OBJECTIVE To establish a “BRAND” pharmaceutical care model for advanced non-small cell lung cancer （NSCLC） patients with positive driver genes， providing theoretical and practical references for the clinical implementation of precise and individualized oncology pharmaceutical care. METHODS One hundred patients admitted to the department of pulmonary and critical care medicine in our hospital from January 2023 to May 2024 were collected meeting the inclusion and exclusion criteria. Patients were randomly divided into control group and intervention group， with 50 patients in each group. The control group received routine pharmaceutical care， while the intervention group received pharmaceutical care under the “BRAND” model （collecting patients’ basic information， reviewing disease treatment-related information， conducting precise medication assessments， formulating individualized pharmaceutical care plans for the next steps， and implementing medication guidance and follow-up management）. The study was conducted in a 3-week cycle for a total of 4 cycles. The medication compliance， quality of life， laboratory test indicators， incidence of drug-related adverse events and satisfaction of patients in both groups were compared before and after the intervention to evaluate the effects. RESULTS After 12 weeks of intervention， compared with the control group， the medication compliance， cognitive function， social function and satisfaction of patients in the intervention group were improved significantly （ P ＜0.05）； the severity of fatigue and constipation and the incidence of drug-related adverse events were significantly reduced （ P ＜0.05）， and there was no statistically significant difference in laboratory test indicators （ P ＞0.05）. CONCLUSIONS The “BRAND” pharmaceutical care model can effectively improve the medication compliance of patients with advanced NSCLC with positive driver genes and improve their quality of life. This study can provide a feasible path for clinical pharmacists to carry out standardized and high-quality pharmaceutical care.

BACKGROUND: China has made significant progress in medical accessibility and quality over the past decades, and quality improvements in gastroenterology and digestive endoscopy have been consistent. The study aimed to describe the status quo of gastroenterology and digestive endoscopy in the Chinese mainland based on the data from the National Clinical Improvement System (NCIS) and the Hospital Quality Monitoring System (HQMS). METHODS: Data were extracted from the NCIS and the HQMS. Data analysis included general information from the Department of Gastroenterology and Endoscopy centers, management of inpatients and outpatients, and annual volume and quality indicators of digestive endoscopy. Acute pancreatitis, gastrointestinal bleeding, inflammatory bowel disease, and cirrhosis were identified as priority diseases and were subjected to detailed analysis. RESULTS: Data from 4620 and 7074 hospitals were extracted from the NCIS and HQMS, respectively. In 2023, 9.6 gastroenterologists, 6.7 endoscopists, and 37.3 gastroenterology beds per hospital nationwide were observed, achieving 19,252.4 outpatient visits, 1615.2 hospitalizations (97.0 for acute pancreatitis, 146.1 for gastrointestinal bleeding, 40.2 for inflammatory bowel disease, and 111.4 for cirrhosis), and 9432.7 digestive endoscopic procedures per hospital. Overall, the quality of practice improved significantly. The proportion of early cancer among gastrointestinal cancers increased from 11.1% in 2015 to 23.4% in 2023, and the adenoma detection rate during colonoscopy increased from 19.3% in 2019 to 26.9% in 2023. Regarding priority diseases, hospitalizations increased, and 31-day unplanned readmission rates decreased between 2019 and 2023. The median hospitalization costs and median proportion of medication costs decreased for acute pancreatitis, gastrointestinal bleeding, and cirrhosis. However, it increased for inflammatory bowel disease. CONCLUSION This report evaluates the status quo and development of gastroenterology and digestive endoscopy in the Chinese mainland, providing guidance for future quality improvements.
Humans ; China ; Gastroenterology/statistics & numerical data* ; Gastrointestinal Hemorrhage ; Endoscopy, Gastrointestinal/statistics & numerical data* ; Endoscopy, Digestive System/statistics & numerical data*

