OBJECTIVE To explore the working model and practical effectiveness of surgical pharmacists participating in the rational medication management of urology department under the background of diagnosis related groups （DRGs） payment system.METHODS In the context of DRGs， surgical pharmacists have constructed a rational drug use control model for key DRGs disease groups with a high number of urological cases in three stages： the pre stage， which includes developing perioperative drug use guidelines and implementing a rational drug use management system intervention； the mid-term stage， which includes conducting specialized evaluations in conjunction with DRGs disease groups， conducting pharmaceutical ward rounds and medical order reviews， conducting rational drug use training and science popularization； the post event stage， which includes establishing a performance evaluation system for clinical departments and surgical pharmacists， and collecting reasons why surgical physicians did not adopt surgical pharmacist recommendations. Patients who entered DRGs groups and were discharged from the urology department of Foshan Second People’s Hospital were selected as the research subjects. The changes in departmental DRGs indicators [including number of DRGs groups， total weight， case mix index （CMI）， average length of stay， time consumption index， average cost per case， cost consumption index， average drug cost per case， drug consumption index， and mortality in low- and medium-risk] were compared before pharmacist intervention （June to December 2022）， after 1 year of intervention （June to December 2023）， and after 2 years of intervention （June to December 2024）. The improvement in medication rational rates （for antibiotics， hemocoagulase， and proton pump inhibitors） and pharmacy performance assessment indicators [average drug cost per case， defined daily doses （DDDs， excluding traditional Chinese medicine）， and antibiotic use density （AUD）] in the top 5 DRGs groups by case volume were statistically analyzed. The reasons for non-adoption of medication intervention recommendations by urologists were further analyzed.RESULTS With the participation of surgical pharmacists in the rational medication management of urology department， the number of DRGs groups， total weight， and CMI in the urology department increased year by year， while the average length of stay， average cost per case， and average drug cost per case decreased year by year， there were no low- to medium-risk deaths before and after the medication management. The average drug cost per case， DDDs， and AUD in the top 5 key DRGs groups （LE15， LE13， MC15， MC13， and LK19） were significantly decreased compared with those before intervention （ P ＜0.05）. The medication rational rates （for antibiotics， hemocoagulase， and proton pump inhibitors） in the above 5 key DRGs groups were significantly increased compared with those before intervention （ P ＜0.05）. After 2 years of pharmacist intervention， the non-adoption rates of urologists for medication interventions related to antibiotics， hemocoagulase， and proton pump inhibitors were significantly lower than those after 1 year of intervention （ P ＜0.05）； the main reason for not adopting interventions related to hemocoagulase was that surgeons believed “increasing the daily dose could shorten the hemostasis course”， the main reason for not adopting interventions related to antibiotics was “postoperative elevation of inflammatory indicators necessitates prolonged treatment”.CONCLUSIONS The hospital has successfully established a model of surgical pharmacists participating in the rational medication management of urology department. This model has improved departmental DRGs indicators and pharmacy performance assessment indicators， and enhanced the medication rational rate.

Endothelial dysfunction(ED)is a crucial pathological feature and a key initiating factor in diabetic angiopathy.A major pathway contributing to ED is the reduction of nitric oxide(NO)production.NO is synthesized by endothelial nitric oxide synthase(eNOS)using L-arginine as a substrate.However,arginase(Arg)can compete with eNOS for this substrate.Arg has subtype 1 and 2.In diabetes mellitus(DM),the abnormal increase in Arg1 can lead to excessive consumption of the substrate in the vascular endothelium,which causes a decrease in NO levels,leading to diabetes-induced vascular ED.This article reviews the research progress of arginase 1 in diabetes-induced vascular ED.

Objective This study aims to analyze the characteristics of inpatients in the cardiovascular department of a tertiary hospital following the chest-pain-center accreditation,and provide guidance for the prevention and treatment of cardiovas-cular diseases.Methods A retrospective descriptive epidemiological approach was adopted to analyze the data of 2115 inpatients at the department of cardiovascular medicine in a tertiary hospital from 2022 to 2024 following chest pain center accreditation.Re-sults The number of the inpatients in 2022,2023,and 2024 was 582 cases(27.52％),684 cases(32.34％),and 849 cases(40.14％),respectively,with the total rising year by year.The proportion of males was higher than that of females,with a male-to-female sex ratio of 1.45∶1.The group aged 40 to 79 years accounted for the highest percentage(80.90％).The top three diseases categorized by percentage were coronary heart disease(754 cases,35.64％),hypertension(479 cases,22.64％),and arrhythmia(167 cases,7.89％).Epidemiological characterization exhibited a statistically significant difference in the disease composition of hospitalized cardiovascular patients in years,genders,ages,and seasons(x2=155.40,36.591,900.597,856.659,P＜0.05).Specific classification showed significant differences in hypertension and other conditions by age(P＜0.05);coronary heart disease and valvular heart disease by gender(P＜0.05);and significant differences across ages in coronary heart disease,hypertension,heart failure,pericardial disease,peripheral vascular disease,congenital heart disease,and others(all P＜0.05).Seasonal differences in coronary heart disease,hypertension,arrhythmia,cardiomyopathy,valvular heart disease,heart failure,pericardial disease,and others were also statistically significant(P＜0.05).Conclusion Against the backdrop of chest pain center accreditation in our hospital,inpatients in our department now demonstrate extinct demographic profiles and seasonal patterns among hospitalized cardiovascular patients.We should strengthen the prevention and treatment of coronary heart disease and hypertension,and establish a comprehensive prevention and control system based on these epidemio-logical characteristics.

