OBJECTIVE To investigate the effectiveness of resident clinical pharmacist-led medication therapy management （MTM） model in geriatric cardiology departments， and provide reference for optimizing resident pharmaceutical services. METHODS A retrospective cohort study was conducted， incorporating data from inpatients admitted to the Department of Cardiovascular Medicine in the Geriatric Medical Center of our hospital during March to August 2023 （conventional group， n＝ 903） and the same period in 2024 （MTM group， n＝963）. The conventional group received only standard pharmaceutical services （including prospective prescription review and retrospective order evaluation）， while the MTM group received additional resident clinical pharmacist-led interventions-such as medication reconciliation， personalized therapeutic drug monitoring （TDM）， standardized intravenous infusion management， and a four-stage closed-loop monitoring process-based on conventional care. The effectiveness of the MTM model was evaluated by comparing the primary outcome measures （e.g.， intravenous infusion rate， TDM target attainment rate） and secondary outcome measures [e.g.， incidence of drug-drug interactions （DDIs）， incidence of grade 3 or higher acute kidney injury， average length of hospital stay， cholesterol， and medication cost per capita] between the two groups. RESULTS Compared with the conventional group， in terms of primary outcome indexes： both the overall intravenous infusion rate and the use rate of acid-suppressive injection were significantly lowered in the MTM group （P＜0.05）； serum concentration target attainment rates for digoxin and vancomycin were increased significantly （P＜0.05）. For secondary outcome indexes， the MTM group exhibited significant decreases in the work incidence of grade 3 or higher acute kidney injury， the incidence of DDIs， the rate of patients leaving the hospital against medical advice， alanine amino-transferase， aspartate transferase and the per capita total medication cost （P＜0.05）. Additionally， there was a notable increase in the creatinine， estimated glomerular filtration rate and a significant shortening of the per capita length of hospital stay （P＜0.05）. CONCLUSIONS The resident clinical pharmacist-led MTM model can significantly optimize medication therapy processes， enhance medication safety and cost-effectiveness， thus playing a positive role in promoting rational drug use and improving patient outcomes.

OBJECTIVE: Therapeutic angiogenesis has become a promising approach for treating ischemic heart disease (IHD). The present study aims to investigate the effects of Qishen Granule (QSG) on angiogenesis in myocardial ischemia (MI) and the potential mechanism. METHODS: In vivo study was conducted on rat model of myocardial infarction. QSG was performed daily at a dose of 2.352 g/kg for four weeks. Cardiac function was assessed by echocardiogram and pro-angiogenic effects were evaluated by Laser Doppler and CD31 expression. Oxygen-glucose deprivation (OGD) was applied in cultured human umbilical vein endothelial cells (HUVECs). Cell viability, wound healing and tube formation assay were used to test functions of HUVECs. ELISA and Western blots were used to assess protein expressions of bone morphogenetic protein 2-delta-like 4-notch homolog 1 (BMP2-Dll4-Notch1) signaling pathway. RESULTS: The results showed that QSG improved heart function, cardiac blood flow and microvessel density in myocardial ischemic rats. In vitro, QSG protected HUVECs by promoting the cell viability and tube formation. QSG upregulated bone morphogenetic protein-2 (BMP2) and downregulated delta-like 4 (Dll4) and notch homolog 1 (Notch1) expressions both in rats and HUVECs. CONCLUSION QSG protected against MI by promoting angiogenesis through BMP2-Dll4-Notch1 pathway. BMP2 might be a promising therapeutic target for IHD.

Beta-amylases (BAMs), key enzymes in starch hydrolysis, play an important role in plant growth, development, and resistance to abiotic stress. To mine the saline-alkali tolerance-related BAM genes in alfalfa (Medicago sativa L.), we identified MsBAM genes in the whole genome. The physicochemical properties, phylogeny, gene structures, conserved motifs, secondary structures, promoter cis-acting elements, chromosome localization, and gene replication relationships of BAM gene family members were analyzed. RNA-seq and quantitative real-time PCR (qRT-PCR) were employed to analyze the expression patterns of BAM family members under saline-alkali stress. The results showed that 54 BAM genes were identified in the genome, which were classified into 8 subgroups according to the phylogenetic tree. The members of the same subgroup had similar gene structures except that those of subgroups 1 and 7 had large differences. Conserved motif analysis showed that all MsBAM proteins had a typical glycohydrolysis domain. The chromosome localization analysis showed that MsBAM gene family members were unevenly distributed on 27 chromosomes. The duplication of gene segments led to the increase in BAM gene number in alfalfa. The promoters of BAM genes contained a large number of elements in response to plant hormones and stress. Transcriptome data and qRT-PCR results showed that the expression levels of most MsBAM genes were up-regulated in response to saline-alkali stress. Under the saline-alkali stress, the expression levels of 28 genes, including MsBAM6, were up-regulated on days 1 and 7, and those of 5 genes, including MsBAM9, were up-regulated by over 2 folds. In addition, under salt-alkali stress, BAM activity and soluble sugar content were significantly increased. These results indicate that BAM genes play a key role in alfalfa in response to saline-alkali stress, laying a foundation for further research in this field.
Medicago sativa/physiology* ; beta-Amylase/metabolism* ; Phylogeny ; Gene Expression Regulation, Plant ; Stress, Physiological/genetics* ; Multigene Family ; Alkalies ; Plant Proteins/genetics*

