OBJECTIVE To investigate the actual construction and operation status of established and under-construction centralized （cloud） prescription review centers （shortened for “prescription review center”） of close-knit county-level medical consortium in a certain city， so as to provide reference for improving the construction quality of the prescription review center. METHODS An online questionnaire survey was conducted to collect the data from 51 established and under-construction prescription review center in the city， covering basic information， funding sources， talent management， system construction， review rule maintenance， prescription review practices， prescription evaluation， data utilization， and current challenges. The collected data were summarized and analyzed. RESULTS A total of 51 valid questionnaires were retrieved， covering 32 established and 19 under-construction prescription review center. Among the 32 established prescription review centers， the main funding sources for their construction came from government financial allocations， accounting for 56.25%. Only 25.00% of prescription review center had review pharmacists who fully met national qualification requirements， and just 55.00% updated more than 10 review rule entries per month on average. Outpatient prescription verification realized full coverage， but 37.50% of prescription review centers only supported rationality verification of single prescriptions， and 50.00% could not retrieve laboratory and examination results to assist in prescription review. Additionally， 40.62% of prescription review center had not regularly conducted prescription evaluations for primary care institutions. The data from prescription review center was mainly used to support medication monitoring. Among the 19 prescription review centers currently in the planning stage， 63.16% had no identified funding sources. CONCLUSIONS The operation and construction of prescription review center in the city face challenges， such as funding shortages， absence of collaborative incentive mechanisms， and insufficient manpower.It is suggested that the state should issue a unified standard for the construction of the prescription review center as soon as possible， and local health administrative departments should formulate supporting policies and clarify assessment indicators in combination with the actual situation of the region.

Objective To develop a rapid and accurate ultra-performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS)method for the detection of etomidate,metomidate,propoxate,and isopropoxate in human hair.Methods Hair samples containing etomidate,metomidate,propoxate,and isopropoxate were extracted with methanol containing the internal standard orthoxine,filtered with a 0.22 μm organic filter membrane and detected vio UPLC-MS/MS.All components were separated by using a gradient elution procedure consisting of 0.01％formic acid(1 mmol/L ammonium acetate)and acetonitrile.Positive electrospray ionization was performed using multiple reaction monitoring(MRM)mode.Results The linear relationships of etomidate,metomidate,propoxate,and isopropoxate were good in the range of 0.01～1 ng/mg(r ≥ 0.997 9),with recovery rates ranging from 87.9％to 101.5％.The accuracy was between 80.0％and 110.0％.The intra-day and inter-day relative standard deviations(RSD)were 2.9％～9.6％and 3.6％～19.9％.Conclusion This method is easy to operate and has high recovery efficiencies.It is sufficiently simple and sensitive to be applied to detect etomidate,metomidate,propoxate,and isopropoxate in hair.

Objectives:QT interval prolongation during treadmill test exercise is one of the clinical feature of patients with long QT syndrome(LQTS).This study aimed to explore the feasibility and efficacy of treadmill exercise testing as an auxiliary diagnosis tool for LQTS in clinical practice.Methods:We enrolled normal healthy individuals,common cardiovascular disease patients,and clinically diagnosed or suspected LQTS patients,who underwent treadmill exercise test from July 2023 to July 2024 at Fuwai Hospital.A special treadmill exercise testing procedure was designed to record the QT interval correction(QTc)intervals of the twelve lead electrocardiogram at 6 time points when performing the exercise tablet,including supine,sitting,standing,peak exercise,and recovery at 1-minute and 4-minute.The differences in QTc intervals among healthy group,cardiovascular diseases group,and suspected LQTS group were compared.Results:A total of 80 cases were consecutively enrolled,including 37 normal healthy controls,25 patients with common cardiovascular disease,and 18 patients with suspected LQTS.The QTc intervals at 6 points did not differ significantly between normal healthy controls and patients with cardiovascular disease,with QTc intervals less than 480 ms at all measurement.For patients with suspected LQTS,67.7%(12/18)of these patients presented a QTc interval≥480 ms at the 4-minute during recovery period.Among them,5 cases were confirmed to have pathogenic gene mutations of LQTS by genetic testing(including 1 case with a lying electrocardiogram QTc interval of 489 ms diagnosed with LQTS 1 type and a QTc interval of 636 ms during the 4-minute recovery period after exercise);5 clinically diagnosed patients(negative or undetectable in genetic testing)with a Schwartz score≥4,and the remaining 2 patients had a Schwartz score of 3.The remaining 5/18 patients,include 2 patients with clinical Schwartz scores≥4 and 3 patients with clinical suspicion(Schwartz scores 2-3)had a 4 min QTc interval of 445-480 ms during exercise recovery.Another patient with clinical suspicion(Schwartz score 3)had a 4 min QTc interval of<445 ms during exercise recovery and a negative genetic test at a later stage.Receiver operating characteristic curve analysis showed a sensitivity of 83.3%and specificity of 98.4%for QTc interval≥482 ms during the 4-minute recovery period of exercise as the LQTS diagnostic cutoff.Conclusions:This study results suggest that this special treadmill exercise testing protocol is effective in identifying LQTS and has strong feasibility and generalizability for clinical practice.

