OBJECTIVE To provide empirical basis for promoting the dynamic adjustment of the pharmaceutical care catalogue and the formulation of policies such as hierarchical payment of medical insurance. METHODS A multicenter cross- sectional survey method was adopted to conduct a questionnaire survey among 424 inpatients in 22 tertiary medical institutions in 12 prefecture-level cities of Hubei Province to evaluate their demand for pharmaceutical care， willingness to pay and preference for service forms. Combined with univariate and multivariate Logistic regression analysis， the influencing factors and key factors that affect patients’ willingness to pay for pharmaceutical care were identified. RESULTS Only 39.86% of the patients were aware of pharmaceutical care or pharmacists， and 89.62% of the patients hope to receive pharmaceutical care. Among the 16 types of pharmaceutical care， the patients surveyed had a relatively high recognition rate for guidance on drug usage and dosage， notification of medication precautions， and the identification， prevention and handling of adverse drug reactions. 96.70%， 95.30%， and 94.12% respectively expressed strong approval and approval. The demand for services such as insurance-related policy consultation， popular science on the mechanism of drug action， and assessment of the combined use of traditional Chinese and Western medicines was relatively low， with 61.65%， 68.47%， and 68.47% expressing strong approval and approval respectively. The positive influencing factors of willingness to pay were household monthly income ＞ 5 000 yuan （OR＝1.742）， awareness of pharmaceutical care or pharmacists （OR＝3.620）， and the desire to receive pharmaceutical care （OR＝4.686） （P＜0.05）， while self-rating health as “good” （OR＝0.390） was a negative influencing factor （P＜0.05）. Cardiovascular and cerebrovascular diseases （54.48%） and antihypertensive drugs （45.05%） were the service scenarios that the surveyed patients most hope to be covered. 85.14% of the patients preferred “service when xiaochnye@126.com needed”， with a single service duration of less than 10 minutes being appropriate （84.43%）， and the willingness to pay within 20 yuan being the main type （85.38%）. CONCLUSIONS Based on the characteristics of patients’ needs and payment behaviors， it is suggested that our country could consider establishing a hierarchical payment mechanism for pharmaceutical care， and focus on differentiated design in combination with diseases and medication situations. At the same time， the rights， responsibilities and service standards of resident pharmacists in the links such as medication reorganization and medical order review should be further clarified to comprehensively enhance the clinical value and policy operability of pharmaceutical care.

BACKGROUND: Senescent human skin primary fibroblast (FB) models have been established for studying aging-related, proliferative, and inflammatory skin diseases. The aim of this study was to compare the transcriptome characteristics of human primary dermal FBs from children and the elderly with four senescence models. METHODS: Human skin primary FBs were obtained from healthy children (FB-C) and elderly donors (FB-E). Senescence models were generated by ultraviolet B irradiation (FB-UVB), D-galactose stimulation (FB-D-gal), atazanavir treatment (FB-ATV), and replication exhaustion induction (FB-P30). Flow cytometry, immunofluorescence staining, real-time quantitative polymerase chain reaction, co-culturing with immune cells, and bulk RNA sequencing were used for systematic comparisons of the models. RESULTS: In comparison with FB-C, FB-E showed elevated expression of senescence-related genes related to the skin barrier and extracellular matrix, proinflammatory factors, chemokines, oxidative stress, and complement factors. In comparison with FB-E, FB-UVB and FB-ATV showed higher levels of senescence and expression of the genes related to the senescence-associated secretory phenotype (SASP), and their shaped immune microenvironment highly facilitated the activation of downstream immune cells, including T cells, macrophages, and natural killer cells. FB-P30 was most similar to FB-E in terms of general transcriptome features, such as FB migration and proliferation, and aging-related characteristics. FB-D-gal showed the lowest expression levels of senescence-related genes. In comparisons with the single-cell RNA sequencing results, FB-E showed almost complete simulation of the transcriptional spectrum of FBs in elderly patients with atopic dermatitis, followed by FB-P30 and FB-UVB. FB-E and FB-P30 showed higher similarity with the FBs in keloids. CONCLUSIONS Each senescent FB model exhibited different characteristics. In addition to showing upregulated expression of natural senescence features, FB-UVB and FB-ATV showed high expression levels of senescence-related genes, including those involved in the SASP, and FB-P30 showed the greatest similarity with FB-E. However, D-galactose-stimulated FBs did not clearly present aging characteristics.
Humans ; Fibroblasts/drug effects* ; Cellular Senescence/physiology* ; Skin/metabolism* ; Child ; Transcriptome/genetics* ; Aged ; Ultraviolet Rays ; Cells, Cultured ; Galactose/pharmacology*

