SAbstact:Objective To establish a method for detecting t he pharmacokinetic parameters of te tramethylpyragine(TMPz ),the main active component in Xiongbing nasal spray(A),Chuanxiong nasal spray(B)and Xiongbing decoction(C),in the rat brain .Methods Gas chromatography was applied for pharmacokinetic analysis of TMPz in v arious time after nasal administration or gastr ic infusion.Results The concentration -time process of A can be described in an open two -department model,which is simi lar to the process of intravenous adm inistration.As compared with B and C,A has its characteristics:quick absorpt ion,quick distribution and quick excretion of TMPz.TMPz passed through blood -brain barrier almost right after administration,and reach the peak concentra tion 1minute after the administrati on.95.7%of TMPz was cleared from brain within 1.5h.Conclusion The application of Borneolum makes T MPz of A enter into the rebral tissue easily.Therefore Xiongbing nasal spray is a quick -effective pre paration for acute ischemic stoke an d can be medicated repeatedly.

Objective To promote the migratory ability and immunological effect of bone marrow-derived dendritic cells ( BMDC) loaded with breast carcinoma antigen. Methods DCs were cultured by the medium containing rmGM-CSF and rmIL-4. After loaded with breast carcinoma antigen, DCs were stimulated with PGE2 for 1day. CD86, CD80, and CCR7 were measured by flow cytometry. The expression of CCR7 on surface of BMDC was also detected by RT-PCR and Western blotting. The chemotaxis assay was measured by migration through a polycarbonate filter in transwell chambers. The competence of inducing mixed lymphocyte response (MLR) and specific cytotoxic T lymphocyte ( CTL) were detected with MTT. The effect of DC blocking tumor growth in breast carcinoma model were also studied. Results Compared with control group, PGE2 upregulated surface markers of CD86, CD80, and CCR7 (P

Objective: Vascular dilation dysfunction has been linked with risk of cardiovascular disease. This study was undertaken to investigate the relationship between physical activity and vascular dilation function in healthy middle-aged adults to help explaining the effect of physical activity on preventing cardiovascular disease. Method: We recruited 91 healthy middle-aged adults to complete a serf-report 7-day physical activity recall questionnaire and an exam of brachial artery flow-mediated dilation(FMD) and Nitroglycerin-mediated dilation (NMD) detected by ultrasound. The relationship between physical activity level (PAL) and FMD and NMD were explored. Result: Physical activity showed a significant and positive relationship with the brachial artery FMD, even after adjustment for possible confounding factors (r=0.363, P<0.01). The group of high physical activity level had the highest FMD. The means of FMD (%) in low, moderate and high PAL groups were respectively 8.70%±3.93%,9.01%±3.22% and 12.38±5.67% with significant difference between individuals of low and high PAL and between moderate and high PAL group(P<0.01). The means of NMD (%) is 25.13%±6.52%,24.38%±5.44% and 29.50%±7.25% respectively (P> 0.05) and there was no significant difference among three groups. There was no positive relation between PAL and FMD in premenopausal females but in men and postmenopausal females. Although individuals of high PAL have the best FMD, the moderate PAL can also retard FMD decrease with ageing. Conclusion: Maintaining high physical activity level can enhance endothelial-dependent vascular dilation, and moderate or high physical activity level can prevent endothelial-dependent vaseular dilation declining with aging, which may contribute to decrease risk of cardiovascular disease in healthy middle-aged adults.

