Objective To analyze the involvement of pharmacists in the pharmaceutical care of olfacatumumab in the treatment of elderly patients with refractory anti-metabotropic glutamate receptor 5(mGluR5)encephalitis and to provide a reference for the treatment and pharmaceutical care of patients with refractory autoimmune encephalitis(AE).Methods An 81-year-old patient with anti-mGluR5 encephalitis who had poor first-line immunotherapy effect.The key points of pharmaceutical care were determined according to the patient's condition and the characteristics of therapeutic drugs.The drug selection,administration mode,drug interaction,adverse reactions,and precautions of ofatumumab were put forward.At the same time,the patients and their families were given medication guidance and discharge education,and regular follow-up was carried out.Results With the cooperation of doctors,the patient was provided with whole-process pharmaceutical care,and the patient's condition was improved,and the patient's condition was good so far.Conclusion Clinical pharmacists pay attention to the effectiveness and safety of the treatment with ofatumumab by carrying out individualized pharmaceutical care for this patient,which fully reflects the value of clinical pharmacists and provides a reference for the treatment and pharmaceutical care of refractory AE patients.

Objective To assess the marginal microleakage of specimens following aging simulation of adhesive restorations for dental defects using methacryloxylethyl cetyldimethyl ammonium chloride(DMAE-CB)and nanoparticles of amorphous calcium phosphate(NACP)binder.Methods DMAE-CB and NACP were synthesized in the laboratory.Eight groups were formed by varying the mass fraction ratios of the two components in the adhesive according to previous experiments,A:binder+3％DMAE-CB+25％NACP,B:binder+4％DMAE-CB+35％NACP,C:binder+1％DMAE-CB+15％NACP,D:binder+4％DMAE-CB+15％NACP,E:binder+1％DMAE-CB+35％NACP,F:binder+3％DMAE-CB,G:binder+25％NACP,H:SBMP binder as the control group.Forty human third molars were collected and randomly divided into 8 groups to prepare standardized Class Ⅱ preparations.Subsequent-ly,dental defect adhesive restoration specimens were made by using the 8 groups of binder,and aging simulation was performed through thermal cycling.After thermal cycling,the specimens were immersed in the dye solution.Each specimen was sectioned into 4 parts of dentin tissue slices along the gingival,proximal,and occlusal walls using a low-speed cutting machine,and the depth of dye penetration was observed under a stereomicroscope and recorded according to a unified standard for microleakage level.Finally,one randomly selected adhesive specimen from each of the 8 groups was subjected to gold sputtering and observed under scanning electron microscopy(SEM)to measure the gap width between the resin and dental tissue.Results Penetration staining showed that there were no statistically significant differences in the depth of marginal microleakage between the experimental and control groups on the gingival and occlusal walls(P＞0.05).However,there was a statistically significant difference in microleakage depth between the gingival and occlusal walls(P＜0.05).Scanning electron microscopy(SEM)results,after averaging particle size measurements,revealed no statistically significant differences in the gap width between the filling restorations and dental hard tissues between the experimental and con-trol groups(P＞0.05).Conclusion Dentin adhesives modified with DMAE-CB and NACP increase antibacterial and remineralization properties without affecting marginal microleakage in adhesive restorations,providing reliable theoretical support for their clinical appli-cation.