Alzheimer's disease (AD) is the most common cause of dementia and is a growing public health challenge. Neuroinflammation has been proposed as a prominent pathological feature of AD and has traditionally been attributed to the innate immune system. However, emerging evidence highlights the involvement of adaptive immunity, particularly T and B lymphocytes, in the neuroinflammatory processes of AD. It remains unclear how adaptive immune responses, originally intended to protect the body, contribute to chronic inflammation and neuronal dysfunction in AD. Here, we review the roles of adaptive immunity, cellular composition, and niches and their contribution to AD development and progression. Notably, we synthesize the crosstalk between adaptive immunity and the innate immune system of the central nervous system (CNS), which is mainly mediated by glial cells and myeloid cells, and their interrelationships with amyloid-β (Aβ)/Tau pathology. We hypothesized that the alterations observed in innate immunity in AD mirror age-related immune alterations, whereas the dysregulation of adaptive immunity contributes more accurately to disease-specific immune responses. Targeting adaptive immunity in the context of neuroinflammation may provide new insights into potential therapeutic strategies designed to modulate immune responses, thereby facilitating the diagnosis, intervention, and treatment of AD.
Alzheimer Disease/metabolism* ; Humans ; Adaptive Immunity/physiology* ; Immunity, Innate/immunology* ; Animals ; Neuroinflammatory Diseases/immunology* ; Inflammation/immunology* ; Amyloid beta-Peptides/metabolism*

Objective To investigate the value of multi-slice spiral CT enhanced scanning combined with CT texture analysis in preoperative International Federation of Gynecology and Obstetrics(FIGO)staging of ovarian cancer.Methods A total of 126 ovarian cancer patients admitted to the Tongzhou District Maternal and Child Health Hospital and Beijing Friendship Hospital,Capital Medical University from March 2021 to September 2023 were selected as the research subjects.All patients underwent multi-slice spiral CT enhanced scanning,and their CT values were measured.Kinetics software was employed for CT texture analysis,and the texture feature-related parameters,including skewness,kurtosis,variance,entropy,and inverse difference,were calculated.The CT values and CT texture feature-related parameters among patients with different FIGO stages were compared.The diagnostic efficacy of CT enhanced scanning,CT texture analysis,and their combination in preoperative FIGO staging of ovarian cancer was evaluated by receiver operating characteristic(ROC)curve,and the consistency between the diagnosis of FIGO stage of ovarian cancer based on CT enhanced scanning,CT texture analysis,and their combination and the pathological diagnosis of FIGO stage of ovarian cancer was evaluated by Cohen's Kappa coefficient analysis.Results The CT value and entropy value of FIGO stage Ⅳ patients were significantly higher than those of FIGO stage Ⅰ,Ⅱ,and Ⅲpatients,and the CT value and entropy value of FIGO stage Ⅲ patients were significantly higher than those of FIGO stage Ⅰand Ⅱ patients(P＜0.05);there was no statistically significant difference in the CT value and entropy value between FIGO stage Ⅰ and stage Ⅱ patients(P＞0.05).There was no statistically significant difference in skewness,kurtosis,variance,and inverse difference among patients with different FIGO stages(P＞0.05).The ROC curve analysis showed that with reference to FIGO stages Ⅰ and Ⅱ,when the cut-off values of CT value and entropy value were 74.645 and 9.540,respectively,the area under the curve(AUC)of CT value and entropy value in diagnosing FIGO stage Ⅲ was 0.733 and 0.743,respectively,the specificity was 0.760 and 0.800,respectively,and the sensitivity was 0.605 and 0.674,respectively;the area under the curve(AUC)of CT value combined with entropy value in diagnosing FIGO stage Ⅲ was 0.818,the specificity was 0.820,and the sensitivity was 0.721.When the cut-off values of CT value and entropy value were 77.095 and 10.020,respectively,the AUC of CT value and entropy value in diagnosing FIGO stage Ⅳ was 0.817 and 0.797,respectively,the specificity was 0.820 and 0.820,respectively,and the sensitivity was 0.545 and 0.667,respectively;the AUC of CT value combined with entropy value in diagnosing FIGO stage Ⅳ was 0.926,the specificity was 0.900,and the sensitivity was 0.758.The consistency between CT enhanced scanning and pathology in diagnosing FIGO stage of ovarian cancer was moderate(Kappa=0.580,P＜0.05),with an accuracy rate of 72.22％(91/126);the consistency between CT texture analysis and pathology in diagnosing FIGO stage of ovarian cancer was moderate(Kappa=0.598,P＜0.05),with an accuracy rate of 73.81％(93/126);the combination of CT enhanced scanning and CT texture analysis in the diagnosis of FIGO stage of ovarian cancer had a high consistency with pathological diagnosis(Kappa=0.868,P＜0.05),with an accuracy rate of 91.27％.Conclusion Multi-slice spiral CT enhanced scanning and CT texture analysis are both reliable methods for the diagnosis of FIGO stage of ovarian cancer.The combination of CT enhanced scanning and CT texture analysis in the diagnosis of FIGO stage of ovarian cancer has a high consistency with pathological diagnosis.The combination of the two can improve the diagnostic efficiency for FIGO stage of ovarian cancer.

