Objective:To compare the differences in chemical compositions before and after processing by different processing methods; To optimize the processing method of Atractylodes lancea Rhizoma.Methods:Atractylodes lancea Rhizoma was processed by stir-frying with bran and treating with rice washing water. The volatile and non-volatile components of raw Atractylodes lancea Rhizoma, bran-fried Atractylodes lancea Rhizoma and rice washing water treated Atractylodes lancea Rhizome were qualitatively analyzed by headspace gas chromatography-mass spectrometry (HS-GC-MS) and ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Q-Orbitrap HRMS), and the differences in chemical composition before and after processing were compared.Results:The volatile components of the three different products were determined to have 18 common components, such as agarospirol, β-eudesol, etc. In addition, 86 non-volatile components were determined. The peak area response value of atractylodin, the index component prescribed by pharmacopoeia, decreased after processing, but there was little difference in bran stir-frying and rice-washed water frying.Conclusions:Different processing methods have certain effects on the chemical composition of Atractylodes lancea Rhizoma. Among them, the bran-frying method is superior in improving the quality of preparations, reducing production costs and improving production efficiency. The bran-fried product can be used as raw material for preparation production.

OBJECTIVE To establish a interview outline design process and quality control evaluation method based on grounded theory,providing ideas for qualitative research interview outline design in medical fields.METHODS A literature review was conducted to understand the current research status;a preliminary interview outline was developed around the research content.The triangulation method,group evaluation,expert review and pre-interview were adopted to execute the interview outline and conduct quality control.The evaluation indicators and target values were formulated(an average score for the overall quality evaluation of all indicators ≥4.5,and an average score for individual indicators ≥ 4.00)to evaluate the effect of the interview outline.Taking the research on the mechanism of physicians'prescribing behavior under the background of Diagnosis Related Groups(DRGs)payment as an example,the methodological contents of above interview outline were applied in practical research.RESULTS The interview outline included basic information and interview questions.The interview questions were divided into three parts:influencing factors survey,promoting and hindering factors of standardizing physician prescription behavior,and communication,with a total of 12 questions.After being reviewed by members of the research group,experts review and pre-interview,a total of 9 people participated in the quality control evaluation of the interview outline.The overall evaluation score was 4.94(＞4.50),and the average score of each indicator was greater than 4.00,indicating that the quality of the outline met the requirements for the interview and could be used for the formal interview.CONCLUSIONS The established interview outline design and quality control method based on grounded theory provides ideas for the qualitative research interview outline design in the medical field,and lays the foundation for further using grounded theory to study the influencing factors and mechanisms of physician prescription behavior under the DRG background.

Objective To evaluate the potential of the BIBP-H fluorescent probe in the detection of the oxidative stress levels after cerebral ischemia-reperfusion(CIRI).Methods In vitro,the potential of BIBP-H probe was in detection of oxidative stress was first assessed with fluorescence imaging in rat neuroblastoma(B104)cells after L-glutamic acid stimulation.And then,the effects of edaravone and dexborneol(EDA)and glutathione(GSH)pretreatment on the fluorescence intensity were evaluated.Later,a totally of 28 male C57BL/6 mice were randomly assigned into four groups:transient middle cerebral artery occlusion(tMCAO)group,EDA+tMCAO group,GSH+tMCAO group,and sham group.After 1.5 h ischemia and 12 h reperfusion,the mice were treated with BIBP-H via tail vein injection.In vivo,ex vivo,and tissue fluorescence imaging were utilized to evaluate the probe's cerebral ischemia-reperfusion injury(CIRI).Results ① BIBP-H probe did not exhibit fluorescence signals in cultured B104 cells,but showed red fluorescence in B104 cells treated with L-glutamic acid.The signals significantly decreased when pretreated with EDA or GSH.② Both the sham-operated mice intravenously injected with the BIBP-H probe and the tMCAO mice without injection of the probe showed negative results in in vivo fluorescence imaging.③ tMCAO mice treated with BIBP-H exhibited red fluorescence signals in the ischemic hemisphere in vivo,with significantly reduced fluorescence intensity after EDA or GSH infusion during reperfusion ④ The fluorescence area examined with BIBP-H was consistent the cerebral infarction area detected with triphenyltertrazolium.Conclusions The BIBP-H probe effectively monitored oxidative stress levels both in vivo and in vitro,demonstrating its potential in CIRI detection.

