OBJECTIVE To formulate Guidelines for the standardized implementation of pharmacist-managed clinics （ 2026 edition ） in response to the challenges faced by such clinics in China， including uneven development， large discrepancies in service specifications， insufficient patient awareness， and limited medical insurance coverage. METHODS Led by the Pharmaceutical Affairs Professional Committee of the Chinese Hospital Association， the Evidence-based Pharmacy Professional Committee of the Chinese Pharmaceutical Association， and the Hospital Pharmacy Professional Committee of the Cross-strait Medical and Health Exchange Association， a total of 19 domestic hospital pharmacy experts were organized. Through a systematic review of national policies and literature research， current practical experience was summarized. Consensus on the contents of the guidelines was reached after in-depth discussions. RESULTS &CONCLUSIONS The guidelines covered five sections： definition and connotation of pharmacist-managed clinics， establishment requirements， implementation and management， post competency， and practical research. Firstly， the definition and connotation included three operational forms of pharmacist-managed clinics （independent mode， physician-pharmacist joint mode， and online pharmacist-managed clinic mode） and classified service modes （specialty-specific， drug-specific， and disease-specific pharmacist-managed clinics）. The establishment requirements were further refined， covering system construction （pharmaceutical service management system， quality control and assessment mechanism）， personnel qualifications （professional credentials， continuing education and professional training， etc）， service recipients， as well as service venues and facilities. Subsequently， the implementation and management of pharmacist-managed clinics were proposed， involving service procedures， intervention measures， documentation and records， patient education and follow-up， humanistic care， as well as risk management and quality control. Finally， post competency encompassed the competency requirements for pharmacists providing services in pharmacist-managed clinics， as well as the suggestions on teaching methods； practical research encouraged the conduct of high-quality pharmaceutical practice in the setting of pharmacist-managed clinics. The guidelines provide valuable guidance for the standardized implementation of pharmacist-managed clinics in China in terms of establishment， management， teaching， and research， fill the guideline gap in this field， and can promote the high-quality development of pharmacist-managed clinics.

Objective To establish a method for determining the amount of silicone oil on the surface of rubber closures,which is one of the packaging material standards in the Pharmacopoeia of the People's Republic of China.Methods The development process of the method for determining silicone oil content on the surface of rubber closures was described,taking the infrared transmission mode as example.Through method validation,the scientific and rational aspects of the method were examined.Key points of the determination method were analyzed,including the selection of quantitative peaks,selection of measurement solvent,selection of extraction solvent and conditions,selection of instrument measurement methods,selection of liquid cell windows for infrared transmission mode,selection of quantification methods,and selection of dimethyl silicone oil reference standards.Results The infrared spectroscopy mode was chosen to determine the amount of polydimethylsiloxane on the surface of rubber closures based on the peak height of the Si-CH3 bond vibration absorption at 1 260 cm-1.Cyclohexane was used as the measurement solvent.The same concentration of polydimethylsiloxane reference solution was measured using both infrared transmission mode and attenuated total reflection mode,and quantification was performed based on peak height.The results from the two measurement modes were essentially the same.The linear range of polydimethylsiloxane was about 0.3-10.0 mg·mL-1,and its correlation coefficient was 0.999 8.The average recovery of the method was 102.3%-105.6%.The LOD of polydimethylsiloxane was 0.1 mg·mL-1.The silicone oil measurement results of seven batches for rubber closures were consistent with the silicone oil amounts provided by the manufacturer.Conclusion Enterprises can choose either the infrared transmission mode or the attenuated total reflection mode to measure the amount of polydimethylsiloxane on the surface of rubber closures based on their actual conditions.

