OBJECTIVE To investigate the application status of prescription pre-review systems in healthcare institutions of Yunnan province， evaluate their system functions and management capabilities， and provide a practical basis for promoting rational drug use. METHODS A questionnaire survey was conducted among public healthcare institutions at or above the secondary level in Yunnan province to investigate the deployment status of the systems. A capability maturity assessment framework was constructed， encompassing 6 dimensions and 39 indicators， including real-time prescription review， prescription correlation review， rule setting， evidence-based information support， prescription authority management， and system operation management. This framework was then used to evaluate the institutions that had implemented the pre-review systems. RESULTS A total of 100 valid questionnaires were collected， with 37 institutions having adopted prescription pre-review systems， mainly tertiary hospitals. The system predominantly adopted a modular architecture and was embedded into the hospital information system through application programming interfaces and middleware， providing certain capabilities for real-time prescription risk identification. Evaluation results indicated that basic functions such as reviewing indications， contraindications， and drug compatibility performed well， while deficiencies remained in functions related to parenteral nutrition prescription， review of drug dosage for specific diseases， individual patient characteristic recognition， and rule setting. Moreover， the construction of review centers and establishment of management systems were also not well-developed. CONCLUSIONS The overall application rate of prescription pre-review systems in Yunnan province remains low. System functions and management mechanisms require further improvement. It is recommended to enhance information infrastructure in lower-level institutions and explore regionally unified review models to promote standardized and intelligent development of prescription review practices.

Objective:To evaluate the accuracy of ultrasound-measured airway indicators in predicting difficult laryngoscopy.Methods:A total of 104 American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-70 yr, undergoing elective operation under general anesthesia, were selected.The airway was evaluated before induction of anesthesia, body mass index (BMI), neck circumference, mouth opening, thyromental distance and modified Mallampati classification were recorded, and mandibular condylar mobility, distance from skin to under surface of tongue, hyomental distance and distance from skin to epiglottis were measured by ultrasound.Anesthesia induction was performed after the end of measurement, and direct laryngoscopy was performed after mask pressure ventilation.Cormack-Lehane (CL) grade was recorded, and difficult laryngoscopy was defined as CL grade≥2b.The patients were divided into non-difficult laryngoscopy group (group NDL) and difficult laryngoscopy group (group DL) according to the view obtainable during laryngoscopy.The factors of which P values less than 0.05 would enter the logistic regression analysis.The accuracy of each index in predicting difficult laryngoscopy was evaluated using the area under the receiver operating characteristic curve (AUC) and 95% confidence interval (CI). The critical value was determined according to Youden index, and the sensitivity and specificity were calculated. Results:Compared with NDL group, BMI, depth of epiglottis and the incidence of modified Mallampti≥grade Ⅲ were significantly increased, and the mouth opening and thyromental distance were decreased in goup DL ( P<0.05). The AUC (95%CI) of modified Mallampti classification and the depth of epiglottis for difficult laryngoscopy prediction were 0.728 (0.619-0.836) and 0.833 (0.743-0.924), respectively.When the critical value of depth of epiglottis was 2.125 cm, the sensitivity and specificity of predicting difficult laryngoscopy were 65.71% and 89.86%, respectively. Conclusion:Ultrasound-measured depth of epiglottis can accurately predict the difficult laryngoscopy.

Alzheimer's disease (AD) is one kind of degenerative diseases of the central nervous system, constituting a major social problem and economic threat around the world. Early diagnosis and intervention are the keys to its prevention and treatment. The traditional diagnosis system based on clinical experience and biomarkers has many limitations. A completely new "digital biomarkers" diagnostic system based on wearable devices is being constructed with the rapid development on artificial intelligence, 5G network and other technologies. This article will comprehensively describe the research progress on wearable devices which used to capture different cognitive-related signals such as memory, visual space, speech, executive functions in the construction of AD "digital biomarkers" diagnosis system, and forecast its application prospect in the future diagnosis, prevention and treatment of AD.

