OBJECTIVE To establish a Chinese drug-related problem （DRP） classification system applicable to pharmacist-led pharmaceutical care in China， providing pharmacists with an effective and practical tool for pharmaceutical care. METHODS A multi-stage process was employed to construct the DRP classification system， including literature review and analysis， comparison of existing classification systems， refinement of classification items and framework development， two rounds of standard case validation， expert discussion， and system revision. The Fleiss′ kappa test was used to calculate the consistency coefficient κ， assessing the reliability of pharmacists participating in evaluating the classification system. An electronic questionnaire comprising six items was employed to evaluate the system’s applicability. RESULTS The constructed Chinese DRP classification system comprised six sections [problem（including potential problems）， DRP evaluation， cause （including possible causes of potential problems）， intervention， acceptance of intervention and DRP status]， with 24 primary codes and 96 secondary codes. In the first round of case validation， κ values exceeded 0.4 for all sections except “intervention” and “DRP status”. In the second round， κ values exceeded 0.4 for all sections. In the applicability evaluation of the classification system， positive ratings （“strongly agree” or “agree”） exceeded 85% for all items. Specifically， positive ratings for“the classification system can provide appropriate category selection”，“ the classification system is comprehensive”，“ the classification system is convenient to use” and “the classification system is highly satisfactory” exceeded 92%. CONCLUSIONS The Chinese DRP classification system developed demonstrates both high reliability and applicability， providing an effective and practical classification tool for pharmacists in China to conduct pharmaceutical care.

Objective: To analyze the association between drinking behaviors and anxiety symptoms, with the mediating role of insomnia symptoms among college freshmen, so as to provide a reference basis for reducing the occurrence of anxiety symptoms in college freshmen. Methods: From October to December 2021, 31 856 freshmen were selected by the purposive sampling method in 22 colleges across 11 provinces (Fujian, Jiangsu, Guangdong, Henan, Anhui, Hubei, Shanxi, Jiangxi, Shaanxi, Yunnan, Chongqing) in China. The Semi quantitative Food Frequency Questionnaire was used to investigate college freshmen drinking behaviors. The Depression Anxiety Stress Scale 21 and the Insomnia Severity Index were used to assess anxiety symptoms and insomnia symptoms in college freshmen. The generalized linear model was employed to analyze the association between drinking behaviors and anxiety symptoms in college freshmen, and the structural equation modeling was used to assess the mediating effect of insomnia symptoms on the association. Results: The detection rate of anxiety symptoms among college freshmen was 28.2%, the detection rates of the mild, moderate, severe and extremely severe were 6.6%, 15.9%, 3.2% and 2.6%, respectively. While 23.6% of college freshmen reported drinking in the past month, the rates were 39.8% among boys and 15.9% among girls. After adjusting for demographic variables (ethnicity, education, major, etc.) and confounding variables (self evaluation of learning burden, number of close friends, screen time, etc.), the results of generalized linear model analysis showed that beer consumption was associated with anxiety symptoms in college freshmen( β =0.09, 95% CI =0.04-0.14), girls( β =0.14, 95% CI =0.07-0.21) and those aged 19-20 years ( β =0.12, 95% CI =0.05-0.19)(all P <0.05). Red wine consumption was associated with anxiety symptoms in male students ( β =0.13, 95% CI =0.02-0.24, P <0.05). Alcohol and beer consumption were associated with insomnia in college freshmen[ β (95% CI ) =0.22(0.08-0.36),0.31(0.23-0.39),both P <0.01]. Insomnia symptoms partially mediated the association between drinking behaviors and anxiety symptoms among college freshmen with a mediating effect value of 0.05, accounting for 50.49% of the total effect. Conclusions Insomnia symptoms partially mediates the association between drinking behaviors and anxiety symptoms in college freshmen. Measures should be taken to simultaneously intervene in the drinking behaviors and insomnia symptoms of college freshmen to prevent the occurrence of their anxiety symptoms.