Objective To evaluate the values of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance. Methods Two hundred and seventy cases of diamniotic twins were included. Both postnatal outcomes and prenatal amniotic fluid discordant variations were analyzed,and the incidences of amniotic fluid discordance were compared between the monochorionic-diamniotic(MCDA)and dichorionic-diamniotic (DCDA) gruop. Results Twenty four cases of twins with amniotic fluid discordance were found in the study. The incidence of amniotic fluid discordance in MCDA group was much higher than that in DCDA group (28.9% vs 5.6%, P ＜0. 001 ) ,and 24 cases of twin-to-twin transfusion syndrome (TTTS) were diagnosed in the former group and none were found in the latter group. Downward tendency of amniotic fluid discordance was shown in non-TTTS cases of MCDA group. Compared with TTTS cases, the postnatal outcomes of non-TTTS cases with amniotic fluid discordance were much better in MCDA group ( P ＜0.001 ). Conclusions TTTS and MCDA twins with amniotic fluid discordance may overlap each other in the early stage. Serial surveillances of ultrasonography are necessary for prenatal differentiating twin pregnancies complicated by amniotic fluid discordance,and providing strong support to clinical treament.

Objective: Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD. Methods: We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age ＜ 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher’s exact tests. Results: We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8−20) vs. 6.7% (95% CI 4.1−9.2), p = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, p ＜ 0.001) and high blood pressure (17% vs. 8%, p = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08−0.69], p = 0.005). Conclusion Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted.

Objective:To investigate the diagnostic value of prognostic nutritional index (PNI) and C-reactive protein to albumin ratio(CAR) in Crohn′s disease complicated with intra-abdominal infection (CD-IAI).Methods:From January 2016 to December 2021, the clinical data of 61 patients with Crohn′s disease (CD) and 61 patients with CD-IAI diagnosed at Nanfang Hospital, Southern Medical University were retrospectively analyzed. Crohn′s disease activity index (CDAI), Crohn′s disease endoscopic index of severity (CDEIS), laboratory parameters(white blood cell count, neutrophil ratio, platelet count, C-reactive protein (CRP), procalcitonin (PCT), D-dimer, prothrombin time (PT), fibrinogen, activated partial thromboplastin time (APTT)), PNI and CAR were compared between CD patients and CD-IAI patients. From January to May in 2022 another 30 patients with CD and 13 patients with CD-IAI diagnosed at Nanfang Hospital, Southern Medical University were selected to verify the accuracy of PNI and CAR in predicting CD-IAI. The optimal cut-off values of PNI and CAR in predicting CD-IAI, area under the curve (AUC), Youden index, sensitivity and specificity were calculated by receiver operating characteristic curve (ROC). Spearman correlation was used to analyze the correlation between PNI, CAR, CDAI, and CDEIS, and logistic regression was performed to analyze the influencing factors of CD-IAI. Independent sample t test and Mann-Whitney U test were used for statistical analysis. Results:CDAI and CDEIS were higher in CD-IAI patients than those of CD patients(256.68±8.50 vs.144.87±7.83; 3.80 (1.80, 5.40) vs. 1.20 (0.20, 2.80)), and the differences were statistically significant( t=-9.67, Z=-4.02, both P<0.001). The white blood cell count, neutrophil ratio, platelet count, CRP, PCT, D-dimer, PT, fibrinogen, and APTT of CD-IAI patients were all higher than those of CD patients (7.81×10 9/L (5.98×10 9/L, 11.39×10 9/L) vs. 5.94×10 9/L (4.86×10 9/L, 7.11×10 9/L); (73.43±10.67)% vs. (62.30±11.03)%; 360.00×10 9/L (266.50×10 9/L, 456.00×10 9/L) vs. 294.00×10 9/L (222.50×10 9/L, 356.00×10 9/L); 44.27 mg/L (16.82 mg/L, 82.65 mg/L) vs. 3.42 mg/L (0.59 mg/L, 18.33 mg/L); 0.07 μg/L (0.04 μg/L, 0.22 μg/L) vs. 0.04 μg/L (0.02 μg/L, 0.05 μg/L); 0.75 mg/L (0.32 mg/L, 2.00 mg/L) vs. 0.26 mg/L (0.15 mg/L, 0.46 mg/L); 11.90 s (11.40 s, 12.90 s) vs. 11.20 s (10.45 s, 11.70 s); 4.58 g/L (3.59 g/L, 5.59 g/L) vs. 2.99 g/L (2.17 g/L, 4.23 g/L); 30.40 s (28.30 s, 32.80 s) vs. 28.00 s (25.45 s, 31.10 s)), and the differences were statistically significant ( Z=-4.48; t=-5.66; Z=-2.71, -6.47, -3.78, -4.87, -4.87, -5.44 and -2.74; all P<0.01). The serum albumin level of CD-IAI patients was lower than that of CD patients (34.10 g/L (31.40 g/L, 36.90 g/L) vs. 39.00 g/L (35.10 g/L, 43.20 g/L)), and the difference was statistically significant( Z=-3.91, P<0.001). The PNI of CD-IAI patients was lower than that of CD patients (41.65, (38.58, 44.58) vs. 47.80 (40.45, 52.98)), while CAR was higher than that of CD patients (1.29 (0.48, 2.67) vs. 0.10 (0.01, 0.46)), and the differences were statistically significant ( Z=-3.83 and -6.44, both P<0.001). The results of Spearman correlation analysis showed that PNI was negatively correlated with CAR, CDAI, and CDEIS ( r=-0.64, -0.53 and -0.50, all P<0.001), and CAR was positively correlated with CDAI and CDEIS ( r=0.63 and 0.52, both P<0.001). The results of logistic regression analysis showed that high level of PNI was a protective factor for CD-IAI ( OR= 0.911, 95% confidence interval 0.864 to 0.961), and high level of CAR was a risk factor for CD-IAI ( OR=2.846, 95% confidence interval 1.745 to 4.644). The results of ROC indicated that the AUC value of combined PNI and CAR in the diagnosis of CD-IAI was 0.829 ( P<0.001), Youden index was 0.541, the sensitivity was 0.934, and the specificity was 0.607. The sensitivity and specificity of optimal cut-off value of the combination of PNI and CAR in predicting CD-IAI were 0.692 and 0.967. Conclusions:PNI and CAR have certain diagnostic value in CD-IAI. The risk of CD-IAI is high when PNI <45.550 and CAR >0.466.