Objective To investigate the effects of low-fat diet or statin intervention at early age on brain amyloid β-protein (Aβ) pathology and behaviors of middle-aged Tg2576 mice.Methods Thirty-five two-month-old Tg2576 mice were randomly divided into following 5 groups:a juvenile statin group,a juvenile low-fat diet group,a young statin group,a young low-fat group,and a blank control group (n=7);mice in the low-fat diet groups were given standard low-fat feed,and mice in the statin group were given atorvastatin at 17 mg/(kg· d) into the normal diet.The initiation times of intervention were,respectively,set to be 2-month-old in juvenile groups and 6-month-old in young groups;meanwhile,mice in the blank-control group were fed with normal diet without statin.All mice were raised to be 10-month-old and tested by Morris water maze for evaluating cognitive behaviors two weeks before execution.After peripheral blood and brains being taken,a monoclonal anti-Aβ42 antibody was employed to immunostain mice brain paraffin tissue sections for assaying tissue Aβ plaque immunoreactivity (TAPIR),and the levels of Aβ40,Aβ42,β-secretase,and γ-secretase in homogenates were detected by enzyme-linked immunosorbent assays (ELISA).Results As compared with those in the blank-control group,the average escape latencies,times of passing through hidden platforms,percentage of strong TAPIR,Aβ42 and γ-secretase level in all intervention groups showed no statistical differences (P＞0.05).As compared with those in the blank control group,Aβ42 in homogenates of young intervention groups and β-secretase level in the young statin group were significantly higher (P＜0.05).Conclusion Interventions initiated from juvenile or young,and low-fat diet intervention or statin intervention can neither improve the mice's Morris water maze testing results,nor reduce Aβs burdens in brain homogenates and Aβ40 immunopathologies in brain tissues of middle-aged mice;over early initiation of low-fat diet intervention or statin intervention might accelerate or worsen Alzheimer's disease progress.

The etiology and pathogenesis of Alzheimer's disease (AD) are still kept to be unknown;up to now,no method is proved to be effective and safe for its prevention and treatment.Recent data have shown that gut microbiota might participate in the onset and development of AD via a variety of pathways.From the perspective of gut microbiota,this review will retrospectively analyze the influence of gut microbiota on AD pathogenesis,outlook its application values of in preventing and treating AD.

Objective To compare different methods for developing rat model of the syndrome of cold fluid retention in lung ( CFRL) , so as to find an easier and more reliable modeling method for CFRL. Methods Twenty rats were divided into 4 groups, namely normal group, lipopolysaccharide (LPS) group, tobacco group, and cold bath group, 5 rats in each group. Lipopolysaccharide group was given intratracheal drip of LPS, tobacco smoking and cold bath, tobacco group was given tobacco smoking and cold bath, and cold bath group was given cold bath and intragastric gavage of cold water. The modeling time in the three groups lasted for 15 days. After the experiment, we compared the general health state, body weight, sputum volume and pathological changes in rats of the four groups. Results (1) Compared with the normal group, activities of rats in the three modeling groups were lowered, body temperature decreased, and the signs of panting, cyanotic nose and lips with excretion, and sneezing (cough) were obvious. (2) Compared with the normal group, the decrease of body weight was obvious (P<0.01), expelling sputum volume was increased (P<0.05) in the model groups. However, the differences among the three model groups had no statistical differences ( P>0.05). ( 3) The results of lung tissue slice examination showed that the injury of lung tissue was severe in LPS group, mild in tobacco group and slight in cold bath group. Conclusion Rat model of CFRL has been established successfully in all of the three modeling groups, and in consideration with all respects, the method for tobacco group is the best.

Objective To investigate the effect of adenoviral-mediated interleukin-10 (IL-10) gene transfection on systemic inflammatory responses in a rat model of ventilator-induced lung injury. Methods Thirty adult male SD rats weighing 200-220 g were randomly divided into 5 groups (n=6 each): group Ⅰ control (group C); group Ⅱ adenovirus without IL-IO gene + 2 h mechanical ventilation (MV) (group B, ); group II1 adenoviruswithout IL-IO gene + 4 h MV (group B_2); group Ⅳ adenovirus with IL-10 gene + 2 h MV (group A_1) and group Ⅴ adenovirus with IL-10 gene + 4 h MV (group A_2). In group Ⅱ-Ⅴ the animals were mechanically ventilated (airway pressure = 25 cm H_2 O) and adenovirus was injected into right ventricle at 48 h before MV. Blood samples were taken from abdominal aorta at the end of 2 h or 4 h MV for determination of serum IL-8 and IL-10 concentrations. The animals were then killed. The pulmonary specimens were obtained for examination of ultrastructure with light and electron microscope. Results Mechanical ventilation significantly increased serum IL-8 and IL-IO concentrations in a duration-dependent manner in group Ⅱ-Ⅴ as compared with group C. Trans-pulmonary administration of adenoviraI-mediated interleukin-10 gene significantly decreased serum IL-8 concentration and increased serum IL-10 concentration and reduced ventilator-induced lung injury alter MV in group A_1 and A_2 as compared with group B_1 and B_2. Conclusion Adenoviml-madiated IL-10 gene transfection can attenuate the systemic inflammatory response and reduce ventilator-induced lung injury.

0.05). ②Plasma endothelin in the two groups was remarkably decreased after treatment(P0.05).③ NO in the two groups was significantly increased after treatment(P0.05). Conclusion TFL can reduce blood pressure and improve endothelial cell function.