1.Role of TBK1/RIPK1 signaling pathway in postoperative cognitive dysfunction in aged mice
Yuhan ZHANG ; Yu QI ; Meiyan ZHOU ; Teng LI ; Jiyan XU ; Liwei WANG
Chinese Journal of Anesthesiology 2025;45(10):1280-1285
Objective:To evaluate the role of the TANK-binding kinase 1 (TBK1)/receptor-interacting protein kinase 1 (RIPK1) signaling pathway in postoperative cognitive dysfunction (POCD) in aged mice.Methods:Fifty SPF healthy male C57BL/6 mice, aged 18 months, weighing 20-25 g, were divided into 5 groups ( n=10 each) using a table of random numbers: control group (group C), POCD group, dimethyl sulfoxide group, GSK group and GSK+ Nec-1 group. A mouse model of POCD was established by the closed reduction internal fixation of the left tibial fracture in anesthetized animals. Dimethyl sulfoxide, TBK1 inhibitor GSK8612 and RIPK1 inhibitor Nec-1 (0.5 μl/side) were stereotactically injected into the hippocampal CA1 region at 30 min before operation. Cognitive function was assessed using the contextual fear conditioning test before operation and at 3 days after operation. The mice were then anesthetized and sacrificed, and the hippocampal tissues were obtained for determination of the expression of TBK1, RIPK1, interleukin-lbeta (IL-1β), tumor necrosis factor-alpha (TNF-α), activator protein 1 (AP-1) and Nestin (by Western blot), the expression of Bcl-2, Bax and caspase-3 mRNA (by fluorescent quantitative real-time polymerase chain reaction) and for examination of TBK1/RIPK1 molecular interactions and neural stem cell proliferation in the hippocampal dentate gyrus (DG) region (by immunofluorescent staining). Results:Compared with C group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, RIPK1, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in POCD group ( P<0.05 or 0.01). Compared with POCD group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in GSK group ( P<0.05 or 0.01). Compared with GSK group, the percentage of freezing time was significantly increased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was down-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was up-regulated, and the proliferation of neural stem cells in the hippocampal DG region was increased in GSK+ Nec-1 group ( P<0.05 or 0.01). Conclusions:The TBK1/RIPK1 signaling pathway is involved in the pathogenesis of POCD in aged mice.
2.Epidemiological investigation of a nosocomial varicella outbreak triggered by a herpes zoster case
LUO Xiulan ; ZHENG Yongtao ; NI Mengjiao ; LU Chao ; XU Tingyan ; WENG Jiyan ; LAI Fenhua
Journal of Preventive Medicine 2025;37(5):490-493
On August 24 2024, Xiaoshan District Center for Disease Control and Prevention, Hangzhou City, received a report of two cases of varicella infection among staff in the intensive care unit (ICU) of a hospital in its jurisdiction. The center immediately organized personnel to conduct an epidemiological investigation of the cases and their close contacts. The index case was a patient admitted to the ICU who had large areas of red rash and pustules on the chest, back, and right axilla. This case was diagnosed with herpes zoster by a dermatology consultation within the hospital. The other nine secondary cases were all nursing staff in the ICU, who were clinically diagnosed with varicella between August 21 and September 1, with an attack rate of 14.06%. All secondary varicella cases had a history of contact with the herpes zoster case and no history of varicella infection. Their varicella vaccination history was unknown. Based on the results of the on-site epidemiological and sanitary investigations, it was determined that this was an outbreak of varicella in the hospital caused by a herpes zoster case. After the last case was diagnosed, no new cases were reported within the longest incubation period (21 days), and the outbreak was declared over on September 21. Close contact with the herpes zoster case was likely the main cause of the outbreak. This highlights the need for early identification and isolation of suspected herpes zoster cases in hospitals in the future, as well as enhanced protective measures to prevent nosocomial infections.