Objective To evaluate the potential of the BIBP-H fluorescent probe in the detection of the oxidative stress levels after cerebral ischemia-reperfusion(CIRI).Methods In vitro,the potential of BIBP-H probe was in detection of oxidative stress was first assessed with fluorescence imaging in rat neuroblastoma(B104)cells after L-glutamic acid stimulation.And then,the effects of edaravone and dexborneol(EDA)and glutathione(GSH)pretreatment on the fluorescence intensity were evaluated.Later,a totally of 28 male C57BL/6 mice were randomly assigned into four groups:transient middle cerebral artery occlusion(tMCAO)group,EDA+tMCAO group,GSH+tMCAO group,and sham group.After 1.5 h ischemia and 12 h reperfusion,the mice were treated with BIBP-H via tail vein injection.In vivo,ex vivo,and tissue fluorescence imaging were utilized to evaluate the probe's cerebral ischemia-reperfusion injury(CIRI).Results ① BIBP-H probe did not exhibit fluorescence signals in cultured B104 cells,but showed red fluorescence in B104 cells treated with L-glutamic acid.The signals significantly decreased when pretreated with EDA or GSH.② Both the sham-operated mice intravenously injected with the BIBP-H probe and the tMCAO mice without injection of the probe showed negative results in in vivo fluorescence imaging.③ tMCAO mice treated with BIBP-H exhibited red fluorescence signals in the ischemic hemisphere in vivo,with significantly reduced fluorescence intensity after EDA or GSH infusion during reperfusion ④ The fluorescence area examined with BIBP-H was consistent the cerebral infarction area detected with triphenyltertrazolium.Conclusions The BIBP-H probe effectively monitored oxidative stress levels both in vivo and in vitro,demonstrating its potential in CIRI detection.

OBJECTIVE To establish a method for the determination of propofol concentration in human plasma and apply it in patients with lymphedema. METHODS The concentration of propofol was determined by UPLC-MS/MS after protein precipitation of plasma samples using thymol as internal standard. The sample was eluted on a Kinetex C18 column with a mobile phase consisting of acetonitrile （A）-water （B） for gradient elution at the flow rate of 200 μL/min. The sample size was 5 μL， and the column temperature was set at 40 ℃. The sample chamber temperature was 15 ℃. Using multi-reaction monitoring mode， the ion pairs for quantitative analysis were m/z 177.0→161.2 （propofol） and m/z 149.0→133.1 （internal standard）， respectively. The above method was used to determine the plasma concentration of propofol in 6 patients with lymphedema. RESULTS The linear range of propofol was 50-5 000 ng/mL （r＝0.995 0）. RSDs of within- and between-batch precision were not more than 8.08%； no endogenous interference， carryover effect， or dilution effect was observed in blank plasma. The extraction recovery ranged from 89.80% to 93.73%， and matrix effects were within the range of 97.93%-101.73%. RSDs of the stability test were all lower than 3.27%. During intraoperative TCI 2-30 min， the plasma concentration of propofol in 6 patients was maintained in the range of 1 865.3-6 056.2 ng/mL， and the propofol was almost excreted within 4-8 h after operation. CONCLUSIONS The established UPLC-MS/MS method in this study can achieve the determination of propofol and a simple and fast sample pretreatment process without derivatization； it is proved to be suitable for the concentration monitoring of propofol in plasma samples of patients with lymphedema.

OBJECTIVE To know about the working mode and human resource status of pharmacy intravenous admixture services （PIVAS） in national medical institutions. METHODS Through questionnaire survey， the national PIVAS was invited to fill out questionnaire and statistical analysis was performed on the effective sample data related to PIVAS working mode and human resources in the questionnaire. RESULTS In this study， 761 PIVAS from 722 medical institutions of 29 provinces were involved in the questionnaire survey， with 471 valid questionnaires for working mode and 441 valid questionnaires for human resources survey. In terms of working mode， among 471 PIVAS， 292 PIVAS （62.0%） were in pharmacist-alone mode， and 176 PIVAS （37.4%） were in pharmacist-nurse cooperative mode； there was no significant difference in the types of medical orders received by PIVAS between these two working modes except for the other medical orders （P＞0.05）. In terms of human resource setting， among 441 PIVAS， the average number of total staff of single PIVAS was 24（16，33）， including 11（6，19） pharmacists， 7（2，13） nursing staff， and 3（1，5） workers； there was a statistically significant difference in the number of personnel among three groups （P＜ 0.01）. The per capita income of PIVAS respondents in 2019 was [7.9（4.8，10.7）]×104 yuan， and in 2021 it was [8.8（5.8，11.7）]× 104 yuan， with an increase of 9.0% compared to 2019. The difference between the two groups was statistically significant （P＜ 0.01）. CONCLUSIONS Medical institutions’ PIVAS in China had not fully implemented the pharmacist-alone work model， and some medical institutions had chosen a pharmacist-nurse cooperative mode. It is suggested that relevant departments formulate corresponding qualification requirements and training standards for nursing personnel as soon as possible based on sufficient research on PIVAS’s demand for nursing professionals.