Objective:To study the optimal anastomotic angle of end-to-side anastomosis autogenous arteriovenous fistula (AVF).Methods:A case-report and case-series design was used to obtain clinical data on 10 patients with diabetic nephropathy from Department of Nephrology, the 905th Hospital of the Chinese People′s Liberation Army Navy from June 2024 to February 2025. The models of "radial artery-cephalic vein" end-to-side anastomosis in the forearm with anastomotic angles of 30°, 40°and 50°were established. Numerical simulation was used to analyze the blood flow in the model, and to study the effect of different anastomotic angles on blood flow. Wall shear stress (WSS), cross section flow velocity and flow rate, and relative residence time (RRT) were studied in the model. The Whitney test with Holm correction was used to evaluate the difference in the median RRT between the three angle models.Results:At the moment of 0.65 s, the area fraction of low wall shear stress (LWSS) in the 30° model was 7.7%, which was reduced by 2.4% and 3.7% compared to the 40°and 50°models, respectively. At the time of 0.2 s, the area proportions of high wall shear stress (HWSS) in the 30°, 40°and 50°models were 54.4%, 43.9% and 37.4%, respectively. At 0.2 s, the maximum cross section flow velocity reached 4.07, 3.84 and 3.67 m/s for the 30°, 40°and 50°models, respectively. In the cycle, the maximum mean flow velocity for the 30°model reached 1.20 m/s. The mean flow rates of the 30°, 40°and 50°models in the J-5 cross section were 349, 316, and 328 ml/min, respectivly. For patient 6, the area proportions of the RRT>1 region were 11.97%, 14.84% and 15.22% for the 30°, 40°and 50°models, respectively.Conclusions:The optimal anastomotic angle of "radial artery-cephalic vein" for end-to-side anastomosis AVF surgery in patients with diabetic nephropathy is 40°.

Objective To develop a rapid and accurate ultra-performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS)method for the detection of etomidate,metomidate,propoxate,and isopropoxate in human hair.Methods Hair samples containing etomidate,metomidate,propoxate,and isopropoxate were extracted with methanol containing the internal standard orthoxine,filtered with a 0.22 μm organic filter membrane and detected vio UPLC-MS/MS.All components were separated by using a gradient elution procedure consisting of 0.01％formic acid(1 mmol/L ammonium acetate)and acetonitrile.Positive electrospray ionization was performed using multiple reaction monitoring(MRM)mode.Results The linear relationships of etomidate,metomidate,propoxate,and isopropoxate were good in the range of 0.01～1 ng/mg(r ≥ 0.997 9),with recovery rates ranging from 87.9％to 101.5％.The accuracy was between 80.0％and 110.0％.The intra-day and inter-day relative standard deviations(RSD)were 2.9％～9.6％and 3.6％～19.9％.Conclusion This method is easy to operate and has high recovery efficiencies.It is sufficiently simple and sensitive to be applied to detect etomidate,metomidate,propoxate,and isopropoxate in hair.

