OBJECTIVE To evaluate the influence of pharmaceutical quality control on the efficiency and outcomes of standardized medication therapy management （MTM） services for patients with coronary heart disease by using Economic， Clinical and Humanistic Outcomes （ECHO） model. METHODS This study collected case data of coronary heart disease patients who received MTM services during January-March 2023 （pre-quality control implementation group， n＝96） and June-August 2023 （post-quality control implementation group， n＝164）. Using propensity score matching analysis， 80 patients were selected from each group. The study subsequently compared the economic， clinical， and humanistic outcome indicators of pharmaceutical services between the two matched groups. RESULTS There were no statistically significant differences in baseline data between the two groups after matching （P＞0.05）. Compared with pre-quality control implementation group， the daily treatment cost （16.26 yuan vs. 24.40 yuan， P＜0.001）， cost-effectiveness ratio [23.12 yuan/quality-adjusted life year （QALY） vs. 32.32 yuan/QALY， P＜0.001]， and the incidence of general adverse drug reactions （2.50% vs. 10.00%， P＝0.049） of post-quality control implementation group were decreased significantly； the utility value of the EuroQol Five-Dimensional Questionnaire （0.74± 0.06 vs. 0.71±0.07， P＝0.003）， the reduction in the number of medication related problems （1.0 vs. 0.5， P＜0.001）， the medication adherence score （[ 6.32±0.48） points vs. （6.10±0.37） points， P＝0.001]， and the satisfaction score （[ 92.56±1.52） points vs. （91.95±1.56） points， P＝0.013] all showed significant improvements. Neither group experienced serious adverse drug reactions. There was no statistically significant difference in the incidence of new adverse reactions between the two groups （1.25% vs. 3.75%， P＝0.310）. CONCLUSIONS Pharmaceutical quality control can improve the quality of pharmaceutical care， and the ECHO model can quantitatively evaluate the effect of MTM services， making pharmaceutical care better priced and more adaptable to social needs， thus being worthy of promotion.

BACKGROUND:The regulation of intestinal flora by exercise is closely related to human health,but intestinal flora involves many factors.Existing studies have lacked consistent evidence on the effect of exercise on the intestinal flora of college students. OBJECTIVE:To explore the effects of exercise on intestinal flora diversity and species composition of college students. METHODS:Through systematic search of PubMed,Web of Science,Embase,Medline,Cochrane Library,CNKI,WanFang Database and VIP database,eight empirical studies were selected and included,and semi-quantitative analysis was performed on them. RESULTS AND CONCLUSION:In terms of the species diversity of the intestinal flora,both high-intensity interval training and Tai Chi exercise significantly enhance the species diversity of intestinal flora in college students,while aerobic exercise does not have a significant effect on the enhancement of intestinal flora diversity in college students.In terms of the species composition of the intestinal flora,all three exercise modalities significantly alter the compositional structure of the intestinal flora in college students,which can increase the abundance of beneficial bacteria such as Ruminalococcus,Faecalis prevotelli,Blautia,and decrease the abundance of harmful bacteria such as Escherichia spp.Compared with high-intensity interval training,aerobic and Tai Chi exercise causes more elevated abundance of beneficial bacteria.In addition to changes in intestinal flora characteristics,exercise improves body composition,cardiorespiratory function,and executive function in college students,and these health benefits are closely linked to exercise-induced changes in intestinal flora that can produce health benefits for the body through metabolic regulation,barrier function,and neuromodulation.Although studies have confirmed the association between exercise and intestinal flora,the mechanism by which exercise affects intestinal flora has not yet been clarified,and at the same time,localizing the flora related to the host health is the key to targeting intestinal flora as a therapeutic target in the future,all of which are worthy of further attention and investigation.

Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

Background::Pulmonary arterial hypertension (PAH) is characterized by excessive proliferation of small pulmonary arterial vascular smooth muscle cells (PASMCs), endothelial dysfunction, and extracellular matrix remodeling. G protein-coupled receptor kinase 2 (GRK2) plays an important role in the maintenance of vascular tone and blood flow. However, the role of GRK2 in the pathogenesis of PAH is unknown.Methods::GRK2 levels were detected in lung tissues from healthy people and PAH patients. C57BL/6 mice, vascular smooth muscle cell-specific Grk2-knockout mice ( Grk2?SM22), and littermate controls ( Grk2flox/flox) were grouped into control and hypoxia mice ( n = 8). Pulmonary hypertension (PH) was induced by exposure to chronic hypoxia (10%) combined with injection of the SU5416 (cHx/SU). The expression levels of GRK2 and Yes-associated protein (YAP) in pulmonary arteries and PASMCs were detected by Western blotting and immunofluorescence staining. The mRNA expression levels of Grk2 and Yes-associated protein ( YAP) in PASMCs were quantified with real-time polymerase chain reaction (RT-PCR). Wound-healing assay, 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide (MTT) assay, and 5-Ethynyl-2′-deoxyuridine (EdU) staining were performed to evaluate the proliferation and migration of PASMCs. Meanwhile, the interaction among proteins was detected by immunoprecipitation assays. Results::The expression levels of GRK2 were upregulated in the pulmonary arteries of patients with PAH and the lungs of PH mice. Moreover, cHx/SU-induced PH was attenuated in Grk2?SM22 mice compared with littermate controls. The amelioration of PH in Grk2?SM22 mice was accompanied by reduced pulmonary vascular remodeling. In vitro study further confirmed that GRK2 knock-down significantly altered hypoxia-induced PASMCs proliferation and migration, whereas this effect was severely intensified by overexpression of GRK2. We also identified that GRK2 promoted YAP expression and nuclear translocation in PASMCs, resulting in excessive PASMCs proliferation and migration. Furthermore, GRK2 is stabilized by inhibiting phosphorylating GRK2 on Tyr86 and subsequently activating ubiquitylation under hypoxic conditions. Conclusion::Our findings suggest that GRK2 plays a critical role in the pathogenesis of PAH, via regulating YAP expression and nuclear translocation. Therefore, GRK2 serves as a novel therapeutic target for PAH treatment.

Asymptomatic carotid artery stenosis (aCAS) is one of the important causes of ischemic stroke. The imaging evaluation of carotid artery plaques is of great significance for selecting the best treatment in patients with aCAS. This article reviews the plaque composition, plaque morphology, and hemodynamic evaluation of aCAS, aiming to provide a basis for developing personalized medical strategies.

Objective To investigate the clinical outcome of modified laparoscopic extravesical ureteral reimplantation for primary obstructive megaureter(POM).Methods A retrospective analysis was made on 11 cases of POM treated with modified laparoscopic extravesical ureteral reimplantation(Lich-Gregoir method)from December 2020 to October 2023.The patients were aged from 7 months to 10 years and 5 months old(mean,57.6±41.9 months).Intraoperatively,a tunnel was created longitudinally from the posterior bladder wall and the ventral end of the new tunnel was used as the ureteral anastomosis.Results All the 11 laparoscopic operations were successful with no intraoperative complications and no conversions to open surgery.The operation time was 105-145 min(mean,125.5±13.9 min).The 11 cases were followed up for 4-25 months(mean,16 months).None of them had difficulty in urination or urinary tract infection.The distal ureter maximum diameter and hydronephrosis were significantly reduced at 3-6 months after surgery than those before surgery[the distal ureter maximum diameter reduced from(23.0±10.0)mm to(5.2±3.4)mm(P=0.000),and the maximal separation value of the renal collecting system reduced from(35.2±21.1)mm to(11.6±6.9)mm(P=0.001)].Conclusion Modified laparoscopic extravesical ureteral reimplantation is easy to perform and can be one of the treatment options for primary obstructive megaureteropathy in children.