3.Efficacy and Safety of Inclisiran in Aisa Atherosclerotic Cardiovascular Disease Patients or High-risk Population:Chinese Mainland Sub-population Analysis of ORION-18 Study
Yong HUO ; Yong LI ; Yajun HAN ; Chunhua DING ; Xiaochun XING ; Xuelian ZHANG ; Jianping LI ; Biao XU ; Jiyan CHEN
Chinese Circulation Journal 2025;40(2):124-130
Objectives:The ORION-18 study has demonstrated that inclisiran can significantly reduce low-density lipoprotein cholesterol(LDL-C)and has good safety in Asian atherosclerotic cardiovascular disease(ASCVD)patients or ASCVD high-risk population.This subgroup analysis aims to further evaluate the efficacy and safety of inclisiran in Chinese mainland population.Methods:ORION-18 study is a multi-center,randomized,double-blind,placebo-controlled,phase Ⅲ clinical trial among Asian subjects,Chinese mainland subgroup included 232 ASCVD patients or ASCVD high-risk subjects who had already been treated with diet control and maximum tolerated doses of statins treatment(with or without other lipid-lowering treatments)but still had elevated LDL-C levels.Subjects were randomized in a 1:1 ratio to the inclisiran group and the placebo group(n=116 each),and received 300 mg of inclisiran or placebo respectively on day 0,90 and 270.The primary endpoint was the percentage change in LDL-C from baseline to day 330.The secondary endpoints included the time-adjusted percentage change and absolute change in LDL-C from baseline after day 90 and up to day 360,the absolute change in LDL-C from baseline to day 330,and the percentage changes from baseline to day 330 in proprotein convertase subtilisin/kexin type 9(PCSK9),total cholesterol,apolipoprotein B(ApoB),non-high-density lipoprotein cholesterol(non-HDL-C).Other secondary endpoints included the proportion of participants reaching LDL-C levels of<1.8 mmol/L at day 330,the proportion of participants with≥50%LDL-C reduction from baseline to day 330 and the proportion of participants who attained global lipid targets(the LDL-C target was<1.4 mmol/L for ASCVD patients and<1.8 mmol/L for ASCVD high-risk subjects)at day 330.Safety endpoints included adverse events during treatment,aboratory test abnormalities during treatment,serious adverse events,and assessed their severity and relation to treatment.Results:The inclisiran group showed a placebo-corrected percentage change in LDL-C from baseline to day 330 of-61.16%,and an absolute change of-1.73 mmol/L(both P<0.0001).Compared to the placebo group,the inclisiran group's time-adjusted percentage change in LDL-C from baseline between day 90 and day 360 was-58.51%,and an absolute change of was-1.64 mmol/L(both P<0.0001).At day 330,reductions from baseline were observed in the inclisiran group for PCSK9,total cholesterol,ApoB,non-HDL-C,with placebo-corrected percentage changes of-77.44%,-35.65%,-43.43%,-50.90%(all P<0.0001),respectively.At day 330,79.6%(74/93)of patients in the inclisiran group and 7.8%(6/77)in the placebo group achieved LDL-C levels<1.8 mmol/L,69.9%(65/93)of patients in the inclisiran group and 0%(0/77)in the placebo group achieved≥50%LDL-C reduction from baseline,66.7%(62/93)of patients in the inclisiran group and 2.6%(2/77)in the placebo group achieved their global LDL-C targets.The safety profile of inclisiran treatment over 12 months was comparable to that of the placebo,with no occurrence of treatment-related serious adverse events.Conclusions:In ASCVD patients or ASCVD high-risk subjects in Chinese mainland who have received diet control and maximum tolerable dose statins treatment(with or without other lipid-lowering treatments)and still have elevated LDL-C,inclisiran has a definite efficacy and good safety in reducing LDL-C.The efficacy and safety results of inclisiran assessed in Chinese mainland population are consistent with those of the general Asia population.