OBJECTIVE：To investigate the role of clinical pharmacists on the individualized treatment of children with subglottic Talaromyces marneffei infection. METHODS ：The clinical pharmacists participated in the medication procedure for a case of subglottic T. marneffei infection child . The clinical pharmacists suggested that Budesonide suspension for inhalation should be stopped，according to the subglottic infection pathogen type （T. marneffei ）；Itraconazole oral solution should be chosen and taken orally 2.5 mg/kg，q12 h，and indicators as liver function ，blood potassium should be monitored regularly. However ，as Itraconazole oral solution needed to be applied for temporary purchase ，Itraconazole capsules 2.5 mg/kg，q12 h，p.o.，was administrated temporarily ；clinical pharmacists suggested that Itraconazole capsules should be taken after meal ，and the doctor changed the feeding mode of milk from q 4 h to continuous pumping. After purchased ，Itraconazole oral solution was used instead 2.5 mg/kg，q12 h in fasting state ，and according the clinical pharmacist ’s suggestion ，the doctor changed the nursing method to q 4 h milk pumping. After purchasing and using oral solution instead ，clinical pharmacists suggested taking it at fasting state ；according to the monitoring results and target range （0.5-1 mg/L），oral dose of Itraconazole oral solution was finally adjusted to 8.3 mg/kg， q12 h. In view of the diarrhea during the treatment ，clinical pharmacists suggested to continue the original treatment after considering the effectiveness and importance of the treatment ；at the same time ，discharge medication education should be carried out. RESULTS ： The doctors adopted the suggestions of the clinical pharmacists. The child got a clinical improvement and was discharged after 48 days. CONCLUSIONS ：Clinical pharmacists participate in the treatment of children with T. marneffei infection，timely assist physicians to adjust and improve the medication regimen ，which improve the efficacy and safety of medication for children.