Objective:To study the clinical characteristics and risk factors for hypertriglyceridemia-induced severe acute pancreatitis (HTG-SAP) complicated by acute kidney injury.Methods:The clinical data of HTG-SAP patients admitted to the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2014 to July 2022 were retrospectively collected, and divided into an AKI group and a non-AKI group according to whether AKI occurred. The general condition, laboratory data and clinical characteristics of the two groups were compared. Factors with statistically significant differences were screened for logistic regression analysis and a predictive model was constructed. We plotted the receiver operating characteristic curve and used the area under the curve (AUC) to evaluate the predictive ability of each predictor for HTG-SAP complicated with AKI.Results:A total of 91 patients were included, including 37 (40.7%) with AKI and 54 (59.3%) without AKI. The proportions of extrapancreatic infection, sepsis and multiple organ dysfunction syndrome, requiring mechanical ventilation, continuous renal replacement therapy (CRRT), retroperitoneal puncture, and surgical intervention were higher in the AKI group than in the non-AKI group (all P<0.05). The length of ICU stay, total length of hospitalization, and mortality rate in the AKI group were higher than those in the non-AKI group (all P<0.05). Multivariate logistic regression analysis showed that acute physiology and chronic health status scoreⅡ (APACHEⅡ) ( OR=2.069, 95% CI: 1.286-3.417, P=0.003), abdominal pressure ( OR=1.469, 95% CI: 1.108-1.958, P=0.007), and lactic acid ( OR=3.156, 95% CI: 1.013-9.831, P=0.047) were independent risk factors for AKI in HTG-SAP patients. The AUCs of the APACHEⅡ score, abdominal pressure, lactic acid level and combined prediction model were 0.951, 0.918, 0.837 and 0.986, respectively. Conclusions:Patients with HTG-SAP complicated with AKI were more likely to have complications related to extrapancreatic infection, sepsis and multiple organ dysfunction, and the proportion of mechanical ventilation, CRRT, retroperitoneal puncture and surgical intervention required during hospitalization was greater, the lengths of ICU stay and total hospital stay were longer, and the mortality rate was higher. APACHEⅡ score, abdominal pressure and lactic acid were independent risk factors for HTG-SAP concurrent AKI, and the prediction model established based on these three factors had higher value in predicting HGT-SAP concurrent AKI

Objective: To establish colorectal cancer LoVo and SW620 cell lines that stably interfere with the expression of LINC01224, and to explore the effect of down-regulating the expression of LINC01224 on cell apoptosis. Methods: The GEPIA2 database was used to analyze the expression of LINC01224 in colorectal cancer tissues; qPCR method was used to detect the expression of LINC01224 in 10 human colorectal cancer cells. Three different LINC01224 siRNAs were respectively transfected into human colorectal cancer LoVo cells, and the LINC01224 shRNA lentiviral vector was constructed with the siRNA sequence with the most obvious inhibitory effect of LINC01224 expression. Recombinant lentiviral particles were packaged in HEK293 T cells and then infected with LoVo and SW620 cells. After selection by puromycin, the monoclonal cells that stably interfere with LINC01224 were obtained by limiting dilution method. MTS method detects cell proliferation ability, and flow cytometry detects cell apoptosis rate. Results: The expression of LINC01224 in colorectal cancer tissues was higher than that in normal colorectal tissues, and its expression in 10 types of colorectal cancer cells was also higher than that in normal colorectal epithelial cells HCOEPic. The inhibition rate of siRNA-3 on the expression of LINC01224 in LoVo cells was higher than that of siRNA-1 and siRNA-2. Therefore, siRNA-3 was chosen to design LINC01224 shRNA.Compared with the control group(sh-NC group), the expression level of LINC01224 in the LoVo and SW620 cells of the stable interference LINC01224 group(sh-LINC01224 group) was reduced(P<0.01), and the cell growth rate was slowed down(P<0.01), the rate of apoptosis also increased(P<0.01). Conclusion The shRNA lentiviral interference vector of LINC01224 is successfully constructed, which can stably infect LoVo and SW620 cells, down-regulate the expression of LINC01224 and induce cell apoptosis.

Objective:To study the clinical effect of different application times of antibiotics in patients with hypertriglyceridemic severe acute pancreatitis(HTG-SAP).Methods:The clinical data of 92 patients with HTG-SAP who were treated at the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2016 to February 2022 were analyzed retrospectively. There were 65 males and 27 females, aged (40.82±10.55) years old. These patients were divided into three groups based on the time of prophylactic use of antibiotics: the early prevention group (used within 72 h after admission, n=39), the delayed prevention group (used after 72 h after admission, n=30) and the nonprevention group ( n=23). The clinical data such as the general data, length of stay and all cause mortality rate of the three groups of patients were analyzed. Results:Compared with patients in the nonprevention group, the incidence rate of pancreatic/peripancreatic infection [10.0%(3/30) vs. 39.1%(9/23)] and the incidence rate of bloodstream infection [6.7%(2/30) vs. 34.8%(8/23)] in the delayed prevention group were significantly decreased (pancreas/peripancreatic infection: χ 2=6.31, P=0.012; bloodstream infection: χ 2=6.72, P=0.010). The infection rate of multiple/pan resistant bacteria in the early prevention group [23.1%(9/39)] was significantly higher than the nonprevention group [4.3%(1/23)] (χ 2=4.49, P=0.034). There were no significant differences in the all cause mortality rate, length of stay, duration of intensive care, hospitalization cost, incidence of intestinal fistula and retroperitoneal hemorrhage, and the proportion of patients requiring surgery among the 3 groups (all P>0.05). Conclusions:Pophylactic use of antibiotics within 72 h of hospital admission significantly reduced the incidence of pancreatic/peripancreatic infection and bloodstream infection in patients with HTG-SAP. There were no significant differences in the final prognosis among these patients with HTG-SAP treated with antibiotics at different times.