Objectives:QT interval prolongation during treadmill test exercise is one of the clinical feature of patients with long QT syndrome(LQTS).This study aimed to explore the feasibility and efficacy of treadmill exercise testing as an auxiliary diagnosis tool for LQTS in clinical practice.Methods:We enrolled normal healthy individuals,common cardiovascular disease patients,and clinically diagnosed or suspected LQTS patients,who underwent treadmill exercise test from July 2023 to July 2024 at Fuwai Hospital.A special treadmill exercise testing procedure was designed to record the QT interval correction(QTc)intervals of the twelve lead electrocardiogram at 6 time points when performing the exercise tablet,including supine,sitting,standing,peak exercise,and recovery at 1-minute and 4-minute.The differences in QTc intervals among healthy group,cardiovascular diseases group,and suspected LQTS group were compared.Results:A total of 80 cases were consecutively enrolled,including 37 normal healthy controls,25 patients with common cardiovascular disease,and 18 patients with suspected LQTS.The QTc intervals at 6 points did not differ significantly between normal healthy controls and patients with cardiovascular disease,with QTc intervals less than 480 ms at all measurement.For patients with suspected LQTS,67.7%(12/18)of these patients presented a QTc interval≥480 ms at the 4-minute during recovery period.Among them,5 cases were confirmed to have pathogenic gene mutations of LQTS by genetic testing(including 1 case with a lying electrocardiogram QTc interval of 489 ms diagnosed with LQTS 1 type and a QTc interval of 636 ms during the 4-minute recovery period after exercise);5 clinically diagnosed patients(negative or undetectable in genetic testing)with a Schwartz score≥4,and the remaining 2 patients had a Schwartz score of 3.The remaining 5/18 patients,include 2 patients with clinical Schwartz scores≥4 and 3 patients with clinical suspicion(Schwartz scores 2-3)had a 4 min QTc interval of 445-480 ms during exercise recovery.Another patient with clinical suspicion(Schwartz score 3)had a 4 min QTc interval of<445 ms during exercise recovery and a negative genetic test at a later stage.Receiver operating characteristic curve analysis showed a sensitivity of 83.3%and specificity of 98.4%for QTc interval≥482 ms during the 4-minute recovery period of exercise as the LQTS diagnostic cutoff.Conclusions:This study results suggest that this special treadmill exercise testing protocol is effective in identifying LQTS and has strong feasibility and generalizability for clinical practice.

Objective:To investigate alterations in functional connectivity network and brain function activity in childhood absence epilepsy (CAE) based on neuromagnetic signals by using multi-frequency magnetoencephalography.Methods:Twenty-five drug-naive children diagnosed with CAE from the Affiliated Brain Hospital of Nanjing Medical University and the Affiliated Children′s Hospital of Nanjing Medical University during October 2022 and March 2024 and 25 healthy controls matched for age and sex from community were recruited in this cross-sectional study. The interictal data, ictal data of CAE and healthy control children were collected using a CTF-275 channel magnetoencephalography system. Corrected amplitude envelope correlation was used to construct functional connectivity network, and network-based statistics were used to compare network differences between groups. Relative power spectral density was used to describe the distribution characteristics of whole-brain spectral power. Nonparametric permutation tests were conducted 1 000 times to compare spectral power differences between groups.Results:In terms of functional connectivity, significant increases in network activity were observed in the low-frequency bands (δ, θ) during interictal periods in children with CAE. A sub-network with significantly increased functional connectivity, including key nodes of the default mode network, was observed in the δ band. Compared with interictal periods, functional connectivity in the δ band decreased during absence seizures in children with CAE, while connectivity in the mid-to-high-frequency bands (α-γ2) increased. In terms of spectral power, children with CAE during interictal periods exhibited widespread magnetic source activation in the δ band, activation in parts of the parietal and occipital lobes in the θ band, and significantly decreased magnetic source intensity in most areas of the parietal, occipital, and temporal lobes in the α-γ2 band. Compared with interictal periods, children with CAE during absence seizures exhibited widespread magnetic source activation in the δ band, and significantly decreased activation in the θ-γ2 band. According to the magnetic source distribution map, during absence seizures, the frontal lobe replaced the parieto-occipital region in cortical activation in the α band.Conclusion:In the analysis of functional network and spectral power based on multi-frequency neuromagnetic signals, the network pattern and magnetic source activation of children with CAE during interictal periods were significantly different from those of healthy children, and there were characteristic changes in neuromagnetic signals during consciousness impairment caused by absence seizures in children with CAE.