Background During pregnancy, negative emotions such as anxiety and depression may induce cortisol disruption. Cortisol can be transmitted to the fetus through the placental barrier, thereby affecting the neurodevelopment of the offspring. Objective To investigate the relationship between placental cortisol, maternal depression during pregnancy, and neurodevelopment of 3-month-old infants. Methods From September 2022 to September 2023, 171 pregnant women ordered routine prenatal checks at the obstetrics outpatient department of a tertiary hospital in Ningxia were selected using a prospective cohort design. After providing informed consent, these women participated in a questionnaire survey that covered general individual characteristics, prenatal depression, and sleep quality. At birth, placental samples were collected to measure cortisol levels using ELISA kits. Follow-up assessments on the neurodevelopmental of 3-month-old infants were conducted using the Warning Sign for Children Mental and Behavioral Development. LASSO regression analysis was conducted to screen the influencing factors of depression during pregnancy. Huber regression analysis was then applied to assess potential linear relationship between depression during pregnancy and placental cortisol levels. Log-binomial regression was used to analyze the linear relationships between cortisol levels and neurodevelopmental delay in 3-month-old infants. Additionally, a mediation effect model was fitted using R 4.3.3 to assess possible mediating role of cortisol in the association between prenatal depression and neurodevelopmental delay in 3-month-old infants. Results The positive rate of prenatal depression was 33.33%. Nine factors affecting prenatal depression were identified by LASSO regression, including rural residence, high school education or above, extroverted personality characteristics, moderate early pregnancy reactions, baby sex expectation, prenatal anxiety, family dysfunction, exposure to stressful life events during pregnancy, and moderate prenatal sleep quality. The Huber regression model showed a positive linear correlation between prenatal depression and placental cortisol (P<0.05). With or without controlling confounding factors, the results of log-binomial regression modeling showed that cortisol levels were associated with a reduced risk of neurodevelopmental delay in 3-month-old infants (crude model: RR=0.988, 95%CI: 0.9768, 0.9996, P＜0.05; adjusted model: RR=0.988, 95%CI: 0.9764, 0.9993, P＜0.05). A mediating effect of placental cortisol between prenatal depression and the risk of neurodevelopmental delay in 3-month-old offspring was found statistically significant (P=0.045), accounting for 67.0% of the total effect. Conclusion Prenatal depression is associated with elevated placental cortisol levels, and higher cortisol levels are found to be related to a lower risk of neurodevelopmental delay in infants. Placental cortisol mediates the relationship between prenatal depression and infant neurodevelopment.

Objective:To comprehensively retrieve and evaluate the best available evidence on perioperative fluid management in patients undergoing hepatectomy for liver cancer, and to provide references for clinical practice.Methods:A systematic search was conducted across multiple platforms, including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, for clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and randomized controlled trials related to perioperative fluid management in patients undergoing hepatectomy for liver cancer. The search period was from database inception to March 13, 2024. The 2014 version of the Joanna Briggs Institute evidence pre-grading and recommendation grading system was used to classify the evidence.Results:A total of 14 articles were included: 3 clinical decision articles, 3 guidelines, 1 evidence summary, 5 expert consensuses, 1 systematic review, and 1 randomized controlled trial. A total of 27 best evidence items were extracted, covering seven aspects: principles of fluid therapy, preoperative fluid management, intraoperative fluid management, postoperative fluid management, fluid type selection, assessment and monitoring, and training and education.Conclusions:This study summarizes the best evidence on perioperative fluid management for hepatectomy in liver cancer patients and provides an evidence-based reference for clinical nursing practice. Healthcare professionals should apply the evidence in a personalized manner based on the actual clinical context to promote scientific fluid management in the perioperative period.

Objective:To comprehensively retrieve and evaluate the best available evidence on perioperative fluid management in patients undergoing hepatectomy for liver cancer, and to provide references for clinical practice.Methods:A systematic search was conducted across multiple platforms, including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, for clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and randomized controlled trials related to perioperative fluid management in patients undergoing hepatectomy for liver cancer. The search period was from database inception to March 13, 2024. The 2014 version of the Joanna Briggs Institute evidence pre-grading and recommendation grading system was used to classify the evidence.Results:A total of 14 articles were included: 3 clinical decision articles, 3 guidelines, 1 evidence summary, 5 expert consensuses, 1 systematic review, and 1 randomized controlled trial. A total of 27 best evidence items were extracted, covering seven aspects: principles of fluid therapy, preoperative fluid management, intraoperative fluid management, postoperative fluid management, fluid type selection, assessment and monitoring, and training and education.Conclusions:This study summarizes the best evidence on perioperative fluid management for hepatectomy in liver cancer patients and provides an evidence-based reference for clinical nursing practice. Healthcare professionals should apply the evidence in a personalized manner based on the actual clinical context to promote scientific fluid management in the perioperative period.

