OBJECTIVE To explore the transformation of the dispensing and drug pickup process in traditional Chinese medicine pharmacy （TCM Pharmacy） in our hospital based on data-intelligence-driven， aiming to improve pharmacists’ work efficiency and patients’ drug pickup experience. METHODS Value stream mapping and journey mapping were used to systematically identify non-value-added links in pharmacists’ dispensing process and key pain points in patients’ drug pickup under the traditional process. An intelligent dispensing and drug pickup system for the TCM Pharmacy was developed based on the C# and Android television platforms， and a machine-learning model was adopted to predict patients’ drug pickup waiting time. A comprehensive evaluation was performed from three perspectives： system performance， prediction accuracy， and satisfaction of pharmacists and patients. RESULTS The system successfully streamlined non-value-added links such as “waiting for writing on the board” and “searching for drugs”， and realized multimodal dynamic prompts of dispensing status through auditory （number calling） and visual （television terminal） channels. The constructed model for predicting drug pickup waiting time exhibited good fitting degree and generalization ability （mean absolute error＝4.28 min， R 2 ＝0.882）. The comprehensive satisfaction scores of pharmacists and patients in the traditional mode were significantly increased from （70.99±1.74） and （73.58±1.98） to （90.02±1.30） and （88.61±2.08） in the new system， respectively （ P ＜0.01）. CONCLUSIONS The transformation of the intelligent drug dispensing and pickup system for TCM pharmacy based on data-intelligence-driven effectively improves the efficiency of pharmacists’ dispensing work， realizes process transparency and waiting time predictability， and significantly enhances patients’ drug pickup experience.

Objective:To analyze the therapeutic effect of ganglioside combined with hyperbaric oxygen in the treatment of cerebral hemorrhage. To investigate the effects of ganglioside combined with hyperbaric oxygen therapy on serum inflammatory factors and neural injury markers in patients.Methods:A randomized controlled study was conducted involving 98 patients with cerebral hemorrhage treated at Bayannur Hospital from January 2022 to January 2024. The patients were randomly assigned to either a control group or a combination group, with 49 cases in each group, using a random number table method. All patients received routine treatment. The control group received hyperbaric oxygen therapy, while the combination group received both hyperbaric oxygen therapy and ganglioside therapy. Both groups were treated for 20 days. The volume of cerebral edema, levels of serum inflammatory factors, and neural injury markers were compared between the two groups before and after treatment, and the efficacy of both groups was evaluated.Results:After treatment, the brain edema volume in the combination group [(12.31 ± 1.31) cm3]was significantly lower than that in the control group [(15.36 ± 1.62) cm3, t = 10.25, P < 0.05]. The Glasgow Coma Scale score in the combination group [(13.64 ± 1.37) points] was significantly higher than that in the control group [(11.42 ± 1.24) points, t = -8.41, P < 0.05]. The serum levels of interleukin-1β and interleukin-8 in the combination group were (5.48 ± 0.56) ng/L and (12.29 ± 1.33) ng/L, respectively, both of which were significantly lower than those in the control group [(6.42 ± 0.67) ng/L, (16.85 ± 1.71) ng/L, t = 7.54, 14.74, both P < 0.05]. The levels of soluble protein-100β (S100β) and high mobility group protein-1 in the combination group were (0.62 ± 0.07) μg/L and (4.17 ± 0.42) μg/L, respectively, both of which were significantly lower than those in the control group [(0.81 ± 0.09) μg/L, (5.59 ± 0.56) μg/L, t = 11.67, 14.20, both P < 0.05]. The National Institutes of Health Stroke Scale score in the combination group [(11.47 ± 1.23) points]was significantly lower than that in the control group [(15.31 ± 1.62) points, t = 13.22, P < 0.05]. The Fugl-Meyer Assessment of Motor Recovery after Stroke score in the combination group [(63.58 ± 6.48) points] was significantly higher than that in the control group [(54.64 ± 5.71) points, t = -7.25, P < 0.05]. The total response rate in the combination group was 91.84% (45/49), which was significantly higher than that in the control group [73.47% (36/49), χ2 = 5.76, P < 0.05]. Conclusions:The use of gangliosides in combination with hyperbaric oxygen therapy for the treatment of cerebral hemorrhage can effectively reduce cerebral edema, lessen inflammatory responses, and minimize neural injury. This approach helps restore patients' neurological and motor functions and enhance overall treatment efficacy.