4.Role of TBK1/RIPK1 signaling pathway in postoperative cognitive dysfunction in aged mice
Yuhan ZHANG ; Yu QI ; Meiyan ZHOU ; Teng LI ; Jiyan XU ; Liwei WANG
Chinese Journal of Anesthesiology 2025;45(10):1280-1285
Objective:To evaluate the role of the TANK-binding kinase 1 (TBK1)/receptor-interacting protein kinase 1 (RIPK1) signaling pathway in postoperative cognitive dysfunction (POCD) in aged mice.Methods:Fifty SPF healthy male C57BL/6 mice, aged 18 months, weighing 20-25 g, were divided into 5 groups ( n=10 each) using a table of random numbers: control group (group C), POCD group, dimethyl sulfoxide group, GSK group and GSK+ Nec-1 group. A mouse model of POCD was established by the closed reduction internal fixation of the left tibial fracture in anesthetized animals. Dimethyl sulfoxide, TBK1 inhibitor GSK8612 and RIPK1 inhibitor Nec-1 (0.5 μl/side) were stereotactically injected into the hippocampal CA1 region at 30 min before operation. Cognitive function was assessed using the contextual fear conditioning test before operation and at 3 days after operation. The mice were then anesthetized and sacrificed, and the hippocampal tissues were obtained for determination of the expression of TBK1, RIPK1, interleukin-lbeta (IL-1β), tumor necrosis factor-alpha (TNF-α), activator protein 1 (AP-1) and Nestin (by Western blot), the expression of Bcl-2, Bax and caspase-3 mRNA (by fluorescent quantitative real-time polymerase chain reaction) and for examination of TBK1/RIPK1 molecular interactions and neural stem cell proliferation in the hippocampal dentate gyrus (DG) region (by immunofluorescent staining). Results:Compared with C group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, RIPK1, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in POCD group ( P<0.05 or 0.01). Compared with POCD group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in GSK group ( P<0.05 or 0.01). Compared with GSK group, the percentage of freezing time was significantly increased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was down-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was up-regulated, and the proliferation of neural stem cells in the hippocampal DG region was increased in GSK+ Nec-1 group ( P<0.05 or 0.01). Conclusions:The TBK1/RIPK1 signaling pathway is involved in the pathogenesis of POCD in aged mice.
5.Efficacy and Safety of Inclisiran in Aisa Atherosclerotic Cardiovascular Disease Patients or High-risk Population:Chinese Mainland Sub-population Analysis of ORION-18 Study
Yong HUO ; Yong LI ; Yajun HAN ; Chunhua DING ; Xiaochun XING ; Xuelian ZHANG ; Jianping LI ; Biao XU ; Jiyan CHEN
Chinese Circulation Journal 2025;40(2):124-130
Objectives:The ORION-18 study has demonstrated that inclisiran can significantly reduce low-density lipoprotein cholesterol(LDL-C)and has good safety in Asian atherosclerotic cardiovascular disease(ASCVD)patients or ASCVD high-risk population.This subgroup analysis aims to further evaluate the efficacy and safety of inclisiran in Chinese mainland population.Methods:ORION-18 study is a multi-center,randomized,double-blind,placebo-controlled,phase Ⅲ clinical trial among Asian subjects,Chinese mainland subgroup included 232 ASCVD patients or ASCVD high-risk subjects who had already been treated with diet control and maximum tolerated doses of statins treatment(with or without other lipid-lowering treatments)but still had elevated LDL-C levels.Subjects were randomized in a 1:1 ratio to the inclisiran group and the placebo group(n=116 each),and received 300 mg of inclisiran or placebo respectively on day 0,90 and 270.The primary endpoint was the percentage change in LDL-C from baseline to day 330.The secondary endpoints included the time-adjusted percentage change and absolute change in LDL-C from baseline after day 90 and up to day 360,the absolute change in LDL-C from baseline to day 330,and the percentage changes from baseline to day 330 in proprotein convertase subtilisin/kexin type 9(PCSK9),total cholesterol,apolipoprotein B(ApoB),non-high-density lipoprotein cholesterol(non-HDL-C).Other secondary endpoints included the proportion of participants reaching LDL-C levels of<1.8 mmol/L at day 330,the proportion of participants with≥50%LDL-C reduction from baseline to day 330 and the proportion of participants who attained global lipid targets(the LDL-C target was<1.4 mmol/L for ASCVD patients and<1.8 mmol/L for ASCVD high-risk subjects)at day 330.Safety endpoints included adverse events during treatment,aboratory test abnormalities during treatment,serious adverse events,and assessed their severity and relation to treatment.Results:The inclisiran group showed a placebo-corrected percentage change in LDL-C from baseline to day 330 of-61.16%,and an absolute change of-1.73 mmol/L(both P<0.0001).Compared to the