Objective The aim of this study was to analyze the clinical features,ultrasonographic manifestations,and medication characteristics of shoulder joint involvement in patients with rheumatoid arthritis during the course of the disease,and to explore the impact of shoulder joint involvement on the overall condition of RA,to further provide a basis for clinical diagnosis and treatment.Methods One hundred and forty RA patients who were hospitalized in our department between August 2023 and August 2024 were selected,and they were divided into the RA involving shoulder joint group and the non-involving group according to whether they were combined with shoulder pain or shoulder arthritis manifestations.The clinical data of the two groups were analyzed and compared,including disease activ-ity,imaging characteristics and treatment modalities.Results The RA-involved shoulder group was significantly higher than the non-involved group in pain visual analog scores,swelling,number of tender joints,28 arthropathic activity scores-erythrocyte sedimentation rate and C reactive protein scores,and the differences were statistically significant(P＜0.001).The two groups had significant differ-ences in blood tests,inflammation indexes,Rheumatoid factor and anti-CCP antibody and other laboratory tests were significantly differ-ent in the morning(P＞0.05),suggesting that shoulder joint involvement may not be readily recognized by routine laboratory tests.The ultrasonographic performance of RA involving the shoulder joint was classified into bilateral and unilateral lesions,in which the unilateral lesions were mostly acromioclavicular joint synovitis,and the bilateral lesions were predominantly humeral head bone erosions.Inflamma-tory changes of synovitis were predominantly in the acromioclavicular joint,while structural changes were focused on bone erosion of the humeral head.In patients with structural changes,the erythrocyte sedimentation rate and C-reactive protein level were higher than those of the group with inflammatory changes,and the difference was statistically significant(P＜0.05),while the difference between the rheu-matoid factor and the anti-CCP antibody was not statistically significant(P＞0.05).The proportion of patients with RA involving the shoulder joint using traditional synthetic antirheumatic drugs(csDMARDs)in combination with biologics(bDMARDs)or targeted syn-thetic antirheumatic drugs(tsDMARDs)was significantly higher,especially the proportion of csDMARDs in combination with bDMARDs was the most prominent.Conclusion Patients with RA who have shoulder involvement during the course of the disease usually present with worsening systemic symptoms,high disease activity,and ultrasonographic findings of synovitis and bone erosion in the shoulder joint.However,conventional laboratory tests and imaging methods lack specificity in the diagnosis of shoulder joint involvement,and therefore,clinical attention should be paid to shoulder joint involvement in RA to prevent disease progression from adversely affecting the overall prognosis.

Objective The aim of this study was to analyze the clinical features,ultrasonographic manifestations,and medication characteristics of shoulder joint involvement in patients with rheumatoid arthritis during the course of the disease,and to explore the impact of shoulder joint involvement on the overall condition of RA,to further provide a basis for clinical diagnosis and treatment.Methods One hundred and forty RA patients who were hospitalized in our department between August 2023 and August 2024 were selected,and they were divided into the RA involving shoulder joint group and the non-involving group according to whether they were combined with shoulder pain or shoulder arthritis manifestations.The clinical data of the two groups were analyzed and compared,including disease activ-ity,imaging characteristics and treatment modalities.Results The RA-involved shoulder group was significantly higher than the non-involved group in pain visual analog scores,swelling,number of tender joints,28 arthropathic activity scores-erythrocyte sedimentation rate and C reactive protein scores,and the differences were statistically significant(P＜0.001).The two groups had significant differ-ences in blood tests,inflammation indexes,Rheumatoid factor and anti-CCP antibody and other laboratory tests were significantly differ-ent in the morning(P＞0.05),suggesting that shoulder joint involvement may not be readily recognized by routine laboratory tests.The ultrasonographic performance of RA involving the shoulder joint was classified into bilateral and unilateral lesions,in which the unilateral lesions were mostly acromioclavicular joint synovitis,and the bilateral lesions were predominantly humeral head bone erosions.Inflamma-tory changes of synovitis were predominantly in the acromioclavicular joint,while structural changes were focused on bone erosion of the humeral head.In patients with structural changes,the erythrocyte sedimentation rate and C-reactive protein level were higher than those of the group with inflammatory changes,and the difference was statistically significant(P＜0.05),while the difference between the rheu-matoid factor and the anti-CCP antibody was not statistically significant(P＞0.05).The proportion of patients with RA involving the shoulder joint using traditional synthetic antirheumatic drugs(csDMARDs)in combination with biologics(bDMARDs)or targeted syn-thetic antirheumatic drugs(tsDMARDs)was significantly higher,especially the proportion of csDMARDs in combination with bDMARDs was the most prominent.Conclusion Patients with RA who have shoulder involvement during the course of the disease usually present with worsening systemic symptoms,high disease activity,and ultrasonographic findings of synovitis and bone erosion in the shoulder joint.However,conventional laboratory tests and imaging methods lack specificity in the diagnosis of shoulder joint involvement,and therefore,clinical attention should be paid to shoulder joint involvement in RA to prevent disease progression from adversely affecting the overall prognosis.

Objective:To explore the microRNA profile changes in the development of NKT cells.Methods: Differently developmental stage of NKT cells in mouse thymus were sorted by flow cytometry.Total RNA were extracted,reversely transcribed and pre-amplified.TaqMan low density microRNA assay and single real-time PCR were applied to detect the expression changes of microRNAs in the developmental process of NKT cells.Results: There were total 92 microRNAs whose expression changed significantly during the development and maturation of NKT cells.Among them,increasly expressed microRNAs were 71,including 36 microRNAs whose expression continuously increased;decreasly expressed microRNAs were 21,including 12 microRNAs whose expression continuously decreased.In addition,single real-time PCR analysis showed that the expression of Let-7f,miR-150,miR-24,miR-29 increased,while the expression of miR-223 and miR-155 decreased during the development and maturation of NKT cells.Conclusion: NKT development and maturation is accompanied by expression changes of large amount of microRNAs,indicating that specific microRNA regulates NKT development and function.

Objective To adjust the layout of secondary medicine shelves in hospital pharmacy for outpatient services and optimize the varieties of automated equipment to improve working process and promote human-machine cooperation.Methods This article discussed the adjustment of the layout of secondary medicine shelves in hospital pharmacy for outpatient services and the optimization of varieties of automated equipment for storing by analyzing actual problems in automated system and clinical drug uses and the requirements of the automated equipment for drug storage respectively to improve working process and to adapt to the operation of outpatient pharmacy automated system.Results Dispensing efficiency of outpatient pharmacy automated system was improved, patients′ waiting time was significantly shortened, and the workload of pharmacists was decreased.Conclusion Optimization of hospital pharmacy drug delivery system and its operation can obviously improve work efficiency, shorten patients′ waiting time and reduce dispensing error, thus ensuring the safety of medication.