Objective To comparatively analyze the friction wear performance,fracture resistance,and displacement resistance before and after aging of full crowns made from PEEK,cobalt-chromium alloy,and zirconia,providing a theoretical basis for the future application of PEEK in crown fabrication.Methods Standard anatomical full crowns of PEEK,cobalt-chromium alloy,and zirconia were fabricated by preparing the upper first premolar and taking silicone rubber impressions,resulting in 25 crowns of each material.The crowns were divided into three groups:Group A(15 crowns,5 from each material),Group B(30 crowns,10 from each materi-al),and Group C(30 crowns,10 from each material,serving as a control).Group A underwent 120 000 chewing simulations under simulated oral physiological conditions,using a stereomicroscope and Micro-image Analysis & Process system to assess and compare wear of antagonists(opposing talc ceramic balls)and material wear.Group B underwent 10 000 thermal cycling aging tests and Group C were served as the control.Universal testing machines were used to evaluate and compare the fracture resistance and displacement re-sistance of Groups B and C.Results ①The wear heights of full crown materials were as follows:cobalt-chromium alloy(0.61±0.05)mm,zirconia(0.81±0.07)mm,and PEEK(0.96±0.04)mm,with PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).For antagonist wear,the wear heights were cobalt-chromium alloy＞zirconia＞PEEK(P＜0.05).②The fracture resistance of cobalt-chromium alloy be-fore and after aging was(3 665.645±71.166)N and(2 906.830±225.143)N,respectively;for zirconia it was(2 447.825±316.961)N and(1 829.229±72.046)N;and for PEEK crowns it was(1 632.378±53.046)N and(1 074.872±105.491)N,showing cobalt-chromi-um alloy＞zirconia＞PEEK(P＜0.05).The displacement resistance for cobalt-chromium alloy before and after aging was(1 604.630±95.680)N and(1 092.137±77.869)N;for zirconia it was(1 768.851±56.273)N and(1 381.618±62.326)N;and for PEEK crowns it was(1 148.811±70.417)N and(931.723±64.454)N,indicating zirconia＞cobalt-chromium alloy＞PEEK(P＜0.05).The aging degradation of cobalt-chromium alloy's fracture and displacement re-sistance was(758.815±157.734)N and(512.492±34.530)N,re-spectively;for zirconia,it was(618.597±251.281)N and(387.233±7.947)N;and for PEEK crowns,it was(557.506±61.950)N and(217.089±14.589)N,with anti-aging performance:PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).Conclusion The wear re-sistance,fracture resistance,and displacement resistance of PEEK meet the clinical standards for full crown materials,and PEEK demonstrates good anti-aging performance while effectively protecting opposing teeth.Therefore,PEEK has the potential to become a novel material for full crown fabrication.

Objective To comparatively analyze the friction wear performance,fracture resistance,and displacement resistance before and after aging of full crowns made from PEEK,cobalt-chromium alloy,and zirconia,providing a theoretical basis for the future application of PEEK in crown fabrication.Methods Standard anatomical full crowns of PEEK,cobalt-chromium alloy,and zirconia were fabricated by preparing the upper first premolar and taking silicone rubber impressions,resulting in 25 crowns of each material.The crowns were divided into three groups:Group A(15 crowns,5 from each material),Group B(30 crowns,10 from each materi-al),and Group C(30 crowns,10 from each material,serving as a control).Group A underwent 120 000 chewing simulations under simulated oral physiological conditions,using a stereomicroscope and Micro-image Analysis & Process system to assess and compare wear of antagonists(opposing talc ceramic balls)and material wear.Group B underwent 10 000 thermal cycling aging tests and Group C were served as the control.Universal testing machines were used to evaluate and compare the fracture resistance and displacement re-sistance of Groups B and C.Results ①The wear heights of full crown materials were as follows:cobalt-chromium alloy(0.61±0.05)mm,zirconia(0.81±0.07)mm,and PEEK(0.96±0.04)mm,with PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).For antagonist wear,the wear heights were cobalt-chromium alloy＞zirconia＞PEEK(P＜0.05).②The fracture resistance of cobalt-chromium alloy be-fore and after aging was(3 665.645±71.166)N and(2 906.830±225.143)N,respectively;for zirconia it was(2 447.825±316.961)N and(1 829.229±72.046)N;and for PEEK crowns it was(1 632.378±53.046)N and(1 074.872±105.491)N,showing cobalt-chromi-um alloy＞zirconia＞PEEK(P＜0.05).The displacement resistance for cobalt-chromium alloy before and after aging was(1 604.630±95.680)N and(1 092.137±77.869)N;for zirconia it was(1 768.851±56.273)N and(1 381.618±62.326)N;and for PEEK crowns it was(1 148.811±70.417)N and(931.723±64.454)N,indicating zirconia＞cobalt-chromium alloy＞PEEK(P＜0.05).The aging degradation of cobalt-chromium alloy's fracture and displacement re-sistance was(758.815±157.734)N and(512.492±34.530)N,re-spectively;for zirconia,it was(618.597±251.281)N and(387.233±7.947)N;and for PEEK crowns,it was(557.506±61.950)N and(217.089±14.589)N,with anti-aging performance:PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).Conclusion The wear re-sistance,fracture resistance,and displacement resistance of PEEK meet the clinical standards for full crown materials,and PEEK demonstrates good anti-aging performance while effectively protecting opposing teeth.Therefore,PEEK has the potential to become a novel material for full crown fabrication.

