on OADs (fasting BG>9.0 mmol/L and HbA1C > 8.5%) to 2 groups additionally treated with glargine or HII. The insulin dose was titrated to achieve fasting capillary BG<6.0 mmol/L. Montoring BG with continuous glucose monitoring system, then the standard deviation of BG (SDBG), maximal excursion of BG (LAGE) and coefficient of variation (CV) of fasting plasma glucose (FPG) were calculated. Results SDBG (1.49±0.35 vs 1.73±0.46), LAGE (3.23±0.76 vs 3.73± 1.00) and CV-FPG (17.26±2.24 vs 20.33±3.21) were lower in glargine group than those in HII group (P< 0.05). No difference could be found in hypoglycaemia between two groups. Conclusion OADs plus glargine could make blood glucose more stable than OADs plus HII without increasing the incidence of hypoglycaemia.

Epigenetics,a branch of molecular biology,plays a pivotal role in the pathological progression of ischemic stroke.Epigenetic modifications are intricately involved in the complex and dynamic processes that regulate gene expression,cellular injury response,motor function,and cognitive ability following stroke.This provides an effective framework for elucidating the targets and mechanisms of action underlying traditional Chinese medicine's treatment of ischemic stroke.Currently,the etiology and pathogenesis of ischemic stroke remain incompletely understood,with modern medical treatments still lacking sufficient efficacy.Traditional Chinese medicine possesses a unique advantage in treating ischemic stroke through its multi-level and multi-target comprehensive regulation.Recent studies have discovered that traditional Chinese medicine can participate in regulating abnormal epigenetic modifications during stroke treatment.This article primarily focuses on the theoretical foundation of traditional Chinese medicine for strokes by exploring its application in DNA methylation,non-coding RNA,histone modification research as well as explaining the epigenetic effects it exerts when treating strokes.The aim is to provide insights for future research and development of traditional Chinese medicine for cerebral ischemia.

Objective:To investigate the clinicopathological characteristics of acidophil stem cell pituitary neuroendocrine tumors (PitNET)/adenoma.Methods:Five cases of acidophil stem cell PitNET/adenoma were diagnosed between May 2022 and July 2023 at the Second Hospital of Hebei Medical University, Shijiazhuang, China. The clinicopathological features of the tumor were analyzed by using histology, immunohistochemistry, and electron microscopy. The relevant literature was reviewed.Results:There were 1 male and 4 females, aged from 23 to 69 years. Patient 3 was 55 years old at the time of diagnosis and first surgery, and relapsed 5 years later. The patients′ median age was 32 years. Patients 1 and 5 showed elevated blood prolactin, with various degrees of hormonal symptoms except Patient 3, who showed only tumor compression symptoms. Imaging studies showed that all cases involved the sellar floor. The tumors of Patients 1, 2 and 5 were closely related to the cavernous sinus segment of the internal carotid artery. The tumors exhibited a diffuse growth pattern with chromophobic to slightly acidophilic cytoplasm. A few of tumor cells showed chromophobic cytoplasm. The nucleoli were conspicuous. Intranuclear inclusion bodies and variably-sized clear vacuoles were observed occasionally. Under electron microscope, marked mitochondrial abnormalities were observed, including increased mitochondria number, expanded hypertrophy, and absence of mitochondrial ridge fracture. Some mitochondrial matrices were dense, while some were vacuolated.Conclusions:Acidophil stem cell PitNET/adenoma is a rare type of pituitary adenomas/PitNETs. It often has a more clinically aggressive manner with immature cells, diffuse expression of PIT1, prolactin, and varying degrees of growth hormone expression. Because of the obvious diversity of their clinical hormone status and hormone immune expression, the diagnosis of this type tumor is still a challenge.

AIM:To explore the protective effect of Xiaoxuming decoction(XXMD)on synaptic plasticity in the context of cerebral ischemia-reperfusion injury following ischemic stroke.METHODS:An oxygen-glucose depriva-tion/reoxygenation(OGD/R)model was employed in vitro using mouse hippocampal neurons(HT22 cells)to simulate ischemia-reperfusion injury.Cell viability was assessed using a CCK-8 assay to determine the optimal XXMD concentra-tion.The HT22 cells were divided into two groups:control and model(OGD/R).Cellular morphological changes were ob-served using an inverted microscope.The levels of IL-1β,IL-6 and TNF-α in the supernatant were quantified by ELISA.Ultrastructural changes were examined by transmission electron microscopy.Immunofluorescence staining was used to de-tect neuron markers NeuN and synaptic proteins NF200 and MAP2.The protein levels of NF200 and MAP2 were analyzed by Western blot.RESULTS:The highest cell survival rate occurred at an XXMD concentration of 100 mg/L(P<0.05).Compared with control group,the cells in model group exhibited round shape and shrinkage,mitochondrial swelling or vacuolization,and a marked decrease in survival rate.There were significant increases in IL-1β,IL-6 and TNF-α levels(P<0.05).Immunofluorescence intensity and protein levels of NeuN,NF200 and MAP2 were notably reduced(P<0.05).Treatment with XXMD improved cell morphology,ultrastructure and survival rate(P<0.05),and decreased in-flammatory factor levels(P<0.05).Compared with model group,the cells in OGD/R+XXMD group showed significantly increased immunofluorescence intensity and protein levels of NeuN,NF200 and MAP2(P<0.05).CONCLUSION:Xiaoxuming decoction may mitigate OGD/R-induced injury,potentially by inhibiting inflammatory responses and enhanc-ing synaptic plasticity.