Objective To explore the effect of community pharmacy outpatient service on patients with type 2 diabetes mellitus. Methods A non-randomized controlled study was conducted, and type 2 diabetes patients managed in the community were divided into an intervention group of 112 cases and a control group of 110 cases. The control group received routine medication guidance during general practice outpatient visits, while the intervention group received comprehensive pharmacy outpatient service intervention based on routine medication guidance in general practice. Follow-up visits were conducted every 3 months. Repeated measurement analysis of variance and multivariate linear regression analysis were used to evaluate the intervention effect of the pharmacy outpatient service. Results Fasting blood glucose and glycosylated hemoglobin levels in the intervention group showed a decreasing trend with the increase of intervention time compared to pre-intervention time （P<0.01）, with increased duration of weekly exercise, decreased staple food intake, increased vegetable intake, and increased medication adherence score （P<0.01）. After adjusting for confounding factors through multivariate linear regression model, pharmacy outpatient intervention was found to be an independent protective factor for fasting blood glucose level （β=−0.891, P<0.01） and glycosylated hemoglobin level （β=−0.760, P<0.01） in the study subjects. Conclusion The community pharmacy outpatient service could enhance the self-management ability of patients with type 2 diabetes mellitus, and effectively improve patients’ fasting blood glucose and glycosylated hemoglobin.

Objective To investigate the effect of miR-142-3p on the apoptosis of rat pancreatic exocrine cell line AR42J by regulating Hmgb1.Methods AR42J cells were divided into blank group(blank),acute pancreatitis model group(AP,100 nmol/L cerulein for 24 h),and then transfected with miR-142-3p mimics,mimics NC,miR-142-3p inhibitor and inhibitor NC,respectively.The cells in the model group were recorded as miR-142-3p mimics group,mimics NC group,miR-142-3p inhibitor group and inhibitor NC.The expression of miR-142-3p in cells was detected by RT-qPCR.The protein expressions of HMGB1,caspase-3,Bax and Bcl-2 were detected by Western blot.Hoechst staining was used to determine cell apoptosis.The apoptosis rate of cells was detected by flow cytometry.The targeting relationship between miR-142-3p and Hmgb1 was determined by dual luciferase reporter gene assay.Results Compared with blank control group,the expression level of miR-142-3p in the AP group was significantly down-regulated(P＜0.01),the expression level of HMGB1 and caspase-3 proteins was up-regulated(P＜0.05),the expression level of Bax protein was significantly up-regulated(P＜0.01),the expression level of Bcl-2 protein was significantly decreased(P＜0.01)and the apoptosis rate increased significantly(P＜0.01).Compared with the mimics NC group,the level of miR-142-3p in the miR-142-3p mimics group was significantly up-regulated(P＜0.01),the expression of HMGB,caspase-3 and Bax proteins was significantly down-regulated(P＜0.01),the expression of Bcl-2 protein was up-regulated(P＜0.05),and the apoptosis rate decreased signifi-cantly(P＜0.01).Compared with inhibitor NC group,the expression level of miR-142-3p in miR-142-3p inhibitor group was down-regulated(P＜0.05),the expression levels of HMGB1,caspase-3 and Bax proteins were signifi-cantly up-regulated(P＜0.01),the expression level of Bcl-2 protein was decreased(P＜0.05)and the apoptosis rate increased significantly(P＜0.01).The dual luciferase reporter gene assay showed that Hmgb1 was the target gene of miR-142-3p.Conclusions 1)The expression of miR-142-3p was low in the model group.2)miR-142-3p can inhibit the apoptosis of AR42J cells by inhibiting the expression of Hmgb1.

The integration of Chinese and Western Medicine(ICWM)in the diagnosis and treatment of depression has been a long-standing issue in the field of mental health.In order to maximize the benefits of this combined approach,the"2023 Guidelines for Diagnosis and Treatment of Depression with Integrative Chinese and Western Medicine"(GDTD-ICWM)has been developed based on organizing evidence-based and standardized workflows for ICWM.This article aims to discuss the background,highlights,summary and outlook of the"Guidelines",as well as offer operational suggestions to guide clinical practices in order to strengthen the implementation,practice and promotion of the"Guidelines".

