In the context of aging population, the issue of polypharmacy among elderly patients with mental disorders has become increasingly prominent.Cognitive decline and depressive symptoms render these patients more vulnerable to medication-related risks, while poorly managed physical illnesses further complicate their treatment.To address these challenges, this paper proposes a series of management strategies that emphasize the critical role of pharmacists in conducting medication reviews.A comprehensive assessment of drug risks, benefits, and patient adherence is essential.The proposed strategies not only require careful consideration of patients' clinical needs and individual preferences but also highlight the importance of multidisciplinary team collaboration to reach a consensus on medication therapy.The use of clinical decision support systems as an auxiliary tool is recommended to enhance the scientific rigor of medication decision-making.Furthermore, pharmacists can optimize medication regimens through scientifically validated methods and promote patient or family involvement in self-management to improve acceptance and adherence to treatment adjustments.

Objective To analyze the endowment features of patients with primary angle-closure glaucoma(PACG)based on circuit-qi theory,thus to provide approaches for revealing the etiology,pathogenesis and prevalence of PACG.Methods From October 2023 to March 2024,a total of 204 patients with PACG admitted to the Eye Hospital,China Academy of Chinese Medical Sciences were enrolled into the analysis.The natal day of the patients was used for the calculation of conception day,and then the conception day was used for the analysis of the features of five circuits and six qi based on the stem-branch lunar year of conception day.A database of information of five circuits and six qi on conception day was constructed,and then the features of their endowments at conception were statistically analyzed.Results No statistically significant differences were shown in the distribution of the dominant qi,guest qi,sitian(celestial control)and zaiquan(terrestrial effect)at conception in PACG patients(P＞0.05),but there were statistically significant differences in the distribution of yearly circuit,comprehensive circuit-qi,and combined circuit-qi at conception in PACG patients(P＜0.05).Most of PACG patients had the circuit-qi features of shaomu(deficiency of wood)-yangming dryness gold-shaoyin monarch fire,and taitu(excess of earth)-shaoyin monarch fire-yangming dryness gold at conception.Conclusion Those who are conceived at the date with circuit-qi features of shaomu and taitu,comprehensive circuit-qi features of shaomu-yangming dryness gold-shaoyin monarch fire and taitu-shaoyin monarch fire-yangming dryness gold,and combined circuit-qi features of shunhua(qi generating circuit)and celestial restriction(qi restricting circuit)are vulnerability to PACG.The development of the constitution of PACG patients may be related to the congenital circuit-qi features of pathogenic dryness attacking the lung,and metal exuberance restricting wood.

In the context of aging population, the issue of polypharmacy among elderly patients with mental disorders has become increasingly prominent.Cognitive decline and depressive symptoms render these patients more vulnerable to medication-related risks, while poorly managed physical illnesses further complicate their treatment.To address these challenges, this paper proposes a series of management strategies that emphasize the critical role of pharmacists in conducting medication reviews.A comprehensive assessment of drug risks, benefits, and patient adherence is essential.The proposed strategies not only require careful consideration of patients' clinical needs and individual preferences but also highlight the importance of multidisciplinary team collaboration to reach a consensus on medication therapy.The use of clinical decision support systems as an auxiliary tool is recommended to enhance the scientific rigor of medication decision-making.Furthermore, pharmacists can optimize medication regimens through scientifically validated methods and promote patient or family involvement in self-management to improve acceptance and adherence to treatment adjustments.

