We provided pharmaceutical care for a cryptococcal meningitis case to study the role that clinical pharmacists played in clinical pharmacotherapy.In this case,clinical pharmacists gave advice on drug therapy strategy which was mostly accepted by physicians.During the whole course of drug treatment,focused on monitoring,prevention,and treatment of adverse reactions,clinical pharmacists carried out pharmaceutical care on efficacy,safety,economics and compliance of drug therapy.After 73 days' treatment,with CSF cryptococcal count negative twice and physical condition improved,the patient was discharged.No serious adverse reaction was observed in the period of treatment.The total pharmaceutical care was completed as planned.Through participating in the formulation of treatment strategy and carrying out pharmaceutical care,clinical pharmacists can play a role in improving the efficacy and safety of drug therapy in cryptococcal meningitis.Abstract:SUMM ARY W e provided pharmaceutical care for a cryptococcal meningitis case to study the role that clinical pharmacists played in clinical pharmacotherapy.In this case,clinical pharmacists gave advice on drug therapy strategy which was mostly accepted by physicians.During the whole course of drug treat-ment,focused on monitoring,prevention,and treatment of adverse reactions,clinical pharmacists carried out pharmaceutical care on efficacy,safety,econom ics and compliance of drug therapy.After 73 days’ treatment,with CSF cryptococcal count negative twice and physical cond ition improved,the patientwas d ischarged.No serious adverse reaction was observed in the period of treatment.The total pharmaceutical care was completed as planned.Through participating in the formulation of treatment strategy and carrying out pharmaceutical care,clinical pharmacists can play a role in improving the efficacy and safety of drug therapy in cryptococcalmeningitis.

Objective To evaluate the effect of propofol on local field potential of prefrontal cortex in rats in order to investigate the reason why pmpefol leads to cognitive dysfunction.Methods Thirty healthy male SD rats weighing 190-230 g were randomly divided into 3 groups(n=10 each):intralipid group(group C),low dose propofol group(group P1)and high dose propofol group(group P2).In group C,P1 and P2,10% intralipid 0.01 ml·kg-1·min-1,pmpofol 0.1 mg·kg-1·min-1,and propofol 0.5 mg·kg-1·min-1 were infused iv through the caudal vein for 2h respectively.The modified Morris water-maze (MWM) test was performed twice a day for 5 consecutive days one day after administration.The escape latency,swimming time in platform quadrant,percentage of swimming distance in platform quadrant in the total swimming distance and the fLrst central point were recorded.Propofol 0.1 and 0.5 mg·kg-1·min-1 were infused iv in group P1 and P2 respectively 14 days after propfol administration.Local field potential of prefrontal cortex was recorded at 1-2 h of administration.Results Compared with group C and P1,the escape latency was prolonged,the swimming time in platform quadrant was shortened,and the percentage of swimming distance in platform quadrant in the total swimming distance and the first central point were signifieandy decreased in group P2(P<0.05).The complexity and power spectrum were significantly lower in group P2 than in group P1(P<0.05).Conclusion The high dose of propofol Can inhibit prefrontal cortex neuronal discharge activity to result in cognitive dysfunction.

OBJECTIVE:To establish the method for simultaneous determination of gallic acid,rosmarinic acid,liquiritin and ammonium glycyrrhetate in Regan saibisitan granules. METHODS:RP-HPLC method was adopted. The determination was per-formed on Waters RP-C18 column with mobile phase consisted of acetonitrile-0.2% phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelengths were 210 nm(gallic acid,rosmarinic acid and liquiritin),230 nm(ammonium glyc-yrrhetate). The column temperature was 28 ℃,and sample size was 20 μL. RESULTS:The linear ranges were 0.2744-7.546 μg for gallic acid(r=0.9998),0.1870-5.143 μg for rosmarinic acid(r=0.9996),0.1300-3.575 μg for liquiritin(r=0.9999)and 0.2540-6.985μg for ammonium glycyrrhetate(r=0.9998),respectively. The LOQ were 2.67,1.36,1.09 and 2.11 ng,respective-ly. The LOD were 1.03,0.62,0.87 and 0.91 ng,respectively. RSDs of precision,stability and repeatability tests were all less than 2.0%. The average recoveries were 97.26%-101.00%(RSD=1.1%,n=9),97.66%-101.80%(RSD=1.3%,n=9),97.45%-101.70%(RSD=1.4%,n=9),97.74%-101.70%(RSD=1.4%,n=9). CONCLUSIONS:The method is simple,accurate and reproducible, and can be applied for simultaneous determination of gallic acid,rosmarinic acid,liquiritin and ammonium glycyrrhetate in Regan saibisitan granules.

