Objective:To analyze the cognitive changes and alterations in the topological properties of functional and structural brain networks in elderly women with mild cognitive impairment (MCI), and explore the relationship between brain network and cognitive function, and find the neuroimaging mechanism of cognitive decline in female patients with MCI.Methods:A cross-sectional study was conducted, collecting clinical data from 38 elderly women with MCI, aged 60-79, recruited between October 1, 2019 and May 31, 2021, through community visits, online advertisements, free consultations by experts at the First Hospital of China Medical University and outpatient promotions. A matched control group of 37 healthy women of similar age was also recruited. Both groups underwent comprehensive neuropsychological assessments and MRI data collection, Brain functional and structural networks were constructed, and the corresponding global and nodal topological metrics were calculated. Differences in general demographic data, cognitive function scores, and network topology attribute indexes were compared. Pearson correlation analysis was used to explore the relationship between the altered topological properties of brain networks and cognitive function differences.Results:Cognitive function assessments showed that compared to the healthy control group, elderly women with MCI scored lower on the Rey Auditory Verbal Learning Test-N5 (AVLT-N5), Digit Span Test (DST), Clock Drawing Test (CDT), and Verbal Fluency Test (VFT) (1.95±1.02 vs 6.42±1.63, t=14.85; 7.14±1.58 vs 8.08±1.29, t=2.93; 3.30±1.12 vs 3.73±0.55, t=2.20; 15.49±3.87 vs 18.53±3.80, t=3.60; all P<0.05). The results of brain functional and structural network nodal topological properties indicated that the left inferior parietal angular gyri, left supramarginal gyrus, right orbital inferior frontal gyrus, and right insula showed incomplete white matter network structure or reduced efficiency in brain network functional transmission ( P<0.05). Conversely, regions such as the left cuneus, left superior frontal gyrus orbital part, left middle occipital gyrus, left precuneus, right superior parietal gyrus, and left paracentral lobule showed enhanced structural integrity of white matter network or increased efficiency in brain network functional transmission ( P<0.05). Correlation analysis suggested that abnormal nodal topological attributes were associated with language function (VFT), short-term memory (AVLT-N5), and visuospatial ability (CDT) in patients with MCI(All P<0.05). Conclusion:Elderly women with MCI exhibit declines in short-term memory, linguistic function, attention, and visuospatial abilities. Changes in the topological properties of brain function and structural networks occur in regions such as the orbital superior frontal gyrus, middle occipital gyrus, and cuneus in the elderly women.

Objective:To investigate the role of clinical pharmacists in the management of pharmacological treatment for pancreatic cancer pain.Methods:A retrospective analysis was conducted on the clinical data of 58 inpatients diagnosed with pancreatic cancer associated pain at the Pancreas Center of Nanjing BenQ Hospital Affiliated to Nanjing Medical University from January 2023 to March 2023. The outcomes of pain control, quality of life (QOL), medication adherence, patient satisfaction with pain management, and trust in clinical pharmacists were compared before and after pharmacist intervention. Adverse drug reactions (ADRs) were also monitored.Results:The involvement of clinical pharmacists in pain medication management significantly reduced pain scores in 58 patients at 12, 24, and 48 hours after intervention compared to pre-intervention levels [(2.64±1.04), (2.72±1.12), and (2.17±0.96) vs (5.88±1.11)]. Pain scores at 48 hours after intervention were significantly lower than those at 12 and 24 hours. QOL scores significantly improved after the intervention [(38.53±7.03), (38.84±7.11), and (39.77±6.71) vs (32.48 ± 7.32)], with scores at 48 hours significantly higher than those at 12 and 24 hours. All the differences were statistically significant (all P value <0.05). After intervention, pain scores were negatively correlated with QOL scores, indicating that a significant reduction in pain was associated with a substantial improvement in quality of life. The proportion of patients with good medication adherence increased from 41.4% before the intervention to 86.2% after the intervention. Trust in clinical pharmacists rose from 70.7% to 100%, with a satisfaction rate of 98.2%. Among the 58 patients, 21 experienced ADRs, including constipation (29.0%), nausea (23.7%), vomiting (13.1%), somnolence (10.5%), dizziness (7.9%), diarrhea (7.9%), fatigue (5.3%), and delirium (2.6%). Conclusions:The involvement of clinical pharmacists in the pharmacological management of pain in pancreatic cancer could significantly reduce pain scores, improve patients' QOL, enhance medication adherence, and monitor ADRs, which may comprehensively promote rational and standardized pain management for pancreatic cancer patients.