Objective:To explore the effect of long non-coding RNA (lncRNA) C10orf25 on the proliferation and invasion ability of prostate cancer cells and the possible role of miRNA-671-5p (miR-671-5p).Methods:Data from the Gene expression omnibus (GEO) database (data updated in January 2023) were used to analyze the differences in the expression levels of C10orf25 in 137 cases of prostate cancer tissues and paracancerous tissues. Prostate cancer C4-2B, DU-145, 22Rv1, PC-3, LNCaP cell lines and immortalized prostate epithelial RWPE-1 cell lines were selected, and then real-time quantitative fluorescence polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of C10orf25 in cell lines. The 22Rv1 cells with the lowest relative expression level of C10orf25 were selected and divided into the control group (transfected with negative plasmid) and the C10orf25 group (transfected with C10orf25 plasmid); the CCK-8 method was used to detect the proliferation activity of 22Rv1 cells in both groups at day 1, 2, 3, 4, 5 (expressed as absorbance value); the Transwell method was used to detect the invasion ability of 22Rv1 cells. Linc2GO software was used to predict miR-671-5p with binding sites for C10orf25. Dual luciferase reporter gene assay was used to verify the targeting relationship between C10orf25 and miR-671-5p. qRT-PCR was used to detect the relative expression levels of C10orf25 and miR-671-5p. Western blot was used to detect the expression of proteins related to the NF-κB signaling pathway of 22Rv1 cells in the both groups.Results:In the GEO database, the relative expression level of C10orf25 in prostate cancer tissues was lower than that in paracancerous tissues ( P < 0.01). The relative expression levels of C10orf25 in immortalized prostate epithelial cell line RWPE-1 and prostate cancer cell lines C4-2B, DU-145, 22Rv1, PC-3, and LNCaP were 1.00±0.05, 0.63±0.04, 0.42±0.03, 0.18±0.04, 0.81±0.02, 0.50±0.07, and the difference was statistically significant ( F = 43.29, P < 0.05). The proliferation ability of 22Rv1 cells in C10orf25 group was lower than that in the control group from the second day, and the differences were statistically significant (all P < 0.05). The number of invasive cells in the control group and C10orf25 group were (97±11) and (36±9), respectively, and the difference was statistically significant ( t = 4.15, P < 0.01). Linc2GO software prediction results showed that C10orf25 had a binding site for miR-671-5p. The dual luciferase reporter gene assay showed that the relative luciferase activity of miR-671-5p and C10orf25 wild plasmid co-transfecting 22Rv1 cells was lower than that of miR-NC and C10orf25 wild plasmid co-transfecting 22Rv1 cells, and the difference was statistically significant ( P < 0.01); when miR-671-5p or miR-NC was co-transfected with C10orf25 mutant plasmid, the difference in the luciferase activity of 22Rv1 cells was not statistically significant ( P > 0.05). The relative expression levels of miR-671-5p in 22Rv1 cells were 7.33±0.99 and 0.98±0.16, respectively in the control group and C10orf25 group, and the difference was statistically significant ( t = 6.32, P < 0.01). The results of Western blot showed that the expression levels of NF-κB signaling pathway protein p50, matrix metalloproteinase 9, c-myc, and vascular endothelial growth factor protein in 22Rv1 cells in C10orf25 group were lower than those in the control group. Conclusions:The overexpression of C10orf25 may inhibit the proliferation and invasion of prostate cancer cells through the miR-671-5p-NF-κB axis.

[Objective]To evaluate the knowledge,attitude and practice(KAP)of medication use and safety among the patients with acquired immune deficiency syndrome(AIDS)in a 3A-grade hospital of Guangzhou city,and to provide scientific basis for AIDS prevention and treatment.[Methods]A questionnaire survey was conducted among AIDS patients aged 18 years and above in our hospital to investigate their KAP regarding medication use and safety.[Results]A total of 549 questionnaires were collected,of which 503 were valid,with an effective recovery rate of 91.6%.The average scores of KAP were(14.58±8.49),(25.21±6.92)and(47.58±3.33),respectively,with the scoring rates of 36.46%,63.02%,and 95.16%,respectively.There were statistically significant differences(P＜0.05)in knowledge scores among people with different ages,education levels and occupations.Multiple linear regression showed that education level and medical insurance status had most significant impact on knowledge scores(P<0.05).Significant differences were found in attitude scores among people with different education levels(P<0.05),as well as in practice scores among people with different occupations(P<0.05).Multiple linear regression revealed that age,occupation,knowledge score and attitude score had a significant impact on practice scores(P<0.05).Patients expected to receive pharmaceutical care services from the pharmacists via face-to-face communication,network platform and telephone consultation on medication knowledge such as adverse drug reactions and response measures,drug-drug interactions,missed medication and response measures,medication adherence measures,etc.[Conclusions]AIDS patients in this hospital have a good awareness of medication safety,but their knowledge of medication use needs improvement.Some bad habits may affect their compliance,resulting in safety hazards.Therefore,there is an urgent demand for pharmaceutical care services related to rational drug use.

