Objective To screen the active antidiarrheal components of salt-processed Alpiniae oxyphyllae Fructus-Foeniculi Fructus medicines(YZYH)and investigate its pharmacological basis and quality markers by examining its"spectrum-effect"relationship.Methods A spleen and kidney yang deficiency model of diarrhea was established in rats.The pharmacodynamic indexes of YZYH in petroleum ether,ethyl acetate,and water fractions were measured,including behavioral indicators such as body weight,anal temperature,diarrhea incubation period(DIP),diarrhea index(DI),and biochemical indicators such as nitric oxide synthase(NOS),cGMP,and creatinine phosphokinase(CPK).We analyzed the components of YZYH by high performance liquid chromatography,and analyzed the"spectrum-effect"relationship between the chemical components and the antidiarrheal efficacy indicators using the grey correlation method.Results Compared with the blank control group,rats in the model group developed watery stools after 15 days,which was the key pathological index of the main syndrome of diarrhea.Rats in the model group also developed abdominal distension,loss of appetite,and back arching,as secondary symptoms of spleen and kidney yang deficiency diarrhea.Administration of the therapeutic drugs improved both the main and secondary symptoms of diarrhea.The positive drug and YZYH-M significantly prolonged DIP(P＜0.01)and decreased DI(P＜0.01)after 28 days.These key indexes of diarrhea,as well as body mass,24 h food intake,water intake,anal temperature,and the serum biochemical indexes NOS,cGMP,CPK were all improved in the positive drug and YZYH-M groups.Examination of the spectral effect relationship showed that anisaldehyde,chromatographic peak 4,and other components were correlated with the pharmacodynamic indexes of DIP,DI,NOS,cGMP,and CPK.Conclusions The ethyl acetate fraction was the active antidiarrheal fraction of salt-processed Alpiniae oxyphyllae Fructus-Foeniculi Fructus medicines.It acts by inhibiting gastrointestinal hyperfunction,regulating energy metabolism and immunity.Ingredients such as anisaldehyde and peak 4 served as quality indicators for its antidiarrheal effect.

OBJECTIVE To explore the specific application and evaluation effect of objective structured clinical examination(OSCE)-guided scenario-based practical teaching mode in training clinical pharmacists. METHODS Fifty-six trainees who participated in the clinical pharmacist training program in the Second Xiangya Hospital of Central South University from October 2020 to September 2022 were selected as the research objects. OSCE-guided teaching was conducted, and the application effect of OSCE-guided teaching mode in clinical pharmacist training was explored and analyzed by using theoretical examination results and OSCE assessment results as evaluation indicators. RESULTS Through comparative analysis, it was found that the OSCE-guided teaching mode not only enabled students to better grasp the theoretical knowledge points required by the training outline, but also improved their clinical thinking ability, problem-solving ability, and communication and coordination skills to varying degrees. CONCLUSION For clinical pharmacist trainees, the OSCE teaching mode is conducive to the comprehensive improvement of clinical pharmacist skills and is suitable for cultivating clinical pharmacists who are capable of independently carrying out clinical pharmacy services in the new situation.

Objective Gastroesophageal reflux disease(GERD)is a condition in which the contents of the stomach break through the anti-reflux barrier and reflux from the stomach into the esophagus and even into the mouth,throat,and airway,causing symptoms or complications,and it is one of the most common intractable diseases of the upper gastrointestinal tract,which seriously affects the quality of life of patients.Traditional Chinese medicine(TCM)is effective and highly accepted in the treatment of GERD,and an animal model that combines disease and syndrome is the basis and prerequisite for conducting relevant research.Methods Relevant databases were searched,and based on the clinical diagnostic criteria of GERD in Chinese and Western medicine,the modeling methods,modeling performance,and modeling characteristics of the existing animal models of GERD combined with disease and syndrome were summarized,and the reasons for the selection of the specific modeling methods and evaluation indexes were explored,and the degree of match was evaluated based on the characteristics of the clinical disease and syndrome in Chinese and Western medicine.Results The combination model of GERD was based on surgical or pharmacological stimulation,such as esophageal instillation of exogenous acid,surgical intervention to change the physiological structure of the gastrointestinal tract of the rat causing gastric reflux or mixed reflux,and imposition of TCM interventions,with chronic unpredictable stimulation for the liver qi depression syndrome type of animal model,with pinch-tail stimulation for the qi-stagnation and phlegm-obstruction type,with chronic stress stimulation in conjunction with a high-fat diet for the blood stasis blocking collaterals type,with internal and external causes of dampness-heat for the splenic-deficiency damp heat syndrome.The intervention method was mainly used.Conclusion The current animal model of GERD has a high degree of consistency with the characteristics of Western medicine,but a lower degree of consistency with Chinese medicine.Therefore,according to the differences in the mechanism of Chinese medicine,we propose corresponding improvements and observation methods,as well as the shortcomings of the current study,in order to provide reference for the establishment of the GERD model,to establish an animal model that conforms to the characteristics of the Western and Eastern medicine and has a high degree of clinical consistency,so as to lay the foundation for the research on the mechanism of GERD and medication.The study will lay the foundation for the research of GERD mechanism and drugs.