Objective To assess the marginal microleakage of specimens following aging simulation of adhesive restorations for dental defects using methacryloxylethyl cetyldimethyl ammonium chloride(DMAE-CB)and nanoparticles of amorphous calcium phosphate(NACP)binder.Methods DMAE-CB and NACP were synthesized in the laboratory.Eight groups were formed by varying the mass fraction ratios of the two components in the adhesive according to previous experiments,A:binder+3％DMAE-CB+25％NACP,B:binder+4％DMAE-CB+35％NACP,C:binder+1％DMAE-CB+15％NACP,D:binder+4％DMAE-CB+15％NACP,E:binder+1％DMAE-CB+35％NACP,F:binder+3％DMAE-CB,G:binder+25％NACP,H:SBMP binder as the control group.Forty human third molars were collected and randomly divided into 8 groups to prepare standardized Class Ⅱ preparations.Subsequent-ly,dental defect adhesive restoration specimens were made by using the 8 groups of binder,and aging simulation was performed through thermal cycling.After thermal cycling,the specimens were immersed in the dye solution.Each specimen was sectioned into 4 parts of dentin tissue slices along the gingival,proximal,and occlusal walls using a low-speed cutting machine,and the depth of dye penetration was observed under a stereomicroscope and recorded according to a unified standard for microleakage level.Finally,one randomly selected adhesive specimen from each of the 8 groups was subjected to gold sputtering and observed under scanning electron microscopy(SEM)to measure the gap width between the resin and dental tissue.Results Penetration staining showed that there were no statistically significant differences in the depth of marginal microleakage between the experimental and control groups on the gingival and occlusal walls(P＞0.05).However,there was a statistically significant difference in microleakage depth between the gingival and occlusal walls(P＜0.05).Scanning electron microscopy(SEM)results,after averaging particle size measurements,revealed no statistically significant differences in the gap width between the filling restorations and dental hard tissues between the experimental and con-trol groups(P＞0.05).Conclusion Dentin adhesives modified with DMAE-CB and NACP increase antibacterial and remineralization properties without affecting marginal microleakage in adhesive restorations,providing reliable theoretical support for their clinical appli-cation.

Objective To analyze the involvement of pharmacists in the pharmaceutical care of olfacatumumab in the treatment of elderly patients with refractory anti-metabotropic glutamate receptor 5(mGluR5)encephalitis and to provide a reference for the treatment and pharmaceutical care of patients with refractory autoimmune encephalitis(AE).Methods An 81-year-old patient with anti-mGluR5 encephalitis who had poor first-line immunotherapy effect.The key points of pharmaceutical care were determined according to the patient's condition and the characteristics of therapeutic drugs.The drug selection,administration mode,drug interaction,adverse reactions,and precautions of ofatumumab were put forward.At the same time,the patients and their families were given medication guidance and discharge education,and regular follow-up was carried out.Results With the cooperation of doctors,the patient was provided with whole-process pharmaceutical care,and the patient's condition was improved,and the patient's condition was good so far.Conclusion Clinical pharmacists pay attention to the effectiveness and safety of the treatment with ofatumumab by carrying out individualized pharmaceutical care for this patient,which fully reflects the value of clinical pharmacists and provides a reference for the treatment and pharmaceutical care of refractory AE patients.

