Objective:To explore the fatigue status and its influencing factors in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI) .Methods:This study is a cross-sectional study. A convenient sampling method was used to select 98 ACS patients who underwent PCI in the Department of Cardiology at China-Japan Union Hospital of Jilin University in February 2024. A general data questionnaire and the Multidimensional Fatigue Inventory-20 (MFI-20) were used to investigate the patients.Results:The total score of MFI-20 for the 98 ACS patients post-PCI was (57.38±15.14). Multiple linear regression analysis showed that hypertension was influencing factor of fatigue in ACS patients after PCI ( P<0.05) . Conclusions:The fatigue level of ACS patients after PCI is at a moderate level. The degree of fatigue is influenced by hypertension. Clinical targeted nursing measures should be implemented to alleviate the fatigue of the patients.

Objective:To compare the effects of standard cognitive behavioral therapy for insomnia (CBT-I) and enhanced cognitive behavioral therapy for insomnia(CBT-I Plus) in patients with chronic insomnia disorder comorbid anxiety or depressive symptoms.Methods:This prospective study included 148 patients with chronic insomnia disorder and anxiety/depression symptoms who were treated at the Sleep Disorder clinic of Shanghai Mental Health Center between July 2020 and August 2023. Participants (56 males, 92 females; aged 18-65 years, mean age 35.08±10.30 years) were randomly assigned in a 1∶2 ratio to the CBT-I group ( n=54) or CBT-I Plus group ( n=94). The CBT-I Plus group received additional treatments targeting anxiety and depressive symptoms. Treatment lasted 8 weeks, with assessment conducted at baseline, weeks 2, 4, and 8. Depression severity was measured using the 17-item Hamilton Depression Rating Scale (HAMD 17), anxiety severity with the Hamilton Anxiety Scale (HAMA), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Paired sample t-tests were used to evaluate within-group changes, repeated-measures ANOVA compared treatment effects between groups, and ANCOVA was employed to adjust for confounding variables. Results:Significant reductions in PSQI, HAMD 17, and HAMA scores were observed in both groups after treatment: CBT-I group: PSQI ((14.15±2.54) vs. (7.50±3.35), t=13.25), HAMD 17 ((14.70±4.09) vs. (7.40±4.61), t=9.33), and HAMA ((14.94±4.11) vs. (5.56±3.67), t=12.38) (all P<0.001).CBT-I Plus group: PSQI ((14.87±3.01) vs. (7.19±3.86), t=18.75), HAMD 17 ((16.84±3.91) vs. (6.84±4.79), t=17.42), and HAMA ((15.57±3.93) vs. (6.10±4.57), t=18.39) (all P<0.001). After adjusting for HAMD 17 scores and medication use, no statistically significant between-group differences were observed in changes in PSQI, HAMD 17, and HAMA scores ( P>0.05). A significant time-by-group interaction was found for the PSQI daytime dysfunction subscale ( F=4.87, P<0.01). Conclusion:Both CBT-I and CBT-I Plus improve sleep and emotional symptoms in patients with chronic insomnia disorder and comorbid anxiety/depression symptoms. However, CBT-I Plus has no significant advantages over standard CBT-I. Further studies are needed to refine the timing and content of interventions.

Objective:To explore the fatigue status and its influencing factors in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI) .Methods:This study is a cross-sectional study. A convenient sampling method was used to select 98 ACS patients who underwent PCI in the Department of Cardiology at China-Japan Union Hospital of Jilin University in February 2024. A general data questionnaire and the Multidimensional Fatigue Inventory-20 (MFI-20) were used to investigate the patients.Results:The total score of MFI-20 for the 98 ACS patients post-PCI was (57.38±15.14). Multiple linear regression analysis showed that hypertension was influencing factor of fatigue in ACS patients after PCI ( P<0.05) . Conclusions:The fatigue level of ACS patients after PCI is at a moderate level. The degree of fatigue is influenced by hypertension. Clinical targeted nursing measures should be implemented to alleviate the fatigue of the patients.