OBJECTIVE To know about the pharmacy intravenous admixture charge and operation balance of pharmacy intravenous admixture services （PIVAS） in national medical institutions. METHODS Using questionnaire survey method， the national PIVAS leaders were invited to fill in the questionnaire， investigation and statistical analysis of the drug dispensing charge standard and the income and expenditure situations of PIVAS nationwide were conducted. RESULTS A total of 761 PIVAS completed the questionnaire， among which 466 PIVAS （61.2%） had already started implementing pharmacy intravenous admixture charge， mainly in tertiary hospitals. The charge standards for chemotherapy drugs and parenteral nutrition solutions were relatively high， while the standards for packaged drugs were the lowest， with differences in charge standards among provinces（P＜0.05）. Among the 25 provinces that reported annual drug preparation fee revenue， Hubei had the highest revenue in both 2019 and 2021. In 2019， the number of PIVAS with a balance of payments was more than that of PIVAS with an imbalance of payments， but the number of PIVAS with an imbalance of payments in 2021 exceeded the number of PIVAS with a balance of payments （P＜0.05）； among them， eight provinces were unbalanced in 2019 and 2021， such as Tianjin， Chongqing， Guizhou， etc. CONCLUSIONS PIVAS charge standards of the surveyed medical institutions in all provinces are not unified. It is suggested to improve the charge standard further， formulate the charge adjustment cycle， and promote a sustainable development of PIVAS.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

OBJECTIVE To study the components of ethyl acetate fraction in Qubai tablet ，and its pharmacodynamics on de melanocyte model ，and explore the material basis for anti-vitiligo effect of Qubai tablet. METHODS The ethyl acetate fraction of Qubai tablets was obtained by extraction ，and its components were analyzed by ultra performance liquid chromatography-mass spectrometry（UPLC-MS）. Model control group ，vehicle control group and 8-methoxypsoralen（8-MOP）administration groups （10，50，100，150，200 μmol/L），ethyl acetate fraction administration groups of Qubai tablet （10，50，100，150，200 μg/mL） were set up in the experiment. By establishing the de melanocyte model ，the effects of ethyl acetate fraction of Qubai tablet on de melanocyte were studied from four aspects ：cell number ，cell viability ，melanin formation and tyrosinase activity. RESULTS UPLC-MS component analysis preliminarily determined the structure of 64 compounds in the ethyl acetate fraction of Qubai tablet ， of which 14 compounds were detected in positive and negative ion mode ；psoralen compounds accounted for the largest proportion ， and the content of psoralen chromone chalcone was the highest in positive and negative ion mode. The results of pharmacodynamic study showed that the ethyl acetate fraction of Qubai tablet could increase the number of de melanocytes ，and significantly improve the cell proliferation rate ，the rate of promoting melanin formation and the rate of promoting tyrosinase activity in the process of melanin formation （P＜0.01）. CONCLUSIONS Psoralen compounds may be the material basis for the anti-vitiligo effect of ethyl acetate fraction of Qubai tablet ；good anti-vitiligo effect of ethyl acetate fraction of Qubai tablet may be related to the promotion of tyrosinase activity.

Objective:To establish a drug-related problems (DRPs) classification system for outpatients and home patients and provide healthcare staff with tools for standardized recording of DRPs.Methods:DRPs classification systems-related literature were collected by searching foreign databases. The selected DRPs classification systems were compared and analyzed, and the initial DRPs classification system was formed by integrating the characteristics of pharmaceutical care for outpatients and home patients in China. The expert consultation form of DRPs classification system was made, expert consultation was performed for 2 rounds using Delphi method, and the final DRPs classification system was formed through modification and adjustment according to expert opinions.Results:A total of 25 DRPs classification systems were obtained, of which 16 were selected and then integrated to form the initial version of the DRPs classification system. The primary structure of the initial DRPs classification system consisted of 5 parts: problem state, problem type, problem cause, problem intervention, and intervention result. Each part had different number of items, among which there were different number of secondary structure items in problem cause, problem intervention, and intervention result. In the first round of consultation, 32 experts were invited and 30 consultation forms were collected, with a recovery rate of 94%. In the second round of consultation, 30 experts were invited and 30 consultation forms were collected, with a recovery rate of 100%. After 2 rounds of consultation, the acceptance rates of experts for the question state, problem type, problem cause, question intervention, and intervention result in the primary structure were 100%, 90%, 83%, 83%, and 97%, respectively. For the evaluation of 5 categories of drug treatment (indications, effectiveness, safety, economy, and compliance) in DRPs classification system, except for that the expert authority coefficient of economics was 0.79, the expert authority coefficient of the other 4 categories of issues was all >0.8. In the first and second round of consultation, the coordination coefficient of expert opinions was 0.386 ( χ2=995.258, P<0.001) and 0.364 ( χ2=971.232, P<0.001), respectively. After modifying with expert opinions, a final version of DRPs classification system was formed, which included 38 primary structure items in 5 categories and 90 secondary structure items in 3 categories. Conclusion:A DRPs classification system for outpatients and home patients suitable for China′s national conditions has been initially established, which can be used as a standardized recording tool for DRP.