Objective This study aimed to explore the differences in global and local brain network topological properties between deficient pattern(DP)and excess pattern(EP)of mild vascular cognitive impairment caused by subcortical small vessel disease based on graph theory network.Methods Patients were recruited prospectively and were classified with DP and EP subtype.The global small-world topological attributes and local nodes were calculated for the comparison of DP,EP,and healthy controls(CN)using the GRETNA platform.Results The three groups all had small-world attributes,but only the patients in EP had a significantly lower small world attribute δ in the range of 0.05-0.26 than the control group(P<0.05).The node efficiency and node strength indicators of multiple brain region were able to significantly distinguish the DP group from the EP group.However,there was no positive brain region in the node efficiency of the DP patients(P>0.05),and only a few brain regions showed increased node strength efficiency(P<0.05).Conclusion The results indicate that the syndrome of DP and EP have significantly different neuroimaging phenotypes,providing a basis for further research of biological classification based on Chinese Medicine syndromes.

BACKGROUND:Traumatic spinal cord injury primarily relies on scale assessment and imaging examinations in clinical practice.However,there are limitations in predicting the prognosis of the injury.Therefore,the use of metabolomics technology for biomarker screening is significant for estimating the extent of damage,injury and recovery,as well as developing new therapies. OBJECTIVE:To characterize the metabolic features of patients with traumatic spinal cord injury using metabolomics technology and explore potential biomarkers and disrupted metabolic pathways. METHODS:Serum and urine samples were collected from 20 patients with traumatic spinal cord injury(observation group)and 10 healthy subjects(control group).Metabolites were analyzed and multivariate statistical analysis was then performed for data processing to screen differential metabolites.Metabolic pathway enrichment was performed using MetaboAnalyst software.Logistic regression was applied to construct a biomarker combination model,and its relationship with the American Spinal Injury Association grading was analyzed. RESULTS AND CONCLUSION:Significant differences in 160 and 73 metabolites were detected in the serum and urine samples of the two groups,respectively.Pathway enrichment analysis showed evident disturbances in lipid metabolism after traumatic spinal cord injury,including sphingolipid,arachidonic acid,α-linolenic acid,and arachidonic acid metabolism,as well as glycerophospholipid and inositol phosphate biosynthesis.The combination of two identified biomarkers,telmisartan and quercetin glycoside,showed a correlation with the American Spinal Injury Association grading in both serum and urine levels.Thus,metabolomics technology provides assistance in further understanding the pathological mechanisms of traumatic spinal cord injury and screening therapeutic targets.The identified metabolic biomarker combination may serve as a reference for assessing the severity of traumatic spinal cord injury.