ObjectiveTo explore the molecular mechanism of Sanhuang Xiexintang （SHXXT） in protecting stress gastric ulcer （SGU） in rats through network pharmacology， molecular docking， and animal experiments. MethodThe active ingredients and corresponding targets in SHXXT were collected and screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， Traditional Chinese Medicine Information Database （TCMID）， Bioinformation Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM）， and Swiss Target Prediction database. SGU-related targets were screened from the Online Mendelian Inheritance in Man （OMIM）， Therapeutic Target Database （TTD）， GeneCards database， and PharmGKB database. Herbal-ingredient-target （H-C-T） network was constructed by using Cytoscape 3.9.1 software. Protein-protein interaction （PPI） of drug and disease intersection targets was analyzed by using the Protein Interaction Platform （STRING） database. Gene ontology （GO） enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis were conducted through the Database for Annotation Visualization and Integrated Discovery （DAVID）. The active ingredients and key targets were validated using AutodockVina 1.2.2 molecular docking software， and the experimental results were further validated through animal experiments. ResultThe 55 active ingredients were screened， and 255 potential target genes for SHXXT treatment of SGU were predicted. The PPI analysis showed that protein kinase B （Akt）， phosphatase and tensin homolog deleted on chromosome ten （PTEN）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and cyclooxygenase-2 （COX-2） are the core targets of SHXXT for protecting SGU. GO and KEGG analyses showed that SHXXT may affect the development of SGU by regulating various biological processes such as the phosphoinositide 3-kinase （PI3K）/Akt signaling pathway and inflammatory processes. The molecular docking results showed that both the active ingredients and key targets had good binding ability. Animal experiments showed that compared with the blank group， the ulcer index （UI） of the model group was significantly increased （P<0.01）， and the serum levels of TNF-α and IL-1β significantly increased （P<0.01）. The phosphorylation level of PTEN in gastric mucosal tissue was significantly down-regulated （P<0.05）. The phosphorylation levels of PI3K， Akt， and nuclear factor kappa-B （NF-κB） were significantly up-regulated （P<0.05）. Compared with the model group， the UI of the treatment group was significantly reduced （P<0.01）， and the serum levels of TNF-α and IL-1β were significantly reduced （P<0.01）. The phosphorylation level of PTEN in gastric mucosal tissue was significantly up-regulated （P<0.01）， and the phosphorylation levels of PI3K， Akt， and NF-κB were significantly downregulated （P<0.01）. ConclusionThe application of network pharmacology prediction， molecular docking simulation， and animal experimental validation confirms that SHXXT regulates the PI3K/Akt/NF-κB signaling pathway to regulate the inflammatory response of rats and thus protects the gastric mucosa of SGU rats.

The aging disease associated with type 2 diabetes mellitus(T2DM)is a hot research topic in the field of diabetes at present.Sarcopenia has become the third major complication of T2DM after microvascular and macrovascular diseases,which could lead to the occurrence and development of various adverse events such as fracture,disability,and dysfunction.The spleen belongs to the earth,is in the middle jiao,governs transportation and transformation,and governs muscle.The functional activities of the spleen manifesting in normal transformation and transportation,the distribution of cereal essence,and the nourishment of muscles are necessary for normal physiological functions to be exerted.Recent studies have shown that skeletal muscle cell ferroptosis plays an important role in the pathogenesis of T2DM sarcopenia.Based on the theory of"spleen governing transportation and transportation and governing muscle",this study explores the pathogenesis of T2DM sarcopenia from the perspectives of the pathogenesis of"dysfunction of spleen in transportation,deficiency of cereal essence,obstruction of dampness and turbidity,and muscle dystrophy"in traditional Chinese medicine and the pathological mechanism of"skeletal muscle cell ferroptosis"in modern medicine.It summarizes the principles of traditional Chinese medicine prevention and treatment for T2DM sarcopenia based on the spleen,to provide theoretical support for enriching the theoretical connotation of spleen visceral state,as well as basic research and clinical trials on the prevention and treatment of T2DM sarcopenia with traditional Chinese medicine.