Objective:To compare the effects of standard cognitive behavioral therapy for insomnia (CBT-I) and enhanced cognitive behavioral therapy for insomnia(CBT-I Plus) in patients with chronic insomnia disorder comorbid anxiety or depressive symptoms.Methods:This prospective study included 148 patients with chronic insomnia disorder and anxiety/depression symptoms who were treated at the Sleep Disorder clinic of Shanghai Mental Health Center between July 2020 and August 2023. Participants (56 males, 92 females; aged 18-65 years, mean age 35.08±10.30 years) were randomly assigned in a 1∶2 ratio to the CBT-I group ( n=54) or CBT-I Plus group ( n=94). The CBT-I Plus group received additional treatments targeting anxiety and depressive symptoms. Treatment lasted 8 weeks, with assessment conducted at baseline, weeks 2, 4, and 8. Depression severity was measured using the 17-item Hamilton Depression Rating Scale (HAMD 17), anxiety severity with the Hamilton Anxiety Scale (HAMA), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Paired sample t-tests were used to evaluate within-group changes, repeated-measures ANOVA compared treatment effects between groups, and ANCOVA was employed to adjust for confounding variables. Results:Significant reductions in PSQI, HAMD 17, and HAMA scores were observed in both groups after treatment: CBT-I group: PSQI ((14.15±2.54) vs. (7.50±3.35), t=13.25), HAMD 17 ((14.70±4.09) vs. (7.40±4.61), t=9.33), and HAMA ((14.94±4.11) vs. (5.56±3.67), t=12.38) (all P<0.001).CBT-I Plus group: PSQI ((14.87±3.01) vs. (7.19±3.86), t=18.75), HAMD 17 ((16.84±3.91) vs. (6.84±4.79), t=17.42), and HAMA ((15.57±3.93) vs. (6.10±4.57), t=18.39) (all P<0.001). After adjusting for HAMD 17 scores and medication use, no statistically significant between-group differences were observed in changes in PSQI, HAMD 17, and HAMA scores ( P>0.05). A significant time-by-group interaction was found for the PSQI daytime dysfunction subscale ( F=4.87, P<0.01). Conclusion:Both CBT-I and CBT-I Plus improve sleep and emotional symptoms in patients with chronic insomnia disorder and comorbid anxiety/depression symptoms. However, CBT-I Plus has no significant advantages over standard CBT-I. Further studies are needed to refine the timing and content of interventions.

Cholesterol is an important precursor of many endogenous molecules. Disruption of cholesterol homeostasis can cause many pathological changes, leading to liver and cardiovascular diseases. CYP1A is widely involved in cholesterol metabolic network, but its exact function has not been fully elucidated. Here, we aim to explore how CYP1A regulates cholesterol homeostasis. Our data showed that CYP1A1/2 knockout (KO) rats presented cholesterol deposition in blood and liver. The serum levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol were significantly increased in KO rats. Further studies found that the lipogenesis pathway (LXRα-SREBP1-SCD1) of KO rats was activated, and the key protein of cholesterol ester hydrolysis (CES1) was inhibited. Importantly, lansoprazole can significantly alleviate rat hepatic lipid deposition in hypercholesterolemia models by inducing CYP1A. Our findings reveal the role of CYP1A as a potential regulator of cholesterol homeostasis and provide a new perspective for the treatment of hypercholesterolemia.

Objective:To explore the application and effect of flipped classroom in community clinical pharmacist training.Methods:Seventeen pharmacists trained in 2017-2018 were used as the control group and received traditional teaching mode. Fourteen pharmacists trained in 2019-2020 were used as the experimental group and received the flipped classroom teaching mode. Finally, the teaching effect was evaluated through the trainees' graduation examination results and satisfaction degree. The SPSS 25.0 was used to conduct the t test and chi-square test. Results:The task performance, prescription audit scores, clinical practice scores, and total scores in the experimental group were significantly higher than those in the control group ( P<0.05). However, there was no significant difference in usual performance between the two groups ( P>0.05). For satisfaction survey, the total score of Likert scale in the experimental group was (20.1±3.4), which was significantly higher than that in the control group (16.9±3.4). However, there was no significant difference in the satisfaction of clinical practice and teachers' level between the two groups ( P>0.05). Conclusion:Flipped classroom can improve the enthusiasm of community clinical pharmacist trainees to participate in learning, increase the level of the trainees' theoretical knowledge and professional practice, and is conducive to the cultivation of high-quality community clinical pharmacists.