Endothelial dysfunction(ED)is a crucial pathological feature and a key initiating factor in diabetic angiopathy.A major pathway contributing to ED is the reduction of nitric oxide(NO)production.NO is synthesized by endothelial nitric oxide synthase(eNOS)using L-arginine as a substrate.However,arginase(Arg)can compete with eNOS for this substrate.Arg has subtype 1 and 2.In diabetes mellitus(DM),the abnormal increase in Arg1 can lead to excessive consumption of the substrate in the vascular endothelium,which causes a decrease in NO levels,leading to diabetes-induced vascular ED.This article reviews the research progress of arginase 1 in diabetes-induced vascular ED.

Objective This study aims to analyze the characteristics of inpatients in the cardiovascular department of a tertiary hospital following the chest-pain-center accreditation,and provide guidance for the prevention and treatment of cardiovas-cular diseases.Methods A retrospective descriptive epidemiological approach was adopted to analyze the data of 2115 inpatients at the department of cardiovascular medicine in a tertiary hospital from 2022 to 2024 following chest pain center accreditation.Re-sults The number of the inpatients in 2022,2023,and 2024 was 582 cases(27.52％),684 cases(32.34％),and 849 cases(40.14％),respectively,with the total rising year by year.The proportion of males was higher than that of females,with a male-to-female sex ratio of 1.45∶1.The group aged 40 to 79 years accounted for the highest percentage(80.90％).The top three diseases categorized by percentage were coronary heart disease(754 cases,35.64％),hypertension(479 cases,22.64％),and arrhythmia(167 cases,7.89％).Epidemiological characterization exhibited a statistically significant difference in the disease composition of hospitalized cardiovascular patients in years,genders,ages,and seasons(x2=155.40,36.591,900.597,856.659,P＜0.05).Specific classification showed significant differences in hypertension and other conditions by age(P＜0.05);coronary heart disease and valvular heart disease by gender(P＜0.05);and significant differences across ages in coronary heart disease,hypertension,heart failure,pericardial disease,peripheral vascular disease,congenital heart disease,and others(all P＜0.05).Seasonal differences in coronary heart disease,hypertension,arrhythmia,cardiomyopathy,valvular heart disease,heart failure,pericardial disease,and others were also statistically significant(P＜0.05).Conclusion Against the backdrop of chest pain center accreditation in our hospital,inpatients in our department now demonstrate extinct demographic profiles and seasonal patterns among hospitalized cardiovascular patients.We should strengthen the prevention and treatment of coronary heart disease and hypertension,and establish a comprehensive prevention and control system based on these epidemio-logical characteristics.

Objective To investigate the predictive value of systemic immune inflammation index(SII)scores in long-term survival of patients with stage Ⅲ squamous lung cancer treated with radical radiotherapy.Methods Clinical data of stage Ⅲ squamous lung cancer patients who underwent radical radiotherapy at the Radiotherapy Department of the Fourth Hospital of Hebei Medical University from January 2010 to December 2018 were retrospectively analyzed.The peripheral hematological indexes one week before radiotherapy were collected and recorded.X-Tile software was applied to determine the best cut-off values for continuous variables.Kaplan-Meier method was used to analyze overall survival(OS)and progression-free survival(PFS).Results A total of 453 patients were included in this study.There were 336 patients in the low SII group(＜1 277.3),and other 117 patients were in the high SII group(≥1 277.3).The median OS and median PFS in the high SII group were shorter than those in the low SII group(OS:20.8 months vs.31.0 months,Log-rank χ2=18.015,P＜0.01;PFS:13.0 months vs.21.0 months,Log-rank χ2=15.062,P＜0.01).Multivariate Cox regression analysis showed that high SII was associated with OS(HR=1.628,95%CI:1.294-2.047,P<0.001)and PFS(HR=1.559,95%CI:1.240-1.961,P<0.001).Other influencing factors included late TNM stage,poor radiotherapy efficacy and decreased HALP score.Conclusion SII can be used to evaluate the long-term survival of patients with stage Ⅲ lung squamous cell carcinoma receiving radical radiotherapy,and the increase of SII indicates a poor prognosis.

