The writing of pharmacist-managed clinics documents （hereinafter referred to as “outpatient medication record”） is a necessary part of pharmacist-managed clinics service. Outpatient medication record is an important carrier to reflect the quality of pharmacist-managed clinics service. The Chinese Hospital Association Pharmaceutical Specialized Committee was entrusted by the Pharmaceutical Administration Department of the National Health Commission to lead the formulation of the Guidelines for the Pharmacist-managed Clinics Service and Document Writing and Usage （Reference） （hereinafter referred to as Guidelines） according to the compilation method of group standards and the technical route of “documentation combing→framework establishment→draft writing→opinion collection→Guidelines formation”. The Guidelines standardizes the basic requirements of pharmacist-managed clinics record management and the basic content of record， and provides a general template and two specialized templates including pregnant and lactating pharmacist-managed clinics record template and cough and asthma pharmacist-managed clinics record template， which provides a reference for medical institutions to write pharmacist-managed clinics record. This paper introduces the formulation process of Guidelines and analyzes the key contents of Guidelines， which is helpful for the application practice of Guidelines and further improves the quality of pharmacist-managed clinics work.

Bawei Chenxiang Powder(BCP), first documented in the Tibetan medical work Four Medical Classics, has been widely applied in clinical practices in Tibetan and Mongolian medicines since its development. It has the effect of clearing the heart heat, calming the mind, and inducing resuscitation. On the basis of BCP, multiple types of formulae have been developed, such as Bawei Yiheyi Chenxiang Powder, Bawei Rang Chenxiang Powder, and Bawei Pingchuan Chenxiang Powder, which are widely used for treating cardiovascular and respiratory diseases. Current pharmacological research has revealed the pharmacological effects of BCP and its related formulae against myocardial ischemia, cerebral ischemia, renal ischemia, and anti-hypoxia. BCP and its related formulae introduced more treatment options for related clinical diseases and provided insights for fully comprehending the essence and pharmacological components of the formulae. This paper systematically reviewed the clinical and pharmacological research on BCP and its related formulae, analyzing the formulation principles and potential key flavors and active ingredients. This lays a fundamental scientific basis for the clinical use, quality evaluation, and subsequent development and application of BCP and its related formulae, providing references for studying traditional Chinese medicine formulae in a thorough and systematic manner.
Drugs, Chinese Herbal/chemistry* ; Humans ; Powders/chemistry* ; Animals ; Medicine, Chinese Traditional

OBJECTIVES: To study genotype-phenotype correlations in children with FGFR3 variants and to improve clinical recognition of related disorders. METHODS: Clinical data of 95 patients aged 0-18 years harboring FGFR3 variants, confirmed by whole‑exome sequencing at Shanghai Children's Medical Center from January 2012 to December 2023, were retrospectively reviewed. Detailed phenotypic characterization was performed for 22 patients with achondroplasia (ACH) and 10 with hypochondroplasia (HCH). RESULTS: Among the 95 patients, 52 (55%) had ACH, 24 (25%) had HCH, 9 (9%) had thanatophoric dysplasia, 3 (3%) had syndromic skeletal dysplasia, 2 (2%) had severe achondroplasia with developmental delay and acanthosis nigricans, and 5 (5%) remained unclassified. A previously unreported FGFR3 variant, c.1663G>T, was identified. All 22 ACH patients presented with disproportionate short stature accompanied by limb dysplasia, commonly with macrocephaly, a depressed nasal bridge, bowed legs, and frontal bossing; complications were present in 17 (77%). The 10 HCH patients predominantly exhibited disproportionate short stature with limb dysplasia and depressed nasal bridge. CONCLUSIONS ACH is the most frequent phenotype associated with FGFR3 variants, and missense variants constitute the predominant variant type. The degree of FGFR3 activation appears to correlate with the clinical severity of skeletal dysplasia.
Humans ; Receptor, Fibroblast Growth Factor, Type 3/genetics* ; Child ; Male ; Child, Preschool ; Female ; Infant ; Adolescent ; Dwarfism/genetics* ; Achondroplasia/genetics* ; Lordosis/genetics* ; Infant, Newborn ; Retrospective Studies ; Genetic Association Studies ; Bone and Bones/abnormalities* ; Phenotype ; Limb Deformities, Congenital