This paper summarized Professor PENG Peichu's experience in the differentiation and treatment of prostate cancer in three phases and four stages. It is considered that prostatic cancer is categorized into root deficiency and branch excess， with depletion of healthy qi as the root， and the accumulation of cancer toxin as the minifestation. Clinical diagnosis and treatment of prostatic cancer can be divided into three phases and four stages according to the exuberance and decline of pathogenic and healthy qi and the changes of deficiency and excess of yin and yang. In the initial accumulation phase of cancer toxin （yang excess stage）， the key pathogenesis is the accumulation of dampness， heat and static blood， and internal generation of cancer toxin， and the treatment should be resolving toxins， fighting cancer and dispelling yang excess. In the phase of healthy qi deficiency and toxin accumulation （yin deficiency stage）， with the lung and kidney yin deficiency， dampness， heat and static toxin accumulation as the key pathogenesis， the treatment should be centered on mutual generation between metal and water to nourish kidney yin， supplemented with the method of clearing heat and draining dampness， activating blood and resolving toxins， for which self-made Nanbei Formula（南北方）is usually used. In the phase of yang deficiency and cold stagnation （yang deficiency stage and yin excess stage）， with the spleen and kidney yang deficiency， cold dampness stagnation， static heat and toxin accumulation as the key pathogenesis， the treatment should be warming and tonifying spleen and kidney to dissipate cold accumulation； for deficiency of both yin and yang， and excess pathogen obstruction， modified Yanghe Decoction（阳和汤） is recommended， while for yang deficiency， cold congealing and blood stasis， self-made Wenshen Sanjie Formula（温肾散结方） can be used， and for cold dampness binding with cancer toxin， and cold complex with heat， self-made Quanan Formula （泉安方） is advised.

Objective:To investigate the effect of pelvic floor muscle exercise (PFMT) combined with transcutaneous electrical nerve stimulation (TENS) on urinary incontinence after radical prostatectomy.Methods:A total of 120 patients with urinary incontinence after radical prostatectomy in Shuguang Hospital, Shanghai University of Traditional Chinese Medicine from July 2020 to June 2021 were retrospective selected and divided into control group and observation groupthe according to different treatment method, 60 cases in each group. The control group was treated with PFMT, and the observation group was treated with PFMT combined with TENS. Urodynamic indexes of 72 h urine pad usage, maximum urine flow rate, maximum cystometric capacity, maximum urethral closure pressure, abdominal leakage point pressure, ICI-Q-SF score and the clinical efficacy were compared between the two groups. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; Chi-square test was used for comparison of enumeration data between groups. Results:After treatment, the 72 h urine urine pad usage in the observation group [(1.95±1.13) pieces] was lower than that in the control group [(6.28±2.47) pieces], and the difference was statistically significant ( P<0.05). After treatment, the maximum flow rate [(13.92±2.53) mL/s], maximum cystometric capacity [(338.72±19.22) mL], maximum urethral closure pressure [(69.75±5.04) cmH 2O], abdominal leakage point pressure [(90.56±5.26) cmH 2O] in observation group after treatment were better than those in control group [(11.48±2.18) mL/s, (325.81±18.63) mL, (65.29±4.78) cmH 2O, (83.58±5.29) cmH 2O], the difference were statistically significant ( P<0.05). After treatment, the ICI-Q-SF score of the observation group [(5.97±1.82) points] was lower than that of the control group [(10.95±2.64) points], and the difference was statistically significant ( P<0.05); the clinical effective rate of observation group (93.33%) was higher than that of control group (78.33%), and the difference was statistically significant ( P<0.05). Conclusion:PFMT combined with TENS is better than PFMT alone in the treatment of postoperative urinary incontinence after radical prostatectomy.