Objective:To investigate the role of clinical pharmacists in the management of pharmacological treatment for pancreatic cancer pain.Methods:A retrospective analysis was conducted on the clinical data of 58 inpatients diagnosed with pancreatic cancer associated pain at the Pancreas Center of Nanjing BenQ Hospital Affiliated to Nanjing Medical University from January 2023 to March 2023. The outcomes of pain control, quality of life (QOL), medication adherence, patient satisfaction with pain management, and trust in clinical pharmacists were compared before and after pharmacist intervention. Adverse drug reactions (ADRs) were also monitored.Results:The involvement of clinical pharmacists in pain medication management significantly reduced pain scores in 58 patients at 12, 24, and 48 hours after intervention compared to pre-intervention levels [(2.64±1.04), (2.72±1.12), and (2.17±0.96) vs (5.88±1.11)]. Pain scores at 48 hours after intervention were significantly lower than those at 12 and 24 hours. QOL scores significantly improved after the intervention [(38.53±7.03), (38.84±7.11), and (39.77±6.71) vs (32.48 ± 7.32)], with scores at 48 hours significantly higher than those at 12 and 24 hours. All the differences were statistically significant (all P value <0.05). After intervention, pain scores were negatively correlated with QOL scores, indicating that a significant reduction in pain was associated with a substantial improvement in quality of life. The proportion of patients with good medication adherence increased from 41.4% before the intervention to 86.2% after the intervention. Trust in clinical pharmacists rose from 70.7% to 100%, with a satisfaction rate of 98.2%. Among the 58 patients, 21 experienced ADRs, including constipation (29.0%), nausea (23.7%), vomiting (13.1%), somnolence (10.5%), dizziness (7.9%), diarrhea (7.9%), fatigue (5.3%), and delirium (2.6%). Conclusions:The involvement of clinical pharmacists in the pharmacological management of pain in pancreatic cancer could significantly reduce pain scores, improve patients' QOL, enhance medication adherence, and monitor ADRs, which may comprehensively promote rational and standardized pain management for pancreatic cancer patients.

Objective:To analyze the cognitive changes and alterations in the topological properties of functional and structural brain networks in elderly women with mild cognitive impairment (MCI), and explore the relationship between brain network and cognitive function, and find the neuroimaging mechanism of cognitive decline in female patients with MCI.Methods:A cross-sectional study was conducted, collecting clinical data from 38 elderly women with MCI, aged 60-79, recruited between October 1, 2019 and May 31, 2021, through community visits, online advertisements, free consultations by experts at the First Hospital of China Medical University and outpatient promotions. A matched control group of 37 healthy women of similar age was also recruited. Both groups underwent comprehensive neuropsychological assessments and MRI data collection, Brain functional and structural networks were constructed, and the corresponding global and nodal topological metrics were calculated. Differences in general demographic data, cognitive function scores, and network topology attribute indexes were compared. Pearson correlation analysis was used to explore the relationship between the altered topological properties of brain networks and cognitive function differences.Results:Cognitive function assessments showed that compared to the healthy control group, elderly women with MCI scored lower on the Rey Auditory Verbal Learning Test-N5 (AVLT-N5), Digit Span Test (DST), Clock Drawing Test (CDT), and Verbal Fluency Test (VFT) (1.95±1.02 vs 6.42±1.63, t=14.85; 7.14±1.58 vs 8.08±1.29, t=2.93; 3.30±1.12 vs 3.73±0.55, t=2.20; 15.49±3.87 vs 18.53±3.80, t=3.60; all P<0.05). The results of brain functional and structural network nodal topological properties indicated that the left inferior parietal angular gyri, left supramarginal gyrus, right orbital inferior frontal gyrus, and right insula showed incomplete white matter network structure or reduced efficiency in brain network functional transmission ( P<0.05). Conversely, regions such as the left cuneus, left superior frontal gyrus orbital part, left middle occipital gyrus, left precuneus, right superior parietal gyrus, and left paracentral lobule showed enhanced structural integrity of white matter network or increased efficiency in brain network functional transmission ( P<0.05). Correlation analysis suggested that abnormal nodal topological attributes were associated with language function (VFT), short-term memory (AVLT-N5), and visuospatial ability (CDT) in patients with MCI(All P<0.05). Conclusion:Elderly women with MCI exhibit declines in short-term memory, linguistic function, attention, and visuospatial abilities. Changes in the topological properties of brain function and structural networks occur in regions such as the orbital superior frontal gyrus, middle occipital gyrus, and cuneus in the elderly women.