Pharmaceutical care thinking is organic combination of the pharmaceutical and clinical thinking. Shang Han Lun contains very rich connotation of the clinical pharmacy, embodies the patient-centered and immediate intervention clinical pharmaceutical service concept in the progress of the diseases. This article sorted out and concluded pharmaceutical care thinking from the aspects of condition assessment and medication selection, medicine taking methods and notes after medication, which provided theoretical supports for the development of clinical pharmacy of TCM.

Objective To investigate the association between CYP2C19 polymorphisms and efficacy of clopidogrel in Chinese Han patients with coronary atherosclerotic heart disease.Methods A total of 176 Chinese Han patients who underwent percutaneous coronary intervention and were treated with dual antiplatelet therapy with aspirin and clopidogrel were enrolled.Polymorphisms of CYP2C19 * 2,* 3 were measured by PCR-restriction fragment length polymorphism (PCR RFLP).The correlation between the genetic variants and cardiovascular events was analyzed.Results In the 176 patients,the allele frequencies of CYP2C19 * 2 and * 3 were 34.38％ and 5.97％ respectively,the percent of patients with poor metabolizer genotypes (* 2/* 2,* 2/* 3,* 3/* 3) was 14.20％.Among the 176 patients,11 patients reoccured acute coronary syndrome,1 patient suffered from stroke,and 4 patients had stent thrombosis.The incidence of cardiovascular events was 9.09 ％.Thecumulative incidence of cardiovascular events had no significant differences between poor metabolizer genotype carriers and extensive and intermediate metabolizer genotype carriers (16.00％ vs.7.95％,x2 =1.683,P=0.195).Conclusions The frequencies of CYP2C19 poor metabolizer genotypes are higher in Chinese Han population than in Caucasians,but the incidence of cardiovascular events in Chinese Han population is not increased.

Objective To investigate the impact ofα?lipoic acid(ALA)treatment on sepsis?induced acute kidney injury in rats and explore the mechanisms. Methods A total of 32 male SD rats were randomized into 4 groups:normal control group(group A),ALA?treated control group (group B),sepsis group(group C)and sepsis with ALA treated group(group D). Group A and B underwent sham operation,while CLP operations were conducted in group C and D. Rats in both group B and group D were then administered with 200 mg/kg ALA by oral gavage immediately after the surgical procedure. Twenty?four hours after the surgical procedure blood samples were obtained for the evaluation of creatinine,BUN,TNF?α,IL?6 and IL?1β. Rat kidneys were rapidly removed for PAS stain. Western blot was employed to determine the expression of NF?κB. Results Pathologi?cal changes of kidney were induced by sepsis and the level of creatinine,BUN,TNF?α,IL?6 and IL?1βwere significantly increased by 178%,66%, 55%,114%and 110%(P<0.01). respectively;simultaneously the phosphorylation and nuclear expression of NF?κB p65 in kidney tissues were significantly increased by 144%and 102%(P<0.01). Sepsis?induced acute kidney injury also significantly reduced the expression of IκBαby 61%(P<0.01). These changes were significantly suppressed by early ALA treatment. Compared with C group,the level of creatinine,BUN,TNF?α,IL?6 and IL?1βwere significantly decreased by 48%,26%,25%,37%and 40%(P<0.05),respectively,and the relative expression of IκBαwas increased by 103%(P<0.05). Conclusion The present study demonstrated that ALA can suppress the activation of NF?κB,thus ameliorat?ing sepsis?related acute kidney injury.

Objective To explore the effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia. Methods Sixty patients with schizophrenia were randomly assigned into Valpar therapy group ( experiment group, n=30) and traditional rehabilitation therapy group ( control group, n=30) according to the order number. The duration of the treatment was six weeks. The brief assess?ment of cognition in schizophrenia ( BACS) and Wisconsin card sorting test ( WCST) were conducted as pre?and post?treatment assessment. Results There were significant differences between scores of BASC in pre?and post?treatment assessment in experiment group. More specifically, the BASC scores in symbol coding (37.50±6.50, t=-4.60, P<0.01),token movement(60.80±8.72, t=-2.54, P=0.017),verbal memory (44.40±11.29, t=-2.19, P=0.037)),and word fluency(14.23±4.35, t=-3.39, P=0.002) were signifi?cantly different when comparing pre?and post?treatment assessment outcomes. In control group,the only sig?nificant difference was found in word fluency (14.23±4.35, t=-3.39, P=0.002).In addition,response errors (57.80±10.35, t=-3.06, P=0.005) and repeat errors (34.67±6.96, t=3.41, P=0.002) in WCST in exper?iment group were significantly different in pre?and post?treatment assessment while only repeat errors (34.30 ±7.01, t=4.36, P=0.000) was different in control group. It was further discovered that scores in in symbol cod?ing( t=2.010, P=0.048),token movement ( t=2.124, P=0.038),response errors ( t=2.413, P=0.020) and repeat errors( t=2.009, P=0.047) in WCST were different between two groups. Conclusion Valpar professional evaluation train?ing system can significantly improve the cognitive function of people with schizophrenia.

