OBJECTIVE To construct a pharmacy service quality evaluation system， identify weaknesses in the integrated development of pharmacy services， and provide a reference for the homogenized and high-quality development of pharmacy services in compact urban medical groups.METHODS Guided by the five core dimensions of the Servperf model， the Delphi method was used to screen and optimize items， and a tripartite pharmacy service quality evaluation system， covering clinicians， pharmacists， and patients， adapted to the characteristics of compact urban medical groups was constructed. A multicenter cross-sectional empirical investigation was conducted in six compact urban medical groups in Chongqing using the evaluation system.RESULTS Through two rounds of Delphi consultation with 12 experts， a tripartite pharmacy service quality evaluation system was successfully constructed， comprising 5 dimensions and 78 items （24 for clinical pharmacists， 23 for clinical medical staff， and 31 for patients and family members）. The Cronbach’s α coefficients for all dimensions exceeded 0.81， and the KMO values all exceeded 0.7. A total of 1 339 valid questionnaires were collected， including 279 from clinical pharmacists， 727 from clinical medical staff， and 333 from patients and family members. The empirical investigation showed that the overall quality of regional basic pharmacy services was good， but significant inter-group differences existed in service perceptions among the three groups. The score differences across the five dimensions were all statistically significant among the three groups （all P ＜0.001）. Except for the tangibles dimension， in which clinical medical staff scored significantly lower than clinical pharmacists and patients/family members， patients/family members scored significantly higher than clinical medical staff and clinical pharmacists in the other four dimensions （ P ＜0.05）. For the 78 items， expert expectations largely matched the perceptions of the three groups， with a mean difference of 0.08 points； only 13 items showed a difference exceeding 0.5 points， representing marked gap，with “participating in multidisciplinary team consultation and making effective recommendations” showing the largest difference of 0.94 points.CONCLUSIONS The physician‑ pharmacist‑patient tripartite evaluation system constructed in this study is scientific and reliable. Empirical investigation confirms that the basic pharmaceutical support services of the medical groups are well established， whereas the development of high‑level collaborative services has notable weaknesses， and marked heterogeneity exists in service perception among the three groups.

ObjectiveTo observe the effect of Huangqi Baihe granules on the hypoxia-inducible factor 1α （HIF-1α）/nuclear factor-κB （NF-κB）/NOD-like receptor hot protein domain related protein 3 （NLRP3） signaling pathway in a rat model of high altitude hypoxia. MethodSixty male SPF SD rats were randomly divided into blank group， model group， dexamethasone group （5 mg·kg^-1）， and high， middle， and low-dose groups of Huangqi Baihe granules （4.1， 2.05， 1.025 g·kg^-1）. Among them， each Chinese medicine group was administrated orally for continuously 14 d， once a day， and the dexamethasone group was injected intraperitoneally for continuously 3 d as the positive control group. On the 15^th d， the model group， dexamethasone group， and high， middle， and low dose groups of Huangqi Baihe granules were exposed to the simulated high altitude， low pressure， and low oxygen environment in the animal low-pressure simulation cabin， and the exposure lasted for 3 d. Blood was collected from the abdominal aorta and serum was separated， and the brain tissue was taken after being killed. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in brain tissue. Enzyme-linked immunosorbent assay （ELISA） was used to detect the content of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-1β （IL-1β） in rat serum. Western blot was used to detect HIF-1α， NLRP3， phosphorylated nuclear factor-κB （p-NF-κB）， NF-κB， desquamation D （GSDMD）， and cysteine aspartate-specitis protein-1（Caspase-1） in rats of each group. The mRNA expression levels of HIF-1α， NLRP3， NF-κB p65， GSDMD， and Caspase-1 were detected by real-time quantitative polymerase chain reaction （Real-time PCR）. ResultThe results of HE staining showed that as compared with the normal group， the pathological sections of brain tissues in the model group showed that pyramidal cells were loosely arranged and distributed in disorder， with different sizes. Compared with the model group， the pathological changes in pyramidal cells in the dexamethasone group and high and middle-dose groups of Huangqi Baihe granules were reduced. The results of ELISA showed that as compared with the normal group， the content of TNF-α， IL-6， and IL-1β in the serum of rats in the model group was significantly higher （P<0.01）. Compared with the model group， the content of TNF-α， IL-6， and IL-1β in the serum of rats in the dexamethasone group and high and middle-dose groups of Huangqi Baihe granules decreased significantly （P<0.05， P<0.01）. The results of Western blot showed that as compared with the normal group， the relative protein expression levels of HIF-1α， NLRP3， p-NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of the model group were significantly higher （P<0.01）. As compared with the model group， the relative expressions of HIF-1α， NLRP3， p-NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of rats in the dexamethasone group and the high-dose group of Huangqi Baihe granules were significantly decreased （P<0.05， P<0.01）. The relative protein expression levels of HIF-1α， NLRP3， p-NF-κB p65， and Caspase-1 in the brain tissue of rats in the middle-dose group of Huangqi Baihe granules decreased significantly （P<0.01）， and the relative protein expression of HIF-1α in the brain tissue of rats in the low-dose group of Huangqi Baihe granules was reduced （P<0.05）. The Real-time PCR analysis showed that as compared with the normal group， the mRNA expression levels of HIF-1α， NLRP3， NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of the model group were significantly increased （P<0.01）. As compared with the model group， the mRNA expression levels of HIF-1α， NLRP3， NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of rats in the dexamethasone group were significantly decreased （P<0.01）. The mRNA expression levels of HIF-1α， NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of rats in the high-dose group of Huangqi Baihe granules decreased significantly （P<0.01）. The mRNA expression levels of HIF-1α， NLRP3， and Caspase-1in the brain tissue of rats in the middle-dose group of Huangqi granules decreased （P<0.05， P<0.01）. ConclusionThe protective effect of Huangqi Baihe granules on acute brain injury in low-pressure hypoxic rats may be related to the HIF-1α/NF-κB/NLRP3 signaling pathway.