Diaphragmatic dysfunction often occurs in ICU patients with prolonged mechanical ventilation, which seriously affects patients′prognosis. This article reviewed the progress of rehabilitation treatment of diaphragmatic dysfunction in ICU patients with mechanical ventilation, focused on the concept and assessment of diaphragm rehabilitation, the current status, evaluation indexes, emphasized the importance of nurses, analyzed the dilemmas and countermeasures in the application, which aimed to provide a reference for the promotion of diaphragm rehabilitation in clinical practice.

Artificial intelligence(AI)has emerged as a cutting-edge technology leading the future and is a key engine for China's development.In the innovation and research of medical devices,AI has provided critical support in the areas of intelligent diagnostic assistance,intelligent therapeutic assis-tance,intelligent monitoring,life support,et al.Ma-chine learning-enabled device software functions(ML-DSFs)have become an essential component of many medical devices.Recently,the United States Food and Drug Administration(FDA)released a draft guidance titled"Marketing Submission Rec-ommendations for a Predetermined Change Con-trol Plan for Artificial Intelligence/Machine Learn-ing(AI/ML)-Enabled Device Software Functions(Draft)."that aimed to provide a forward-looking approach to foster the development of ML medical devices.By supporting iterative updates through modifications,this approach ensures the continu-ous safety and effectiveness of the devices.This guidance represents the latest in regulatory direc-tion and is especially beneficial for enhancing the quality and efficiency of clinical trials for AI prod-ucts.Therefore,we plan to provide a detailed intro-duction and interpretation of the guidance,with the aim of learning from international advanced regulatory concepts and experiences to promote the development of ML-DSFs with more profound international influence.

The aim of this study was to investigate the mechanism of quercetin in inhibiting the fer-roptosis induced by zearalenone(ZEN)via mediating the nuclear factor erythroid-2-related factor 2(Nrf2)/glutathione peroxidase 4(GPX4)signaling pathway.IPEC-J2 cells were cultured in vitro and treated with ZEN(25 mg/L)and different concentrations of quercetin(10,20,40 μmol/L).Bi-ochemical methods were used to detect the levels of lactate dehydrogenase(LDH)in the cell cul-ture medium supernatant,total antioxidant capacity(T-AOC),superoxide dismutase(SOD),glu-tathione(GSH),and malondialdehyde(MDA).Fluorescence probes were used to detect the levels of Fe2+,reactive oxygen species(ROS),and lipid peroxidation.Western blot was performed to de-tect the expression levels of Nrf2,long chain acyl CoA synthetase 4(ACSL4),and GPX4.The IPEC-J2 cells were divided into the control group,ZEN group,quercetin group,and ML385(Nrf2 inhibitor)+quercetin group for further analysis.Except for the control group,the other groups were treated with ZEN in the prescence of quercetin and ML385.The changes of Nrf2/GPX4 path-way-related proteins and ferroptosis-related indexes(LDH,Fe2+,MDA,and GSH)were detected.Compared with the control group,IPEC-J2 cells in the ZEN group exhibited a decrease in cell via-bility,T-AOC,and GSH,SOD levels,Nrf2,and GPX4 protein expressions(P＜0.05),while LDH release rate,Fe2+and ROS,lipid peroxidation,MDA levels,and ACSL4 protein expression de-creased in the ZEN group(P＜0.05).Compared with ZEN group,the cell viability,the levels of T-AOC,SOD and GSH,the protein expression of Nrf2 and GPX4 in quercetin groups were increased(P＜0.05),while the LDH release rate,the levels of Fe2+,ROS,lipid peroxidation,and MDA as well as the protein expression of ACSL4 were decreased(P＜0.05).Compared with the quercetin group,the protein expression of Nrf2 and GPX4 and the level of GSH in ML385+quercetin group reduced(P＜0.05),the LDH release rate and the levels of Fe2+and MDA increased(P＜0.05).In summary,quercetin could inhibit ZEN-induced ferroptosis of IPEC-J2 cells,and its mechanism may be related to the induction of Nrf2/GPX4 signaling pathway.

