OBJECTIVE To systematically review the status on pharmacist competency assessment tools both domestically and internationally， providing a theoretical basis for constructing scientific and applicable pharmacist competency assessment tools in China. METHODS Through literature review and comparative analysis， 15 representative domestic and international pharmacist competency assessment tools were systematically summarized， and their theoretical foundations， core dimensions， methodological characteristics and practical applications were compared and implications were given. RESULTS &CONCLUSIONS International research has established relatively mature evaluation systems. Represented by those developed from the United Kingdom， the United States， and the International Pharmaceutical Federation， these assessment tools demonstrate scientific structure， wide application， and dynamic and international applicability. While domestic research has progressed in sub-specialties such as clinical pharmacists， licensed pharmacists and pediatric pharmacists， it still faces challenges including insufficient standardization， inadequate validation， delayed updates， and limitations in practical application. The reasons for the disparities in assessment tools between China and other countries include differences in pharmaceutical care models， varying pharmacist training systems， cultural and social background factors， as well as differences in industry management and international influence. Based on this， the author suggests promoting the development and research of assessment tools for pharmacist job competency in China from four aspects： mechanism construction， system refinement， standardization development， and practical implementation.

BACKGROUND:Postoperative results with Meek skin grafting in some patients with extremely severe burns have not been satisfactory,with problems of delayed healing or skin graft failure. There have been fewer studies on the treatment of patients with failed Meek skin grafting due to insufficient skin source. This study aimed to explore a treatment method for such patients. OBJECTIVE:To observe the curative effect of stamp-shaped skin allograft in the treatment of severe burns after Meek skin graft failure. METHODS:Twenty-three patients with extremely severe burns who were admitted at Department of Burns and Skin Surgery,the First Affiliated Hospital of the Air Force Medical University from August 2013 to August 2023 with poor healing after Meek skin grafting were enrolled and divided into allogeneic skin treatment group and dressing change group according to different treatment methods. There were 10 cases in the allograft group and 13 cases in the dressing change group. Preoperative hemoglobin,platelet count,albumin count,white blood cell count,neutrophil count,procalcitonin count,and positive rate of microbial culture before secondary Meek skin grafting were compared between two groups. Survival rate of skin grafts before and after the second operation were compared. The number of operations,incidence of sepsis,and wound scars at 3 months and 6 months after operation were retrospectively analyzed. RESULTS AND CONCLUSION:The preoperative hemoglobin,platelet count and albumin count in the allogeneic skin treatment group were significantly higher than those in the dressing change group (Z=-3.172,P=0.002;Z=-3.010,P=0.003;Z=-2.761,P=0.006). There was no significant difference in the preoperative white blood cell count and neutrophil count between the two groups before secondary Meek skin grafting (Z=1.148,P=0.251;Z=0.373,P=0.709),but the serum procalcitonin count in the allogeneic skin treatment group prior to the second operation was significantly lower than that in the dressing change group (Z=2.955,P=0.002). Burn patients in the dressing change group exhibited a higher microbial culture rate than those in the allogeneic skin treatment group (x2=6.303,P=0.029). The survival rate of skin grafts before the second operation in the allogeneic skin treatment group[(74.8±13.3)％]was significantly higher than that in the dressing change group[(58.4±14.2)％;t=2.85,P=0.01). The survival rate of skin grafts after the second stage operation in the allogeneic skin treatment group[(84.0±11.5)％]was significantly higher than that in the dressing change group[(67.6±20.7)％;t=2.24,P=0.03). The frequency of postoperative surgery in the allogeneic skin treatment group was less than that in the dressing change group (Z=2.27,P=0.02). The incidence of sepsis in the dressing change group was significantly higher than that in the allogeneic skin treatment group (x2=5.490,P=0.03). There was no significant difference in the Vancouver Scar Scale scores of the scars between the two groups at 3 and 6 months after operation (t=0.96,1.138,P>0.05). To conclude,stamp-shaped skin allograft has good curative effect in the treatment of wounds with poor healing of skin after Meek micro-transplantation. The utilization rate of skin in the later stage is significantly increased,which reduces the probability of wound infection and solves the problem of insufficient skin source.