Poor ovarian response (POR) is a reproductive endocrinology disease that seriously affects the number of oocytes retrieved and reduces the success rate of in vitro fertilization (IVF). The double stimulation protocol utilizes the principle of ovarian stimulation in both the follicular and luteal phase. By retrieving oocytes within one menstrual cycle, more oocytes can be obtained in a fairly short period of time. Therefore, to further explore this new ovarian stimulation protocol may help to provide better treatment strategies for POR patients. This paper reviews the definition of POR, the mechanism and developments of double stimulation, and its application in POR patients.

Poor ovarian response (POR) is a reproductive endocrinology disease that seriously affects the number of oocytes retrieved and reduces the success rate of in vitro fertilization (IVF). The double stimulation protocol utilizes the principle of ovarian stimulation in both the follicular and luteal phase. By retrieving oocytes within one menstrual cycle, more oocytes can be obtained in a fairly short period of time. Therefore, to further explore this new ovarian stimulation protocol may help to provide better treatment strategies for POR patients. This paper reviews the definition of POR, the mechanism and developments of double stimulation, and its application in POR patients.

OBJECTIVE: To study the mechanisms of Tongxia Huayu Decoction (a Chinese herbal decoction for purgation and removing blood stasis) in prognostic improvement for severe acute pancreatitis by early intervention on pancreatic microcirculatory disturbance. METHODS: Fifty-three patients with severe acute pancreatitis were divided randomly into treatment group (n=28) and control group (n=25). Tongxia Huayu Decoction was given to the patients in treatment group in addition to the normal treatment in control group for one week. The clinical symptoms and signs, hemodiastase, urinary amylase, C-reactive protein (CRP) and endothelin (ET) of the patients in the two groups before and after treatment were observed and detected. RESULTS: The total response rate of the treatment group was 98.4%, while that of the control group was 80%, with significant difference between them (P<0.05). There was no significant difference of the contents of hemodiastase, urinary amylase, CRP and ET between the two groups before treatment, while they were significantly decreased after treatment (P<0.01) with more obvious change in treatment group (P<0.01). CONCLUSION: Tongxia Huayu Decoction brings satisfied therapeutic effect on severe acute pancreatitis. The mechanisms may associate with its reducing function on ET releasing so as to inhibit the pancreatic microcirculatory disturbance and acinar cell injury induced by ET.

OBJECTIVE: To study the changes of the center of cellular immune thymus and the interference of Jinhong Tablet, a compound traditional Chinese herbal medicine, during the course of cholangitis. METHODS: Twenty-four male Wistar rats were randomly divided into three groups. Ligation group, simple ligation of bile duct without producing infection and fed with normal saline; untreated group, reproduce acute cholangitis and fed with normal saline; Jinhong Tablet-treated group, reproduce cholangitis and treated with Jinhong Tablet. Five days after modeling, the rats were sacrificed and the thymus were sampled to observe the morphological changes with an electronic microscope, count the index of thymus and apoptosis and assay the expressions of Bcl-2 gene coding protein and Fas gene coding protein. RESULTS: The frequency of apoptosis of thymus in the untreated group was higher than that in the Jinhong Tablet-treated group and the ligation group, and the frequency of apoptosis of thymus in the Jinhong Tablet-treated group was higher than that in the ligation group. Compared with the Jinhong Tablet-treated group and the ligation group, the weight and index of thymus were lower and the index of apoptosis of thymus was higher significantly in the untreated group (P<0.01). The expression of Bcl-2 gene coding protein in the ligation group and the Jinhong Tablet-treated group were much higher than that in the untreated group (P<0.01), but there were no significant differences of the expression of Fas gene coding protein among the three groups. CONCLUSION: There exists a promotion of non-physiological apoptosis of cellular immune center such as decrease of the weight and the index of thymus and increase of the index of apoptosis of thymus during acute cholangitis, which may be inhibited by up-regulation of Bcl-2 gene coding protein with antipyretic and purgative herbs Jinhong Tablet.