OBJECTIVE To construct a pharmaceutical care framework suitable for elderly individuals in nursing homes， so as to provide standardized content guidance for relevant practice. METHODS The initial items of pharmaceutical care content in n ursing homes were drafted through literature research and semi-structured interviews. Delphi method was used to conduct correspondence consultation among 38 experts from related fields in Xinjiang. The expert positive coefficient， authority coefficient， and Kendall’s W were calculated， and the analytic hierarchy process was employed to determine the weight of each item. After thorough discussion among the research team members， the pharmaceutical care framework suitable for elderly individuals provided by hospital pharmacists collaborating with nursing homes was finalized. RESULTS The questionnaire recovery rates for both rounds of expert correspondence consultation were 100%， with an authority coefficient ＞0.8 and Kendall’s W ranging between 0.153 and 0.185 （ P ＜0.001）. A total of 7 primary items and 31 secondary items were ultimately determined， with the consistency ratio of the item weights all being less than 0.1. Based on the integration of importance and feasibility， among the primary items， “assessment of pharmaceutical care needs” was assigned the highest weight. Among the secondary items， highly practical items such as “survey of pharmaceutical care needs”“guidance on usage and dosage”“methods for correctly reading drug package inserts”， and “self-management of common chronic diseases in the elderly” were assigned relatively high comprehensive weights. CONCLUSIONS The pharmaceutical care framework suitable for elderly individuals provided by hospital pharmacists collaborating with nursing homes， which was constructed based on the Delphi method， demonstrates good scientific validity and reliability， and can serve as a reference for pharmacists to provide pharmaceutical care in nursing homes.

OBJECTIVE To investigate the levels of procalcitonin(PCT),platelet-to-lymphocyte ratio(PLR),neu-trophil-to-lymphocyte ratio(NLR),white blood cell count(WBC)and serum amyloid A(SAA)in newborns with bloodstream infection,and their diagnostic value for early diagnosis of bloodstream infection in newborns.METHODS A total of 100 neonates with positive blood culture results from Jan.2021 to Jan.2024 at Taizhou Hos-pital of Zhejiang Province were selected.These cases were divided into three groups based on the type of pathogen:74 cases in the gram-negative bacterial group,19 cases in the gram-positive bacterial group,and 7 cases in the fungal group.Additionally,100 neonates with negative blood culture results during the same period were selected as the control group.By comparing the levels of PCT,PLR,NLR,WBC and SAA in the blood of newborns infec-ted with different pathogens,the diagnostic value of various indicators on the receiver operating characteristic(ROC)curve for diagnosis of bloodstream infection in newborns was evaluated.RESULTS Among 100 newborns with positive blood cultures,74 strains of gram-negative bacteria,19 strains of gram-positive bacteria,and 7 strains of fungi were identified.The levels of PCT,PLR,NLR,WBC and SAA in the gram-positive,gram-negative and fungal groups were all higher than those in the control group(P＜0.05).The ROC curve re-sults showed that the diagnostic efficacy of the combination of PCT,PLR,NLR,WBC and SAA for gram-nega-tive and gram-positive bloodstream infections was superior to that of each individual indicator(P＜0.05),with ar-ea under the curve(AUC)of 0.982 and 0.969,respectively.CONCLUSION PCT,PLR,NLR,WBC and SAA can serve as effective biomarkers for the early diagnosis of bloodstream infection in newborns,aiding in the rapid and accurate identification of the type of infection.

Objective To explore the preventive effect of auricular point bean embedding on sufentanil-induced cough reflex during induction of general anesthesia undergoing breast mass resection.Methods Clinical data of patients undergoing elective mammary mass resection with general anesthesia from June 2021 to May 2023 were retrospectively collected.The patients who received auricular point bean embedding therapy before surgery were included in the observation group,and patients who did not receive auricular point bean embedding therapy before surgery were included in the control group.The propensity score matching(PSM)method was used to perform 1∶1 matching based on basic data.The time effect,intergroup effect and interaction effect of vital signs parameters were analyzed by repeated measures analysis of variance.The GEE was used to analyze visual analogue scale(VAS)at different time points after operation.The Log-binomial regression model was used to analyze the incidence of postoperative adverse reactions and the association between subtypes.Results After PSM,50 patients were included in the observation and control groups.The time effect,intergroup effect and interaction effect of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO2)in 2 groups were statistically significant(P＜0.05).Within the same group,SBP,DBP,MAP,HR and SpO2 were statistically significant at immediately after intravenous sufentanil injection(T1),2 min after injection(T2),1 min before intubation(T3)and 1 min after intubation(T4)(P＜0.05).At T2,SBP,DBP,MAP and HR in the observation group were significantly lower than those in the control group,and SpO2 was significantly higher than that in the control group(P＜0.05).The cough control,VAS score and total incidence of postoperative adverse reactions in the observation group were significantly better than those in the control group(P＜0.05).The result of GEE model analysis showed that the improvement of postoperative VAS scores of patients in the observation group was better than that in the control group(P＜0.05).Conclusion Preoperative auricular point bean embedding has a specific preventive effect on sufentanil induced cough reaction in patients with breast mass resection under general anesthesia.

