OBJECTIVE To investigate the current career development status and existing bottlenecks among graduates of clinical pharmacist training bases， and to provide evidence for optimizing the training system， enhancing trainees’ job competency， and promoting the sound development of the clinical pharmacy discipline. METHODS Graduates from a clinical pharmacist training base in a tertiary class A hospital were selected as survey subjects. A six-dimensional questionnaire was designed using “Wenjuanxing” platform， distributed and collected via a mobile APP and E-mail. The survey analyzed participants’ basic characteristics， the impact of training on their professional roles， as well as their satisfaction regarding professional sentiment， competence， career status， professional recognition， the current state of the clinical pharmacist workforce， and the teaching model of the training base. The reliability of the questionnaire responses was assessed using Cronbach’s α coefficient. RESULTS A total of 164 questionnaires were distributed， and 147 valid responses were recovered， yielding a valid response rate of 89.63%. The Cronbach’s α coefficient for the questionnaire content was 0.943. The surveyed trainees were primarily employed at general hospitals （81.63%） and tertiary class A hospitals （72.11%）， with women constituting the majority （79.59%）. Their ages were concentrated between 26 and 35 years old （63.27%）， and most of them were supervising pharmacists（59.86%）. After training， 96.60% of graduates returned to their original institutions， and the proportion working in clinical pharmacist positions increased from 52.38% to 84.35%. Trainees’ overall satisfaction rate with the training model was 84.35%. However， their satisfaction with innovation and research capacity in clinical pharmacy was only 42 .18%， the satisfaction with salary and benefits was 35.37%， and the satisfaction with both occupational recognition and rationality of staffing was less than 50%. CONCLUSIONS Clinical pharmacist training bases can effectively promote trainees’ career transition， enhance job competency， and stabilize the talent pool among trainees. Nonetheless， the profession still faces bottlenecks such as relatively weak research capacity， low compensation， insufficient professional recognition， and unreasonable staffing. These issues require a multi-pronged， collaborative approach involving the optimization of training systems， the enhancement of career support， and the improvement of industry policies.

With changes in lifestyle,the incidence of osteoporotic vertebral burst fractures is increasing.These fractures are prone to being underdiagnosed or misdiagnosed.In severe cases,they can lead to nonunion,kyphotic deformity,and even neurological injury.The best treatment plan for such unstable fractures has always been controversial.On the one hand,the fracture degree is severe and the morphology is complex,and there is no unified classification standard.On the other hand,the general condition and bone quality of the patients are poor,which affects the surgical decision.This article reviews the progress in the diagnosis and treatment of osteoporotic lumbar body blowout fractures.

Objective To compare the safety and efficacy of curettage and their combination with uterine artery embolization(UAE)in the treatment of cesarean scar pregnancy(CSP)patients with a low score(≤4)in the ultrasound quantification scoring system.Methods Based on our inclusion and exclusion criteria of this randomized controlled study,the women with CSP who had an ultrasonic quantitative score≤4 and were treated in our department from May 2020 to August 2023 were enrolled,and then randomly divided into a curettage group(n=48)and a UAE combination group(n=47)in a ratio of 1∶1.General information,intraoperative conditions,and use of rescue measures within 3 months after operation were collected in the 2 groups of patients.All the patients were followed up until October 2024 to observe the pregnancy outcomes and determine the impact on the menstrual volume after the resumption of normal menstruation.Results The patients from the both groups completed the follow-up.Except for the maximum gestational sac diameter,there were no significant differences in other baseline data between the 2 groups,and the curettage group had notably more patients having a gestational sac diameter≤25 mm than the combination group[37(77.1%)vs 27(57.4%),P<0.05].No statistical differences were observed between the 2 groups in the intraoperative bleeding volume and use of rescue measures within 3 months after surgery.The combination group had obviously more patients with reduced menstrual volume after the resumption of normal menstruation than the dilation and curettage group[30(63.8%)vs 13(27.1%),P<0.001].There were no statistically differences in pregnancy outcomes and the number of days to resume menstruation between the 2 groups.Conclusion For CSP patients with a score of≤4 in the ultrasound quantification scoring system,curettage show no significant difference in therapeutic effectiveness,and even have better efficacy and safety when compared with curettage combined with UAE.