Objective:To identify the current situation of contract signing for family physician services in Luohu District, Shenzhen, and to explore the associated factors with contract signing and access to services.Methods:Using the WeChat official account of"People′s Hospital of Luohu", an online survey was conducted to investigate the status of family physician′s contract services for residents in Luohu District from May 19th to 25th, 2019. A total of 14 487 valid responses were received. Chi-square test and Logistic regression models were used to analyze the contract signing of family physician services and the related factors.Results:8 560 (59.09%) of the participants had signed with a family physician, and 12 696 of them had learnt about the service before. The awareness rate of family doctor services was 87.64%. The contract signing rate of those unemployed, who living or working in Luohu less than 5 years, who living alone, having no Shenzhen medical insurance, or having not heard of family physicians signing services were less than 50%. The signing rate was positively correlated with the awareness of family physician contract service, as well as the possibility of accepting signed medical examination, traditional Chinese medicine services and health information. Only 9.70% of the contractors received health services information.Conclusions:The contract Signing rates and awareness rate of family physicians among young and middle-aged residents in Luohu District are relatively high. However, access to contract services varies considerably. The signing rate and accepted services are mainly affected by job, length of residence in Shenzhen, type of medical insurance, and understanding of contract.

Objective: To observe the long-term efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) for systemic sclerosis (SSc) patients. Methods: Between May 2007 and June 2009,4 patients with SSc were enrolled in the study. Peripheral blood stem cells were mobilized with cyclopho-sphamide (CTX) followed by granulocyte colony stimulating factor (G-CSF). Conditioning was performed with i.v. cyclophosphamide 50 mg·kg^-1·d^-1 for 4 days. The results of the modified Rodnan skin score (mRSS), thoracic high-resolution computer tomography and pulmonary function were collected after transplantation. Results: There was an improvement in mRSS, lung function and HRCT in the six months after AHSCT. Within six month to one year after transplantation, one patient had sustained and two patients recurred. After active treatments two patients were improved again. During the follow-up of 8.7 (4.1-9.8) years, three patients were stable and one patient died. Infection and hepatic function injury were the major complications. There was not transplant-related mortality. Conclusion AHSCT with CTX as a pre-conditioning regimen is safe and effective for SSc. The efficacy for patients with short course, rapid progress and edema is significant. However, long-term efficacy is poor, and long-term maintenance treatment is needed.

Objective: To explore the correlation between obesity and the risk of colorectal adenoma, so as to provide theoretic evidence for the intervention of the high-risk population for colorectal cancer. Methods: Based on the Screen Project of Early Diagnosis and Treatment of Colorectal Cancer in Jiashan County, from August 2012 to March 2018, the results of colonoscopy and body measurement information of the high-risk population for colorectal cancer were collected. According to the results of colonoscopy, 3 895 patients with colorectal adenoma and 11 232 healthy controls were enrolled. Multivariate logistic regression was used to analyze the correlation between overweight (body mass index (BMI) 24.0 to 27.9 kg/m²), obesity (BMI≥28.0 kg/m²) and the risk of colorectal adenoma. Results: After adjusting for gender and age, compared with that of individuals with normal weight (BMI 18.5 to 23.9 kg/m²), the risk of colorectal adenoma of obese patients increased by 36% (odds ratio (OR)=1.36, 95% confidence interval (CI) 1.18 to 1.56). After stratifing by gender, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese males increased by 30% (OR=1.30, 95%CI 1.07 to 1.59), the risk of colorectal adenoma of overweight females and obese females increased by 15% (OR=1.15, 95%CI 1.01 to 1.31) and 40% (OR=1.40, 95%CI 1.14 to 1.71), respectively. After stratifing by age, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese patients aged between 40 and 59 years increased by 31% (OR=1.31, 95%CI 1.07 to 1.61), and the risk of colorectal adenoma of overweight and obese patients aged between 60 and 74 years increased by 13% (OR=1.13, 95%CI 1.01 to 1.27) and 39% (OR=1.39, 95%CI 1.15 to 1.70), respectively. The results of subgroup analysis according to pathological types indicated that the risk of non-advanced adenoma and advanced adenoma of obese patients increased by 35% (OR=1.35, 95%CI 1.16 to 1.57) and 39% (OR=1.39, 95%CI 1.06 to 1.83), respectively. Conclusions Obesity is correlated with colorectal adenoma, which is more significant in women, individuals aged between 60 and 74 years and advanced adenoma. The intervention of high-risk population for colorectal cancer should include body mass control.