Objective:To compare the assay and related substance detection methods of erythromycin lactobionate in the Chinese Pharmacopoeia 2020(ChP),USP 2023(USP),JP18(JP),BP2023(BP)and EP 11.0(EP),investigate the differences between the test results obtained from 7 batches of erythromycin lactobionate for injection samples by using ChP and BP methods and thus provide a reference for the improvement of specification of erythromycin lactobionate.Methods:The differences of test methods and limits under the items of assay and related substances of erythromycin lactobionate in the above five pharmacopoeias were listed and compared.The related substances and contents of erythromycin lactobionate for injection samples from different manufactures were tested with methods stated in ChP and BP,and then compared and analyzed.Results:The items of related substances were determined by high performance liquid chromotographic methods in the ChP,EP and BP.The test methods and limits in the EP and BP were the same,which were different from that in ChP.The related substances were not determined in the USP and JP.There are obvious differences between the chromatographic methods and limits for the items of related substances in the ChP and BP,i.e.,BP contains 7 specific impuri-ties,while ChP contains only 2 specific impurities.The limits for any other impurity and the total amount of impurities were lower in the BP than those in the ChP.The antibiotic microbiological assay was used as the test method for the item of assay in the ChP,USP and JP based on different bacterial strains,which was different from the chromatographic method used in the BP.Based on the different methods of the ChP and BP,the related substances and content determination results of 7 batches of erythromycin lactobionate for injection samples met the acceptance criteria.The detection efficiency of BP related substances inspection method for specific impurities and total impurities were significantly higher than that of the ChP method.Conclusion:The BP method is superi-or to the ChP method in the detection of erythromycin lactobionate and erythromycin lactobionate for injection related substances.In terms of content determination,the external standard method adopted by BP is feasible to replace the antibiotic microbiological assay adopted by the ChP.Related substances and content determination methods adopted by the BP can provide an important reference for the revision and improvement of erythromycin lactobionate standard in the ChP.

Objective:To explore the expression level and clinical significance of serum Hsa_circ_0089761 in patients with cervical cancer.Methods:A total of 107 cervical cancer patients, 80 cervical intraepithelial neoplasia (CIN) patients, and 60 normal control group were selected and analyzed from January 2021 to March 2023 at the Ninth Affiliated People's Hospital of Shanghai Jiao Tong University School of Medicine. We compared the levels of serum Hsa_circ_0089761, squamous cell carcinoma antigen (SCCA), and carcinoembryonic antigen (CEA) among different groups, and analyzed the relationship between the expression level of serum Hsa_circ_0089761 and the clinical and pathological characteristics of cervical cancer. The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of serum Hsa_circ_0089761, SCCA, and CEA levels for cervical cancer. Pearson correlation analysis was used to evaluate the correlation between serum Hsa_circ_0089761 expression levels and SCCA and CEA in cervical cancer patients.Results:The expression levels of serum Hsa_circ_0089761[(2.96±0.95) vs (1.83±0.74), (0.92±0.41)], SCCA[(9.63±1.84)ng/ml vs (2.28±0.65)ng/ml, (1.30±0.27)ng/ml], and CEA[(6.47±2.20)ng/ml vs (1.61±0.57)ng/ml, (1.15±0.12)ng/ml] in the cervical cancer group were significantly higher than those in the CIN group and the control group (all P<0.001), and the serum Hsa_circ_0089761 expression levels in the CIN group were significantly higher than those in the control group ( P<0.001). Cervical cancer patients in stages Ⅲ-Ⅳ, with low differentiation, lymph node metastasis, infiltration depth ≥1/2 of the muscle layer, positive SCCA, and positive CEA had significantly higher levels of serum Hsa_circ_0089761 expression (all P<0.05). The ROC curve analysis showed that the specificity of diagnosing cervical cancer was highest (85.00%) for Hsa_circ_0089761 ≥2.25, and the area under the ROC curve (AUC) for diagnosing cervical cancer in combination with SCCA was highest (0.932, 95% CI: 0.874-0.993), with the highest accuracy (89.30%). The sensitivity of the combination of Hsa_circ_0089761+ SCCA+ CEA in diagnosing cervical cancer was highest (96.26%). The correlation analysis results showed that the serum Hsa_circ_0089761 expression levels in cervical cancer patients were positively correlated with SCCA ( r=0.775, P<0.001) and CEA ( r=0.613, P<0.001). Conclusions:The expression level of serum Hsa_circ_0089761 in cervical cancer patients is significantly increased, which is related to clinical and pathological characteristics. The combination of Hsa_circ_0089761 and SCCA detection has high value in the diagnosis of cervical cancer.