Objective:To investigate the clinical application value of a novel filter's retraction hook capture technique of pull-assisted method for the endovascular retrieval of conical inferior vena cava (IVC) filters whose hook attached to the wall.Methods:From January 2020 to December 2024, patients with conical filters whose hook attached to the wall admitted at Beijing Jishuitan Hospital were enrolled consecutively.Results:A total of 46 patients underwent filter retrieval using filter's retraction hook capture technique of pull-assisted method. Among these patients, 39 cases (84.8%) were successful in filter retrieval, with the penetration distance of cranial anchor vertex of 3.3(2.5, 4.4) mm, and 13 (33.3%) filters were deformed. The other 7 cases were unsuccessful, with a penetration distance of cranial anchor vertex of 5.0 (4.3, 5.0) mm, and 6 (85.7%) filters were deformed. There was a statistically significant difference between the two groups ( P<0.05). One case (2.2%) had IVC injury, one case (2.2%) experienced filter fracture, and no symptomatic pulmonary embolism occurred. Logistic regression analysis showed that filter deformation was an independent dangerous factor for filter's retraction. Conclusions:Filter's retraction hook capture technique of pull-assisted method is effective in removing conical filters whose hook attached to the wall, with no symptomatic PE occurring. This method can be considered as a new adjuvant technique for filter retrieval.

BACKGROUND:Postoperative results with Meek skin grafting in some patients with extremely severe burns have not been satisfactory,with problems of delayed healing or skin graft failure. There have been fewer studies on the treatment of patients with failed Meek skin grafting due to insufficient skin source. This study aimed to explore a treatment method for such patients. OBJECTIVE:To observe the curative effect of stamp-shaped skin allograft in the treatment of severe burns after Meek skin graft failure. METHODS:Twenty-three patients with extremely severe burns who were admitted at Department of Burns and Skin Surgery,the First Affiliated Hospital of the Air Force Medical University from August 2013 to August 2023 with poor healing after Meek skin grafting were enrolled and divided into allogeneic skin treatment group and dressing change group according to different treatment methods. There were 10 cases in the allograft group and 13 cases in the dressing change group. Preoperative hemoglobin,platelet count,albumin count,white blood cell count,neutrophil count,procalcitonin count,and positive rate of microbial culture before secondary Meek skin grafting were compared between two groups. Survival rate of skin grafts before and after the second operation were compared. The number of operations,incidence of sepsis,and wound scars at 3 months and 6 months after operation were retrospectively analyzed. RESULTS AND CONCLUSION:The preoperative hemoglobin,platelet count and albumin count in the allogeneic skin treatment group were significantly higher than those in the dressing change group (Z=-3.172,P=0.002;Z=-3.010,P=0.003;Z=-2.761,P=0.006). There was no significant difference in the preoperative white blood cell count and neutrophil count between the two groups before secondary Meek skin grafting (Z=1.148,P=0.251;Z=0.373,P=0.709),but the serum procalcitonin count in the allogeneic skin treatment group prior to the second operation was significantly lower than that in the dressing change group (Z=2.955,P=0.002). Burn patients in the dressing change group exhibited a higher microbial culture rate than those in the allogeneic skin treatment group (x2=6.303,P=0.029). The survival rate of skin grafts before the second operation in the allogeneic skin treatment group[(74.8±13.3)％]was significantly higher than that in the dressing change group[(58.4±14.2)％;t=2.85,P=0.01). The survival rate of skin grafts after the second stage operation in the allogeneic skin treatment group[(84.0±11.5)％]was significantly higher than that in the dressing change group[(67.6±20.7)％;t=2.24,P=0.03). The frequency of postoperative surgery in the allogeneic skin treatment group was less than that in the dressing change group (Z=2.27,P=0.02). The incidence of sepsis in the dressing change group was significantly higher than that in the allogeneic skin treatment group (x2=5.490,P=0.03). There was no significant difference in the Vancouver Scar Scale scores of the scars between the two groups at 3 and 6 months after operation (t=0.96,1.138,P>0.05). To conclude,stamp-shaped skin allograft has good curative effect in the treatment of wounds with poor healing of skin after Meek micro-transplantation. The utilization rate of skin in the later stage is significantly increased,which reduces the probability of wound infection and solves the problem of insufficient skin source.