Objective:To study the application effect of the Benner's theory stratified training based on the "Protect the World" platform for nurses specialized in neurological rehabilitation.Methods:A total of 70 nurses who underwent on-the-job training for neurorehabilitation nursing specialists in 2023 were divided into control group ( n=35) and observation group ( n=35) based on random odd and even numbers to receive different training methods. The control group received routine nursing training, while the observation group received Benner's theory stratified training based on the "Protect the World" platform. The theoretical and skill assessment scores, job competency, and satisfaction scores of two groups of nurses were compared before and after training. SPSS 25.0 was used for t-test and chi-square test. Results:Before training, there were no significant differences between the two groups of nurses in terms of theory scores [(88.35±4.41) vs. (89.43±4.07)] and skill assessment scores [(89.22±3.27) vs. (88.43±3.16)]. After training, the theoretical and skill assessment scores were significantly higher in the observation group as compared with the control group [(95.51±5.01) vs. (90.24±4.99) and (95.15±4.24) vs. (91.13±4.33), both P<0.05]. After training, the competency scores and total scores of education guidance, management function, diagnostic function, assistance role, and intervention treatment were significantly higher in the observation group than in the control group ( P<0.05). The satisfaction survey scores were significantly higher in the observation group than in the control group ( P<0.05). Conclusions:The Benner's theory stratified training based on the "Protect the World" platform can improve the theoretical and skill assessment scores of nurses specialized in neurological rehabilitation. This approach significantly boosts their overall professional competence and holds considerable potential for broader adoption.

Objective To analyze the current status, hotspots and difficulties of research on colorectal serrated polyps using CiteSpace software. Methods Chinese literature was searched in the China National Knowledge Infrastructure (CNKI) database from its inception to March 6, 2023. English literature was searched in the Medline database from its inception to March 21, 2023. CiteSpace software was used to create visual maps and conduct visual analysis of publication volume, institutions and keywords. Results A total of 198 Chinese articles were included in this study, with Beijing Military General Hospital publishing the most articles. "Pathology" appeared with the highest frequency, and clinic and endoscopic characteristics had been research hotspots in recent years. This study included 1 257 English articles. The keyword "colorectal cancer" appeared with the highest frequency, adenoma detection, colon cancer screening, computer-aided detection, adenoma missed diagnosis rate and artificial intelligence had been research hotspots in recent years. Conclusion The research interest in colorectal serrated polyps is gradually increasing both domestically and internationally, with research hotspots focusing on adenoma detection, colon cancer screening, computer-aided detection, adenoma missed diagnosis rate, and artificial intelligence.

Juvenile idiopathic arthritis (JIA) is a genetically heterogeneous group of connective tissue diseases that are commonly characterized by chronic joint synovial inflammation with unknown etiology in childhood.It is cu-rrently incurable and the main therapeutic goal is to achieve clinical remission.The drugs currently used to treat JIA mainly include non-steroid anti-inflammatory drugs, glucocorticoid, disease modifying antirheumatic drugs, and biological agents.In this article, recent advances in the understanding of JIA treatment and related clinical research were reviewed, in an attempt to provide prospects for the future direction of drug development and treatment concepts.

Objective:To evaluate the relationship between the mechanism of promoting wound healing by modified autologous blood transfusion and metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1) in diabetic mice. Methods:Twenty SPF ICR mice, weighing 21-25 g, in which the diabetic model was successfully established, were divided into 2 groups ( n=10 each) using a random number table method: modified preservation group (group I) and ordinary preservation group (group O). Peripheral venous blood samples were collected and stored in the corresponding preservation solution for 7 days.The platelet aggregation rate, blood glucose, serum glycosylated hemoglobin (GHB) and phosphodiesterase (DPG) concentrations and WBC were measured.Autologous blood was transfused back immediately after the wound model was established.The percentage of wound healing area was calculated at 7, 10 and 14 days after autologous blood transfusion.The expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, β-actin, type Ⅰ collagen (Col Ⅰ), Col Ⅲ protein and mRNA and MALAT1 was determined by Western blot, immunohistochemistry and quantitative real-time polymerase chain reaction respectively, at 14 days after transfusion. Results:Compared with group O, the blood glucose, serum concentrations of GHB and DPG, and WBC were significantly decreased, platelet aggregation rate was increased, the percentage of wound healing area was increased, the positive staining rate of Col Ⅰ and Col Ⅲ was increased, and the expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, ColⅠ, Col Ⅲ and β-actin protein and mRNA and MALAT1 was up-regulated in group I ( P<0.05). Conclusion:The mechanism by which modified autologous blood transfusion promotes wound healing may be related to up-regulating MALAT1 expression in diabetic mice.

