Objective To investigate the association between intraoperative hypotension and post-operative acute kidney injury(AKI)in patients undergoing brain tumor resections.Methods A total of 428 patients undergoing elective craniotomy for tumor resection were selected,276 males and 152 females,aged≥18 years,BMI 15-36 kg/m2,ASA physical statusⅡ orⅢ.Based on postoperative occurrence of AKI,the patients were divided into two groups:the AKI group and the control group.This study defined three thresholds for hypotension,including MAP during surgery below 65 mmHg,60 mmHg,and 55 mmHg.Multivariate logistic regression was used to analyze the correlation between intraoperative hypotension and postoperative AKI under three thresholds.Results A total of 107 patients had postoperative AKI.The re-sults of multivariable regression analysis indicated that intraoperative MAP＜65 mmHg(OR = 1.11,95%CI 1.03-1.20,P = 0.010)and intraoperative MAP＜60 mmHg(OR = 1.12,95%CI 1.02-1.23,P = 0.017)were associated with postoperative AKI.Conclusion Intraoperative MAP＜65 mmHg or 60 mmHg is associated with postoperative AKI in patients undergoing brain tumor resection.

Objective:To investigate the hot topics and trends of implementation science in the transformation of clinical practice guidelines, in order to provide ideas and references for clinical managers to reasonably apply and implement scientific promotion guidelines.Methods:CiteSpace6.2.R3 software was used to visualize the literature, which retrieved from the core database of Web of Science, including the number of articles, countries and high-frequency keywords and keyword clustering and emergence for visual analysis, etc.Results:A total of 4 593 articles were included in the final analysis. Since 1993, the number of published papers had increased year by year. The hot topics focused on primary care, attitudes, knowledge translation, clinical trials, risk factors and machine learning. The research trends included older adults and artificial intelligence.Conclusions:The rapid development of implementation science in guideline translation research suggests that scholars from various countries, especially hospital administrators should reasonably apply implementation science framework to integrate evidence into clinical practice, and promote the implementation of clinical practice guidelines.

Objective:To investigate the influencing factors of post-traumatic stress disorder(PTSD)in hospitalized patients with placenta previa.Methods:A total of 110 hospitalized patients with placenta previa admitted to our hospital from Oct 2019 to Jan 2023 were selected,and the occurrence of PTSD during hospitalization was evaluated by using Post-Traumatic Stress Disorder Checklist-Civilian Version(PCL-C),and relevant data were collected.Multivariable logistic regression analysis was used to analyze the influencing factors of PTSD in these patients.Results:Among 110 patients,41 cases developed PTSD(37.27% ).Univariable analysis showed that the type of pregnant women(primigravida),optimistic tendency,family support,psychological resilience and personality traits were associated with PTSD in hospitalized patients with placenta previa(P＜0.05).Other information such as age,gestational age,parity,unplanned pregnancy and education level were not associated with PTSD(P＞0.05).Multivariable logistic regression analysis showed that primiparas and introversion were risk factors for PTSD(OR＞1,P＜0.05),and higher optimism tendency,higher degree of family support and higher psychological resilience were protective factors for PTSD in hospitalized patients with placenta previa(OR＜1,P＜0.05).Conclusions:The incidence of PTSD is higher in hospitalized patients with placenta previa.The risk factors of PTSD are primiparas,low level of optimistic tendency,low degree of family support,low psychological resilience and introversion.

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Clinical pharmacists participated in the anti-infection treatment of a patient with Bartonella henselae meningitis.According to the clinical manifestations and the quantitative metagenomic second-generation sequencing(mNGS)of cerebrospinal fluid,the patient was diagnosed as Bartonella henselae infection.According to the relevant clinical guidelines and foreign case treatment reports,it is recommended to use minocycline hydrochloride capsule oral treatment combined with rifampicin injection.Follow-up treatment of the patient was dynamically adjusted based on the reexamination results of cerebrospinal fluid and related inflammatory indicators.In the treatment process,clinical pharmacists give full play to their professional expertise,provide the patient with individualized pharmaceutical care,optimize anti-infection programs,and further promote clinical rational drug use.

Objective:To analyze the current situation of middle-level cadres in functional departments of scientific research institutes and to construct a job competency model for middle-level cadre.Methods:A cluster random sampling method was used to conduct a questionnaire survey in March 2022 on the satisfaction level of middle-level cadres in the functional departments of the Institute of Blood Transfusion of the Chinese Academy of Medical Sciences,a mid-level cadre competency questionnaire survey was conducted to collect data among functional department personnel of scientific research institutes affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College.The principal component analysis method was used to extract factors,and the maximum variance rotation method was used to conduct exploratory factor analysis to construct a competency model.Results:The Middle-level cadres in scientific research institutes had problems such as old age,traditional management style,etc.The competency model of middle-level cadres in functional departments of scientific research institutes included 3 main competencies:responsibility taking ability,communication ability and learning execution ability,and 34 competency factors.Conclusion:The competency model of middle-level cadres in functional departments of scientific research institutes can provide basis and reference for the selection and appointment,education and training,performance management and career planning of middle-level cadres in scientific research institutes.