By consulting the ancient and modern literature， the name， origin， quality evaluation， harvesting and processing methods of Curculiginis Rhizoma（CR） were systematically combed and verified， in order to provide a basis for the development and utilization of famous classical formulas containing CR. The results of herbal textual research showed that the name Xianmao was first recorded in Leigong Paozhilun， the name of CR was used in all dynasties and this name came from its efficacy and morphological characteristics， the mainstream source for CR of the past dynasties was the rhizome of Curculigo orchioides or C. capitulata， since modern times， C. orchioides has been the main source of commodities. In ancient times， most of the places of origin of the description were the western regions and southwest China， while in modern times， Sichuan and Guizhou were regarded as genuine places. Since modern times， its quality has been summarized as the best with thick roots， firm texture and black-brown surface， the harvesting and processing methods recorded in the past dynasties are mainly sun drying after harvest in the second， eighth and ninth months of the lunar calendar， and most of them are harvested in autumn and winter in modern times. In ancient times， there were many processing methods of CR， mainly in processing with rice swill， while in modern times， stir-frying with wine was the main processing method. The nature， taste， meridian tropism， functions and indications of CR are basically consistent from ancient to modern times， the taboos for taking are to avoid iron， cow's milk， and beef. Although there are some differences in the understanding of the toxicity of CR in the past dynasties， most of the materia medica are clear that it has a certain toxicity. Based on the research conclusion， it is suggested that the rhizome of C. orchioides of Lycoris family should be used as its source in the famous classical formulas， and the corresponding processing method should be selected according to the processing requirements in the formulas， while the raw products is recommended to be selected as medicine if the processing requirement is not specified.

In recent years, with the progress of minimally invasive treatment technology of hepatolithiasis in China, as well as the in-depth understanding of the pathological mechanism of hepatolithiasis and the integration of precision surgery concept and digital medical technology, minimally invasive surgery has gradually presented standardization and precision in the treatment of hepatolithiasis. Laparoscopic hepatectomy, as a representative of minimally invasive surgery, has become one of the most important means to treat hepatolithiasis. With the continuous accumulation of surgery, the improvement of operation technology and the innovation of instruments and equip-ment, laparoscopic hepatectomy has reached a new height in the treatment of hepatolithiasis. Com-bined with the clinical practice of the team, the authors review the relevant literature and explore the progress of laparoscopic hepatectomy in the treatment of hepatolithiasis, in order to provide clinicians with a more comprehensive and in-depth treatment reference, so as to improve the pro-gnosis and quality of life of patients.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

OBJECTIVE To identify, synthesize and analyze the structure of unknown impurities unique to bromhexine hydrochloride injection and set the impurities as known impurity to control. METHODS The structure of unknown impurities was derived through two-dimensional liquid chromatography tandem mass spectrometry(2DLC-HRMS/MS), and the source of impurities was derived based on the product's prescription process. The mechanism of impurities generation was analyzed, and impurity monomers were obtained through directional synthesis. The structure of impurities was confirmed using techniques such as 2DLC-HRMS/MS and nuclear magnetic resonance. Finally, HPLC was used to verify the analysis method of impurities. RESULTS It was confirmed that such impurities were produced in a reaction between bromhexine and the excipient glucose. The correction factor of the two impurities were 2.2 and 2.4, the analytical method was specific and reproducible. CONCLUSION Name the two injection specific impurities as impurity 1 and impurity 2 respectively, and use them as known impurities to be included in the standard, calculate the impurity content using the self control and correction factor method. This study is of great significance in guiding the impurity control of bromhexine hydrochloride injection and the screening of excipient glucose.

In recent years, with the progress of minimally invasive treatment technology of hepatolithiasis in China, as well as the in-depth understanding of the pathological mechanism of hepatolithiasis and the integration of precision surgery concept and digital medical technology, minimally invasive surgery has gradually presented standardization and precision in the treatment of hepatolithiasis. Laparoscopic hepatectomy, as a representative of minimally invasive surgery, has become one of the most important means to treat hepatolithiasis. With the continuous accumulation of surgery, the improvement of operation technology and the innovation of instruments and equip-ment, laparoscopic hepatectomy has reached a new height in the treatment of hepatolithiasis. Com-bined with the clinical practice of the team, the authors review the relevant literature and explore the progress of laparoscopic hepatectomy in the treatment of hepatolithiasis, in order to provide clinicians with a more comprehensive and in-depth treatment reference, so as to improve the pro-gnosis and quality of life of patients.