Objective:To investigate the changes of hippocampal gray matter volume and expression of candidate immune related genes in a rat model of schizophrenia established by repeated administration of dizocilpine(MK-801).Methods:Thirty SPF grade Sprague-Dawley male rats at postnatal day 28 were randomly divided into MK-801 medium-dose (0.25 mg/kg) group, MK-801 high-dose(0.50 mg/kg) group and normal saline (5 mL/kg) group according to random number table method, with 10 in each group.Rats were given continuous intraperitoneal administration according to grouping once a day for 14 days.Open field test, novel object recognition test and Y-maze test were used at postnatal day 60 to detect spontaneous activity, exploration ability, anxiety level, object recognition memory ability and spatial working memory of rats, respectively.At postnatal day 67, structural magnetic resonance imaging was used to detect the changes of hippocampal gray matter volume in rat.And at postnatal day 70, qRT-PCR was used to detect the expression of candidate immune-related genes in rat hippocampus.SPSS 25.0 was used for statistical analysis, one-way ANOVA was used for comparison among multiple groups, and Tukey test was used for further pairwise comparisons.Results:(1)The behavioral results showed that there were significant differences in the total movement distance, central area activity time, novel object recognition index, and spontaneous correct alternation rate among the three groups ( F=11.15, 10.11, 13.62, 11.99, all P<0.05). The total movement distances in MK-801 medium-dose group and MK-801 high-dose group ((21.44±2.17) m, (22.87±1.96)m) were higher than that in the normal saline group ((18.70±1.88) m) (both P<0.05). The activity time of the central area in the MK-801 medium-dose group and MK-801 high-dose group((3.24±1.58) s, (2.50±1.32) s) were lower than that of the normal saline group ((6.05±2.48)s) (both P<0.01). Novel object recognition indexes in the MK-801 medium-dose group and MK-801 high-dose group((56.10±3.99)%, (54.00±6.41)%) were both lower than that in the normal saline group ((65.90±5.65)%)(both P<0.01), and the rates of spontaneous correct alternation ((54.60±7.03)%, (51.60±8.84)%) in the two groups were lower than that of the normal saline group ((68.40±8.57)%) (both P<0.01). (2) The results of structural magnetic resonance imaging showed that there were significant differences in the volume of hippocampal gray matter among the three groups ( F=9.24, P<0.001). The volumes of hippocampal gray matter in MK-801 medium-dose group and MK-801 high-dose group were lower than that in normal saline group(both P<0.001). (3)By constructing protein-protein interaction network, four candidate immune related genes were screened out: neuropeptide Y (NPY), somatostatin (SST), cholecystokinin (CCK) and tachykinin 1 (TAC1). The results showed that the mRNA expression levels of NPY, SST and CCK in the hippocampus of the three groups were significantly different ( F=11.41, 10.43, 5.85, all P<0.05), but there was no statistical difference in the TAC1 mRNA expression level ( F=0.08, P>0.05). The mRNA levels of NPY, SST and CCK in the hippocampus of rats in the MK-801 high-dose group were lower than those in the normal saline group (all P<0.05). Conclusion:Both medium dose and high dose MK-801 administration can reduce the volume of hippocampal gray matter in schizophrenia model rats, but they have different effects on the expression of hippocampal immune related genes, of which high dose administration has a greater effect.