Objective:To explore the effect of sports training guidance based on Internet platform on the limb function and quality of life in home rehabilitation of stroke hemiplegic patients.Methods:Eighty patients with stroke and hemiplegia admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from June 2018 to December 2019 were selected and divided into observation group and control group with 40 cases in each group by random digits table method. The control group was given routine rehabilitation training. In addition to the regular rehabilitation training, the observation group was supplemented with home rehabilitation based on the WeChat platform for modified constraint-induced movement therapy. The limb motor function Fugl-Meyer Assessment (FMA) score, Upper Extremity Function Test (UEFT) score, Stroke-Specific Quality of Life scale (SS-QOL) score before and after intervention, and patients′ satisfaction and cares′ satisfaction score were compared between the two groups.Results:There was no significant difference in the score of FMA, UEFT, SS-QOL before intervention between the two groups( P>0.05). After discharge, the FMA score, UEFT score and physical function, physiological function, mental health, social function of SS-QOL score were (68.87±6.64),(72.38±7.33), (35.28±4.13), (36.55±4.23), (37.22±3.84), (38.23±3.44) points in the observation group and (55.25±6.20), (61.24±6.47), (28.72±4.56), (30.85±5.30), (31.28±4.63), (31.02±5.16) points in the control group, and the differences were statistically significant between the two groups( t values were 5.316-9.482, P<0.01). During the nursing period, the patients′ satisfaction and cares′ satisfaction score were 92.50%(37/40), 87.50%(35/40) in the observation group and 72.50%(29/40), 67.50%(27/40) in the control group, and the differences were statistically significant between the two groups( χ 2 values were 5.541, 4.588, P<0.05). Conclusions:The home rehabilitation based on the Internet platform for modified constraint-induced movement therapy helps to promote the recovery of limb motor function in stroke hemiplegic patients, improve the nursing satisfaction of patients and their families, and has a positive effect on improving the quality of life of patients.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T

Objective:To evaluate the effect of stored autologous blood transfusion on the function of bone marrow hematopoietic stem cells and the recovery of reticulocytes in peripheral blood of rabbits.Methods:Thirty healthy male New Zealand rabbits, aged 3-6 months, weighing 2.5-3.0 kg, were divided into 5 groups ( n=6 each) using a random number table method: control group (C group), operation group (O group), blood collection group (O+ B group), stored autologous whole blood group (O+ WB group) and stored autologous component blood group (O+ CB group). In O+ B group, O+ WB group and O+ CB group, blood was collected via the right femoral artery at a rate of 3-5 ml/min at 7 days before surgery, the blood volume was 10% of the total blood volume, and blood was stored at 4-6 ℃.In O+ CB group, blood was centrifuged to remove plasma and white blood cells, and red blood cell suspension was prepared and placed in a blood storage bag.In O, O+ B, O+ WB and O+ CB groups, hepatectomy was performed, and bleeding was performed through the right femoral artery at a rate of 3-5 ml/min, and the blood volume was 10% of the total blood volume.Lactated Ringer′s solution 1 ml/min was intravenously infused during surgery in O and O+ B groups, stored autologous whole blood was intravenously infused during surgery in group O+ WB, and stored autologous red blood cell suspension 1 ml/min was intravenously infused during surgery in group O+ CB.Bone marrow blood samples were collected immediately before the start of surgery (T 2) and at 6 and 24 h after surgery (T 3, 4) to determine the percentage of CD34 + cells, cell cycle and relative expression of telomere DNA.Peripheral venous blood samples were collected before storage (T 1) and at T 4 for determination of the percentage of reticulocytes. Results:Compared with group C, the percentage of CD34 + cells was significantly increased at T 3 and T 4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in group O, and the percentage of reticulocyte in peripheral blood was increased at T 4 in the remaining 4 groups ( P<0.05). Compared with group O, the percentage of CD34 + cells was significantly increased at T 2-4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in O+ B, O+ WB and O+ CB groups, and the percentage of reticulocyte in peripheral blood was increased at T 4 in O+ WB and O+ CB groups ( P<0.05). Compared with group O+ B, the percentage of CD34 + cells was significantly increased at T 3 and T 4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in O+ WB and O+ CB groups, and the percentage of reticulocyte in peripheral blood was decreased at T 4 in O+ WB and O+ CB groups ( P<0.05). Compared with O+ WB group, the percentage of CD34 + cells was significantly decreased at T 3 and T 4, the percentage of CD34 + cells in G 1 phase was increased, the expression of telomere DNA in CD34 + cells was down-regulated, and the percentage of reticulocytes in peripheral blood was increased at T 4 in group O+ CB ( P<0.05). Conclusion:Stored autologous blood transfusion can inhibit the function of bone marrow hematopoietic stem cells and is not helpful for recovery of reticulocytes in peripheral blood of rabbits; stored autologous component blood transfusion has less effect on the hematopoietic function of bone marrow than stored autologous whole blood transfusion.