OBJECTIVE To analyze the risk factors for peripherally inserted central catheter(PICC)central line-as-sociated bloodstream infection in cancer patients and explore corresponding management strategies.METHODS The data of 52 chemotherapy patients with PICC central line-associated bloodstream infection(PICC-CLABSI)ad-mitted to the Department of Gastroenterology of the First Affiliated Hospital of Air Force Medical University be-tween May 2021 and May 2023 were collected retrospectively,and the patients were classified as the infection group.Additionally,183 chemotherapy patients without PICC-CLABSI during the same period were included as the non-infection group.Clinical data from both groups were collected.Logistic regression analysis was used to identify risk factors for PICC-CLABSI in cancer patients,and receiver operating characteristic(ROC)curves were employed to assess the accuracy of predictive variables.RESULTS A total of 57 pathogens were isolated from 52 patients with PICC-CLABSI,including 15 strains of Escherichia coli,12 strains of Klebsiella pneumoniae,9 strains of Pseudomonas aeruginosa and 9 strains of Staphylococcus aureus.Diabetes(OR=2.694),catheter in-dwelling time≥30 d(OR=7.146),number of chemotherapy(OR=6.617),maintenance frequency of once per week(OR=2.803)and maintenance method(OR=6.289)were identified as risk factors for PICC-CLABSI(P＜0.05).The area under the curve for the combined prediction of PICC-CLABSI was 0.904,with a sensitivity of 0.750 and a specificity of 0.907.CONCLUSIONS Diabetes,catheter indwelling time and number of chemotherapy are risk factors for PICC-CLABSI,while a maintenance frequency of once per week and the maintenance method are protective factors.Close attention should be paid to the assessment of risk factors after catheter placement,and targeted anti-infection strategies should be implemented.

OBJECTIVE To investigate the levels of procalcitonin(PCT),platelet-to-lymphocyte ratio(PLR),neu-trophil-to-lymphocyte ratio(NLR),white blood cell count(WBC)and serum amyloid A(SAA)in newborns with bloodstream infection,and their diagnostic value for early diagnosis of bloodstream infection in newborns.METHODS A total of 100 neonates with positive blood culture results from Jan.2021 to Jan.2024 at Taizhou Hos-pital of Zhejiang Province were selected.These cases were divided into three groups based on the type of pathogen:74 cases in the gram-negative bacterial group,19 cases in the gram-positive bacterial group,and 7 cases in the fungal group.Additionally,100 neonates with negative blood culture results during the same period were selected as the control group.By comparing the levels of PCT,PLR,NLR,WBC and SAA in the blood of newborns infec-ted with different pathogens,the diagnostic value of various indicators on the receiver operating characteristic(ROC)curve for diagnosis of bloodstream infection in newborns was evaluated.RESULTS Among 100 newborns with positive blood cultures,74 strains of gram-negative bacteria,19 strains of gram-positive bacteria,and 7 strains of fungi were identified.The levels of PCT,PLR,NLR,WBC and SAA in the gram-positive,gram-negative and fungal groups were all higher than those in the control group(P＜0.05).The ROC curve re-sults showed that the diagnostic efficacy of the combination of PCT,PLR,NLR,WBC and SAA for gram-nega-tive and gram-positive bloodstream infections was superior to that of each individual indicator(P＜0.05),with ar-ea under the curve(AUC)of 0.982 and 0.969,respectively.CONCLUSION PCT,PLR,NLR,WBC and SAA can serve as effective biomarkers for the early diagnosis of bloodstream infection in newborns,aiding in the rapid and accurate identification of the type of infection.