OBJECTIVE To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)after COVID-19 epidemic so as to offer help for early clinical diagnosis and treatment.METHODS The clinical data that were collected from the MPP patients who were treated in the fever clinic of the First Medical Center of Chinese PLA General Hospital from Jul.2023 to Aug.2024 were retrospectively analyzed.The results of laboratory tests for the different age groups of patients complicated with other pathogens were statistically analyzed.RESULTS Of totally 161 MPP patients who were enrolled in the study,78(48.85％)were male,and 83(51.55％)were fe-male;the average age was(32.98±14.35)years old,and the patients aged between 20 and 40 years old accoun-ted for 43.48％(70 cases).The enrolled patients were divided into the simple MPP group with 92(57.14％)ca-ses and the MPP+mixed group with 69(42.86％)cases according to the result of etiological test of sputum;the patients of MPP+mixed group were divided into the MPP+bacteria group with 42(60.87％)cases,the MPP+fungi group with 10(14.49％)cases,and the MPP+viruses group with 17(24.64％)cases.There was significant difference in the age among the groups(P＜0.05);there were no significant differences in the sex,white blood cell counts and percentage of mononuclear cells among the groups,the percentage of lymphocytes was highest in the simple MPP group,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were highest in the MPP+bacteria group,and there were significant differences(P＜0.05).All of the patients were divided into three groups:the ≤20-year-old group the＞20-40-year old group and the＞40-year-old group.There were no sig-nificant differences in the white blood cell counts,percentage of lymphocytes,percentage of mononuclear cells and IL-6 level among the three groups,and the CRP level was highest in the＞20-40-year old group(P=0.025).Ran-dom forest model analysis showed that the weight of CRP was highest(22.65％)among the clinical characteristics of the MPP patients,which played a key role in construction of model.As for other factors,the weight of age was 17.02％,the percentage of lymphocytes 15.34％,the white blood cells counts 14.86％,the percentage of mono-nuclear cells 14.39％,the IL-6 13.61％,the gender 2.13％.CONCLUSION MPP maintains common among the patients aged less than 40 years old after the COVID-19 epidemic,nearly half of the patients are complicated with the infections of other pathogens,and CRP is more helpful for the clinical diagnosis and treatment of the MPP in early stage.