Objective: This study aims to investigate the therapeutic effects and underlying mechanisms of Xuanfei Baidu Decoction (XFBD) in a mouse model of dampness-heat toxin pneumonia. By exploring how XFBD exerts its effects, we seek to deepen our understanding of its role in treating pulmonary diseases and to address the current knowledge gap regarding its mechanisms of action, thereby supporting its clinical application. Methods: Ultra-high-performance liquid chromatography and high-resolution mass spectrometry (HRMS) were employed to analyze the chemical constituents of XFBD. The protective effects of XFBD were evaluated using a dampness-heat toxin-induced mouse model, established through dampness-heat exposure and HCoV-229E infection. XFBD was administered orally, followed by assessments including lung index measurement, micro-CT imaging, viral load quantification, cytokine analysis, and histological evaluation via hematoxylin-eosin staining. Proteomics and single-cell transcriptomic analyses were conducted to explore the potential mechanisms underlying XFBD’s pharmacological effects. A cellular model of HCoV-229E infection was developed to investigate changes in the cAMP/PKA signaling pathway. Molecular docking and surface plasmon resonance (SPR) experiments confirmed the strong binding affinity between key XFBD components and PKA. Finally, PKA activators and inhibitors were applied in vitro to validate these mechanistic findings. Results: In vivo studies demonstrated that XFBD significantly reduced the lung index, improved the structural integrity of lung and tongue tissues, and decreased levels of proinflammatory mediators, including IL-6, IL-8, and TNF-α. Proteomic and single-cell transcriptomic analyses showed that the differentially expressed proteins after XFBD treatment were primarily associated with inflammatory responses and immune regulation. The cAMP/PKA signaling pathway was identified as a key mechanism underlying these therapeutic effects. Notably, Western blot, ELISA, molecular docking, and SPR analyses confirmed that XFBD elevated cAMP levels and p-PKA expression, thereby activating the cAMP/PKA signaling pathway in vitro. Conclusion: This study demonstrated that XFBD significantly alleviates symptoms in mice with dampness-heat toxin pneumonia. Its therapeutic effects are mediated, at least in part, through activation of the cAMP/PKA signaling pathway. These findings provide compelling evidence that XFBD is an effective herbal remedy against HCoV-229E infection.

Linxian County in Henan Province, Northern China is known as the region with the highest incidence and mortality rate of esophageal cancer worldwide. Since 1959, the Henan medical team has conducted field work on esophageal cancer prevention and treatment in Linxian. Through three generations of effort exerted by oncologists over 65 years of research on esophageal cancer prevention and treatment in Linxian, the incidence rate of esophageal squamous cell carcinoma in this area has dropped by nearly 50%, and the 5-year survival rate has increased to 40%, reaching the international leading level. This article aims to summarize the history, present opportunities and new challenges, and explore the experience of esophageal cancer prevention and treatment in Linxian (referred to as the “Linxian experience”), providing reference and guidance to cancer prevention and treatment research in China.

Objective:To evaluate the improvement in the outcome of intracapsular condylar fractures(ICFs)treatment with pre-cise soft tissue reduction in combination with open reduction and internal fixation(PSTR-ORIF)by comparson with traditional open reduction and internal fixation(T-ORIF).Methods:40 patients with ICFs were treated by T-ORIF and PSTR-ORIF(n=20)re-spectively.Preoperative and 6-month postoperative whole-mouth panoramic tomography,CT and MRI imaging data were analyzed,the repositioning of the soft and hard tissues of temporomandibular joints(TMJs),the Helkimo index,clinical symptoms and subjec-tive symptoms were compared between the 2 groups.Results:In PSTR-ORIF(26 sides)and T-ORIF(27 sides)groups,the rate of complete anatomical restoration of fractured segments at 6 months after surgery was 96.15％and 81.48％,and the overall effective rate of ICF articular disc restoration was 96.15％and 74.07％respectively,the height of the ascending mandibular branch was bet-ter restored in patients with B-type fracture after surgery(P＜0.05).At 6 months postoperatively,patients in the PSTR-ORIF group showed significant improvement in mouth opening,mandibular anterior extension distance,and lateral movement compared with the T-ORIF group(P＜0.05).The Helkimo index showed that the PSTR-ORIF group got a significant improvement in the complaint symptom index score and the clinical symptom index score compared with the T-ORIF group(P＜0.05).Conclusion:PSTR-ORIF is more effective than T-ORIF in the treatment of ICFs for the healing of condylar fractures,restore postoperative TMJ mobility and reduce the postoperative joint discomfort through good repositioning of soft tissues.