ObjectiveTo explore the characteristics of circadian rhythm of blood pressure in patients with masked hypertension （MH） and its relationship with twelve two-hour peirods， providing a basis for early detection and intervention of MH. MethodsPatients who underwent 24-hour ambulatory blood pressure examination in the ambulatory blood pressure room of Jiangsu Province Hospital of Chinese Medicine from January to December 2022 were enrolled， and according to their outpatient blood pressure measurements， 24-hour ambulatory blood pressure monitoring and follow-up survey results， the MH， essential hypertension （EH） and normal blood pressure groups were classified， with 50 cases in each group. The general data， office blood pressure and 24-hour ambulatory blood pressure monitoring data were collected. The circadian rhythm of blood pressure including 24-hour average systolic blood pressure （24h SBP）， daytime average systolic blood pressure （d SBP）， nighttime average systolic blood pressure （n SBP）， 24-hour average diastolic blood pressure （24h DBP）， daytime average diastolic blood pressure （d DBP）， and nighttime average diastolic blood pressure （n DBP） were compared among the groups， and the nighttime blood pressure dipping percentage was calculated. The type of circadian rhythm was determined based on the nighttime blood pressure dipping percentage. The variability of blood pressure including 24h SBP standard deviation （24h SBP-SD）， d SBP standard deviation （dSBP-SD）， n SBP standard deviation （nSBP-SD）， 24h DBP standard deviation （24h DBP-SD）， d DBP standard deviation （dDBP-SD）， and n DBP standard deviation （nDBP-SD） were compared among groups， and the corresponding coefficient of variation （CV）， that is， 24h SBP-CV， d SBP-CV， n SBP-CV， 24h DBP-CV， d DBP-CV and n DBP-CV， were calculated. Based on the 24-hour ambulatory blood pressure monitoring results， the twelve two-hour average SBP and DBP in each group were calculated and compared. Simultaneously， patients with EH were divided into grades 1， 2， and 3 for further stratified analysis. ResultsThe age of the MH group was significantly higher than that of the EH group and the normal blood pressure group （P＜0.01）. The body mass index （BMI） and the proportion of smoking and alcohol consumption in the MH group and the EH group were significantly higher than those in the normal blood pressure group （P＜0.05 or P＜0.01）. In the normal blood pressure group， there were 49 dipper patterns （98.0%） and one non-dipper pattern （2.0%）； in the MH group， there were two dipper patterns （4.0%）， 29 non-dipper patterns （58.0%） and 19 reverse-dipper patterns （38.0%）； in the EH group， there were 20 dipper patterns （40.0%）， 23 non-dipper patterns （46.0%） and seven reverse-dipper patterns （14.0%）. Compared to the normal blood pressure group， the groups of MH and EH had significantly decreased proportion of dipper pattern and increased proportion of non-dipper and reverse-dipper pattern （P＜0.01）； the proportion of dipper pattern in the MH group was lower than that in the EH group， while the proportion of reverse-dipper pattern was higher （P＜0.01）. Compared to those in the normal blood pressure group， n SBP and n DBP in the MH group， as well as the the average SBP and average DBP at Zi hour （子时， 23：00-1：00）， Chou hour （丑时， 1：00-3：00）， Yin hour （寅时， 3：00-5：00）， Mao hour （卯时， 5：00-7：00） and average SBP at Hai hour （亥时， 21：00-23：00） in the MH group increased，while the average DBP at Si hour （巳时， 9：00-11：00） decreased （P＜0.01）； 24h SBP， 24h DBP， d SBP， d DBP， n SBP， and n DBP，d SBP-SD， n SBP-SD，n DBP-SD increased， as well as the average SBP and average DBP at twelve two-hour periods increased in the EH group，while the 24h SBP-CV， 24h DBP-CV，and d DBP-CV in the EH group decreased（P＜0.05 or P＜0.01）. The EH group had higher 24h SBP， 24h DBP， d SBP， d DBP， n SBP， n DBP， 24h DBP-SD and n DBP-SD ， as well as higher average SBP and DBP at all twelve two-hour periods， and lower d DBP-CV than the MH group（P＜0.05 or P＜0.01）. The EH group had 18 cases of grade 1 （36.0％）， 19 cases of grade 2 （38.0％） and 13 cases of grade 3 （26.0％）， with no significant differences among groups （P＞0.05）. ConclusionThe circadian rhythm of blood pressure in MH patients are mostly non-dipper and reverse-dipper patterns， and the abnormal elevation of blood pressure is obvious at Zi hour， Chou hour， Yin hour and Mao hour （23：00-7：00）.

Moral consciousness is closely related to ethical culture,and the level of moral consciousness and its cultivation among medical staff are crucial for developing the national healthcare industry.Starting from the development of moral consciousness theories at home and abroad,this paper clarified the concept of moral consciousness,and systematically expounded the concept of medical staff's moral consciousness based on this.The medical staff's moral consciousness was scientifically analyzed from five dimensions,including moral awareness,moral emotional consciousness,moral value consciousness,moral behavioral consciousness,and moral developmental consciousness.Combining the actual situation,the current state where the overall medical staff's moral consciousness is improving while there are cases of moral misconduct is analyzed.From the understanding of the value of labor,the shaping of family relationships,the construction of the social environment,the promotion of traditional culture,and the improvement of safeguard policies,five aspects are explored to seek paths for cultivating and enhancing the medical staff's moral consciousness,providing new ideas for the cultivation of medical staff's moral consciousness.

Objective:To dynamically study the iodine nutritional status of pregnant women in Guangxi Zhuang Autonomous Region (referred to as Guangxi), providing a basis for timely implementation of targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:From 2015 to 2022, a survey was conducted in Guangxi on a county-by-county basis. One township/street was selected from each county based on the east, west, south, north, and center directions, and 20 pregnant women were selected from each township/street. Salt and urine samples were collected from the homes of pregnant women to detect salt and urine iodine levels.Results:A total of 78 034 pregnant women were surveyed from 2015 to 2022, with a median salt iodine concentration of 24.4 mg/kg. The overall coverage rate of iodized salt, qualification rate of iodized salt, consumption rate of qualified iodized salt, and the rate of non-iodized salt were 99.0% (77 250/78 034), 95.9% (74 105/77 250), 95.0% (74 105/78 034), and 1.0% (784/78 034), respectively. The comparison of qualified iodized salt consumption rates in different regions (cities) showed statistically significant difference (χ 2 = 3 801.28, P < 0.001), with Baise City had the highest (98.1%, 8 328/8 488) and Beihai City had the lowest (70.7%, 1 909/2 700); except for Beihai City, the consumption rate of qualified iodized salt in all other cities was over 90%. The median urinary iodine level among pregnant was 148 μg/L. The difference in urinary iodine levels among pregnant women between different years was statistically significant ( H = 2 516.52, P < 0.001), with the highest level in 2020 (169 μg/L) and the lowest level in 2015 (126 μg/L). From 2020 to 2022, the median urinary iodine level for pregnant women was ≥150 μg/L, while from 2015 to 2019, it was < 150 μg/L. There were statistically significant difference in urinary iodine levels among pregnant women in different regions (cities, H = 495.69, P < 0.001), with Liuzhou City and Guilin City had the highest levels (both at 156 μg/L), and Beihai City had the lowest level (132 μg/L). The median urinary iodine levels of pregnant women in the early, middle, and late stages of pregnancy were 154, 147, and 154 μg/L, respectively. There were statistically significant differences in urine iodine levels among pregnant women in different pregnancy stages ( H = 158.64, P < 0.001), with mid pregnancy being lower than early and late pregnancy ( P < 0.017). Conclusions:The overall iodine nutrition level of pregnant women in Guangxi is slightly insufficient, especially in coastal cities such as Beihai City. We should continue to adhere to the strategy of using iodized salt to prevent and control iodine deficiency disorders. At the same time, we should strengthen health education for pregnant women, and adopt targeted and precise iodine supplementation measures for pregnant women in different regions and during pregnancy.

