Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Objective To observe the difference between Radix AstragaLi(RA) and Radix Fici Hirtae(RFH) in immune regulation and improvement of anaemia.Methods Fatigue resistance,brain hypoxia and normal hypoxia tolerance were observed to measure the anti-stress function.Bloodletting-induced anemia model and cyclophosphamid-induced anemia model were used to observe the effect of blood enrichment.Phagocytic function of macrophage,serum hemolysin level and delayed type hypersensitivity(DTH) reaction were also detected.Results RA and RFH could improve the fatigue resistance,normal hypoxia tolerance and brain hypoxia tolerance,and increase the red blood cell count and hemoglobin content,enhance phagocytic function of macrophage and serum hemolysin level,and increase the DTH reaction.Conclusion Both RA and RFH have an effect on improving anti-stress ability,immune function and blood enrichment,and there are no significant difference between RA and RFH.

Objective This article reported the treatment process and pharmaceutical monitoring points of a 73 year old patient with latent tuberculosis and positive hepatitis B core antibody,whose focal segmental glomerulosclerosis(FSGS)was trea-ted with cyclosporine and rituximab instead of glucocorticoids because of gastrointestinal ulcer.Methods Clinical pharmacist participated in the treatment process of immunosuppressive therapy,infection prevention,and complications management of ne-phrotic syndrome,and then conducted pharmaceutical monitoring.Results The patient's nephrotic syndrome was relieved,and the urine protein decreased from around 8 g to below 1 g,indicating good disease control.Conclusion The combination of rituximab and cyclosporine could achieve in partial or nearly complete relief of nephrotic syndrome.For patients with latent tuber-culosis and hepatitis B core antibody positive,attention should be paid to the prevention of infection when using immunosuppres-sants such as monoclonal antibody.As patients with nephrotic syndrome were treated with multiple medications,drug interactions and concentrations monitoring should be focused on when using cyclosporine,as well as regular follow-up of patients and guarding against adverse reactions including renal dysfunction and infection.The participation of clinical pharmacists in the clinical therapy was of great significance,which ensured the effectiveness of disease treatment and medication safety.

Objective To investigate the effect of transcranial alternating current stimulation(tACS)on cerebral blood flow(CBF)in patients with Alzheimer's disease(AD).Methods A ret-rospective study was conducted on 21 mild AD patients admitted in our hospital from September 2019 to April 2022.All of them received tACS treatment for 3 weeks.Mini-mental state examina-tion(MMSE),auditory verbal learning test(AVLT)and MRI were applied to obtain the data at baseline(T0),the end of the treatment(T1)and in three months after treatment(T2).Z-trans-form CBF(zCBF)was performed to reduce individual variability.The changes in MMSE and AVLT scores,as well as brain zCBF and CBF values before and after tACS treatment were ana-lyzed.Spearman correlation analysis was used to examine the relationship of zCBF and CBF with cognitive scores.Results In the AD patients,their MMSE score was significantly increased at T1 than at T0[22.00(20.00,25.00)vs 20.00(18.00,21.50),P＜0.01].Based on voxel analysis,the AD patients exhibited significantly increased zCBF in the bilateral frontal and temporal cortex at T1,and in the right frontal and temporal cortex at T2 when compared with the levels at T0(P＜0.05).The most pronounced increase in zCBF was observed in the right insular.Based on region of inter-est analysis,increased zCBF and CBF in the right frontal and temporal cortex at T1 were observed(P＜0.05).There was a positive correlation between the change of CBF in the right frontal cortex and AVLT-recognition recall at T1(r=0.617,P=0.005)and between the change of CBF in the left frontal cortex and MMSE at T2(r=0.596,P=0.012).Conclusion MRI 3D-ASL can objec-tively evaluate the changes of CBF in AD patients after tACS treatment,and it provides a reliable imaging marker for evaluating the efficacy of tACS.