placebo group,the inclisiran group's time-adjusted percentage change in LDL-C from baseline between day 90 and day 360 was-58.51%,and an absolute change of was-1.64 mmol/L(both P<0.0001).At day 330,reductions from baseline were observed in the inclisiran group for PCSK9,total cholesterol,ApoB,non-HDL-C,with placebo-corrected percentage changes of-77.44%,-35.65%,-43.43%,-50.90%(all P<0.0001),respectively.At day 330,79.6%(74/93)of patients in the inclisiran group and 7.8%(6/77)in the placebo group achieved LDL-C levels<1.8 mmol/L,69.9%(65/93)of patients in the inclisiran group and 0%(0/77)in the placebo group achieved≥50%LDL-C reduction from baseline,66.7%(62/93)of patients in the inclisiran group and 2.6%(2/77)in the placebo group achieved their global LDL-C targets.The safety profile of inclisiran treatment over 12 months was comparable to that of the placebo,with no occurrence of treatment-related serious adverse events.Conclusions:In ASCVD patients or ASCVD high-risk subjects in Chinese mainland who have received diet control and maximum tolerable dose statins treatment(with or without other lipid-lowering treatments)and still have elevated LDL-C,inclisiran has a definite efficacy and good safety in reducing LDL-C.The efficacy and safety results of inclisiran assessed in Chinese mainland population are consistent with those of the general Asia population.
6.Effects of Bimin Formula (鼻敏方) on the Nasal Mucosa TMEM16A/NF-κB/MUC5AC Signaling Pathway in a Rat Model of Allergic Rhinitis with Lung-Spleen Qi Deficiency
Ningcong XU ; Yiwei HUA ; Xi TAN ; Jinhan WANG ; Zihua LIANG ; Shiqing ZHOU ; Yunying LI ; Wenyong CHEN ; Jiyan XIA ; Qiulan LUO
Journal of Traditional Chinese Medicine 2024;65(8):842-848
ObjectiveTo explore the possible mechanism of Bimin Formula (鼻敏方) in treating lung-spleen qi deficiency syndrome of allergic rhinitis (AR) with high mucin secretion. MethodsThirty-four SD rats were randomly divided into a blank group (8 rats), a model group (8 rats), a low-dose Bimin Formula group (8 rats), and a high-dose Bimin Formula group (10 rats). Except for the blank group, the other groups were subjected to AR lung-spleen qi deficiency rat models induced by smoking, gavage of Ginkgo biloba leaf extract, and ovalbumin. After modeling, rats in the low- and high-dose Bimin Formula groups were given Bimin Formula concentrate (concentration of 2.16 g/ml) by gavage at doses of 1.08 g/100 g and 2.16 g/100 g, respectively, while rats in the model group were given 0.5 ml/100 g of normal saline by gavage, once daily for 28 days; the blank group was not intervened. Behavioral assessments were performed after intervention. ELISA was used to detect the levels of peripheral blood total immunoglobulin E (IgE). HE staining was used to observe the pathological changes of nasal mucosa epithelium in rats, while immunohistochemistry was used to detect the expression of transmembrane protein 16A (TMEM16A) and mucin 5AC (MUC5AC) protein in nasal mucosa. Western Blot was used to detect the expression of nuclear factor kappa B (NF-κB) protein, and RT-PCR was used to detect the expression of TMEM16A, MUC5AC, and NF-κB mRNA in nasal mucosa. ResultsHE staining showed that the nasal mucosa epithelial cell structure in the blank group was intact without shedding, swelling, or necrosis; the nasal mucosa epithelial tissue of rats in the model group was thickened and partially shed, with infiltration of eosinophils and lymphocytes visible; the pathological changes in nasal mucosa tissue of rats in the high- and low-dose Bimin Formulagroups were improved, and more improvement was showen in the high-dose group. Compared with those in the blank group, the behavioral scores and peripheral blood total IgE levels of rats in the model group significantly increased, as well as the expression of TMEM16A, MUC5AC, and NF-κB proteins and mRNA in nasal mucosa (P<0.05 or P<0.01). Compared with those in the model group, the behavioral scores and peripheral blood total IgE levels of rats in the high-dose Bimin Formula group decreased, and the expression of TMEM16A, MUC5AC, and NF-κB proteins and mRNA in nasal mucosaalso decreased (P<0.05 or P<0.01); the behavioral scores and peripheral blood total IgE levels of rats in the low-dose Bimin Formula group were reduced, and the expression of TMEM16A and MUC5AC proteins and mRNA in nasal mucosa, as well as the expression of NF-κB protein decreased (P<0.05 or P<0.01), but the difference in NF-κB mRNA expression was not statistically significant (P>0.05). Compared with the low-dose Bimin Formula group, the expression of NF-κB protein in the high-dose group decreased (P<0.01). ConclusionBimin Formula may improve the symptoms and high mucus secretion of AR lung-spleen qi deficiency by regulating the TMEM16A/NF-κB/MUC5AC signaling pathway in nasalmucosa.
