The paper introduced a few models characteristic of pharmaceutical service(PS)in the hospital,classifying the service applicable in the hospital into personalized PS based on time,social PS based on space,and connotative PS based on expertise.This way pharmacist,doctors and nurses can work as a close team,providing not only high quality PS to a greater population,but also personalized and integrated PS to patients of special needs.In the end,PS can help improve hospital quality of care in general.

Objective To detect the existence of gonadotropin-releasing hormone receptors(GnRH-R) in rat liver,and to supply morphological evidence for studying the functional significance of the GnRH in hepatocyte. Methods Immunohistochemical SABC method and in situ hybridization with a digoxigenin labeled probe were used to study the localization of GnRH-R in the livers of five rats. Results The rat hepatocytes were found with the GnRH-R immunoreactivity and GnRHR mRNA hybridization signals.The GnRH-R immunoreactive substance was distributed in the cytoplasm of all positive cells,with immuno-negative nuclei.The GnRHR mRNA hybridization signals were also detected in the cytoplasm of all positive cells but not in the nuclei.Hepatocytes in different parts of liver lobules showed different intensity of GnRH-R immunoreactivity and GnRH-R mRNA hybridization signals.Conclusion The rat hepatocyte may express GnRH-R.The hepatocytes in different parts in liver lobules exhibit different levels of GnRH-R expression.

Objective To explore the bias between the real pressure and the measured values when handheld pressure gauge (HPG) was used to monitor intermittently the pressure in the intubation balloon,so as to provide some measures for the correct use of HPG.Methods In the first part of the study,HPG was used to measure the pressure with the balloon connected with a three-way tube with which to control the inflation and deflation in a laboratory to measure the pressure in the air bag.After gaining the deviation in this in vitro experiment,it was tested and verified in vivo in adult patients undergoing endotracheal intubation.Results After 132 times of measurements,it was found that measurement with a HPG might result in an inherent loss (3.928 ± 0.291) cmH2O (1 cmH2O=0.098 kPa,t =155.273,P =0.000) between inflation value [(30.000 ± 0.000) cmH2O] and measured value [(26.072 ± 0.291) cmH2O].In addition,after 214 times repeated measurements,the pressure loss during disconnection of the gauge was as high as (1.196 ± 0.954) cmH2O (t=18.348,P=0.000) between filled values [(30.000 ± 0.000) cmH2O] and measured values [(28.804 ± 0.954) cmH2O] and it was named as error loss.At last,the total error was verified by clinical test,and it was (5.270 ± 2.583) cmH2O (t=29.632,P=0.000) between pressure of filled value [(30.000 ± 0.000) cmH2O] and measured value [(24.730 ± 2.583) cmH2O].Conclusions When the balloon pressure was Monitored intermittently with HPG,the real value should be the measured value plus the error.In addition,subglottic aspiration should be done before the connection of the balloon to the gauge to prevent the secretions on the cuff falls into the deeper airway,and to maintain the cuff pressure at 30 cmH2O.

Objective: To explore the therapeutic efficacy and safety of chemotherapy sequential epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) for advanced non-small cell lung cancer (NSCLC) patients with EGFR-TKI acquired resistance. Methods: The clinical features of 96 advanced NSCLC patients with EGFR mutation positive and EGFR-TKI acquired resistance from January 2013 to December 2016 were retrospectively reviewed. Forty-five patients who received chemotherapy sequential EGFR-TKI were enrolled in observation group, and another fifty-one who accepted chemotherapy alone were enrolled in control group. The objective response rates, disease control rates and adverse effects were compared between two groups. Results: Compared with that of the control group, the objective response rate of the observation group was significantly higher [24.4% (11/45) vs.11.8% (6/51), P=0.037], the disease control rate was also significantly increased [77.8% (35/45) vs.52.9% (27/51), P=0.023], the progression free survival was obviously prolonged [(7.4 ± 2.0) months vs.(4.5 ± 1.2) months, P=0.029], the incidence of rash in adverse reactions was significantly increased [35.6% (16/45) vs. 7.8%(4/51), P=0.008]. There were no significant difference in the side effects between the two groups (P > 0.05). Conclusions Compared with chemotherapy alone, chemotherapy combined with sequential EGFR-TKI could bring better clinical efficacy for NSCLC patients with EGFR-TKI acquired resistance, and the adverse effects could be tolerated.