Objective Gastroesophageal reflux disease(GERD)is a condition in which the contents of the stomach break through the anti-reflux barrier and reflux from the stomach into the esophagus and even into the mouth,throat,and airway,causing symptoms or complications,and it is one of the most common intractable diseases of the upper gastrointestinal tract,which seriously affects the quality of life of patients.Traditional Chinese medicine(TCM)is effective and highly accepted in the treatment of GERD,and an animal model that combines disease and syndrome is the basis and prerequisite for conducting relevant research.Methods Relevant databases were searched,and based on the clinical diagnostic criteria of GERD in Chinese and Western medicine,the modeling methods,modeling performance,and modeling characteristics of the existing animal models of GERD combined with disease and syndrome were summarized,and the reasons for the selection of the specific modeling methods and evaluation indexes were explored,and the degree of match was evaluated based on the characteristics of the clinical disease and syndrome in Chinese and Western medicine.Results The combination model of GERD was based on surgical or pharmacological stimulation,such as esophageal instillation of exogenous acid,surgical intervention to change the physiological structure of the gastrointestinal tract of the rat causing gastric reflux or mixed reflux,and imposition of TCM interventions,with chronic unpredictable stimulation for the liver qi depression syndrome type of animal model,with pinch-tail stimulation for the qi-stagnation and phlegm-obstruction type,with chronic stress stimulation in conjunction with a high-fat diet for the blood stasis blocking collaterals type,with internal and external causes of dampness-heat for the splenic-deficiency damp heat syndrome.The intervention method was mainly used.Conclusion The current animal model of GERD has a high degree of consistency with the characteristics of Western medicine,but a lower degree of consistency with Chinese medicine.Therefore,according to the differences in the mechanism of Chinese medicine,we propose corresponding improvements and observation methods,as well as the shortcomings of the current study,in order to provide reference for the establishment of the GERD model,to establish an animal model that conforms to the characteristics of the Western and Eastern medicine and has a high degree of clinical consistency,so as to lay the foundation for the research on the mechanism of GERD and medication.The study will lay the foundation for the research of GERD mechanism and drugs.

Diabetic patients with poor glycemic control are exposed to media containing mold spores, and spores enter the body, which may lead to refractory infections. This article combines case and literature reviews, proposes the diagnosis and treatment method of mold infection, and provides some guidances for subjects who long-term exposure to mold groups such as farmers and immunocompromised people.

Objective: To identify the clinical manifestations, imaging findings, and genetic mutation characteristics in a rare case of adrenoleukodystrophy(ALD)with adrenocortical dysfunction(Addison′s disease)as the first manifestation. Methods: The clinical data of the proband and his family members were comprehensively collected, and ABCDl gene sequencing was meticulously performed for the proband and his mother using high-throughput sequencing method. Results: The patient presented with systematical skin pigmentation accompanied by fatigue in early stage, arose stroke-like episodes manifested as a sudden loss of consciousness and incontinence induced by high fever, and followed by progressive unclear speech, unstable walking and worsening vision. Serum very long-chain fatty acid(VLCFA)concentration increased over normal range. The brain MRI showed an abnormal signal of the symmetric distribution of the bilateral corpus callosum. A new c. 874_876del GAG hemizygous variation in the patient′s ABCD1 gene was detected, while his mother had a nucleotide heterozygous variation to this site . Conclusion The diagnosis of ALD requires a combination of clinical manifestations, imaging examination, and serum VLCFA level measurement, while the detection of ABCD1 gene mutations is considered to be the most reliable approach.

To report the clinical, imaging and pathological feature of a case of primary hyperparathyroidism(PHPT) with multiple brown tumors whose complain was repeated epistaxis, and to conduct a retrospective analysis with relevant literatures. A postmenopausal middle-aged woman, with a history of joint pain, fracture, and kidney stone which were neglected due to the lack of specificity of symptoms for years, went to hospital due to repeated epistaxis. Laboratory results showed high blood calcium, hypophosphatemia, alkaline phosphatase(ALP), and parathyroid hormone(PTH) levels, as well as increased urinary calcium. Imaging examination showed systemically multiple brown tumors and extensive osteoporosis. Meanwhile an abnormal mass was found behind the right thyroid. Taking all findings into account, the diagnosis was made with PHPT, and the histopathology further confirmed that the lesion was a parathyroid adenoma. This case seems to be a rare case of multiple brown tumor caused by parathyroid adenoma, which compressed and destructed nasal blood vessels, thus induced a repeated nasal discharge. After resection of parathyroid adenoma, the patient experienced a transient hypocalcemia and PTH level elevation. After 5-month follow up, part of the brown tumors spontaneously regressed, bone density increased, and her clinical symptoms were mostly relieved.