Objective To explore the prognostic value of serum interleukin-36(IL-36)family cyto-kines in patients with Guillain-Barre syndrome(GBS).Methods A retrospective trial was conduc-ted on 176 GBS patients admitted to our hospital from December 2020 to January 2023.According to their Hughes score at 6 months'follow-up,they were divided into good prognosis group(n=92)and poor prognosis group(n=84).Their general data were collected,and the levels of IL-36 family cytokines,such as IL-36α,IL-36β,IL-36γ and IL-36Ra were detected.Multivariate logistic regression analysis was employed to identify the influencing factors for poor prognosis of GBS patients,and ROC curve was plotted to analyze the predictive values of related factors.Results There were significant differences in age,injury types by electromyography(EMG),length of hospital stay and respiratory assisted ventilation between the two groups(P＜0.05,P＜0.01).The levels of IL-36α,IL-36β and IL-36γ were obviously higher while that of IL-36Ra was notably low-er in the poor prognosis group than the good prognosis group(P＜0.01).Multivariate logistic regression analysis showed that age,respiratory assisted ventilation,EMG injury types(myelin sheath and axon are damaged),and serum IL-36γ and IL-36Ra levels were independent influen-cing factors for poor prognosis of GBS patients(P＜0.05,P＜0.01).ROC curve analysis indicated that the AUC value of IL-36γ,IL-36Ra and their combination was 0.674(95％CI:0.599-0.742),0.862(95％CI:0.80 3-0.910)and 0.888(95％CI:0.832-0.931),respectively.Calibration positive curve analysis showed that the combined model of IL-36γ and IL-36Ra levels presented good con-sistency with the actual risk in predicting the risk of poor prognosis in GBS patients.Conclusion Age,respiratory assisted ventilation,EMG injury types(myelin sheath and axon are damaged),and IL-36γ and IL-36Ra levels are independently risk factors for poor prognosis of GBS patients.The combination of IL-36γ and IL-36Ra levels has a good predictive value for poor prognosis of GBS patients,and can be used as an effective indicator for the prediction.

Objective:To evaluate the effect of age factor on the potency of cisatracurium-induced neuromuscular block in the obese patients.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ obese patients, with a body mass index of 30-35 kg/m 2 and waist circumference (female ≥ 80 cm, male ≥ 90 cm), 40 elderly patients (age 65-75 yr) and 40 young and middle-aged patients (age 18-64 yr), scheduled for elective surgery with general anesthesia, were included in this study. Based on the random number table method, the patients were assigned into dosage groups of 40, 50, 60 and 70 μg/kg, served as OF1-4 groups and YF1-4 groups, with 10 patients in each group. The consumption of cisatracurium was calculated based on fat-free mass using a single-dose method. The neuromuscular block of cisatracurium was monitored by recording the response of the adductor pollicis muscle to TOF stimulation, the maximum suppression degree of T 1 and onset time were recorded using the Mindray BeneVision N17 monitor, and the dose-response relationship regression equation was developed to calculate the median effective dose. Results:There was no significant difference in the onset time among groups ( P>0.05). The median effective dose in elderly obese patients and young and middle-aged obese patients were 50.01 and 48.71 μg/kg, respectively, and there was no significant difference between the two groups ( P>0.05). Conclusions:There is no significant difference in the potency of cisatracurium-induced neuromuscular block between elderly obese patients and young and middle-aged obese patients, suggesting that age factor has no significant effect on it.