Objective To evaluate the therapeutic effects and safety of acitretin for severe inherited keratodermas in children and adolescents. Methods Acitretin was given to 23 children and adolescents with either lamellar ichthyosis, bulbous ichthyosiform erythroderma, pityriasis rubra pillars, progressive sym- metrical erythrokeratoderma, keratitis ichthyosis deafness syndrome, generalized porokeratosis, inflammatory liner verrucous epidermal nevus, ichthyosis hystrix and non-bullous ichthyosiform erythroderma. The thera- peutic dosage was 0.67-1.07 mg/(kg?d),and maintenance dosage 0.08-0.94 mg/(kg?d).The effects on the patients' growth and development of the drug were evaluated based on the changes of body weight and height in the children. The total follow-up period was 6-35 months in an interval of 1-3 months. Results The considerable overall improvement was achieved after 1-6 months' treatment, with an overall clinical cure rate of 82.6%. Only one case responded poorly to the therapy. The excellent responses were observed in patients with bulbous ichthyosiform erythroderma, lamellar ichthyosis, and pityriasis rubra pillars, etc, and the much poor responses in ichthyosis hystrix. The most frequent adverse reaction was mild to moderate dry lips (65.2%),the next were pruritus(39.1%),skin fragility(34.8%),and dry mouth(30.4%).The less frequent adverse reactions were alopecia(13%),anorexia(8.7%),headache (4.3%) and hypoacusis (4.3%).No effects on the growth and development were found in those children during the follow up period. Conclusions The considerable overall improvement is achieved with the acitretin therapy for children and adolescents with inherited keratodermas, with only mild to moderate adverse reactions and no effects on the growth and development in the children.

Objective　To investigate the clinical and neuroimaging features of dementia with Lewy bodies (DLB).Methods　The clinical data of 26 patients with DLB were retrospectively analyzed.Results　The initial symptoms were cognitive symptoms (65%),Parkinsonism (19%),or both.In the clinical manifestations,38% of patients showed fluctuating cognition,77% showed Parkinsonism,62% showed hallucinations,and 50% showed rapid eye movement sleep behavior disorder,65% showed severe autonomic dysfunction.59% of the patients revealed the preservation of hippocampal structures on MRI scan.In addition,FDG PET showed hypo-metabolism in bilateral parietal and occipital lobe in 7 patients,and CFT PET demonstrated reduced dopamine transporter uptake in the basal ganglia in 2 patients.Conclusion　Cognitive impairment was the initial symptoms in most patients with DLB,and the clinical symptoms were characterized by Parkinsonism,hallucinations,rapid eye movement sleep behavior disorder and psychiatric symptoms.Neuroimaging examination including MRI and PET scan were useful to diagnose.

Objective:To investigate the clinicopathological features and differential diagnosis of eosinophilic vacuolated tumor (EVT).Methods:Seven cases of EVT with characteristic morphology and unequivocal diagnosis from the Affiliated Hospital of Qingdao University (6 cases), Qingdao, China and the 971 Hospital of PLA Navy (1 case), Qingdao, China between January 2010 and December 2021 were subject to morphological and immunohistochemical analyses. Additionally, whole exome sequencing (WES) was performed in two cases. Twenty-two cases of renal oncocytoma (RO) and 17 cases of eosinophilic chromophobe renal cell carcinoma (eChRCC) diagnosed at the same time were used as controls.Results:Four males and three females with a mean age of 42 years (range: 29-61 years) were included in the study. The tumors were nodular and well-circumscribed, with sizes ranging from 1.5 to 4.5 cm. On cross-section, they appeared gray-red or gray-white, solid, and soft. Tumor cells were arranged in nests, solid sheets, and acinar or small vesicular structures. These cells exhibited eosinophilic cytoplasm with large, prominent clear vacuoles and round nuclei with prominent nucleoli. Perinuclear halos were focally present in four cases, while small tumor cells with sparse cytoplasm and hyperchromatic nuclei were seen in one case. No necrosis or mitosis was noted. Edematous stroma was detected in three cases. All tumors were positive for CD117 and Cathepsin K, but negative for vimentin and CK7. CK20 was positive in scattered individual cells, and Ki-67 positivity ranged from 1% to 4%. Point mutations in MTOR were identified in both patients who were subject to the molecular analysis. Statistical differences in the expression of Cathepsin K, CD10, S-100A1, and Cyclin D1 between EVT and RO ( P<0.05) were significant, so were the differences in the expression of Cathepsin K, CD10, CK7 and claudin 7 between EVT and eChRCC ( P<0.001). Seven patients were followed up for 4 to 96 months (mean, 50 months), with no recurrences or metastases. Conclusions:EVT is a rare renal tumor that shares morphological and immunophenotypic features with RO and eChRCC, and it is closely linked to the TSC/MTOR pathway. The presence of large prominent transparent vacuoles in eosinophilic cytoplasm along with conspicuous nucleoli is its key morphological characteristics. The use of combined immunohistochemical stains greatly aids in its diagnosis. Typically, the tumor exhibits indolent biological behaviors with a favorable prognosis.