Objective:To compare the effects of early orthodontic intervention and conventional sequential periodontal-orthodontic treatment to periodontal health in patients with stage Ⅳ periodontitis.Methods:A total of 30 patients with stage Ⅳ periodontitis, who underwent combined periodontal and orthodontic therapies at the Department of Periodontology, the Second Affiliated Hospital of Zhejiang University School of Medicine, from January 2018 to August 2024, were included. Patients who underwent early orthodontic intervention were initiated simultaneously or within one month after supragingival scaling and subgingival root planning ( n=15). While patients in control group accomplished supragingival scaling, subgingival root planning, and corresponding periodontal surgeries to achieve inflammation control before starting orthodontic treatment ( n=15). Periodontal parameters, including clinical attachment loss (CAL), probing depth (PD), and bleeding on probing (+) % [BOP (+) %], were measured at baseline, one year after orthodontic treatment, and at the end of combined periodontal-orthodontic therapy respectively. Improvements in periodontal parameters and differences in tooth loss between the two groups were compared. Results:After receiving combined periodontal-orthodontic treatment, the CAL of the early orthodontic intervention group significantly decreased from (4.39±0.90) mm before treatment to (2.41±0.35) mm at the end of treatment ( t=7.92, P<0.001). Similarly, the PD significantly reduced from (4.20±1.04) mm before treatment to (2.20±0.38) mm at the end of treatment ( t=7.01, P<0.001). The BOP(+)% also showed a significant improvement, decreasing from 89.29% (68.00%, 100.00%) before treatment to 13.04% (7.14%, 17.86%) at the end of treatment ( Z=-3.41, P<0.001). There were no statistically significant differences between the early orthodontic intervention group and control group in terms of baseline mean CAL, mean PD, and BOP(+)% ( t=1.30, P=0.205; t=1.28, P=0.212; Z=0.58, P=0.559). Furthermore, the improvements in CAL and PD between the two groups were not significantly different compared to baseline ( Z=-1.10, P=0.272; Z=-0.93, P=0.351). However, the number of missing teeth was significantly lower in the early orthodontic intervention group than in the control group (χ2=3.96, P=0.047). The duration of combined periodontal-orthodontic treatment in the early orthodontic intervention group was [33.13 (23.37, 36.20) months], which was significantly shorter than that in the control group [37.47 (32.33, 50.90) months] ( Z=2.07, P=0.037). Conclusions:Both early orthodontic intervention and conventional periodontal-orthodontic treatment significantly improved CAL, PD, and BOP(+)% in stage Ⅳ periodontitis patients. Early orthodontic intervention contributed to the preservation of natural teeth and shortened the treatment duration of stage Ⅳ periodontitis.

Objective:To investigate the efficacy and safety of darolutamide in the treatment of patients with metastatic hormone-sensitive prostate cancer.Methods:A retrospective analysis was conducted on 17 cases of prostate cancer patients who received treatment with darolutamide in combination with ADT at our hospital from January to December 2022. The median age was 70 (range: 56 to 92) years old. The median pre-treatment prostate-specific antigen (PSA) level was 63.50 (range: 29.16 to 700.74) ng/ml. Sixteen cases had a Gleason score of 8 or above, and 11 cases were classified as high tumor burden (with four or more bone metastases and/or visceral metastases). The patients were treated with darolutamide in combination with goserelin (10.8 mg, subcutaneous injection, every 12 weeks). The decrease in PSA levels was observed at 2 weeks and at 1, 2, 3, and 6 months post-treatment. The time to achieve a 50% decrease in PSA level (PSA50), a 90% decrease (PSA90), and a PSA level of ≤0.2 ng/ml was recorded.Adverse drug reactions were also documented.Results:All the 17 patients were followed up and continued to receive darolutamide at our center without any loss to follow-up. The median follow-up time was 11.4(8.9, 15.3)months. It showed a median PSA decrease from baseline of 83.33% at 2 weeks, 95.37% at 1 month, 96.71% at 2 months, 97.22% at 3 months, and 99.10% at 6 months. The median time to achieve PSA50, PSA90, and PSA ≤ 0.2 ng/ml were 1.3 (0.9, 1.7)months, 1.7 (1.2, 2.4)months, and 3.6 (2.9, 4.5)months respectively. Six patients with bone metastases experienced relief of metastatic lesions after treatment. Only one patient developed papules on the left upper limb, which were assessed as grade 1 rash, and the rash disappeared after three days treatment of topical application of hydrocortisone cream.Conclusions:Darolutamide could rapidly control and significantly reduce PSA levels in prostate cancer patients, with a favorable safety profile.