Objective:To examine a survival prognostic model applicable for patients with intrahepatic cholangiocarcinoma (ICC) based on Bayesian network.Methods:The clinical and pathological data of ICC patients who underwent curative intent resection in ten Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected.A total of 516 patients were included in the study. There were 266 males and 250 females.The median age( M( Q R)) was 58(14) years.One hundred and sixteen cases (22.5%) with intrahepatic bile duct stones,and 143 cases (27.7%) with chronic viral hepatitis.The Kaplan-Meier method was used for survival analysis.The univariate and multivariate analysis were implemented respectively using the Log-rank test and Cox proportional hazard model.One-year survival prediction models based on tree augmented naive Bayesian (TAN) and na?ve Bayesian algorithm were established by Bayesialab software according to different variables,a nomogram model was also developed based on the independent predictors.The receiver operating characteristic curve and the area under curve (AUC) were used to evaluate the prediction effect of the models. Results:The overall median survival time was 25.0 months,and the 1-,3-and 5-year cumulative survival rates was 76.6%,37.9%,and 21.0%,respectively.Univariate analysis showed that gender,preoperative jaundice,pathological differentiation,vascular invasion,microvascular invasion,liver capsule invasion,T staging,N staging,margin,intrahepatic bile duct stones,carcinoembryonic antigen,and CA19-9 affected the prognosis(χ 2=5.858-54.974, all P<0.05).The Cox multivariate model showed that gender,pathological differentiation,liver capsule invasion, T stage,N stage,intrahepatic bile duct stones,and CA19-9 were the independent predictive factors(all P<0.05). The AUC of the TAN model based on all 19 clinicopathological factors was 74.5%,and the AUC of the TAN model based on the 12 prognostic factors derived from univariate analysis was 74.0%,the AUC of the na?ve Bayesian model based on 7 independent prognostic risk factors was 79.5%,the AUC and C-index of the nomogram survival prediction model based on 7 independent prognostic risk factors were 78.8% and 0.73,respectively. Conclusion:The Bayesian network model may provide a relatively accurate prognostic prediction for ICC patients after curative intent resection and performed superior to the nomogram model.

Objective:To examine a survival prognostic model applicable for patients with intrahepatic cholangiocarcinoma (ICC) based on Bayesian network.Methods:The clinical and pathological data of ICC patients who underwent curative intent resection in ten Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected.A total of 516 patients were included in the study. There were 266 males and 250 females.The median age( M( Q R)) was 58(14) years.One hundred and sixteen cases (22.5%) with intrahepatic bile duct stones,and 143 cases (27.7%) with chronic viral hepatitis.The Kaplan-Meier method was used for survival analysis.The univariate and multivariate analysis were implemented respectively using the Log-rank test and Cox proportional hazard model.One-year survival prediction models based on tree augmented naive Bayesian (TAN) and na?ve Bayesian algorithm were established by Bayesialab software according to different variables,a nomogram model was also developed based on the independent predictors.The receiver operating characteristic curve and the area under curve (AUC) were used to evaluate the prediction effect of the models. Results:The overall median survival time was 25.0 months,and the 1-,3-and 5-year cumulative survival rates was 76.6%,37.9%,and 21.0%,respectively.Univariate analysis showed that gender,preoperative jaundice,pathological differentiation,vascular invasion,microvascular invasion,liver capsule invasion,T staging,N staging,margin,intrahepatic bile duct stones,carcinoembryonic antigen,and CA19-9 affected the prognosis(χ 2=5.858-54.974, all P<0.05).The Cox multivariate model showed that gender,pathological differentiation,liver capsule invasion, T stage,N stage,intrahepatic bile duct stones,and CA19-9 were the independent predictive factors(all P<0.05). The AUC of the TAN model based on all 19 clinicopathological factors was 74.5%,and the AUC of the TAN model based on the 12 prognostic factors derived from univariate analysis was 74.0%,the AUC of the na?ve Bayesian model based on 7 independent prognostic risk factors was 79.5%,the AUC and C-index of the nomogram survival prediction model based on 7 independent prognostic risk factors were 78.8% and 0.73,respectively. Conclusion:The Bayesian network model may provide a relatively accurate prognostic prediction for ICC patients after curative intent resection and performed superior to the nomogram model.

Objective: To observe the expression of the G-protein-coupled-receptor 14 (GPR14), urotensinⅡreceptor, in the cardiovascular system and brain of SD rats. Methods: Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the GPR14 mRNA. Results: In cardiovascular system, GPR14 mRNA was detected in the left ventricle, left atrium, thoratic aorta and carotid aorta. The highest level of expression was found in the left ventricle. In the brain, GPR14 mRNA was detected in cortex, hippocampus, hypothalamus and cerebellum, and higher level of expression was found in the cerebellum. Conclusion: GPR14 mRNA expression is found in the cardiovascular and neural tissues of tested rat, suggesting that urotensinⅡ may play an important role in cardiovasculature and central nervous activity.