7.Effect of urolithin A on postoperative cognitive dysfunction induced by isoflurane anesthesia in mice and its mechanism
Minhui XU ; Xiaolei CHENG ; Jiyan XU ; Linhao JIANG ; Tianjiao XIA
Journal of Jilin University(Medicine Edition) 2024;50(3):596-601
Objective:To discuss the improvement effect of uric acid(UA)on the postoperative cognitive dysfunction(POCD)in the mice anesthetized with isoflurane for a long duration,and to clarify its possible mechanism.Methods:Twenty-four healthy male C57BL/6 mice were randomly divided into blank control group,anesthesia group,and UA group,and there were eight mice in each group.The mice in UA group were injected intraperitoneally with 200 μL UA solution daily for 2 d before anesthesia.The mice in blank control group and anesthesia group were given the same volume of saline;the mice in anesthesia group and UA group were used to prepare the models of long-duration isoflurane anesthesia,while the mice in blank control group were untreated.Y-maze tests was used to detect the alternation success rate,movement distances,and movement speeds of the mice in various groups;situational fear experiment was used to detect the percentages of freezing time;Western blotting method was used to detect the expression levels of interleukin(IL)-1β,IL-10,and mature brain-derived neurotrophic factor(mBDNF)proteins in hippocampus tissue of the mice in various groups.Results:The Y-maze test results showed that compared with blank control group,the alternation success rate of the mice in anesthesia group was significantly decreased(P<0.01);compared with anesthesia group,the alternation success rate of the mice in UA group was significantly increased(P<0.01).The situational fear experiment results showed that compared with blank control group,the percentage of freezing time of the mice in anesthesia group was significantly decreased(P<0.01);compared with anesthesia group,the percentage of freezing time of the mice in UA group was significantly increased(P<0.05).The cued memory experiment resutls showed that there were no significant differences of the percentage of freezing time of the mice between various groups(P>0.05).The Western blotting results showed that compared with blank control group,the expression level of IL-1β protein in hippocampus tissue of the mice in anesthesia group was increased(P<0.01),while the expression levels of IL-10 and mBDNF proteins were decreased(P<0.01);compared with anesthesia group,the expression level of IL-1β protein in hippocampus tissue of the mice in UA group was decreased(P<0.05),and the expression levels of IL-10 and mBDNF proteins were increased(P<0.05 or P<0.01).Conclusion:UA can improve the POCD in the mice,and its mechnasim may be related with its anti-inflammatory activity inhibiting the central inflammation and upregulating the mBDNF protein expression.