After the New Coronary Pneumonia pandemic, people^'s social behavior has changed, and the current health management and development approaches should also change accordingly. This article analyzes the changes of social behavior during different anti-epidemic periods, demonstrates the necessity and possibility to change the current health management formats and development paths, and proposes a new concept of family-centered health management. The main target of the current urgent need for family health management is to expand the household entry units, build learning and sports units, etc. This article provides ideas for health management in the post-pandemic era.

Professor Liu Guangxian used traditional Chinese medicine (TCM) for the treatment of patient with cholangiocarcinoma after surgery achieved unique effect. On the one hand, the classical prescriptions Yinchenhao decoction and Xiaoshi Fanshi powder combined with processed pangolin scales and cremastrae pseudobulbus were used to promote diuresis and clear jaundice, eliminate phlegm and resolve static blood, and soften hard mass and remove stagnation, in order to eliminate the pathogens; on the other hand, Sijunzi decoction was used as the main prescription to invigorate the spleen and benefit qi to strengthen vital qi, in order to protect the spleen and stomach and strengthen the body resistance. After more than 3 months of treatment for a patient with cholangiocarcinoma, the patient had significant improvement in symptoms, signs, imaging findings, and laboratory results.

Objective To investigate the affective and somatic symptoms of patients with somatoform disorders (SFD) and their related factors to their social support and alexithymia. Methods Seventy-one patients with SFD and 75 healthy controls (HC) were recruited. Health Questionnaire?9 (PHQ?9), General Anxiety Scale (GAD?7), Patient Health Questionnaire 15?Item Somatic Symptom Severity Scale (PHQ?15), Toronto Alexithymia Scale (TAS?20) and Social Support Rating Scale (SSRS) were evaluated for all subjects. Results (1) The total scores of all the PHQ?9, GAD?7 and PHQ?15 in patients group were significantly higher than that in HC (t=46.67, 41.24, 49.64, P<0.01). (2) Except the objective social support, subject social support and social support utilization in SFD group were lower than those in HC (36.97±6.74 vs. 40.54±5.47, 19.34±3.17 vs. 23.53±3.62, 6.41±3.13 vs. 8.36±2.43; t=7.46, 4.28, 3.52; P<0.01). There were significant differences in TAS?20 between the two groups (t=8.08, 8.52, 5.54, 7.35, P<0.01). (3) By the correlation analysis in patient group, the sum score of the affective and somatic symptom (PHQ?9+GAD?7+PHQ?15) was significantly correlated to the subjective social support, social support utilization, social support total score, TAS?Ⅰ, TAS?Ⅱ, TAS?Ⅲand TAS?20 total score (r=-0.372,-0.359,-0.426, 0.368, 0.327, 0.306, 0.364, P<0.01). And the numbers of non?mental health clinic visits (χ1), social support utilization (χ2), adverse reactions(χ3), TAS?Ⅱ (χ4) and TAS?Ⅰ (χ5) contributed to the multiple regression equation for the sum of PHQ?9, GAD?7 and PHQ?15 scores. Conclusion The alexithymia and incapability of perceiving and utilizing social support, numbers of visits in non?mental health clinic and the medication adverse reactions that subjectively perceived in the patients with SFD may be the key factors that could impact their affective and somatic symptoms.

Objective To investigate the affective and somatic symptoms of patients with somatoform disorders (SFD) and their related factors to their social support and alexithymia. Methods Seventy-one patients with SFD and 75 healthy controls (HC) were recruited. Health Questionnaire?9 (PHQ?9), General Anxiety Scale (GAD?7), Patient Health Questionnaire 15?Item Somatic Symptom Severity Scale (PHQ?15), Toronto Alexithymia Scale (TAS?20) and Social Support Rating Scale (SSRS) were evaluated for all subjects. Results (1) The total scores of all the PHQ?9, GAD?7 and PHQ?15 in patients group were significantly higher than that in HC (t=46.67, 41.24, 49.64, P<0.01). (2) Except the objective social support, subject social support and social support utilization in SFD group were lower than those in HC (36.97±6.74 vs. 40.54±5.47, 19.34±3.17 vs. 23.53±3.62, 6.41±3.13 vs. 8.36±2.43; t=7.46, 4.28, 3.52; P<0.01). There were significant differences in TAS?20 between the two groups (t=8.08, 8.52, 5.54, 7.35, P<0.01). (3) By the correlation analysis in patient group, the sum score of the affective and somatic symptom (PHQ?9+GAD?7+PHQ?15) was significantly correlated to the subjective social support, social support utilization, social support total score, TAS?Ⅰ, TAS?Ⅱ, TAS?Ⅲand TAS?20 total score (r=-0.372,-0.359,-0.426, 0.368, 0.327, 0.306, 0.364, P<0.01). And the numbers of non?mental health clinic visits (χ1), social support utilization (χ2), adverse reactions(χ3), TAS?Ⅱ (χ4) and TAS?Ⅰ (χ5) contributed to the multiple regression equation for the sum of PHQ?9, GAD?7 and PHQ?15 scores. Conclusion The alexithymia and incapability of perceiving and utilizing social support, numbers of visits in non?mental health clinic and the medication adverse reactions that subjectively perceived in the patients with SFD may be the key factors that could impact their affective and somatic symptoms.