Kv1.3,a voltage-gated potassium channel,is highly expressed in T lymphocytes,the nervous system,and vascular smooth muscle cells.It plays a critical role in membrane excitability and electrical signal transduction,serving as an important target for studying T-cell function and providing a promising direction for developing therapeutics against autoimmune and inflammatory diseases.Therefore,the de-velopment of specific inhibitors of Kv1.3 channel has emerged as a novel therapeutic strategy for these disorders.In this study,we isolated and purified a novel Kv1.3-inhibitory peptide toxin,LmKTx13,from the venom of the scorpion Lychas mucronatus using reversed-phase high-performance liquid chroma-tography(RP-HPLC).LmKTx13 consists of 38 amino acid residues,including six cysteines that form three disulfide bonds.Whole-cell patch-clamp recordings revealed that LmKTx13 potently inhibited Kv1.3 with an IC50 of 7.92±3.0 nmol/L.Selectivity analysis showed that 2 μmol/L LmKTx13 also in-hibited Kv1.2 and Kv1.7,but exhibited no significant effects on other potassium channel subtypes or voltage-gated sodium channels.Further investigation into the mechanism demonstrated that LmKTx13 acts as a pore-blocking inhibitor of Kv1.3.By analyzing the effects of LmKTx13 on Kv1.3 channel gating ki-netics and performing sequence alignment of the pore regions of Kv1.3 and Kv1.5,we constructed site-directed mutants and identified the pore region of Kv1.3 as the critical binding site for LmKTx13.Key residues involved in the interaction included T425,G427,and H451.In summary,we discovered a no-vel pore-blocking Kv1.3 inhibitor,LmKTx13,from L.mucronatus venom,which exhibits high affinity and selectivity for Kv1.3.These findings highlight its potential as a potential lead molecule for developing Kv1.3-targeted therapeutics.

Objective To assess the mid-term clinical prognosis and radiological outcomes of a novel expandable PEEK(polyetheretherketone)vertebral replacement device used for anterior and middle column recon-struction in the thoracolumbar spine of osteoporotic patients.Methods A retrospective analysis was performed on 52 patients with single-segment osteoporotic thoracolumbar fractures who underwent vertebral body replacement surgery between January 2020 and December 2023.The surgical procedures included either a thoracoscopic or minimally invasive anterior approach,combined with posterior short-segment cement-augmented screw fixation.According to the type of replacement material used,patients were categorized into two groups:the novel PEEK group and the titanium Mesh cage group.Data on surgical time,intraoperative blood loss,and postoperative complications were collected.The Visual Analogue Score(VAS),Oswestry Disability Index(ODI),local kyphotic angle(LKA),fusion segment height(D-line),anterior vertebral body height(AVBH),and posterior vertebral body height(PVBH)were assessed at three stages:preoperatively,immediately postoperatively,and during the final follow-up.Results All patients were successfully discharged.In the PEEK group,the average operative time was(235.28±58.69)minutes,and intraoperative blood loss was(680.00±163.30)mL.The mean follow-up duration was(14.12±2.44)months.The VAS score decreased significantly from(7.44±0.87)preoperatively to(2.24±0.93)at the final follow-up,and the ODI score also decreased significantly from(42.64±4.86)preoperatively to(11.84±3.73)at the final follow-up,indicating substantial improvement in symptoms and function(P<0.05).At the final follow-up,LKA,D-line,and AVBH exhibited partial loss compared to immediate postoperative values(P>0.05),but they remained significantly improved compared to preoperative values(P<0.05).The postoperative complication rate was 12.00%(3/25),and the fusion rate at the final follow-up was 100.00%.Similarly,the Mesh group effectively improved patient symptoms,function,and vertebral height(P<0.05).However,at the final follow-up,the PEEK group demonstrated significantly better LKA,D-line,and AVBH values compared to the Mesh group(P<0.05).Conclusion The short-segment cement-augmented internal fixation in combination with the novel expandable PEEK replacement device represents a viable solution for anterior column reconstruction in osteoporotic thoracolumbar fractures,as evidenced by its mid-term outcomes of effective pain relief,significant functional improvement,sustained maintenance of vertebral height,and successful deformity correction.