Objective:To investigate the cognitive status of nurses at different levels of comprehensive hospitals in Zhuhai regarding dysphagia in the elderly and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 554 nurses from departments with frequent dysphagia in 8 general hospitals in Zhuhai were selected as the research objects from June to July 2021. The Self-made General Data Questionnaire and Questionnaire of Nurses' Cognition of Dysphagia in the Elderly were used to investigate. Multiple stepwise linear regression analysis was used to analyze the factors influencing nurses' cognition of dysphagia in the elderly. A total of 554 questionnaires were collected in this study, of which 515 were valid, with an effective rate of 92.96%.Results:The total cognitive score of 515 elderly nurses with dysphagia was 94.64 (87.50, 100.00). Multiple stepwise linear regression analysis showed that hospital level, frequency of dysphagia knowledge training, and initial education background of nurses were the influencing factors for nurses' cognition of dysphagia in the elderly ( P<0.05) . Conclusions:The higher the hospital level, the more the training times and the higher the initial education background of nurses, the higher the cognition level of elderly patients with dysphagia.

This study aimed to explore the link between block copolymers' interfacial properties and nanoscale carrier formation and found out the influence of length ratio on these characters to optimize drug delivery system. A library of diblock copolymers of PEG-PCL and triblock copolymers with additional PEI (PEG-PCL-PEI) were synthesized. Subsequently, a systematic isothermal investigation was performed to explore molecular arrangements of copolymers at air/water interface. Then, structural properties and drug encapsulation in self-assembly were investigated with DLS, SLS and TEM. We found the additional hydrogen bond in the PEG-PCL-PEI contributes to film stability upon the hydrophobic interaction compared with PEG-PCL. PEG-PCL-PEI assemble into smaller micelle-like (such as PEG-PCL4006-PEI) or particle-like structure (such as PEG-PCL8636-PEI) determined by their hydrophilic and hydrophobic block ratio. The distinct structural architectures of copolymer are consistent between interface and self-assembly. Despite the disparity of constituent ratio, we discovered the arrangement of both chains guarantees balanced hydrophilic-hydrophobic ratio in self-assembly to form stable construction. Meanwhile, the structural differences were found to have significant influence on model drugs incorporation including docetaxel and siRNA. Taken together, these findings indicate the correlation between molecular arrangement and self-assembly and inspire us to tune block compositions to achieve desired nanostructure and drug loading.

Human embryonic stem cells (hESCs) depend on glycolysis for energy and substrates for biosynthesis. To understand the mechanisms governing the metabolism of hESCs, we investigated the transcriptional regulation of glucose transporter 1 (GLUT1, SLC2A1), a key glycolytic gene to maintain pluripotency. By combining the genome-wide data of binding sites of the core pluripotency factors (SOX2, OCT4, NANOG, denoted SON), chromosomal interaction and histone modification in hESCs, we identified a potential enhancer of the GLUT1 gene in hESCs, denoted GLUT1 enhancer (GE) element. GE interacts with the promoter of GLUT1, and the deletion of GE significantly reduces the expression of GLUT1, glucose uptake and glycolysis of hESCs, confirming that GE is an enhancer of GLUT1 in hESCs. In addition, the mutation of SON binding motifs within GE reduced the expression of GLUT1 as well as the interaction between GE and GLUT1 promoter, indicating that the binding of SON to GE is important for its activity. Therefore, SON promotes glucose uptake and glycolysis in hESCs by inducing GLUT1 expression through directly activating the enhancer of GLUT1.