OBJECTIVE To formulate Guidelines for the standardized implementation of pharmacist-managed clinics （ 2026 edition ） in response to the challenges faced by such clinics in China， including uneven development， large discrepancies in service specifications， insufficient patient awareness， and limited medical insurance coverage. METHODS Led by the Pharmaceutical Affairs Professional Committee of the Chinese Hospital Association， the Evidence-based Pharmacy Professional Committee of the Chinese Pharmaceutical Association， and the Hospital Pharmacy Professional Committee of the Cross-strait Medical and Health Exchange Association， a total of 19 domestic hospital pharmacy experts were organized. Through a systematic review of national policies and literature research， current practical experience was summarized. Consensus on the contents of the guidelines was reached after in-depth discussions. RESULTS &CONCLUSIONS The guidelines covered five sections： definition and connotation of pharmacist-managed clinics， establishment requirements， implementation and management， post competency， and practical research. Firstly， the definition and connotation included three operational forms of pharmacist-managed clinics （independent mode， physician-pharmacist joint mode， and online pharmacist-managed clinic mode） and classified service modes （specialty-specific， drug-specific， and disease-specific pharmacist-managed clinics）. The establishment requirements were further refined， covering system construction （pharmaceutical service management system， quality control and assessment mechanism）， personnel qualifications （professional credentials， continuing education and professional training， etc）， service recipients， as well as service venues and facilities. Subsequently， the implementation and management of pharmacist-managed clinics were proposed， involving service procedures， intervention measures， documentation and records， patient education and follow-up， humanistic care， as well as risk management and quality control. Finally， post competency encompassed the competency requirements for pharmacists providing services in pharmacist-managed clinics， as well as the suggestions on teaching methods； practical research encouraged the conduct of high-quality pharmaceutical practice in the setting of pharmacist-managed clinics. The guidelines provide valuable guidance for the standardized implementation of pharmacist-managed clinics in China in terms of establishment， management， teaching， and research， fill the guideline gap in this field， and can promote the high-quality development of pharmacist-managed clinics.

Objective:To investigate the neuro-electrophysiological characteristics of patients with primary brain stem hemorrhage (PBSH).Methods:This is a retrospective case series study. The clinical data of 17 PBSH patients with Glasgow coma score 3 to 8 points who were admitted to the Department of Neurosurgery, Xiangya Hospital of Central South University from January 2022 to December 2023 were retrospectively analyzed. There were 14 males and 3 females, with an age( M (IQR)) of 46.0(14.0) years (range: 18.0 to 70.0 years).All patients underwent electro-physiological monitoring within 28 days after the onset of the disease. According to Glasgow outcome scale(GOS) 6 months after onset, PBSH patients were divided into two groups: unregained consciousness group with (GOS 1 to 2 points, 13 cases) and regained consciousness group (GOS 3 to 5 points, 4 cases). The neuro-electrophysiological indicators involved in this study included short latency somosensory evoked potential (SLSEP) component N20, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG) background activity, EEG reactivity (EEG-R), EEG sleep structure waves, absolute amplitude of N1 at electrode Fz (FzN1A) and Cz (CzN1A), respectively, absolute amplitude of mismatch negativity at electrode Fz (FzMMNA) and Cz (CzMMNA), respectively. Then, the Fisher exact probability test and Mann Whitney U test were used for counting data and measurement data, respectively, to analyze the differences of neuro-electrophysiological indicators between the two groups. Results:The EEG background activity of 17 PBSH patients was mainly α-mode, α-θ mode and θ mode. Four patients with α-mode, 3 of whom regained consciousness (all with EEG-R). There were 3 patients with α-θ pattern. And 5 patients with θ pattern, 2 of whom died. Five patients with background EEG activity of delta pattern had poor prognosis, of which 4 patients died and 1 patient survived but did not regain consciousness 6 months after onset. SLSEP component N20 were absent bilaterally in 12 cases and BAEP in 5 cases. FzN1A and CzN1A were not extracted in 4 cases, and FzMMNA and CzMMNA were not extracted in 6 cases. The study showed that BAEP, EEG background activity, EEG-R, FzN1A, CzN1A, FzMMNA and CzMMNA were different between the two groups (all P<0.05), while there was no difference between N20 and EEG sleep structure (all P>0.05). Conclusion:The neuro-electrophysiological indicators including BAEP, EEG background activity, EEG-R, FzN1A, CzN1A, FzMMNA, and CzMMNA may be related to whether PBSH patients can regain consciousness 6 months after onset, and it is best to combine multiple indicators for comprehensive analysis in clinical practice.