Objective To investigate the neuroprotective effect of Tibetan medicine 70 Wei Pearl Pill(RNSP)on 6-hydroxydopamine(6-OHDA)induced Parkinson's disease model rats and its related mechanism.Methods Totally 48 male SD rats were randomly divided into control group,model group,model plus low-dose RNSP group(90 mg/kg),model plus medium-dose RNSP group(180 mg/kg),model plus high-dose RNSP group(360 mg/kg),and model plus madopar group(50 mg/kg),with 8 rats in per group.Except for the control group,the other rats were treated with 6-OHDA single injection into the striatum to establish the PD model.Each group was given intragastric administration after modeling and the control group and model group were given an equal volume of saline once a day for 4 weeks.The rats were subjected to apomorphine-induced rotation,experiments at the 2nd and 4th week after the completion of modeling,and the open field experiment was conducted the next day after the last rotation experiment to observe the animal behavior.After the behavioral experiment,the rats were stained with tyrosine hydroxylase(TH)in the substantia nigra pars compacta by immunohistochemical method and the positive neurons were counted.The protein levels of Bcl-2,BAX,Caspase-3 in substantia nigra and P38,P-P38,ERK,P-ERK,JNK,P-JNK in the striatum were detected by Western blotting.Results Compared with the control group,the rotation frequency and percentage of rotating rats in the model group increased significantly at the 2nd and 4th weeks after modeling;the open field active distance,average speed and times of crossing the grid were significantly decreased;and the rest time was significantly increased.While the number of TH positive neurons in the substantia nigra was significantly decreased,the BAX and Caspase-3 protein levels were increased significantly,Bcl-2 was decreased significantly,the ratios of P-P38/P38,P-JNK/JNK and P-ERK/ERK in the striatum were significantly increased in PD group.Compared with the model group,the rotation frequency and percentage of rotating rats in the low-,medium-and high-dose groups of RNSP had no significant changes after 2 weeks of administration,the rotation frequency in the high-dose group and percentage of rotating rats in the low-and medium-dose RNSP groups significantly decreased after 4 weeks of administration.The open field active distance,average speed,and times of crossing the grid were significantly increased;the rest time was significantly decreased.The number of TH positive neurons in the substantia nigra was significantly increased,the Bax and Caspase-3 protein levels were decreased significantly while the Bcl-2 was significantly increased.The ratios of P-P38/P38,P-JNK/JNK and P-ERK/ERK in the striatum were significantly decreased.Conclusion Tibetan medicine RNSP can improve the motor ability and reduce the loss of DA neurons in PD rats,and its mechanism may be related to inhibiting P38/JNK/ERK signaling pathway and reducing the apoptosis of midbrain neurons.

Objective:To analyze the therapeutic effect of ganglioside combined with hyperbaric oxygen in the treatment of cerebral hemorrhage. To investigate the effects of ganglioside combined with hyperbaric oxygen therapy on serum inflammatory factors and neural injury markers in patients.Methods:A randomized controlled study was conducted involving 98 patients with cerebral hemorrhage treated at Bayannur Hospital from January 2022 to January 2024. The patients were randomly assigned to either a control group or a combination group, with 49 cases in each group, using a random number table method. All patients received routine treatment. The control group received hyperbaric oxygen therapy, while the combination group received both hyperbaric oxygen therapy and ganglioside therapy. Both groups were treated for 20 days. The volume of cerebral edema, levels of serum inflammatory factors, and neural injury markers were compared between the two groups before and after treatment, and the efficacy of both groups was evaluated.Results:After treatment, the brain edema volume in the combination group [(12.31 ± 1.31) cm3]was significantly lower than that in the control group [(15.36 ± 1.62) cm3, t = 10.25, P < 0.05]. The Glasgow Coma Scale score in the combination group [(13.64 ± 1.37) points] was significantly higher than that in the control group [(11.42 ± 1.24) points, t = -8.41, P < 0.05]. The serum levels of interleukin-1β and interleukin-8 in the combination group were (5.48 ± 0.56) ng/L and (12.29 ± 1.33) ng/L, respectively, both of which were significantly lower than those in the control group [(6.42 ± 0.67) ng/L, (16.85 ± 1.71) ng/L, t = 7.54, 14.74, both P < 0.05]. The levels of soluble protein-100β (S100β) and high mobility group protein-1 in the combination group were (0.62 ± 0.07) μg/L and (4.17 ± 0.42) μg/L, respectively, both of which were significantly lower than those in the control group [(0.81 ± 0.09) μg/L, (5.59 ± 0.56) μg/L, t = 11.67, 14.20, both P < 0.05]. The National Institutes of Health Stroke Scale score in the combination group [(11.47 ± 1.23) points]was significantly lower than that in the control group [(15.31 ± 1.62) points, t = 13.22, P < 0.05]. The Fugl-Meyer Assessment of Motor Recovery after Stroke score in the combination group [(63.58 ± 6.48) points] was significantly higher than that in the control group [(54.64 ± 5.71) points, t = -7.25, P < 0.05]. The total response rate in the combination group was 91.84% (45/49), which was significantly higher than that in the control group [73.47% (36/49), χ2 = 5.76, P < 0.05]. Conclusions:The use of gangliosides in combination with hyperbaric oxygen therapy for the treatment of cerebral hemorrhage can effectively reduce cerebral edema, lessen inflammatory responses, and minimize neural injury. This approach helps restore patients' neurological and motor functions and enhance overall treatment efficacy.