Objective To understand the risk of acute renal injury (AKI)in patients using compound diclofenac sodium injection after surgeries and analyze the influencing factors. Methods Data of patients who had normal renal function before receiving compound diclofenac sodium injection treatment after surgeries in 2015 in the Second Xiangya Hospital of Central South University were collected and studied retrospectively (unmatched case-control study). The patients with AKI after treatment were included in the case group and the patients without AKI were included in the control group. The general condition, postoperative medication,and renal function before and after medication in the 2 groups were compared. The risk and related factors of AKI using compound diclofenac sodium injection were analyzed. Results A total of 821 patients were enrolled into this study,including 63 cases in the case group [43 males and 20 females,average age(51 ± 13)years]and 758 cases in the control group [425 males and 33 females, average age(50 ±14)years]. The proportion of patients with hypertension and liver cirrhosis in the case group was higher than that in the control group [25. 4％ (16/ 63)vs. 13. 1％ (99/ 758),P =0. 009;9. 5％(6 / 63) vs. 2. 8％ (21 / 758),P = 0. 013],the proportion of patients with general surgeries in the case group was higher than that in the control group [42. 9％(27 / 63)vs. 26. 9％ (204 / 758),P = 0. 007],the proportion of patients with neurosurgery in the case group was lower than that in the control group [15. 9％(10 / 63)vs. 33. 5％ (254 / 758),P = 0. 004],the proportion of patients using compound sodium diclofenac injection within 24 h after operation in the case group was higher than that in the control group [20. 6％(13 / 63)vs.10. 7％(81 / 758),P = 0. 017]. The results of binary logistic regression analysis showed that the risk of AKI in patients with hypertension was significantly higher than the other patients with other diseases (OR =2. 847,95％ CI:1. 498-5. 410,P = 0. 001);the risk of AKI in patients with compound diclofenac sodium injection treatment within 24 h after operation was significantly higher than that in patients with compound diclofenac sodium injection treatment 24 h after the surgery(OR =1. 956,95％ CI:1. 154-3. 315,P =0. 013). Conclusion The patients with compound diclofenac sodium injection treatment after surgeries could develop AKI,the combination of hypertension and the use of the drug within 24 hours postoperatively could significantly increase the risk of AKI.

Objective To understand the risk of acute renal injury (AKI)in patients using compound diclofenac sodium injection after surgeries and analyze the influencing factors. Methods Data of patients who had normal renal function before receiving compound diclofenac sodium injection treatment after surgeries in 2015 in the Second Xiangya Hospital of Central South University were collected and studied retrospectively (unmatched case-control study). The patients with AKI after treatment were included in the case group and the patients without AKI were included in the control group. The general condition, postoperative medication,and renal function before and after medication in the 2 groups were compared. The risk and related factors of AKI using compound diclofenac sodium injection were analyzed. Results A total of 821 patients were enrolled into this study,including 63 cases in the case group [43 males and 20 females,average age(51 ± 13)years]and 758 cases in the control group [425 males and 33 females, average age(50 ±14)years]. The proportion of patients with hypertension and liver cirrhosis in the case group was higher than that in the control group [25. 4％ (16/ 63)vs. 13. 1％ (99/ 758),P =0. 009;9. 5％(6 / 63) vs. 2. 8％ (21 / 758),P = 0. 013],the proportion of patients with general surgeries in the case group was higher than that in the control group [42. 9％(27 / 63)vs. 26. 9％ (204 / 758),P = 0. 007],the proportion of patients with neurosurgery in the case group was lower than that in the control group [15. 9％(10 / 63)vs. 33. 5％ (254 / 758),P = 0. 004],the proportion of patients using compound sodium diclofenac injection within 24 h after operation in the case group was higher than that in the control group [20. 6％(13 / 63)vs.10. 7％(81 / 758),P = 0. 017]. The results of binary logistic regression analysis showed that the risk of AKI in patients with hypertension was significantly higher than the other patients with other diseases (OR =2. 847,95％ CI:1. 498-5. 410,P = 0. 001);the risk of AKI in patients with compound diclofenac sodium injection treatment within 24 h after operation was significantly higher than that in patients with compound diclofenac sodium injection treatment 24 h after the surgery(OR =1. 956,95％ CI:1. 154-3. 315,P =0. 013). Conclusion The patients with compound diclofenac sodium injection treatment after surgeries could develop AKI,the combination of hypertension and the use of the drug within 24 hours postoperatively could significantly increase the risk of AKI.

Objective To explore the efficacy and toxicities of S-1 in the maintenance treatment of advanced esophageal cancer. Methods A total of 52 advanced esophageal cancer patients who benefited from the first-line treatment were randomly divided into experimental group (26 cases received S-1 orally as maintenance treatment) and control group (26 cases received placebo orally) by means of coin toss. After treatment, the efficacy and toxicities of the two groups were observed comparatively. Results The overall response rates (ORR) in experimental group and control group were 84.6% (22/26) and 76.9% (20/26), respectively, and there was significant difference between the two groups (χ2=3.885, P=0.049). The median progression free survival (PFS) time of experimental group was 14.4 months, and that of control group was 12.5 months (χ2= 3.885, P= 0.049). The main adverse reactions of the two groups were grade 1-2, and grade 4 adverse reactions did not appear in all patients. Conclusion S-1 is effective and well-tolerated in the maintenance treatment of advanced esophageal cancer.