AIM To investigate the effects of Rutong Ruanjian Tablets on angiogenesis in cancer tissues of rats with preneoplastic breast cancer(PBC).METHODS 60 female SD rats were randomly divided into a blank group of 10 rats and a model group of 50 rats for the establishment of the PBC models of Liver-Qi Stagnation and Blood Stasis Pattern with 9 weeks of oral administration of 7,12-dimethylbenz[a]anthracene(DMBA)and cervical ligation.After successful modeling,the rats were randomly divided into the model group,the tamoxifen group(3.2 mg/kg),the Rutong Ruanjian Tablets group(128 mg/kg),the 3,5-difluorobenzoyl group(DAPT,5 mg/kg),and the Rutong Ruanjian Tablets(128 mg/kg via gavage)+DAPT(5 mg/kg intraperitoneal injection)group,for 1 month corresponding drug administration,with 10 rats in each group.Then the rats had their cancer progression and syndrome scores observed;their angiogenesis evaluated by assessment of microvascular density(MVD);their vascular endothelial growth factor(VEGF)expression assessed by immunohistochemistry;and their mRNA and protein expressions of proteins related to the DLL4/Notch1/Hes1 pathway measured using RT-qPCR,immunohistochemistry and Western blot.RESULTS During carcinogenesis of rats induced by DMBA,there was gradual disappearance of E-cadherin expression and consistency of HE staining result with the PBC progression confirming the success of the modeling.Compared with the blank group,the model group showed increased MVD values,mRNA expression of Notch1 and Hes1,and protein expressions of VEGF,DLL4,Notch1 and Hes1(P＜0.05,P＜0.01).Compared with the model group,the Rutong Ruanjian Tablets group exhibited reduced MVD values,mRNA expression of Notch1 and Hes1,and protein expressions of VEGF,DLL4,Notch1 and Hes1(P＜0.05,P＜0.01).The Rutong Ruanjian Tablets+DAPT group showed reduced mRNA expression of Notch1 and Hes1,and protein expressions of DLL4,Notch1 and Hes1 compared to the Rutong Ruanjian Tablets group(P＜0.05,P＜0.01).CONCLUSION Rutong Ruanjian Tablets can inhibit angiogenesis and attenuate cancer progression in PBC rats of Liver-Qi Stagnation and Blood Stasis Pattern,and the mechanism may lie in the downregulation of DLL4/Notch1/Hes1 signaling pathway related proteins.