Objective To screen the optimized Buyang Huanwu Decoction (BYHWD);To verify it. Methods H2O2 was used to induce PC12 cell oxidative stress models. MTT method was used to determine the prevention effects of BYHWD at different concentrations (0.1, 0.2, 0.5, 1.0, 2.0, 3.5 mg/mL) on in vitro oxidative stress cell models to define the optimized concentration. Orthogonal design was used to divide BYHWD single medicine into decomposed BYHWD groups, control group (only with DMEM), normal group (without H2O2 and medicine processing), and model group, to investigate the protective effects on PC12 cells. Optimized BYHWD was screened to decide the compatibility ratio of each medicine. MTT was used to detect the cell survival rate in each group. Middle cerebral artery occlusion was used to replicate MACO rat models. SD rats were randomly divided into sham-operation group, model group, BYHWD group and optimized BYHWD high-, medium-and low-dose groups. Each medication group was given relevant medicine for gavage. The screened results were verified. Results Compared with other decomposed BYHWD groups, the protective effects of the compatibility of Astragali Radix+Chuanxiong Rhizoma+Pheretima on PC12 cells was the best (P<0.05), which was nearly equaled to BYHWD. Compared with the model group, BYHWD and the optimized one could evidently reduce cerebral cortex infarction area and improve the impaired brain edema (P<0.05), and the medium-dose group was the best. Conclusion The optimized BYHWD ratio is:Astragali Radix:Chuanxiong Rhizoma:Pheretima=10:3:1.

Aim To evaluate the regulation of thin recipe of Buyang Huanwu decoction on cyclin-dependent kinase 5(Cdk5)expressions in hippocampus tissue of rats after cerebral ischemia.Methods Male SD rats were divided into sham-operation group,MCAO group,Buyang Huanwu decoction group(ig.3.15 g·kg-1)and its thin recipe composition group(ig.2.41 g·kg-1).Each group was then divided into five subgroups based on the time after administration for 1,3,7,14,28 d respectively.Cdk5 protein and mRNA levels in each group were examined by using immunohistochemistry,Western blot and real-time PCR respectively.Results The up-regulation of Cdk5 was observed in model rat hippocampus after cerebral ischemia 1 day,and kept increasing with the aggravation of ischemia injury,the peaked expression was observed after 7～14 d,while the downtrend was observed after 28 days compared with the corresponding sham-operation groups(P<0.01),suggesting that the Cdk5 signal pathway would be activated by cerebral ischemic injury.The expression of Cdk5 in thin recipe of Buyang Huanwu decoction group was significantly lower than that in model group at each time point(P<0.05),and there was also more obvious down-regulation with the extend of intervene time.The regulation effects of thin recipe of Buyang Huanwu decoction was up to the best after 28 days of administration,which indicated the thin recipe was positive to the abnormal expression of Cdk5,and there was no difference between Buyang Huanwu decoction and its thin recipe treated groups(P>0.05).Conclusion The thin recipe of Buyang Huanwu decoction could exert the protective effect by regulating Cdk5 after cerebral ischemia.

Objective To study the pharmacokinetic features of ferulaic acid, senkyunolide A and ligustilide in Buyang Huanwu associated prescriptions (Buyang HuanwuDecoction andNaojianTablets).MethodsHPLC-DAD was applied for simultaneous determination plasma concentration of three ingredients with jugular venous cannula rats after intragastric administration ofBuyang Huanwu associated prescriptions. The pharmacolinetic parameters of each ingredient was calculated by DAS2.0, and then the total quantum statistical moment (TQSM) standard similarity was used to measure the overall pharmacokinetics behaviors.Results There were great differences in the three ingredients after the administration of two prescriptions, while the total quantum statistical parameters were very closely. The TQSM pharmacokinetic parameters of the three components inBuyang HuanwuDecoction andNaojian Tablets showed that AUC, MRT, VRT were 240.6 and 133.0, 3.192 min and 3.259 min, 21.59 min2and 19.75 min2, respectively.The similarity was up to 0.977 8.Conclusion The metabolic processes in vivo ofBuyang Huanwu Decoction andNaojianTablets have similarities. The efficacy of Chinese herbal compounds mostly depends on the multi-components overall contributions.