Purpose To clarify the morphologic changes and significance of interstitial cells of Cajal-like cells in the bladder of diabetic guinea pig.Methods The experimental guinea pigs were induced by a single intraperitoneal injection of streptozotocin(STZ).The diabetic guinea pig model, who were made succesful for 4 weeks, were detected through the urodynamic evaluation.The distribution of ICCs-like cells in the detrusor, which were taken from these guinea pigs,were quantitatively analyzed after frozen section and indirect immunofluorescence methods and observed by electron microscopy.Results In the diabetic group, the maximum detrusor pressure was signifently lower than controls (P＜0.01), maximum bladder capacity, compliance, residual volume and leak point pressures was significently higer than controls (P＜0.05 or P＜0.01);In detrusor, compared with control, the ICCs-like cells of diabetes group showed significently decreased in quantity. In diabetic bladder, the quantity of gap junctions between ICCs-like cells and cells around,such as smoth muscle cells,terminal nerves and other ICCs-like cells,decreased significently.And more cavities and less organoids occurred in cytoplasm of diabetic ICCs-like cells. Mitochondria became swollen or even disapeared, accompanied with swollen endocytoplasmic reticulum.Conclusion The decrease and injures of ICCs-like cells in bladder may be one of the mechanisms resulting in urodynamic changes of diabetic cystopathy.

To investigate the effects of cycloartocarpin A (ACR-2) and artocarpin (ACR-3), monomeric compounds isolated from Fructus Artocarpi Heterophylli, on apoptosis of SMMC-7721 and SGC-7901 cell lines.

OBJECTIVE: To investigate the effects of three compounds extracted from Tripterygium wilfordii Hook (TW) on angiogenesis in the chick chorioallantoic membrane (CAM). METHODS: Fifty fresh Hongkong Mahua chicken eggs were divided into five groups: PBS-treated group, TW1-, TW2- and TW3-treated groups and Rg3-treated group. After disinfection, the eggs were incubated for six days in a constant temperature box with the temperature being controlled within 37.8 degrees C, then exposed CAM, laid the filter papers with specimen on the CAM, and the eggs were incubated for another two days. CAM was fixed with the mixture of methyl alcohol and acetone at room temperature for about 15 min, and then cutting the CAM, taking photos and observing the angiogenesis in the CAM. RESULTS: There were many CAM vessels in the PBS-treated group and the blood vessel net could be seen clearly. The number of CAM vessels in the TW1-, TW2- and TW3-treated groups (10 microg/egg) was much less than that in the PBS-treated group. Furthermore, the frame of the vessels was not clear, and the color was obscure. Inhibition rates of angiogenesis in the TW1-, TW2- and TW3-treated groups were 80%, 60% and 100% respectively, while the inhibition rate of angiogenesis in the Rg3-treated group (10 microg/egg) was only 10%. CONCLUSION: TW1, TW2 and TW3 can obviously restrain the angiogenesis in CAM and still need further study.

Objective To determine vascular endothelial growth factor(VEGF)-460 gene polymorphism in Uyghurs and its relationship to urolithiasis in south Xinjiang. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),gene sequencing and genetic analysis methods were used in 200 urolithiasis patients of Uyghurs, and 200 healthy Uyghurs. Results The distribution of genotype and allele had no significant difference between urolithiasis patients and normal controls (P＞0. 05). The frequencies for the CC,TT and CT genotypes in patients with urolithiasis and normal controls were 1.5 %, 29.0 %, 69.5 % and 0. 5 %, 27.5 %, 72.0 %, respectively. The frequencies for C and T allele were 36.2%,63.7% and 36.9% ,63.1%, respectively. Conclusions The results of VEGF-460 gene polymorphisms indicate no significant relationship between patients with turolithiasis and normal controls in Uyghurs in south Xinjiang,which may not be urolithiasis susceptibility genetic locus.