Computational approaches, encompassing both physics-based and machine learning (ML) methodologies, have gained substantial traction in drug repurposing efforts targeting specific therapeutic entities. The human dopamine (DA) transporter (hDAT) is the primary therapeutic target of numerous psychiatric medications. However, traditional hDAT-targeting drugs, which interact with the primary binding site, encounter significant limitations, including addictive potential and stimulant effects. In this study, we propose an integrated workflow combining virtual screening based on weighted holistic atom localization and entity shape (WHALES) descriptors with in vitro experimental validation to repurpose novel hDAT-targeting drugs. Initially, WHALES descriptors facilitated a similarity search, employing four benztropine-like atypical inhibitors known to bind hDAT's allosteric site as templates. Consequently, from a compound library of 4,921 marketed and clinically tested drugs, we identified 27 candidate atypical inhibitors. Subsequently, ADMETlab was employed to predict the pharmacokinetic and toxicological properties of these candidates, while induced-fit docking (IFD) was performed to estimate their binding affinities. Six compounds were selected for in vitro assessments of neurotransmitter reuptake inhibitory activities. Among these, three exhibited significant inhibitory potency, with half maximal inhibitory concentration (IC₅₀) values of 0.753 μM, 0.542 μM, and 1.210 μM, respectively. Finally, molecular dynamics (MD) simulations and end-point binding free energy analyses were conducted to elucidate and confirm the inhibitory mechanisms of the repurposed drugs against hDAT in its inward-open conformation. In conclusion, our study not only identifies promising active compounds as potential atypical inhibitors for novel therapeutic drug development targeting hDAT but also validates the effectiveness of our integrated computational and experimental workflow for drug repurposing.

Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.

Objective : To investigate the effect of long non-coding RNA LUCAT1 (lncRNA LUCAT1) on the biological behavior of MIA PaCa-2 in human pancreatic cancer cells , and to explore the potential role of LUCAT1 in the malignant progression of pancreatic cancer. Methods : The mutation and expression of LUCAT1 in pancreatic cancer were analyzed by GEPIA , the expression levels of LUCAT1 in human pancreatic ductal cells HPNE and hu- man pancreatic cancer cells were detected by q-PCR , and the expression and distribution of LUCAT1 in human pancreatic cancer tissues were detected by FISH . CCK-8 assay and Transwell assay were used to detect the effects of LUCAT1 on the proliferation , apoptosis , drug resistance , and migration of MIA PaCa-2 cells . Gene ensemble enrichment analysis was performed to compare the related signaling pathways involved in LUCAT1 , and Western blot assay was used to verify the protein expression level . Results : The results of GEPIA analysis showed that the expression level of LUCAT1 in human pancreatic cancer tissues was up-regulated , and the expression of LUCAT1 in human pancreatic cancer cells was significantly higher ( P < 0. 05 ) . Knockdown and overexpression of LUCAT1 could affect the proliferation , apoptosis , gemcitabine resistance , migration and invasion of pancreatic cancer cells , and the differences were statistically significant (P < 0. 05) . In addition , LUCAT1 affected p-Akt expression levels in pancreatic cancer and was inhibited after treatment with Akt inhibitor MK-2206 . Conclusion LUCAT1 regulates the malignant progression of MIA PaCa-2 in pancreatic cancer cells through the PI3K-Akt signaling pathway.

OBJECTIVE To analyze the risk factors for peripherally inserted central catheter(PICC)central line-as-sociated bloodstream infection in cancer patients and explore corresponding management strategies.METHODS The data of 52 chemotherapy patients with PICC central line-associated bloodstream infection(PICC-CLABSI)ad-mitted to the Department of Gastroenterology of the First Affiliated Hospital of Air Force Medical University be-tween May 2021 and May 2023 were collected retrospectively,and the patients were classified as the infection group.Additionally,183 chemotherapy patients without PICC-CLABSI during the same period were included as the non-infection group.Clinical data from both groups were collected.Logistic regression analysis was used to identify risk factors for PICC-CLABSI in cancer patients,and receiver operating characteristic(ROC)curves were employed to assess the accuracy of predictive variables.RESULTS A total of 57 pathogens were isolated from 52 patients with PICC-CLABSI,including 15 strains of Escherichia coli,12 strains of Klebsiella pneumoniae,9 strains of Pseudomonas aeruginosa and 9 strains of Staphylococcus aureus.Diabetes(OR=2.694),catheter in-dwelling time≥30 d(OR=7.146),number of chemotherapy(OR=6.617),maintenance frequency of once per week(OR=2.803)and maintenance method(OR=6.289)were identified as risk factors for PICC-CLABSI(P＜0.05).The area under the curve for the combined prediction of PICC-CLABSI was 0.904,with a sensitivity of 0.750 and a specificity of 0.907.CONCLUSIONS Diabetes,catheter indwelling time and number of chemotherapy are risk factors for PICC-CLABSI,while a maintenance frequency of once per week and the maintenance method are protective factors.Close attention should be paid to the assessment of risk factors after catheter placement,and targeted anti-infection strategies should be implemented.

Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.