Objective : To explore the correlation between uteroglobulin-related protein 1(UGRP1) and primary hypothyroidism. Methods : Ninety-six patients with primary hypothyroidism were selected, including 66 patients with positive thyroid peroxidase antibodies(TPOAb) or anti-thyroglobulin antibodies(ATG) as the antibody-positive group, 30 patients with negative thyroid autoantibodies as the antibody-negative group, and 96 healthy people as the control group. The general clinical data, thyroid-related indicators and serum UGRP1 levels were compared among these three groups. Human thyroid normal cells(NTHY-ORI 3-1) were transfected with plasmids in vitro, thus establishing the control group as well as the UGRP1 group. Enzyme linked immunosorbent assay(ELISA) was used to detect and compare the T4 level in the cell culture supernatant. Results : The differences in thyroid stimulating hormone(TSH), TPOAb and ATG among the three groups were statistically significant(P<0.05). The serum UGRP1 levels in the antibody-positive(303.97±156.00) pg/ml and antibody-negative groups(352.13±188. 37) pg/ml were higher than those in the control group( 237. 54 ± 137. 20) pg/ml,and the differences between the groups were statistically significant( P = 0. 005). Meanwhile,there was no statistically significant difference between the antibody-positive and antibody-negative groups. Multi-factor Logistic regression analysis showed that UGRP1 was the risk factor for the occurrence of primary hypothyroidism( OR = 1. 004,95% CI: 1. 001-1. 007,P =0. 007). The difference between the control group and UGRP1 group in T4 concentration secreted by human thyroid normal cells was not statistically significant. Conclusion Serum UGRP1 levels increase in patients with primary hypothyroidism,and the high expression of UGRP1 may have no direct relation to the function of thyroid cells secreting T4.

Objective:To investigate the clinical application value of a novel filter's retraction hook capture technique of pull-assisted method for the endovascular retrieval of conical inferior vena cava (IVC) filters whose hook attached to the wall.Methods:From January 2020 to December 2024, patients with conical filters whose hook attached to the wall admitted at Beijing Jishuitan Hospital were enrolled consecutively.Results:A total of 46 patients underwent filter retrieval using filter's retraction hook capture technique of pull-assisted method. Among these patients, 39 cases (84.8%) were successful in filter retrieval, with the penetration distance of cranial anchor vertex of 3.3(2.5, 4.4) mm, and 13 (33.3%) filters were deformed. The other 7 cases were unsuccessful, with a penetration distance of cranial anchor vertex of 5.0 (4.3, 5.0) mm, and 6 (85.7%) filters were deformed. There was a statistically significant difference between the two groups ( P<0.05). One case (2.2%) had IVC injury, one case (2.2%) experienced filter fracture, and no symptomatic pulmonary embolism occurred. Logistic regression analysis showed that filter deformation was an independent dangerous factor for filter's retraction. Conclusions:Filter's retraction hook capture technique of pull-assisted method is effective in removing conical filters whose hook attached to the wall, with no symptomatic PE occurring. This method can be considered as a new adjuvant technique for filter retrieval.

Background and Aims:Acute lower extremity deep vein thrombosis (DVT) is a common clinical condition. In the acute phase,it can lead to secondary complications such as acute pulmonary embolism (PE) and limb swelling,while in the chronic phase,it may result in post-thrombotic syndrome (PTS),posing significant health risks. Early mechanical thrombectomy can restore venous patency,alleviate symptoms,and reduce the incidence of PTS. AngioJet percutaneous mechanical thrombectomy (PMT) offers the advantages of rapid and efficient thrombectomy with fewer complications,making it widely used in clinical practice. However,there are currently no standardized guidelines at home or abroad regarding the choice of access route for PMT. This study was performed to compare the clinical outcomes and effects on venous valve function of antegrade versus retrograde AngioJet PMT for treating acute lower extremity DVT,aiming to explore the optimal surgical approach for thrombectomy.Methods:A prospective,randomized controlled study was conducted,enrolling 96 patients with acute lower extremity DVT treated at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University,from January 2022 to June 2024. Patients were divided into an antegrade group and a retrograde group based on the direction of operation and valve opening. Surgical outcomes and risks were evaluated for both groups,and factors influencing the 3-month postoperative venous patency rate were analyzed.Results:A total of 92 patients were finally included,with 47 cases in the antegrade group (51.1％) and 45 cases in the retrograde group (48.9％),all treated with AngioJet PMT. Baseline characteristics showed no significant differences between the two groups (all P>0.05). In the antegrade group,14 cases (29.8％) had thrombus interception by filters,with 7 cases (14.9％) being effective;4 cases (8.5％) developed new or worsened PE. In the retrograde group,18 cases (40.0％) had thrombus interception by filters,with 8 cases (17.8％) being effective;5 cases (11.1％) developed new or worsened PE. No significant differences were observed between the two groups in these or other safety and laboratory variables (all P>0.05). The antegrade group had a higher proportion of intraoperative manual aspiration thrombectomy compared to the retrograde group (68.1％ vs. 26.7％,P<0.001). However,there were no significant differences in thrombus grade Ⅲ clearance rate (61.7％ vs. 68.9％),3-month venous patency rate (93.6％ vs. 91.1％),or other perioperative variables (all P>0.05). Regression analysis of factors affecting 3-month venous patency showed that immediate venous patency (OR=3.043,95％ CI=0.993-1.209) and radiation dose (OR=0.868,95％ CI=-0.001-0.000) in the antegrade group,as well as immediate venous patency (OR=2.333,95％ CI=0.655-0.980) in the retrograde group,were significantly associated with 3-month patency rate (all P<0.001). Regression analysis also showed a significant linear relationship between immediate venous patency and VCSS/Villalta scores in both groups (all P<0.001). Conclusion:Both antegrade and retrograde AngioJet PMT procedures are equally safe and effective for treating acute lower extremity DVT. However,the risk of intraoperative thrombus detachment remains high,warranting the use of inferior vena cava filters to prevent fatal PE. Patients with immediate venous patency require standardized postoperative management and follow-up to prevent PTS.