Objective To systematically retrieve,evaluate and integrate the best evidences on the early fluid resuscitation management in the patients with acute pancreatitis(AP)at home and abroad to provide ref-erence for clinical decision.Methods The related evidences on the early fluid resuscitation management in the AP patients were retrieved by computer from the databases of BMJ Best Practice,Up To Date,JBI,National Institute for Health and Care Excellence,Registered Nurses Association of Ontario,Guideline International Network,Scottish Intercollegiate Guidelines Network,International Association of Pancreatology,American Pancreatic Association,American College of Gastroenterology,Yimaitong,Cochrane Library,PubMed,Em-bass,CINAHL,The Web of Science,CNKI,Wanfang databases.The retrieval time limit was from the data-base establishment to March 20,2022.The literatures types included thematic evidence summarization,guide-lines,evidence summaries,systematic reviews and expert consensus.The researchers conducted the literature quality evaluation.The literatures meeting the standard conducted the evidence extraction.Results A total of 13 arti-cles were included,including 3 special subject evidence summary,4 guidelines,2 evidence summary,2 systematic evalu-ation and 2 expert consensus.A total of 16 pieces of best evidence were integrated,involving 4 aspects of organization management,evaluation and monitoring,fluid infusion strategy and health education.Conclusion It is recommended to use the target-oriented therapy for early fluid resuscitation management,and perform the fluid resuscitation immediate-ly after diagnosis,according to the patient's underlying disease,disease changes and monitoring indicators,implement precise early fluid resuscitation in order to reverse pancreatic microcirculation disorder,increase tissue perfusion and improve the patient's prognosis.

Objective:To explore the value of apparent diffusion coefficient (ADC) and renal volume in assessing fetal kidney development and disease.Methods:From January 2016 to October 2020, 84 fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) were identified with MRI (CAKUT group), and 97 fetuses with no significant abnormalities on MRI or postnatal follow-up (control group) from the Obstetrics and Gynecology Hospital of Fudan University were enrolled and analyzed retrospectively. ADC value and renal volume were measured to compare the two groups, and the relationship was analyzed between these two parameters in the control group with gestational age, location (left or right kidney), and fetal gender. Two independent or paired sample t-tests, and linear correlation analyses, were adopted for the statistical analysis. Results:(1) There were 84 pregnant women in the CAKUT group, including a twin pregnancy, with an average age of (29±4) years old, ranging from 21 to 39 years old. The gestational age at MRI was (26±4) weeks with a range of 21-34 weeks. Of the 85 fetuses, 52 were male (61.2%), and 33 were female (38.8%). The polycystic dysplastic kidney was found in 32 cases (37.6%), hydronephrosis in 29 cases (34.1%), and an isolated kidney in 24 cases (28.2%). There were 97 singleton pregnancies in the control group, including 45 (46.4%) male and 52 (53.6%) female fetuses. The average maternal age was (30±5) years old, with a range of 19-41 years old, and the gestational week at MRI was (27±4) weeks, with a range of 21-34 weeks. (2) In the control group, the mean ADC value and renal volume were (1.255±0.112)×10 －3 mm2/s and (4 747±2 479) mm 3, which were negatively ( R 2=0.30, P<0.01) and positively correlated ( R 2=0.80, P<0.01) with the gestational age, respectively. There was no significant difference between ADC value and renal volume between different fetal gender in the control group. (3) The ADC value and the renal volume of fetuses with polycystic dysplastic kidney [(1.720±0.200) ×10 －3 mm2/s and (8 154±8 337) mm 3] were higher than those in the control group ( t=－13.11 and－3.08, P<0.001 and P=0.004). Compared with the control group, ADC of fetuses with hydronephrosis [(1.333±0.171) ×10 －3 mm2/s] was higher ( t=－3.90, P<0.001); and the renal volume [(7 201±4 460) mm 3] was larger but without statistical significance. The fetuses with an isolated kidney had an increasing trend in renal volume [(5 239±4 244) mm 3] and a decreasing trend in the ADC value [(1.239±0.125) ×10 －3 mm2/s] when compared with the normal fetuses, but neither difference was significant. Conclusions:In normal fetuses, the ADC value decreases, and the renal volume increases with the gestational age. Fetuses with CAKUT may have a larger kidney than normal.