Objective:To evaluate the strategy and skills of reoperation for recurrent carcinoma at the stoma of esophagojejunostomy after total gastrectomy.Methods:The management experience in 18 patients at the Department of General Surgery, Tumor Hospital of Zhengzhou University from Oct 2016 to Jul 2021 were analyzed retrospectively.Results:Thirteen patients underwent left thoracoabdominal combined incision to completely remove the tumor.One patient developed anastomotic leakage, two patients developed pulmonary infection, one patient developed costochondritis, all were cured and discharged after conservative treatment; Nine patients had no postoperative complications. Two patients abandoned surgery due to high position of the tumor, 3 patients due to poor cardiopulmonary function, and were given radiotherapy and chemotherapy.The postoperative follow-up period was 4.6 to 42.9 months. Four patients died of tumor recurrence, and the remaining patients survived until the end of the follow-up. The overall 1-and 3-year recurrence-free survival rates were 100% and 20%, respectively.Conclusion:Surgery on recurrent carcinoma at esophagojejunostomy stoma after total gastrectomy, although difficult and challenging,could still benefit most patients when at the hands of expertise.

Specnuezhenide(SNZ)is among the main components of Fructus Ligustri Lucidi,which has anti-inflammation,anti-oxidation,and anti-tumor effect.The low bioavailability makes it difficult to explain the mechanism of pharmacological effect of SNZ.In this study,the role of the gut microbiota in the metabolism and pharmacokinetics characteristics of SNZ as well as the pharmacological meaning were explored.SNZ can be rapidly metabolized by the gut microbiome,and two intestinal bacterial metabolites of SNZ,salidroside and tyrosol,were discovered.In addition,carboxylesterase may be the main intestinal bacterial enzyme that mediates its metabolism.At the same time,no metabolism was found in the incubation system of SNZ with liver microsomes or liver homogenate,indicating that the gut microbiota is the main part involved in the metabolism of SNZ.In addition,pharmacokinetic studies showed that salidroside and tyrosol can be detected in plasma in the presence of gut microbiota.Interestingly,tumor development was inhibited in a colorectal tumor mice model administered orally with SNZ,which indicated that SNZ exhibited potential to inhibit tumor growth,and tissue distribution studies showed that salidroside and tyrosol could be distributed in tumor tissues.At the same time,SNZ modulated the structure of gut microbiota and fungal group,which may be the mechanism governing the antitumoral activity of SNZ.Furthermore,SNZ stimulates the secretion of short-chain fatty acids by intestinal flora in vitro and in vivo.In the future,targeting gut microbes and the interaction between natural products and gut microbes could lead to the discovery and development of new drugs.

Nanoparticulate drug delivery systems (Nano-DDSs) have emerged as possible solution to the obstacles of anticancer drug delivery. However, the clinical outcomes and translation are restricted by several drawbacks, such as low drug loading, premature drug leakage and carrier-related toxicity. Recently, pure drug nano-assemblies (PDNAs), fabricated by the self-assembly or co-assembly of pure drug molecules, have attracted considerable attention. Their facile and reproducible preparation technique helps to remove the bottleneck of nanomedicines including quality control, scale-up production and clinical translation. Acting as both carriers and cargos, the carrier-free PDNAs have an ultra-high or even 100% drug loading. In addition, combination therapies based on PDNAs could possibly address the most intractable problems in cancer treatment, such as tumor metastasis and drug resistance. In the present review, the latest development of PDNAs for cancer treatment is overviewed. First, PDNAs are classified according to the composition of drug molecules, and the assembly mechanisms are discussed. Furthermore, the co-delivery of PDNAs for combination therapies is summarized, with special focus on the improvement of therapeutic outcomes. Finally, future prospects and challenges of PDNAs for efficient cancer therapy are spotlighted.

Stimulus-specific adaptation (SSA), defined as a decrease in responses to a common stimulus that only partially generalizes to other rare stimuli, is a widespread phenomenon in the brain that is believed to be related to novelty detection. Although cross-modal sensory processing is also a widespread phenomenon, the interaction between the two phenomena is not well understood. In this study, the thalamic reticular nucleus (TRN), which is regarded as a hub of the attentional system that contains multi-modal neurons, was investigated. The results showed that SSA existed in an interactive oddball stimulation, which mimics stimulation changes from one modality to another. In the bimodal integration, SSA to bimodal stimulation was stronger than to visual stimulation alone but similar to auditory stimulation alone, which indicated a limited integrative effect. Collectively, the present results provide evidence for independent cross-modal processing in bimodal TRN neurons.
Acoustic Stimulation ; Animals ; Auditory Perception/physiology* ; Geniculate Bodies ; Rats ; Rats, Wistar ; Thalamic Nuclei/physiology*