Objective:To explore the potential categories of symptom characteristics of early breast cancer patients undergoing postoperative chemotherapy, analyze the differences of symptoms among different categories of patients, and compare their quality of life according to different categories.Methods:This was a cross-sectional study. From January to June 2023, 240 patients with early breast cancer who received chemotherapy after surgery in General Hospital of Ningxia Medical University were selected by convenience sampling. They were investigated by general information questionnaire, Memory Symptom Assessment Scale, and Functional Assessment of Caner Therapy-Breast Cancer. Mplus 8.3 was used to carry out potential profile analysis and identify the potential categories of symptom characteristics of early breast cancer patients undergoing postoperative chemotherapy. Binary Logistic regression analysis was used to determine the influencing factors of symptom characteristics. SPSS 26.0 software was used to compare the differences in quality of life scores of patients undergoing postoperative chemotherapy for different categories of early breast cancer.Results:Totally 233 valid questionnaires were ultimately collected, with an age of 50.85 ± 8.09. There were two potential categories of postoperative chemotherapy patients with early breast cancer: low symptom troubled group (159 cases, 68.2%) and high symptom troubled group (74 cases, 31.8%). The quality of life score of the high symptom distress group was (76.84 ± 13.15) points, which was significantly lower than (89.56 ± 11.29) points of the low symptom distress group, and the difference was statistically significant ( t=7.18, P<0.01). Logistic regression analysis showed that patients with early breast cancer who had financial burden after postoperative chemotherapy were more likely to belong to the group with high symptoms [ OR (95% CI) was 3.028 (1.434-6.394), P<0.01]. Postoperative chemotherapy patients with early breast cancer who had satisfactory sleep at night are more likely to belong to the group with low symptoms [ OR(95% CI) was 0.446 (0.217-0.920), P<0.05]. Conclusions:There is population heterogeneity in the symptom characteristics of patients with early breast cancer undergoing postoperative chemotherapy. and economic burden and night sleep are the influencing factors of symptom distress categories of breast cancer patients. It is suggested that medical staff should give individualized and targeted intervention measures centered on patients′ needs according to different types of population characteristics, so as to reduce the symptom burden and improve their quality of life.

Objective To assess the mid-term clinical prognosis and radiological outcomes of a novel expandable PEEK(polyetheretherketone)vertebral replacement device used for anterior and middle column recon-struction in the thoracolumbar spine of osteoporotic patients.Methods A retrospective analysis was performed on 52 patients with single-segment osteoporotic thoracolumbar fractures who underwent vertebral body replacement surgery between January 2020 and December 2023.The surgical procedures included either a thoracoscopic or minimally invasive anterior approach,combined with posterior short-segment cement-augmented screw fixation.According to the type of replacement material used,patients were categorized into two groups:the novel PEEK group and the titanium Mesh cage group.Data on surgical time,intraoperative blood loss,and postoperative complications were collected.The Visual Analogue Score(VAS),Oswestry Disability Index(ODI),local kyphotic angle(LKA),fusion segment height(D-line),anterior vertebral body height(AVBH),and posterior vertebral body height(PVBH)were assessed at three stages:preoperatively,immediately postoperatively,and during the final follow-up.Results All patients were successfully discharged.In the PEEK group,the average operative time was(235.28±58.69)minutes,and intraoperative blood loss was(680.00±163.30)mL.The mean follow-up duration was(14.12±2.44)months.The VAS score decreased significantly from(7.44±0.87)preoperatively to(2.24±0.93)at the final follow-up,and the ODI score also decreased significantly from(42.64±4.86)preoperatively to(11.84±3.73)at the final follow-up,indicating substantial improvement in symptoms and function(P<0.05).At the final follow-up,LKA,D-line,and AVBH exhibited partial loss compared to immediate postoperative values(P>0.05),but they remained significantly improved compared to preoperative values(P<0.05).The postoperative complication rate was 12.00%(3/25),and the fusion rate at the final follow-up was 100.00%.Similarly,the Mesh group effectively improved patient symptoms,function,and vertebral height(P<0.05).However,at the final follow-up,the PEEK group demonstrated significantly better LKA,D-line,and AVBH values compared to the Mesh group(P<0.05).Conclusion The short-segment cement-augmented internal fixation in combination with the novel expandable PEEK replacement device represents a viable solution for anterior column reconstruction in osteoporotic thoracolumbar fractures,as evidenced by its mid-term outcomes of effective pain relief,significant functional improvement,sustained maintenance of vertebral height,and successful deformity correction.