Objective:To evaluate the effects of remazolam and propofol on the hemodynamics during induction of anaesthesia in elderly patients using the area under curve (AUC) method.Methods:Eighty elderly patients of either sex, aged 65-75 yr, with body mass index of 20-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective non-cardiac surgery, were divided into 2 groups ( n=40 each) by using a random number table method: remazolam group (R group) and propofol group (P group). Remazolam 1 mg/ml or propofol 10 mg/ml was slowly and intravenously injected through titration to achieve loss of responsiveness to verbal command. The accumulative areas under the curve below (AUC MAP-) or above (AUC MAP+ ) baseline mean arterial pressure and under the curve below or above 10% of baseline heart rate at the same time (AUC HR-, AUC HR+ ) were calculated within the first 10 min after administration of propofol or remazolam. The use of vasoactive drugs and injection pain were recorded during this period. The intraoperative awareness during the 24-h follow-up after surgery and development of cardiovascular complications, cerebral infarction and oliguria or anuria within 30 days after surgery were recorded. Results:Compared with R group, AUC MAP- was significantly enlarged (the mean difference 59.375 mmHg·min, 95% confidence interval 26.763-91.987 mmHg·min), AUC HR- was enlarged ( P<0.05), and no significant change was found in AUC MAP+, AUC HR+, requirement for vasoactive drugs, frequency of vasoactive drugs, and postoperative complications in P group ( P>0.05). No injection pain or intraoperative awareness was found in two groups. Conclusions:Remazolam is superior to propofol in maintaining hemodynamic stability during anesthesia induction in elderly patients.

Objective:To use the resting state functional network connectivity (FNC) method based on independent component analysis (ICA) to analyze the characteristics of FNC changes in patients with basal ganglia aphasia (BGA) after stroke, and to explore its occurrence and recovery mechanism under the intervention of acupuncture combined with language rehabilitation training.Methods:Using a prospective observational research method, 16 right-handed BGA patients who were treated at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from July 2021 to December 2022, as well as 14 healthy subjects matched in age, gender, education level, and handedness, were included. The resting state functional magnetic resonance imaging, demographic information, and Western Aphasia Examination data of healthy subjects and BGA patients before and after intervention were collected. The GIFT toolbox based on MATLAB platform was applied for ICA and resting state brain network FNC analysis. The FNC differences between BGA patients and healthy subjects were compared horizontally, and the FNC changes in BGA patients before and after intervention were compared vertically.Results:Compared with healthy subjects, post-stroke BGA patients showed decreased connectivity between the basal ganglia network, default network, and visual network before intervention, while increased connectivity between the auditory network, right frontoparietal network, and anterior cuneiform network; After the intervention of acupuncture combined with language rehabilitation training, the connectivity between the basal ganglia network, visual network, and anterior cuneiform network decreased, while the connectivity between the anterior convex network and bilateral frontoparietal network decreased, while the connectivity between the default network, auditory network, right frontoparietal network, and visual network increased. The BGA patient group showed enhanced connectivity between the basal ganglia network and the left frontoparietal network before and after intervention.Conclusions:The FNC changes between the basal ganglia network and other brain networks are key to reflecting the mechanism of BGA occurrence and language function recovery. Acupuncture combined with language rehabilitation training may improve language function by enhancing the connectivity between the basal ganglia network and the left frontoparietal network, and the redistribution of attention resources may also be one of the reasons for promoting language function recovery in BGA patients.

According to the literature review, no cyst of the hip ligamentum teres has been reported. In this study, a 50?year?old female patient was admitted to the hospital because of sprained left hip pain with movement restriction for 15 months. The unilateral hip joint MRI showed cyst of the hip ligamentum teres, which was diagnosed as left hip joint cyst in the outpatient de?partment. Thus, the patient was admitted to the hospital. Physical examination showed that the left hip joint movement was slightly restricted with positive FADDIR test and FABER test. Arthroscopic surgical examination revealed a 1.5 cm×1.0 cm cyst at the lo?cation of the round ligament which was then cleared with a planer knife and radiofrequency. The treatment results were satisfacto?ry. The present study reviewed the literature about anatomical and biomechanical physicochemical properties of the ligamentum teres. The function of the ligamentum teres is important for the hip joint. In diagnosis of hip disease, unilateral hip MRI plays an important role in accurate diagnosis of such diseases. The hip arthroscopy provide a minimal invasive technique in treating cyst of the hip ligamentum teres. With the application of the hip arthroscopy, it will undoubtedly improve the diagnosis and treatment of hip diseases.