General anesthesia, pivotal for surgical procedures, requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments. Traditional assessment methods, relying on physiological indicators or behavioral responses, fall short of accurately capturing the nuanced states of unconsciousness. This study introduces a machine learning-based approach to decode anesthesia depth, leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats. Our findings demonstrate the model's robust predictive accuracy, underscored by a novel intra-subject dataset partitioning and a 5-fold cross-validation method. The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states, highlighting distinct EEG patterns and enhancing prediction accuracy. Moreover, the model's ability to generalize across individuals suggests its potential for broad clinical application, distinguishing between anesthetic agents and their depths. Despite relying on rat EEG data, which poses questions about real-world applicability, our approach marks a significant advance in anesthesia monitoring.
Animals ; Machine Learning ; Electroencephalography/methods* ; Ketamine/administration & dosage* ; Rats ; Male ; Propofol/administration & dosage* ; Rats, Sprague-Dawley ; Anesthesia, General/methods* ; Brain/physiology* ; Intraoperative Neurophysiological Monitoring/methods*

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

Objective:To investigate the effects of elesclomol-Cu(ES-Cu)on the proliferation and cuproptosis of human acute myeloid leukemia(AML)cells.Methods:The effects of ES-Cu on the proliferation of AML cells and the AML cells pre-treated with ammonium tetrathiomolybdate(TTM)were examined by CCK-8 assay.The Calcein/PI kit was used to detected the changes in activity and cytotoxicity of AML cells induced by ES-Cu.Flow cytometry and Cytation3 fully automated cell imaging multifunctional detection system were used to analyze DCFH-DA fluorescence intensity,so as to determine the level of reactive oxygen species(ROS).The GSH and GSSG detection kits were used to measure the intracellular GSH content.Western blot was used to detected the expression of cuproptosis-related proteins ATP7B,FDX1,DLAT and DPYD.Results:ES-Cu inhibited the proliferation of Kasumi-1 and HL-60 cells in a concentration-dependent manner(rKasumi-1=-0.99,rHL-60=-0.98).As the concentration of ES-Cu increased,the level of intracellular ROS also increased(P＜0.01-0.001).TTM could significantly reverse the inhibitory effect of ES-Cu on cell proliferation and its promoting effect on ROS.With the increase of ES-Cu concentration,the content of GSH was decreased(r=-0.98),and Western blot showed that the protein expressions of ATP7B,FDX1,DLAT and DPYD were significantly reduced(P＜0.05).Conclusion:ES-Cu can induce cuproptosis in AML cells,which provides a new idea for the treatment of AML.

Objective:This study analyzed the provincial policy on the"dual channel"management of drugs,provided suggestions for improving the"dual channel"management models.Methods:From May 10,2021 to April 10,2024,the official websites of the Healthcare Security Administration and the Health Commission of various provinces were searched for policy documents related to the"dual channel"management,and the text data were statistically analyzed.Results:The"dual-channel"management policies of various provinces coexisted with commonalities and differences.Conclusions:It is recommended to refine the access standards of the drug catalog,standardize the setting of the entry threshold of pharmaceutical institutions,scientifically determine the level of medical insurance treatment,and formulate differentiated drug identification and management methods,so as to further weaken the policy restrictive factors.