Objective:To investigate the association between single nucleotide polymorphism (SNP) of the protein phosphatase 1 regulatory subunit 1B( PPP1R1B) gene and schizophrenia in the Han population of northern Henan province. Methods:Utilizing Psychiatric Genomics Consortium 3 (PGC3) data, the SNPs of PPP1R1B gene which were significantly associated with schizophrenia were screened.Subsequently, totally 1 721 schizophrenia patients and 6 726 healthy controls from the Han population in northern Henan province were recruited for further analysis. The SNP rs907094, located within the PPP1R1B gene was validated, and the clinical symptoms of 386 schizophrenia patients were evaluated using the positive and negative syndrome scale (PANSS). Additionally, expression quantitative trait loci (eQTL) association analysis was conducted to explore the relationship between the rs907094 polymorphism and PPP1R1B gene expression.The PLINK v1.9, Genetic Power Calculater, SPSS 20.0 softwares were used for data analysis. Results:Significant differences in genotype AA, AG, GG(schizophrenia group: AA, 489(28.4%); AG, 848(49.3%); GG, 384(22.3%); control group: AA, 1 450(21.6%); AG, 3 386(50.3%); GG, 1 890(28.1%), χ2=45.418, P<0.05) and allele frequency(schizophrenia group: A, 1 826(53.1%); G, 1 616(46.9%); control group: A, 6 286(46.7%); G, 7 166(53.3%), χ2=43.877, P<0.05) were observed for SNP rs907094 between the schizophrenia group and control group. Individuals carrying allele A were identified to have a higher risk of developing schizophrenia compared to those carrying allele G ( OR=1.288, 95% CI=1.195-1.388). Furthermore, the genotype PPP1R1B gene was found to be associated with the clinical features of schizophrenia. A statistically significant difference was observed in the excitement/hostility factor between AA and GG patients with rs907094 (13.62±5.65, 15.54±4.66)( P<0.05). Additionally, significant differences were noted in the cognitive factor scores between AA and GA genotypes (17.76±5.58, 19.43±5.73)( P<0.05). Conclusions:In the Han population from northern Henan province, the rs907094 polymorphism of the PPP1R1B gene is associated with schizophrenia.And the specific locus may be implicated in arousal/hostility symptoms and cognitive dysfunction.

Objective:To analyze the association between inflammation-related dietary patterns and the risk for cognitive impairment in older adults aged ≥65 years in longevity areas in China by using reduced rank regression (RRR) analysis.Methods:This study used cross-sectional data from the 2021 Healthy Aging and Biomarkers Cohort Study, including the information about study participants' demographic characteristics, lifestyles, daily life activities, and disease histories. Dietary intake was obtained by using a simplified food frequency questionnaire. Cognitive impairment was evaluated based on the Mini-Mental State Examination Scale combined with years of education. Fasting venous blood samples were collected to detect inflammatory markers, especially high-sensitivity C-reactive protein (hs-CRP) and the platelet-to-lymphocyte ratio (PLR). RRR analysis was used to obtain inflammation-related dietary patterns using hs-CRP and PLR as response variables. Multivariate logistic regression model was used to analyze the association between dietary pattern score and the risk for cognitive impairment. Restricted cubic spline was used to explore the dose response relationship, and mediation analysis was used to quantify the mediating effects of hs-CRP and PLR.Results:Two dietary patterns were identified with RRR. The primary pattern was characterized by higher intakes of flour, red meat, and dairy products, and lower intake of fresh vegetables, explaining 6.84% of the variance in food intake and 0.50% of the variance in inflammatory markers. Compared with the T1 group, the T3 group had significantly higher risk for cognitive impairment ( OR=1.242, 95% CI: 1.034-1.491). Each one standard deviation increase in the dietary pattern score was associated with an 8.7% increase in the risk for cognitive impairment ( OR=1.087, 95% CI: 1.008-1.172), with a significant linear trend (overall-model P<0.001, non-linear P=0.295). Mediation analysis indicated that hs-CRP mediated 6.2% of the association between the dietary pattern and the risk for cognitive impairment. Conclusion:The inflammation- related dietary pattern characterized by higher consumption of flour, red meat, and dairy products and lower consumption of fresh vegetables is associated with an increased risk for cognitive impairment in older adults, and hs-CRP partially mediates this association.