Objective:To explore the current situation of synergistic allocation of factors of production in China's medical research institutes,sort out the focuses and deficiencies of the existing policies,so as to provide references for the optimization of production factor and the new quality productivity formation in medical institutions.Methods:Based on the two-factor productivity theory,the index evaluation system is constructed,and the composite system synergy model is used to analyze the degree of order of production factors and the degree of synergy of the composite system,and explore the change of synergy degree of each sequential covariate;and the macro model of the health system is used in conjunction with the content analysis method to carry out the frequency counting of the policies to promote the enhancement of the capacity of each production factor of the main body of innovation of the medical scientific research institutes.Results:The synergistic degree of the production factors and the composite system of medical research institutions showed a non-synergistic development trend,with the worst synergistic level in 2021;number of personnel,number of institutions,building floor space,production factors and sequential coefficients were weakly synergized and in a state of non-synergistic development.Among the 43 policy texts,the internal submodular policy tools were used more,the external submodular policy tools were used less,and the use of internal and external policy tools is unbalanced.Conclusion:The number of personnel,institutions and building area of medical research institutions are constraints on the synergistic development of innovative entities.It is recommended to increase the training of innovative talents in medical research institutions,improve the construction of new institutions,coordinate the layout of large scientific devices and functional housing,introduce targeted systematic planning,improve the market of factors of production,and consolidate the technological foundation for future development.

Objective To predict the core targets and action pathways of Hedysari Radix based on UPLC-MS/MS and network pharmacology methods,and to verify the results of network pharmacology by molecular docking and molecular dynamics techniques.This article aims to investigate immune regulation mechanism of effective components absorbed into blood from Hedysari Radix.Methods Qualitative quantification of effective components absorbed into blood from Hedysari Radix were operated by using UPLC-MS/MS technique.The corresponding targets of effective components absorbed into blood from Hedysari Radix were screened by TCMSP and HERB databases.Targets of immune-related disease were obtained through DisGeNET,OMIM,TTD,and MalaCards databases.The network of"components absorbed into blood from Hedysari Radix-immune-related diseases"was then constructed.GO and KEGG enrichment analysis and mapped the PPI network were performed.Molecular docking and molecular dynamics techniques were applied for validation.Results A total of 8 prototype components absorbed into blood,synergistically acting on 101 targets,were identified by UPLC-MS/MS.They mediated 538 biological processes including immune response,positive regulation of gene expression,receptor binding,and cytokine activity.Meanuhile,116 signaling pathways,such as HIF-1,Toll-like receptor,JAK-STAT,T cell receptor,PI3K-Akt,and FoxO etc.were involved.The core targets were MAPK14,PTGS2,MMP9,PPARG,CCND1,etc..The results of molecular docking showed that formononetin and calycosin had strong docking binding activity with MAPK14.And molecular dynamics simulations further demonstrated that the binding between MAPK14 and formononetin or calycosin had good structural stability and binding affinity.Conclusion The results of serum pharmacochemistry,network pharmacology and molecular dynamics were verified to reveal the material basis and mechanism of Hedysari Radix in regulating immunity.The aim of this study is to provide scientific basis for its immunomodulatory mechanism.