Objective:To investigate the effect of rat platelet-rich plasma (PRP) gel on autologous adipose-derived mesenchymal stem cells (ADSCs) overexpressing glial-derived neurotrophic factor (GDNF).Methods:This study was an experimental study. Five adult male Sprague-Dawley rats were used, and the primary ADSCs were obtained by collagenase digestion, and then the cells were identified successfully. The 3 rd passage of ADSCs were obtained and divided into negative control group infected with unloaded adenovirus and overexpressing GDNF group infected with overexpressing GDNF adenovirus, according to random number table method (the grouping method was the same below). After 48 hours of culture, the infection of cells was observed. Five adult male Sprague-Dawley rats were used, and the PRP was obtained after collecting blood by differential centrifugation. PRP was prepared into a gel and its microstructure was observed by scanning electron microscope. The ADSCs of 3 rd passage were added into the PRP solution mixture and cultured for 48 hours after gelation. The cell growth was observed by hematoxylin-eosin staining and calcein/propyl iodide staining. ADSCs infected with unloaded adenovirus and ADSCs infected with overexpressing GDNF adenovirus were routinely cultured in PRP gel. After 48 hours of culture, the cell growth was detected by calcein/propyl iodide staining. After culture for 24, 48, 72 hours and 1, 2, 3, 4 weeks, the supernatant of cell culture medium was collected, the absorbance value was determined by microplate analyzer, and the GDNF content was calculated, with the sample number of 3. After 48 hours of culture, the expression of S100 protein (a specific marker of Schwann cells) was detected by immunofluorescence assay. Results:After 48 hours of culture, the proportions of cells infected with adenovirus in negative control group and overexpressing GDNF group were close to 90%, and the cell growth was good. The cells in negative control group grew normally. The morphology of the cells in overexpressing GDNF group changed significantly with 80%-90% of the cells having two or more protrusions, and the protrusions were interwoven to form a network wherever the cells gathered. PRP gel formed a three-dimensional network structure with different pore sizes. After 48 hours of culture, ADSCs could be well attached to PRP gel, and 98% of the cells were alive. After 48 hours of culture, ADSCs infected with unloaded adenovirus grew well and showed typical ADSC-like spindle-shaped growth. ADSCs infected with overexpressing GDNF adenovirus grew well, and most of the cells had two or more protrusions, and the protrusions were interwoven into a network. After culture for 24, 48, 72 hours and 1, 2, 3, 4 weeks, the content of GDNF in the supernatant of ADSCs infected with overexpressing GDNF adenovirus was (90±10), (133±15), (150±10), (137±15), (132±18), (120±10), and (127±16) pg/mL, which was significantly higher than (42±7), (44±7), (43±6), (47±6), (49±5), (49±6), and (51±4) pg/mL of ADSCs infected with unloaded adenovirus (with t values of 6.20, 8.08, 15.18, 9.12, 7.99, 9.61, and 7.86, respectively, P<0.05). After 48 hours of culture, the fluorescence intensity of S100 protein expression of ADSCs infected with overexpressing GDNF adenovirus was significantly stronger than that of ADSCs infected with unloaded adenovirus. Conclusions:The prepared autologous three-dimensional PRP gel has good biocompatibility and can carry rat GDNF-overexpressing ADSCs and release GDNF slowly, inducing ADSCs to differentiate into Schwann cells that express high level of S100 protein.