8.Comparative study on the characteristics of Traditional Chinese Medicine symptoms and cluster analysis of syndrome types between cancer-related fatigue and non-cancer-related fatigue
Shanshan GU ; Yun XU ; Feiye WANG ; Lutian GONG ; Jinghui WANG ; Xinyu GUO ; Li FU ; Jiyan SHI
International Journal of Traditional Chinese Medicine 2024;46(8):972-979
Objective:To investigate the distribution patterns of TCM syndrome elements and syndrome types in cancer-related fatigue (CRF).Methods:A cross-sectional survey was conducted on tumor patients attending the outpatient clinic and wards of the Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to December 2021. Descriptive analysis was used to compare the distribution difference of TCM syndrome elements, symptoms and tongue symptoms of CRF and non-CRF patients. The TCM symptoms of CRF were clustered to summarize the common TCM syndromes of CRF.Results:A total of 306 tumor patients were finally included, of which 229 (75%) were CRF and 77 (25%) were non-CRF. Qi deficiency, blood deficiency, and cold-dampness were the most common deficiency and excess syndrome elements in CRF, and liver deficiency, yin deficiency, and blood stasis syndrome elements occurred more frequently in non-CRF than in CRF. TCM symptoms with a frequency greater than 50% in CRF patients, from high to low, were: fatigue > shortness of breath > insomnia or dreaminess > mental fatigue > forgetfulness>lazy speech > impatience, irritability, depression with sighing. The most frequent tongue symptoms, tongue coating, and pulse symptoms were respectively pale tongue, white and greasy coating or smooth white, and pulse deficiency. The symptoms with greater than 30% frequency in 77 non-CRF patients were, from highest to lowest: impatience and irritability or depression with sighing > insomnia or dreaminess > shortness of breath > dry mouth and throat > lumbar spine pain (excluding traumatic) > numbness of limbs > forgetfulness. The highest-ranked tongue, tongue coating, and pulse symptoms were pale tongue, red tongue or less coating, no coating, and thin pulse, respectively. Through clustering analysis, six common syndromes of CRF were obtained, including qi and blood deficiency syndrome, heart and liver blood deficiency syndrome, kidney yang deficiency syndrome, qi and yin deficiency syndrome, spleen deficiency and qi stagnation syndrome, and cold dampness and spleen stagnation syndrome.Conclusions:CRF is a common symptom of different types of tumors. Generally, deficiency syndrome is the main symptom. Qi deficiency and blood deficiency are the common syndrome elements. Common symptoms of high frequency and tongue and pulse are fatigue, shortness of breath, mental fatigue, forgetfulness, pale tongue and thin pulse. The common TCM syndrome types can be preliminarily summarized into 6 types: qi and blood deficiency syndrome, heart and liver blood deficiency syndrome, kidney yang deficiency syndrome, qi and yin deficiency syndrome, spleen deficiency and qi stagnation syndrome, cold dampness and spleen stagnation syndrome.
9.Summary of best evidence for early ambulation in patients undergoing open lumbar surgery
Miao YU ; Xiaoshu ZHOU ; Jiyan JIN ; Baohua LI ; Ruifeng XU
Chinese Journal of Modern Nursing 2024;30(20):2701-2708
Objective:To retrieve, evaluate, and integrate the best evidence for early ambulation in patients undergoing open lumbar surgery.Methods:A systematic search was conducted in databases including UpToDate, British Medical Journal (BMJ) Best Practice, Guidelines International Network (GIN), The National Institute for Health and Care Excellence (NICE), The Agency for Healthcare Research and Quality (AHRQ), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Medlive, North American Spine Society (NASS), Best Practice in General Surgery Group from the University of Toronto, ERAS? Society, PubMed, Embase, Web of Science, Medline, CNKI, and Wanfang. The search included literature on early ambulation post-open lumbar surgery, such as guidelines, expert consensus, evidence summaries, recommended practices, systematic reviews, and high-quality original research. The search period was from January 1, 2014, to June 20, 2023. Two researchers independently evaluated the quality of the literature and extracted relevant data.Results:A total of 23 articles were included, comprising three guidelines, two systematic reviews, six expert consensus statements, seven randomized controlled trials, one quasi-experimental study, and four cohort studies. The evidence was categorized into six themes: multidisciplinary team collaboration, health education, facilitation measures, pre-activity assessment, activity content, and safety assurance, resulting in 25 evidence-based recommendations.Conclusions:This study summarizes 25 best evidence-based recommendations for early ambulation in patients undergoing open lumbar surgery. Healthcare providers are advised to apply these recommendations in clinical practice while considering the specific clinical context and individual patient differences. Multidisciplinary collaboration is essential to develop personalized early ambulation plans.