ObjectiveTo explore the possible mechanism of the treatment of dry eye with liver-meridian constraint-heat syndrome by Runmu Xiaoyao Powder （润目逍遥散） by miR-146a-5p and interleukin-1 receptor-associated kinase 1/tumour necrosis factor receptor associated factor 6/nuclear factor-κB （IRAK1/TRAF6/NF-κB） signalling pathway. MethodsEighty C57BL/6J mice were randomly divided into normal group， model group， agonist group， inhibitor group， sodium hyaluronate group， and Runmu Xiaoyao Powder high-， medium-， and low-dose groups， with 10 mice in each group. Except for the normal group， the mice of dry eye with liver-meridian constraint-heat syndrome were modeled by using benzalkonium chloride solution eye drops combined with chronic pain stimulation. Beginning on the 30th day of modelling， mice in Runmu Xiaoyao Powder high-， medium-， and low-dose groups were given 29， 14.5， and 7.25 g/kg of Runmu Xiaoyao Powder respectively twice daily by gavage； mice in sodium hyaluronate group were given 5 μl of sodium hyaluronate drops twice daily； mice in the agonist group were given 2 nmol of agomir-146a-5p drops in each eye at a time， and those in the inhibitor group were given 5 nmol of antagomir-146a-5p drops in each eye， with every other day， 3 times per week； mice in the normal and model groups were gavaged with deionised water at 1 ml/（100 g·d）. The intervention was continued for 14 days in each group， and mice in each group were examined for tear secretion， tear film rupture time， corneal fluorescein staining， and irritability scores on the day following the last intervention； HE staining was used to observe the pathological conditions of the cornea and lacrimal glands in each group； corneal and lacrimal gland inflammatory factors， such as interleukin 1β （IL-1β）， tumour necrosis factor α （TNF-α）， miR-146a-5p expression， were examined； matrix metalloproteinase 3 （MMP-3） and matrix metalloproteinase 9 （MMP-9） expression in cornea， IRAK1， TRAF6， nuclear factor κB p65 （NF-κB p65） protein and mRNA expression in cornea and lacrimal gland， and phosphorylated nuclear factor κB p65 （p-NF-κB p65） protein expression were detected. ResultsCompared with the normal group， mice in the model group showed reduced tear secretion， shorter tear film rupture time， higher irritability score （P＜0.05）， and pathological examination showed staining in the centre of the cornea， obvious corneal damage， increased volume of lacrimal gland follicular cells， disordered arrangement， a large number of inflammatory cell infiltration， and increased neovascularisation； corneal and lacrimal gland tissues showed elevated expression of IL-1β and TNF-α， decreased expression of miR -146a-5p， elevated expression of IRAK1， TRAF6， NF-κB p65， p-NF-κB p65 protein and IRAK1， TRAF6， NF-κB p65 mRNA， and elevated expression of MMP-3， MMP-9 protein in the cornea （P＜0.05）. Compared with the model group， all of the above indexes were significantly improved in high-dose group of Runmu Xiaoyao Powder， while some indexes were improved in the sodium hyaluronate group and the middle- and low-dose Runmu Xiaoyao Powder groups （P＜0.05）. Compared with the model group， corneal and lacrimal IRAK1 and TRAF6 mRNA and IRAK1， TRAF6 and p-NF-κB p65 protein expression decreased in the agonist group； compared with the inhibitor group， IRAK1， TRAF6， NF-κB p65 mRNA and protein expression in the cornea and lacrimal gland in the Runmu Xiaoyao Powder groups decreased （P＜0.05）. ConclusionRunmu Xiaoyao Powder can negatively regulate the IRAK1/TRAF6/NF-κB signalling pathway in the cornea and lacrimal gland of mice with dry eye of liver-meridian constraint-heat syndrome by up-regulation of miR-146a-5p， so as to inhibit inflammatory response and reduce the damage of the ocular surface tissues， and the high doses group showed the best effect.

OBJECTIVE To explore the application effects of the multi-disciplinary treatment （MDT）-based continuous pharmaceutical care system in patients undergoing anti-infection treatment. METHODS This research team innovatively developed an MDT continuous pharmaceutical care system， which was applied to cases of anti-infection treatment following MDT due to infection， aiming to innovate the continuous medication supervision model. A retrospective analysis method was used to collect data from 150 patients in the intensive care unit who underwent conventional anti-infection MDT consultations from January to October 2021 in Banan Hospital Affiliated to Chongqing Medical University， serving as the control group， and 130 patients in the intensive care unit who were under the MDT continuous pharmaceutical care system from January to October 2022 were selected as the intervention group. The general information of the patients， the information continuous tracking management， the outcomes of anti- infection treatment， adverse drug reactions， antibacterial drug management indicators， and the degree of satisfaction of relevant medical staff with the clinical pharmacists’ pharmaceutical services were compared between the two groups. RESULTS Comparison of general information between the two groups showed no statistically significant differences （P＞0.05）. The proportion of continuous tracking management in the intervention group was significantly higher than in the control group （P＜0.01）， and the differences in the initiators and reasons for continuous tracking management between the two groups were statistically significant （P＜0.05）. The intervention group had better outcomes in anti-infection treatment compared to the control group （P＜0.05）. The antibacterial drug management indicators （total length of hospital stay， duration of antibacterial drug use， total drug costs， and amount of antibacterial drugs used） in the intervention group were significantly lower than in the control group， while overall degree of satisfaction among medical staff was significantly higher in the intervention group than in the control group （P＜0.05）. No statistically significant differences were found in adverse reaction occurrence and antibacterial drug costs between the two groups （P＞0.05）. CONCLUSIONS The application of this system in patients who underwent anti-infection treatment after MDT can achieve continuous multi-disciplinary tracking management with clinical pharmacists at the core， which is beneficial for promoting the follow-up efficiency of the MDT team， raising the quality of clinical pharmacists’ pharmaceutical services， strengthening treatment outcomes， and promoting the rational use of antibacterial drugs in clinical practice.