Objective:To explore the clinical effect of composite skin transplantation combined with systemic rehabilitation in the treatment of extensive scar contracture deformity around the popliteal fossa in children after burns.Methods:A retrospective observational research method was adopted. Seventeen children with extensive scar contracture deformities around the popliteal fossa after burns who met the inclusion criteria and were admitted to the First Affiliated Hospital of Air Force Military Medical University from March 2018 to April 2022 were selected. Among them, there were 10 males and 7 females, aged 2-11 years, with scar contracture deformities lasting from 10 months to 9 years, all located around the popliteal fossa, 10 cases of right popliteal fossa, 5 cases of left popliteal fossa, 2 cases of bilateral popliteal fossa, scars around the popliteal fossa result in a knee joint extension angle of only 95° to 115°. The scar contracture during surgery was thoroughly released, joint mobility was restored, so as to form a secondary wound range of 10 cm×8 cm-20 cm×13 cm. In stage Ⅰ, after completely releasing the scar contracture, the wound was covered with negative pressure closure drainage (VSD) for 2-3 days. In stage Ⅱ, a large autologous blade thick scalp and allogeneic decellularized dermal matrix composite graft was performed to repair the wound around the popliteal fossa. After 8-10 days of surgery, the dressing was changed to check the survival of the skin graft. One week after the skin graft survived, a 12 month orderly knee joint function training was conducted under the guidance of a rehabilitation therapist. Postoperative sequential treatment with a combination of strong pulsed light and ultra pulsed carbon dioxide lattice laser for 5-7 courses of significant scar hyperplasia in the skin graft area and edges.Results:15 cases of pediatric patients had good skin graft survival; One patient developed a wound due to partial displacement of the transplanted autologous scalp, and one patient developed a plasma swelling under the limb graft, which was drained through an opening. Two patients underwent dressing changes for 3 weeks before the wound healed. After follow-up for 6 to 36 months, the elasticity and appearance of the skin graft were similar to those of a medium thickness skin graft. Children with knee joint contracture were able to fully extend to 180°, and knee joint function was significantly improved. There was no scar formation or hair loss in the donor skin area.Conclusions:The combination of composite skin transplantation and systematic rehabilitation has a good effect on the treatment of extensive scar contracture around the popliteal fossa in children after burns, avoiding the problem of scars left in the donor area due to autologous skin grafting.

Objective The existing evidence of exercise rehabilitation in patients undergoing surgery for valvular heart disease was analyzed,described and evaluated by using evidence mapping methods.Methods Systematic reviews and randomized controlled trials on exercise rehabilitation of patients undergoing valvular heart disease surgery were searched from CNKI,Wanfang Data,VIP,CBM,Embase,PubMed,Cochrane Library,Web of Science,Ovid,CINAHL and other databases,and the search period was established until April 23,2024.The quality of the included literature was evaluated,and the feature information of the included literature was visualized in the form of bubble map and table.Results Fifty-one literatures(including 44 randomized controlled trials and 7 systematic evaluations)were finally included.Among the 44 randomized controlled trials,the types of exercise were mainly related to anaerobic exercise(3 literatures),aerobic exercise(11 literatures),flexibility training(8 literatures),and multisport exercise(22 literatures);postoperative inpatient rehabilitation accounted for a relatively high proportion(16 literatures),followed by overall postoperative rehabilitation(13 literatures)and pre-operative prehabilitation(7 literatures).Twenty-seven conclusions were categorized as"beneficial",15 as"possibly beneficial,"and one ach as"unclear"and"no effect".Seven systematic evaluations were subjected to Meta-analysis,and in terms of the design of the included studies,there were only 3 systematic reviews that included randomized controlled trials.Of the study conclusions,three were"beneficial",three were"possibly beneficial"and one was"unclear".Conclusion The evidence mapping shows that exercise rehabilitation is generally beneficial or potentially beneficial in the rehabilitation of valvular heart disease surgery,mainly in the postoperative inpatient rehabilitation phase.High-quality studies are needed to further investigate the effectiveness of exercise programs with different intensities,frequencies,and durations,as well as different valve types,adverse effects of exercise,and other outcome indicators.