10.Systematic analysis of clinical pharmaceutical rehabilitation model based on data mining
Chang SONG ; Chunshuo ZHU ; Shuai GUAN ; Yingqi JIAO ; Fengjin WANG ; Jiyan ZHANG ; Weiying GAO ; Jiali ZHANG ; Lele XU
Journal of Navy Medicine 2024;45(9):973-978
Objective To systematically analyze the clinical pharmaceutical rehabilitation model based on data mining,so as to explore its role in improving drug treatment efficacy,reducing drug side effects,and optimizing rehabilitation experience.Methods We retrieved published literatures related to clinical pharmaceutical rehabilitation from CNKI,Wanfang,VIP,and PubMed,with a search time from inception to June 30,2022.Results Totally 11 articles were enrolled in this study.A study involving 69 randomized controlled trials(RCTs)demonstrated that the involvement of pharmacists in medication reviews significantly improved the control of hypertension,type 2 diabetes,and high cholesterol.The odds ratio(OR)for improved control was 2.71(95%confidence interval[CI]:1.03-7.01)for hypertension,3.12(95%CI:1.12-5.84)for type 2 diabetes,and 1.90(95%CI:1.05-3.35)for high cholesterol.A study involving 6 RCTs and 2 573 patients with chronic kidney disease(CKD)showed that pharmacist-led blood pressure monitoring,lifestyle,and medication regimen assessments significantly improved blood pressure control in CKD patients,with an OR of 1.51(95%CI:1.13-2.03).A Meta-analysis,including 5 RCTs and 3 observational studies,explored the impact of medication education and behavioral interventions on the treatment outcomes of gout.The results revealed that patients receiving medication education and behavioral interventions had a significantly higher rate of uric acid control and a higher proportion of patient with uric acid less than 360 μmol/L.A Meta-analysis of 14 RCTs involving 4 509 patients showed that pharmacist interventions such as medication education and counseling significantly reduced the 30-day readmission rates for hypertension and diabetes patients,with a relative risk(RR)of 0.75(95%CI:0.53-0.96).Eighteen RCTs involving 7 244 patients investigated the impact of pharmacist-led discharge counseling on the readmission rate.The findings showed that discharge counseling significantly reduced readmission rate,with a RR of 0.864(95%CI:0.763-0.997,P=0.020).Eight studies assessed the impact of pharmacist services on readmission rate,and the result showed that patients receiving pharmacy-related services had significantly reduced readmission rates,with a 32%reduction in the risk of readmission(OR=0.74,95%CI:0.62-0.89).A Meta-analysis including 123 studies investigated the effect of pharmacist interventions in patient care on the readmission rate,and the result indicated that pharmacist interventions led to a decrease in readmission rates,with the maximum decrease of 44.5%.A Meta-analysis of 23 RCTs evaluated the impact of pharmacist interventions on medication-related adverse events in elderly residents of nursing homes.The study found that pharmacist-led medication reviews and education significantly reduced adverse events.Another Meta-analysis of 14 RCTs and intervention studies explored the effect of pharmacist involvement in multidisciplinary care on medication-related adverse events.The analysis showed that pharmacist participation in multidisciplinary care was significantly associated with a reduction in the incidence of adverse events(RR=0.47,95%CI:0.28-0.77,P<0.01).A Meta-analysis of 6 RCTs involving 29 291 pediatric inpatients revealed that pharmacist interventions effectively reduced the risk of medication errors in hospitalized children(OR=0.27,95%CI:0.15-0.49).A literature analysis on the effectiveness of clinical pharmaceutical services in patient drug treatment showed that introducing a clinical pharmaceutical service model can reduce the use of antibiotics,lower medical costs,and improve medication satisfaction among patients treated with antibiotics.Conclusion In-depth exploration of clinical pharmaceutical rehabilitation model plays an important role in clinical treatment,which can improve the effectiveness of rehabilitation and reduce the incidence of adverse reactions.


Result Analysis
Print
Save
E-mail