Objective: To analyze the prevalence of comorbidity of spinal curvature abnormality and malnutrition among primary and secondary school students aged 10-18 years in Tianjin in 2023, so as to provide scientific basis for the combined prevention of common diseases and multiple diseases among students and the construction of school health system. Methods: In September to October 2023, 31 884 primary and secondary school students aged 10 to 18 years in Tianjin were selected using stratified cluster random sampling. Abnormal spinal curvature in children and adolescents was assessed by Sereening of Spinal Curvature Abnormality of Children and Adolescents, while stunting, wasting, overweight, and obesity were determined according to the Screening for Malnutrition among Schoolage Children and Adolescents and Screening for Overweight and Obesity among Schoolage Children and Adolescents. The χ2 test was used to compare betweengroup differences in coprevalence, and multiple Logistic regression models were used to analyze the risk of different comorbidity types in different clusters. Results: The coprevalence of spinal curvature abnormality and malnutrition among primary and secondary school students in Tianjin was 1.6%, which was higher for girls than boys (1.8%, 1.4%), higher (2.5%) for senior high schools than for junior high schools and elementary schools (2.0%, 0.5%), and higher in rural than in urban areas (2.1%, 1.1%) (χ2=9.45, 141.92, 46.94, P<0.05). Multiple Logistic regression models showed that junior high school girls had a higher risk of incorrect posture comorbid with stunting and wasting (OR=4.52, 95%CI=1.84-11.06) and incorrect posture comorbid with overweight and obesity (OR=2.67, 95%CI=1.74-4.10) than boys, and that scoliosis/sagittal spinal abnormality comorbid with stunting and wasting (OR=0.10, 95%CI=0.02-0.44) risk was lower than that of boys, senior high school girls had a lower risk of scoliosis/sagittal spinal abnormality comorbid with overweight and obesity (OR=0.27, 95%CI=0.11-0.66) (P<0.05). Conclusions The coprevalence of spinal curvature abnormality and malnutrition is specific among primary and secondary school students in Tianjin, and the comorbidity type varies by gender and education stage. There is a need to increase prevention and control of spinal curvature abnormalities in school health working, intensive screening of key populations, and timely intervention.

Background Currently,there has been a gradual increase in the incidence of mental diseases,becoming a problem that has attracted great concern of the general public.Zhuhai is a core city of the Guangdong-Hong Kong-Macao Greater Bay Area,and the local government have attached great importance to the mental health of residents.The systematic study on the mental health has focused largely on pregnant women and medical workers,yet few are on the adult residents.Objective To investigate the prevalence and its influencing factors of anxiety and depression among adult residents in Zhuhai,so as to provide references for formulating targeted psychological intervention strategies.Methods From September 1 to December 1,2021,a cohort of 5 600 permanent residents aged 18 years and above in Zhuhai were selected through multistage sampling.All participants were subjected to complete Patients' Health Questionnaire Depression Scale-9 item(PHQ-9),Generalized Anxiety Disorder Scale-7 item(GAD-7)and National Mental Health Literacy Questionnaire based on Wenjuanxing software.Then Logistic regression was employed to identify the factors associated with anxiety and depression among the residents.Results Among the 5 600 residents,depressive symptoms were detected in 842(15.04％)residents and anxiety symptoms in 579(10.34％)residents.Logistic regression analysis yielded that female gender(OR=1.488),living in Doumen district(OR=1.942),junior college/undergraduate level(OR=3.602),postgraduate and above(OR=5.904),irregular meal pattern(OR=3.320),comorbid chronic diseases(OR=3.244),disqualification of self-assessment(OR=3.414)and disqualification of mental health skill(OR=2.131)were risk factors for depression symptoms,whereas age≥25 years old(of all age groups OR<1),monthly per capita income>20 000 yuan(OR=0.438)and exercising≥3 times a week(OR=0.431)were protective factors for depression symptoms.Age of 25～34 years old(OR=2.051),living in Jinwan district(OR=1.729)or Doumen district(OR=1.901),junior college/undergraduate level(OR=2.955),postgraduate and above(OR=6.662),irregular meal pattern(OR=2.741),comorbid chronic diseases(OR=3.535),disqualification of self-assessment(OR=3.325)and disqualification of mental health skill(OR=1.838)were risk factors for anxiety symptoms,while monthly per capita income of 6 001～9 000 yuan(OR=0.665)and exercising≥3 times a week(OR=0.572)were protective factors for anxiety symptoms.Conclusion The mental health status of adult residents in Zhuhai is affected by various factors,including gender,age,region of residence,education level,meal pattern,exercise frequency and chronic diseases.