OBJECTIVES: To assess the therapeutic effect of aucubin in mice with knee osteoarthritis (KOA) and investigate the underlying mechanism. METHODS: Sixty C57BL/6J mice were randomized equally into sham operation group, KOA model group, glucosamine (positive control) treatment group, and low-, medium-, and high-dose aucubin treatment groups (2, 4, and 8 mg/kg, respectively). KOA mouse models were established by transection of the anterior cruciate ligament (ACL), and the treatment was initiated on day 1 postoperatively and administered weekly for 8 weeks. Safranin O-fast green staining, immunohistochemistry, and microCT were used to evaluate the changes in cartilage pathology, inflammatory protein expression, and subchondral bone volume fraction (BV/TV). The expression levesl of COL2, SOX9, p-P65, IL-1β and MMP13 proteins in the cartilage tissues were detected using Western blotting. In a chondrocyte model with IL-1β treatment for mimicking KOA, the effect of aucubin on chondrogenic differentiation was observed with Alcian blue and Safranin O staining, and cellular COL2, SOX9 and TNF‑α mRNA expressions were detected with RT-qPCR. RESULTS: Compared with those in the model group, the mouse models receiving aucubin treatment showed significantly upregulated COL2 and SOX9 protein levels and downregulated p-P65, IL-1β and MMP13 expressions in the cartilage tissues. In the IL-1β-induced chondrocyte model, aucubin treatment significantly upregulated the mRNA expressions of SOX9 and COL2 but lowered the mRNA expression of TNF-α. Alcian blue and Safranin O staining confirmed that aucubin promoted the synthesis of cartilage extracellular matrix and enhanced chondrogenic differentiation of the cells. CONCLUSIONS Aucubin can effectively alleviate KOA in mice by inhibiting NF‑κB-mediated cartilage inflammation, promoting cartilage matrix synthesis, and improving subchondral bone microstructure.
Animals ; Mice, Inbred C57BL ; Mice ; Osteoarthritis, Knee/drug therapy* ; Signal Transduction/drug effects* ; NF-kappa B/metabolism* ; Iridoid Glucosides/therapeutic use* ; SOX9 Transcription Factor/metabolism* ; Chondrocytes/drug effects* ; Male ; Interleukin-1beta/metabolism* ; Matrix Metalloproteinase 13/metabolism* ; Collagen Type II/metabolism* ; Disease Models, Animal

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 investigate the effects of soybean isoflavones(SIF)on immune function of rats with ulcerative colitis(UC)by regulating high-mobility group protein B1(HMGB1)/receptor for advanced glycation end products(RAGE)signal pathway.Methods:Sixty SD rats were randomly grouped into Model group,low dose SIF group(SIF-L group,300 mg/kg SIF),high dose SIF group(SIF-H group,450 mg/kg SIF),high dose SIF+HMGB1 inhibitor glycyrrhizic acid group(SIF-H+glycyrrhizic acid group,450 mg/kg SIF+30 mg/kg glycyrrhizic acid)and Control group,with 12 rats in each group.The UC rat model was established by TNBS/ethanol combined enema.Body weight changes of rats in each group were measured,and disease activity index(DAI)was determined in each group.Histopathological changes of colon were observed by HE staining;levels of superoxide dismutase(SOD)and malondial-dehyde(MDA)in colon tissue of rats were measured by colorimetry;serum levels of IL-1β,TNF-α and IL-4 were determined by ELISA;flow cytometry was used to determine the percentages of CD3+T,CD4+T and CD8+T lymphocytes in peripheral blood mononuclear cells;levels of serum IgA and IgG were measured by automatic specific protein analyzer;expressions of HMGB1 and RAGE in colon tissues were determined by Western blot and immunohistochemistry.Results:Compared with Control group,levels of DAI,serum TNF-α,IL-1β,IgA,IgG,MDA in colon tissue,HMGB1 and RAGE protein expressions in colon tissue of Model group were obviously higher(P<0.05),while SOD level,IL-4,CD3+T,CD4+T and CD8+T lymphocyte percentages,CD4+/CD8+T were obviously lower(P<0.05),the mucosa of colon tissue was damaged.Compared with Model group,changes of relevant indexes in SIF-H group were contrary to the above(P<0.05),and the damage of colon tissue was alleviated.Conclusion:SIF may enhance the immune function of UC rats by inhibiting HMGB1/RAGE signal pathway.