Objective:To investigate the awareness and behavior of iodine deficiency disorders prevention and control knowledge among pregnant women in Guangxi Zhuang Autonomous Region (referred to as Guangxi), and provide a basis for further targeted health education.Methods:From June to August 2023, a cross-sectional study method was used conduct a questionnaire survey about the awareness and behavior of iodine deficiency disorders prevention and control knowledge on 819 pregnant women who underwent prenatal or inpatient examinations at county people's hospitals, maternal and child health centers, and township health centers in 14 counties of 7 cities in Guangxi.Results:A total of 819 valid questionnaires were collected in this survey. The score of iodine deficiency disorders prevention and control knowledge among pregnant women was (6.1 ± 2.8) points, with an awareness rate of 62.4% (511/819). There were statistically significant differences in the awareness rate of iodine deficiency disorders prevention and control knowledge among pregnant women of different ages, residence areas, fertility status, educational level, employmnet status, occupation, and per capita monthly income(χ 2 = 9.17, 37.51, 5.15, 87.12, 54.22, 50.17, 67.623, P < 0.05). There were statistically significant differences in various behaviors related to salt consumption habits, home salt packaging, awareness of which salt to eat, choices made when buying salt, salt preservation habits, whether or not the subject had eaten iodine-rich foods in the week before the survey, how often they had eaten iodine-rich foods in the year before the survey, and whether or not they had actively learned about iodine knowledge during pregnancy or before pregnancy between pregnant women with different levels of knowledge (χ 2 = 21.64, 12.81, 101.79, 123.20, 36.78, 59.76, 109.14, 98.10, P < 0.05). The main ways to obtain knowledge on prevention and control of iodine deficiency disorders were medical workers(71.3%, 381/534), traditional media(54.5%, 291/534), community advocacy(53.4%, 285/534), news client and new media(50.2%, 268/534). Conclusions:The overall awareness rate of iodine deficiency disorders prevention and control knowledge among pregnant women in Guangxi is not high. We should strengthen health education for pregnant women, especially young and multiparous women, those with low education and low income.

Objective:To design a multi-epitope antigen of norovirus(NoV)based on bioinformatics technology and to pre-pare and characterize it.Methods:Bioinformatics methods were used to construct and analyze the NoV multi-epitope antigen NoV-ZH.Recombinant proteins were prepared and characterized by prokaryotic expression system,and monoclonal antibodies were prepared by animal immunization and hybridoma technology,and initially applied in colloidal gold platform.Results:The designed multi-epitope antigen had a large proportion of random curls in the secondary structure,with theoretical molecular mass and isoelectric point(PI)of 13.1 ku and 7.16,which were stable and hydrophilic.It had good immunogenicity and could activate humoral and cellular immune re-sponses.The proteins prepared by ligating pET-28a(+)and pET-32a vectors with antigenic sequences were expressed as inclusion body proteins and soluble proteins,respectively.A pair of paired antibodies was obtained by animal immunization and hybridoma tech-nique,and applied to colloidal gold test strips with a sensitivity of 0.5 ng/ml,and the test strips could specifically bind two genotypes of NoV recombinant capsid proteins.Conclusion:The successful preparation and characterization of multi-epitope antigen of norovirus provides a reference for the subsequent exploration of NoV universal detection targets and the development of diagnostic raw materials.