Gastric carcinoma is extremely rare in pregnancy and the prognosis for this malignancy tends to be dismal. We herein describe a case of gastric cancer in pregnancy to alert clinicians to this rare possibility. A 29-year-old woman developed abdominal spastic pain and diarrhea during the 26 weeks of gestation and her condition was confusing and hard to recognize. The patient was initially misdiagnosed as enterogastritis and inflammatory intestinal obstruction and was finally confirmed by exploratory laparotomy with intestinal and peritoneum metastases. Because the disease was not detected early enough and progressed rapidly, the pregnancy was terminated by cesarean section at 30 weeks of gestation, and then followed by systemic chemotherapy, but eventually succumbed to the lethal pneumonia. Therefore, it is of great significance to alert clinicians to note this rare possibility and to consider the differential diagnosis of this disease in pregnant women with a long course of gastrointestinal symptoms that cannot be explained by pregnancy alone, and cancer should be suspected and tested with sophisticated diagnostic procedures.

Gastric carcinoma is extremely rare in pregnancy and the prognosis for this malignancy tends to be dismal. We herein describe a case of gastric cancer in pregnancy to alert clinicians to this rare possibility. A 29-year-old woman developed abdominal spastic pain and diarrhea during the 26 weeks of gestation and her condition was confusing and hard to recognize. The patient was initially misdiagnosed as enterogastritis and inflammatory intestinal obstruction and was finally confirmed by exploratory laparotomy with intestinal and peritoneum metastases. Because the disease was not detected early enough and progressed rapidly, the pregnancy was terminated by cesarean section at 30 weeks of gestation, and then followed by systemic chemotherapy, but eventually succumbed to the lethal pneumonia. Therefore, it is of great significance to alert clinicians to note this rare possibility and to consider the differential diagnosis of this disease in pregnant women with a long course of gastrointestinal symptoms that cannot be explained by pregnancy alone, and cancer should be suspected and tested with sophisticated diagnostic procedures.

Objective:The current study aims to explore the factors related to the efficacy of cognitive behavior therapy for insomnia (CBT-I) from the perspective of patients and to provide references for more effective implementation of CBT-I.Methods:Using qualitative research methods, 21 insomnia patients with depression/anxiety were treated with CBT-I for 8 consecutive times. Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD 17), and Hamilton Anxiety Scale (HAMA) were assessed at baseline and the end of the 8th week of treatment. The paired sample t-test was conducted. Semi-structured interviews were performed at week 2, week 4, and week 8 respectively and thematic analysis was used to code and analyze the interview data. Results:Compared with baseline data, the symptoms of insomnia (13.6±2.0 vs. 6.9±2.4), depression (14.6±5.5 vs. 5.0±3.6), and anxiety (17.2±3.4 vs. 5.3±3.9) were significantly improved after 8 weeks of CBT-I treatment ( t=-3.31, -3.19, -2.94, all P<0.01). The patient factors influencing the efficacy of CBT-I were treatment expectation and approval, motivation, compliance, and internalization of treatment content. The therapist factors were professionalism, well-directed, treatment style, supervision, and giving hope. Conclusion:Compliance and high levels of participation of the patients can benefit the treatment efficacy of CBT-I. Therapists should have sufficient experience, stimulate patients′ motivation, improve patients′ compliance, and carry out adequate psychological education in the early stage to increase the efficacy of CBT-I.

Objective:The current study aims to explore the factors related to the efficacy of cognitive behavior therapy for insomnia (CBT-I) from the perspective of patients and to provide references for more effective implementation of CBT-I.Methods:Using qualitative research methods, 21 insomnia patients with depression/anxiety were treated with CBT-I for 8 consecutive times. Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD 17), and Hamilton Anxiety Scale (HAMA) were assessed at baseline and the end of the 8th week of treatment. The paired sample t-test was conducted. Semi-structured interviews were performed at week 2, week 4, and week 8 respectively and thematic analysis was used to code and analyze the interview data. Results:Compared with baseline data, the symptoms of insomnia (13.6±2.0 vs. 6.9±2.4), depression (14.6±5.5 vs. 5.0±3.6), and anxiety (17.2±3.4 vs. 5.3±3.9) were significantly improved after 8 weeks of CBT-I treatment ( t=-3.31, -3.19, -2.94, all P<0.01). The patient factors influencing the efficacy of CBT-I were treatment expectation and approval, motivation, compliance, and internalization of treatment content. The therapist factors were professionalism, well-directed, treatment style, supervision, and giving hope. Conclusion:Compliance and high levels of participation of the patients can benefit the treatment efficacy of CBT-I. Therapists should have sufficient experience, stimulate patients′ motivation, improve patients′ compliance, and carry out adequate psychological education in the early stage to increase the efficacy of CBT-I.