Objective To observe the efficacy and safety of rituximab in the treatment of systemic sclerosis (SSc).Methods This was a prospective,non-randomized controlled trial.All patients with SSc were hospitalized from January 2011 to August 2015.Fifty-two patients were enrolled,including 15 patients in the intervention group and 37 patients in the control group.Both groups were given cyclophos-phamide and prednisone.The intervention group was also given rituximab 375 mg/m2,once every 4 weeks,a total of 4 treatments.The erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),intedeukin 6 (IL-6),modified Rodnan skin score (mRSS),HRCT,forced vital capacity (FVC％),1％ forced expiratory volume percentage (FEV 1％),percentage of carbon monoxide dispersion percentage (DLCO％) were assessed alternatively before treatment,6 months and 12 months after treatment.The repeated measures analysis of variance and t-test were used for statistical analysis.Results Both groups showed improvement in ESR,CRP,IL-6,mRSS,HRCT,FVC％,FEV1％ and DLCO％ (P＜0.05),but ESR [6 month after treatment (33±9) mm/1 h,12 month after treatment (20±4) mm/1 h],CRP [6 month after treatment (12.7±3.4) mg/L,12 months after treatment (12.7± 3.4) mg/L],IL-6 [6 month after treatment (73±10) pg/ml,12 month after treatment (57±11) pg/ml],mRSS [6 months after treatment (22.2±1.3),12 month after treatment (18.4±3.1)],HRCT score [6 month after treatment (11.9±1.4),12 month after treatment (11.3±1.0)],in patients of the intervention group were decreased more significantly than patients of the control group (P＜0.05),and FVC％ [6 month after treatment (69.0± 3.4)％,12 month after treatment (77.2±4.1)％],FEV1％[6 month after treatment (73.3±3.4)％,12 month after treatment (78.4±1.6)％] and DLCO％ [6 month after treatment (60.6±2.7)％,12 month after treatment (70.7± 3.0)％] were increased more significantly than patients of the control group (P＜0.05).It showed that the efficacy of the intervention group was better than the control group.There was no infusion reactions,infection,hepatitis B virus reactivation and other side effects in the treatment were observed.Conclusion Rituximab can reduce the level of inflammation in patients with SSc and improve skin sclerosis and lung function.Rituximab combined cyclophosphamide is expected to be a new,safe and effective treatment of SSc.

Objective To understand the status of knowledge, attitude and practice (KAP) about stroke among the residents in a community of Wenzhou, and to clarify the characteristics of the intervention population and the key points for intervention, so as to carry out health education and health promotion, and improve the prevention and treatment of stroke. Methods An investigation was conducted in a total of 658 residents in a community of Wenzhou, aged from 18 to 90. The content of the investigating included the general information, the KAP about stroke, the identification of stroke warning information and the behavior of seeking medical advice. Results The highest and lowest rate of the knowledge about stroke prevention and treatment was 88.68% and 33.54%; the highest and lowest rate of the correct attitude was 79.75% and 32.67%; and the highest and lowest rate of the correct behavior was 56.17% and 10.89%. The differences of KAP in populations with different characteristics were statistically significant (P< 0.01). The top three stroke warning symptoms were one side of the face or limb numbness or weakness (59.57%), consciousness disturbance (59.42%) and comprehension disturbance (59.12%). The thop three emergency seeking hospital service behaviors of stroke were immediate delivery to hospital (19.60%), continued observation (18.54%) and calling ambulance (18.24%). Conclusions The status quo of community residents' KAP of stroke in Wenzhou is at a low level. It is suggested to carry out targeted health education to improve the residents' knowledge of stroke and promote the change of attitude and behavior, so as to prevent or delay the incidence of stroke.