Objective:To investigate the intervention effect of exercise rehabilitation based on constructivism teaching mode on pelvic girdle pain (PGP) in pregnant women in late pregnancy, and to provide guidance for improving the pregnancy experience of PGP pregnant women.Methods:A quasi-experimental study was conduced, from November 2023 to February 2024, using convenience sampling method to select late pregnant women with PGP who had been filed and had regular obstetric checkups in the Second Hospital of Shandong University as the study subjects, they were randomly divided into intervention group (granted exercise rehabilitation based on the constructivism teaching model) and control group (granted exercise rehabilitation based on the traditional teaching model) according to the random number table method. Compare the pain scores and teaching effectiveness of pregnant women before and after the intervention in the two groups.Results:The final number of the two groups were 50 in each group, aged (32.38 ± 3.93) years in the intervention group; aged (31.34 ± 3.19) years in the control group. After the intervention, the pain scores of pregnant women in the intervention group (1.48 ± 1.26) scores were significantly lower than those in the control group (2.96 ± 1.42) scores, and the difference was statistically significant ( t = -5.45, P<0.05). The scores of the evaluation of the teaching effect memory problem scores, movement mastery scores, and classroom evaluations were (7.96 ± 1.30) scores, (13. 96 ± 0.88) scores, (27.54 ± 3.08) scores in the intervention group, which were significantly higher than those in the control group (5.80 ± 1.29) scores, (8.48 ± 1.82) scores, (16.24 ± 3.80) scores, the differences were statistically significant ( t = 8.30, 19.16, 16.31, all P<0.05). Conclusions:Based on the constructivism teaching model, exercise rehabilitation for pregnant women with PGP in late pregnancy can effectively alleviate their pelvic girdle pain, and the teaching effect is better than the traditional teaching model, which has the potential to be promoted and applied in the teaching of obstetric maternity schools.

Objective:To investigate the effect of advanced glycation end products (AGEs) on ferroptosis in human retinal pigment epithelium (RPE) cell cultured in vitro. Methods:ARPE-19 cell lines were cultured in DMEM medium containing 10% fetal bovine serum (FBS), and the 3rd to 6th generations of cells were used for further study.Cell activity was detected by using the cell counting kit 8 after ARPE-19 were cultured with AGEs at 0, 50, 100, 200, 400 μg/ml for 48 hours.The cells were cultured with 200 μg/ml AGEs for 48 hours.Cell lipid peroxidation level was measured by Lipid Peroxidation Assay Kit (Bodipy 581/591 C11) combined with flow cytometry.The relative mRNA and protein expression levels of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) were determined by quantitative real-time PCR (qRT-PCR) and Western blot.The morphology of mitochondria was observed by transmission electron microscope.Results:The activity of ARPE-19 cells decreased with increasing AGEs concentration, and the overall difference of ARPE-19 activity among 0, 50, 100, 200, 400 μg/ml AGEs groups was statistically significant ( F=6.21, P<0.01).The cell activity of ARPE-19 cells in 200 and 400 μg/ml AGEs groups was lower than that in control group (both P<0.05).Flow cytometry showed that the fluorescence intensity in AGEs group was 622.0±11.3, which was significantly higher than 487.7±12.8 in control group ( t=6.809, P=0.002).qRT-PCR showed that the mRNA and protein relative expression levels of SLC7A11 and GPX4 were lower in AGEs group than those in control group (mRNA: t=3.72, 7.14, both P<0.05; protein: t=6.20, 5.15, both P<0.05).Transmission electron microscopy showed that mitochondria in AGEs group shrank with significantly reduced volume, decreased mitochondrial cristae, and increased mitochondrial membrane density. Conclusions:AGEs can induce ferroptosis in ARPE-19 cultured in vitro.

Objective To compare the efficacy of anticoagulation treatment(AT)alone and combining mechanical thrombectomy(MT)for cerebral venous sinus thrombosis(CVST).Methods Totally 150 patients with CVST were collected,including 90 underwent only AT(AT group)and 60 underwent MT+AT(combined group).The rate of venous sinus recanalization at discharge,the prognosis at discharge and 6,12 months after discharge(modified Rankin scale[mRS]score of 0 to 2 was considered as good prognosis)were compared between groups,and relative complications were recorded.Results At discharge,the rate of complete and partial recanalization of venous sinuses in combined group were both higher than that in AT group(both P＜0.001).No significant difference of the rate of good prognosis at discharge was found between groups(P=0.191),while 6 and 12 months after discharge,the rate of good prognosis in combined group were both higher than that in AT group(P=0.046,0.028).During the treatment and follow-up period,no significant difference of the incidence of complications was found between groups(5.00%[3/60]vs.11.11%[10/90],P=0.245).Conclusion Compared with AT alone,AT combining with MT could improve revascularization rate and prognosis of CVST without increasing the risk of complications.