Diaphragmatic dysfunction often occurs in ICU patients with prolonged mechanical ventilation, which seriously affects patients′prognosis. This article reviewed the progress of rehabilitation treatment of diaphragmatic dysfunction in ICU patients with mechanical ventilation, focused on the concept and assessment of diaphragm rehabilitation, the current status, evaluation indexes, emphasized the importance of nurses, analyzed the dilemmas and countermeasures in the application, which aimed to provide a reference for the promotion of diaphragm rehabilitation in clinical practice.

OBJECTIVE To study the clinical efficacy of Professor Li Bingmao's Tongfu Xiere Quyu Shuli Prescription in the treatment of patients with functional dyspepsia(FD)of spleen and stomach damp-heat and qi stagnation and blood stasis type.METH-ODS A total of 206 patients with functional dyspepsia of spleen and stomach damp-heat and qi stagnation and blood stasis type diag-nosed by Hengshui People's Hospital were included in the study and randomly divided into a study group and a control group with 103 cases in each group.During the treatment,3 cases dropped out in each group.The control group adopted the conventional Western medicine treatment plan for functional dyspepsia(mosapride+rabeprazole),and the study group took Tongfu Xiere Quyu Shuli Pre-scription on the basis of the treatment of the control group.The treatment course of both groups was 4 weeks.The traditional Chinese medicine(TCM)syndrome scores,psychological status[self-rating anxiety scale(SAS),self-rating depression scale(SDS),and quality of life[Nepean dyspepsia life quality index(NDLQI)of the two groups of patients before and after treatment were observed and the clinical efficacy was evaluated;serum motilin(MTL),ghrelin,gastrin(GAS),corticotropin-releasing hormone(CRH)and pep-sinogen(PG Ⅰ,PG Ⅱ)were measured by enzyme-linked immunosorbent assay;changes in gastric motility indexes were analyzed by electrogastrogram analyzer;changes in intestinal flora were detected by instillation method.The occurrence of adverse reactions in the two groups of patients was monitored during treatment.RESULTS After treatment,the TCM syndrome scores of the two groups were significantly reduced(P<0.05,P<0.01),and the score in the study group was lower than that in the control group(P<0.01).The total effective rate of the study group was significantly higher than that in the control group(P<0.01).After treatment,the expression levels of MTL,Ghrelin,GAS,PG Ⅰ and PG Ⅱ in the two groups increased,and CRH decreased,and the improvement degree of the study group was better than that of the control group(P<0.01).After treatment,the main frequency and slow wave percentage of the electrogastrogram increased in the two groups,and the study group was better than that of the control group(P<0.01).After treat-ment,the number of bifidobacteria and lactobacilli in the two groups increased,and the number in the study group was greater than that in the control group,while the number of enterobacteria,enterococci and yeast decreased,and the number in the study group was less than that in the control group(P<0.01).There was no significant difference in adverse reactions between the two groups(P>0.05).CONCLUSION Tongfu Xiere Quyu Shuli Prescription is effective in the treatment of FD patients with spleen and stomach damp-heat syndrome,and can improve FD clinical symptoms,quality of life,anxiety and depression symptoms,regulate gastrointesti-nal hormone expression levels,gastric motility and intestinal flora expression,and does not increase adverse reactions,and is safe and reliable.