Objective:To investigate the effects of soybean isoflavones(SIF)on immune function of rats with ulcerative colitis(UC)by regulating high-mobility group protein B1(HMGB1)/receptor for advanced glycation end products(RAGE)signal pathway.Methods:Sixty SD rats were randomly grouped into Model group,low dose SIF group(SIF-L group,300 mg/kg SIF),high dose SIF group(SIF-H group,450 mg/kg SIF),high dose SIF+HMGB1 inhibitor glycyrrhizic acid group(SIF-H+glycyrrhizic acid group,450 mg/kg SIF+30 mg/kg glycyrrhizic acid)and Control group,with 12 rats in each group.The UC rat model was established by TNBS/ethanol combined enema.Body weight changes of rats in each group were measured,and disease activity index(DAI)was determined in each group.Histopathological changes of colon were observed by HE staining;levels of superoxide dismutase(SOD)and malondial-dehyde(MDA)in colon tissue of rats were measured by colorimetry;serum levels of IL-1β,TNF-α and IL-4 were determined by ELISA;flow cytometry was used to determine the percentages of CD3+T,CD4+T and CD8+T lymphocytes in peripheral blood mononuclear cells;levels of serum IgA and IgG were measured by automatic specific protein analyzer;expressions of HMGB1 and RAGE in colon tissues were determined by Western blot and immunohistochemistry.Results:Compared with Control group,levels of DAI,serum TNF-α,IL-1β,IgA,IgG,MDA in colon tissue,HMGB1 and RAGE protein expressions in colon tissue of Model group were obviously higher(P<0.05),while SOD level,IL-4,CD3+T,CD4+T and CD8+T lymphocyte percentages,CD4+/CD8+T were obviously lower(P<0.05),the mucosa of colon tissue was damaged.Compared with Model group,changes of relevant indexes in SIF-H group were contrary to the above(P<0.05),and the damage of colon tissue was alleviated.Conclusion:SIF may enhance the immune function of UC rats by inhibiting HMGB1/RAGE signal pathway.

Objective:To investigate the neuro-electrophysiological characteristics of patients with primary brain stem hemorrhage (PBSH).Methods:This is a retrospective case series study. The clinical data of 17 PBSH patients with Glasgow coma score 3 to 8 points who were admitted to the Department of Neurosurgery, Xiangya Hospital of Central South University from January 2022 to December 2023 were retrospectively analyzed. There were 14 males and 3 females, with an age( M (IQR)) of 46.0(14.0) years (range: 18.0 to 70.0 years).All patients underwent electro-physiological monitoring within 28 days after the onset of the disease. According to Glasgow outcome scale(GOS) 6 months after onset, PBSH patients were divided into two groups: unregained consciousness group with (GOS 1 to 2 points, 13 cases) and regained consciousness group (GOS 3 to 5 points, 4 cases). The neuro-electrophysiological indicators involved in this study included short latency somosensory evoked potential (SLSEP) component N20, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG) background activity, EEG reactivity (EEG-R), EEG sleep structure waves, absolute amplitude of N1 at electrode Fz (FzN1A) and Cz (CzN1A), respectively, absolute amplitude of mismatch negativity at electrode Fz (FzMMNA) and Cz (CzMMNA), respectively. Then, the Fisher exact probability test and Mann Whitney U test were used for counting data and measurement data, respectively, to analyze the differences of neuro-electrophysiological indicators between the two groups. Results:The EEG background activity of 17 PBSH patients was mainly α-mode, α-θ mode and θ mode. Four patients with α-mode, 3 of whom regained consciousness (all with EEG-R). There were 3 patients with α-θ pattern. And 5 patients with θ pattern, 2 of whom died. Five patients with background EEG activity of delta pattern had poor prognosis, of which 4 patients died and 1 patient survived but did not regain consciousness 6 months after onset. SLSEP component N20 were absent bilaterally in 12 cases and BAEP in 5 cases. FzN1A and CzN1A were not extracted in 4 cases, and FzMMNA and CzMMNA were not extracted in 6 cases. The study showed that BAEP, EEG background activity, EEG-R, FzN1A, CzN1A, FzMMNA and CzMMNA were different between the two groups (all P<0.05), while there was no difference between N20 and EEG sleep structure (all P>0.05). Conclusion:The neuro-electrophysiological indicators including BAEP, EEG background activity, EEG-R, FzN1A, CzN1A, FzMMNA, and CzMMNA may be related to whether PBSH patients can regain consciousness 6 months after onset, and it is best to combine multiple indicators for comprehensive analysis in clinical practice.

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.

The"biographical disruption"theory aims at explain the crises and conflicts in human development,as well as explore how to restore or rebuild an individual's identity and values.From the perspective of the"biographical disruption"theory,this paper analyzed the dilemmas and causes of children with epilepsy from four aspects,including disruption of physical and mental health,cognitive,social relationships,and family life.Based on these,the following suggestions were proposed to enhance the quality of life of children with epilepsy,including adjusting living habits and improving treatment compliance;formulating early rehabilitation training plans to develop language and thinking abilities;understanding and caring about their psychological state and correctly cultivating their sense of self-worth;providing personalized education programs and enhancing their leisure time;offering professional psychological counseling and strengthening the understanding and support of all sectors;establishing self-cognition groups and empowering children with a sense of control over the disease;changing the misunderstandings and prejudices about epilepsy;removing stigmatization of epilepsy patients;encouraging children to actively participate in social activities and providing a safe and positive social environment;encouraging social workers to actively intervene to restore and enhance family cohesion;actively seeking social support and resources and improving their social security system.

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.