Purpose To construct a nomogram model based on ultrasonographic features and to evaluate its value in differentiating benign from malignant bladder neoplasms.Materials and Methods A total of 538 consecutive bladder neoplasm patients(including 84 benign cases and 454 malignant cases)confirmed by surgery or biopsy pathology from January 2016 to January 2022 were retrospectively enrolled,the ultrasonographic features(including lesion number,location,maximum diameter,echogenicity,morphology,basement,calcification,color Doppler flow imaging signal)and brief clinical data(gender,age,urinary tract malignant tumors history and gross haematuria)were all collected for univariate and multivariate Logistic regression analysis.Independent predictors for malignant bladder neoplasm were screened and nomogram model based on univariate Logistic regression analysis was constructed.Internal validation was performed by Bootstrap resampling.Meanwhile,the receiver operating characteristic curve,calibration curve and decision curve were drawn.Results Univariate and multivariate Logistic regression analysis showed patient gender(OR=1.822,P=0.038),age(OR=1.044,P=0.000),lesion location(OR=0.359,P=0.000)and color Doppler flow imaging signal(OR=2.052,P=0.007)were independent factors in predicting the malignancy of bladder lesions.Area under the curve of the nomogram prediction model based on univariate Logistic regression analysis were 0.780,the sensitivity,specificity and accuracy of the prediction model were 72.91%,71.43%and 72.68%,respectively.The calibration curve and decision curve showed good consistency and clinical practicability of the model.Conclusion The nomogram model based on ultrasonographic features and simple clinical characteristics shows good predictive accuracy in differentiating bladder neoplasms and has potential clinical application value.

Objective:To evaluate insulin sensitivity(IS)and pancreatic β-cell secretion function in the elderly, analyze the influencing factors, and compare these parameters with those observed in adults.Methods:A total of 301 participants were selected from the health examination population at the Geriatrics Endocrinology Department of Jiangsu Provincial People's Hospital, all of whom had no history of diabetes, between December 2018 and June 2021.Participants were categorized into elderly and adult groups based on age.Personal and medical histories were recorded, and various measurements, including height, weight, waist circumference, hip circumference, blood lipids, and nutritional metabolic indicators, were obtained.Body composition was assessed using dual-emission X-ray absorptiometry(DXA).The oral minimal model(OMM)method was utilized to derive the insulin sensitivity index(ISI), dynamic insulin secretion(Φd), static insulin secretion(Φs), total insulin secretion(Φt), and disposition index(DI).Participants were grouped according to the results of oral glucose tolerance tests.Finally, the factors influencing IS and pancreatic β-cell function were analyzed in both elderly and adult populations, as well as to identify any differences between the two groups.Results:Following adjustments for gender and body mass index(BMI), partial correlation analysis indicated a decrease in Φd, DI-Φd, and DI-Φt with advancing age( r=-0.219, -0.210, -0.187; P=0.005, 0.015, 0.017).In contrast, ISI, Φs, Φt, and DI-Φs showed no significant correlation with age.Although ISI levels were comparable between the elderly and adult groups, individuals newly diagnosed with diabetes in the elderly cohort exhibited higher DI-Φd, DI-Φs, and DI-Φt compared to those in the adult group after ISI correction.When incorporating age, high-density lipoprotein cholesterol(HDL-C), total muscle mass, the android to gynoid ratio(A/G), and fat mass index(FMI)into a binary Logistic regression model, the findings underscored FMI as a common risk factor for both elderly and adult cohorts concerning the ISI( OR=2.324, 1.773; P=0.032, 0.005).The A/G ratio was identified as a risk factor for DI-Φd in both age groups( OR=69 252.464, 407.653; P=0.012, 0.001).Furthermore, HDL-C was recognized as a protective factor for ISI( OR=0.024, P=0.012)in the elderly, while advancing age( OR=1.454, P=0.039)was found to be a risk factor for DI-Φs in this demographic.Total muscle mass and the A/G ratio were also acknowledged as risk factors for ISI( OR=1.054, 15.725; P=0.021, 0.026), with FMI serving as a risk factor for DI-Φs in the adult cohort( OR=1.826, P=0.035). Conclusions:The secretion function of pancreatic β-cells declines with age, whereas ISI remains unchanged.The factors affecting ISI, DI-Φd, and DI-Φs in elderly and adult populations show notable differences.This indicates that implementing targeted lifestyle interventions for distinct age groups may be more effective in preserving both ISI and pancreatic β-cell function.