Objective:To investigate the effects of self-made Gujin Xiaoji Mixture combined with warming needle therapy on the clinical efficacy and immune function of patients with advanced non-small cell lung cancer (NSCLC) with qi and yin deficiency syndrome.Methods:This experiment was a randomized controlled trial study. 180 patients with advanced NSCLC qi and yin deficiency syndrome in the oncology centre of Qingdao Hospital of Traditional Chinese Medicine were selected as the observation subjects from March 2021 to August 2022, and were divided into 2 groups using the random number table method, with 90 cases in each group. The control group received conventional chemotherapy combined with Sintilimab injection, 21 days as a cycle, with a total of 4 cycles of treatment; and the observation group received Gujin Xiaoji Mixture combined with warming needle therapy based on the control group, 7 days as one course of treatment, with a total of 12 courses. Both groups were followed up for 12 months. The TCM syndrome scores were performed before and after treatment. The functional assessment of cancer therapy-lung (FACT-L) was used to evaluate the quality of life of patients; flow cytometry was used to detect the levels of CD3 +, CD4 +, CD8 + and NK cell, and the CD4 +/CD8 + ratio was calculated; adverse drug reactions and progression free survival of patients during treatment were observed and recorded, the efficacy of TCM syndrome and objective efficacy of solid tumors were evaluated. Results:After treatment, the observation group's post-treatment TCM syndrome score (5.67±1.99 vs. 7.12±2.31, t=-4.53) was lower than that of the control group ( P<0.001); mobility (23.03±2.80 vs. 20.69±2.46, t=5.96), daily living (23.06±2.56 vs. 20.71± 2.33, t=6.42), emotional status (18.44±2.32 vs. 16.12±2.71, t=6.18), and other factors (33.14±4.11 vs. 27.39±4.64, t=8.81) and total score (97.68±7.23 vs. 84.91±7.49, t=11.64) were higher than those in the control group ( P<0.01). In the observation group, after treatment, the levels of CD3 + [(65.14±6.06)% vs. (59.84±5.74)%, t=6.02], CD4 + [(40.09±4.09)% vs. (35.69±3.86)%, t=7.43], NK cell [(29.11±4.81)% vs. (22.38±4.51)%, t=9.68] and CD4 +/CD8 + [(1.52±0.27) vs. (1.14±0.12), t=12.63] were higher than those in the control group ( P<0.01), and CD8 + [(26.82±3.79)% vs. (31.76±4.65)%, t=-7.81] level was lower than that of the control group ( P<0.01). After treatment, the objective remission rate in the observation group was 7.8% (7/90), and the disease control rate was 87.8% (79/90), while the objective remission rate after treatment in the control group was 5.5% (5/90), and the disease control rate was 82.2% (74/90), and there were no statistical significance in the comparison of objective remission rate and disease control rate of the 2 groups ( χ2=0.09, 0.70, P=0.765, 0.407). The total effective rate after treatment was 62.2% (56/90) in the observation group and 34.4% (31/90) in the control group, and the difference between the 2 groups was statistically significant ( Z=-3.89, P<0.001). WBC [(4.27±1.12)×10 9/L vs. (3.84±1.11)×10 9/L, t=2.58] and haemoglobin [(119.93±17.25)g/L vs. (109.76±15.61)g/L, t=4.15] levels of the observation group were higher than those in the control group after treatment ( P<0.01). During follow-up, the median progression-free survival was 6.2 months in the observation group and 5.5 months in the control group patients, and the difference between the 2 groups was not statistically different ( t=0.11, P>0.05). Conclusion:The combination of Gujin Xiaoji Mixture with warming needle therapy can effectively improve the clinical symptoms of patients with advanced NSCLC with deficiency of qi and yin syndrome, improve the immunity and clinical efficacy of patients, alleviate the adverse effects of drugs, and prolong the progression-free survival period.

Objective:To explore the relationships among the activity level of coagulation factor XII (FXII), coagulation function indexes, polymorphisms of F12 gene loci rs17876030 and rs1801020, as well as their correlations with deep venous thrombosis (DVT) in fracture patients. Methods:A case-cohort control study was conducted. 200 fracture patients diagnosed and treated in the Department of Traumatic Orthopedics of Tianjin Hospital from September 2015 to September 2023 were included. They received routine anticoagulant prophylaxis for DVT treatment but still developed DVT during hospitalization (thrombus group). 100 fracture patients hospitalized during the same period without DVT under the same anticoagulant strategy were matched (non-thrombus group). 100 healthy people who underwent physical examinations in the outpatient department of Tianjin Hospital during the same period were also matched (normal group). Plasma samples of all subjects were collected. Laboratory tests were performed to measure activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), D-Dimer. The activity level of FXII was detected by the one-stage fixation method, the antigen of FXII was detected by enzyme-linked immunosorbent assay, and the polymorphisms of F12 gene loci rs17876030 and rs1801020 were detected by direct sequencing method. The relationships among various detection indexes and their correlations with DVT were analyzed. Results:There were no statistically significant differences in APTT, PT, and TT among the thrombus group, non-thrombus group, and normal group ( F=0.748, P=0.483; F=0.092, P=0.840; F=0.031, P=0.660). The Fg in the thrombus group was 4.5±2.4 g/L and D-Dimer was 786.2±234.9 mg/L, which were statistically different from 2.9±1.8 g/L and 261.3±165.5 mg/L in the non-thrombus group and 2.2±1.1 g/L and 198.1±96.4 mg/L in the normal group respectively ( F=3.473, P=0.046; F=34.960, P<0.001; P<0.05). The activity of FⅫ in the thrombus group was 78.3%±21.9%, which was statistically different from 97.8%±31.4% in the non-thrombus group and 94.5%±35.7% in the normal group ( F=3.581, P=0.032; P<0.05). The activity of FXII was negatively correlated with APTT ( r=-0.149, P=0.035). In the thrombus group, there were 122 cases (61.0%) with the TT genotype of rs17876030, which was statistically different from 34 cases (34.0%) in the non-thrombus group and 30 cases (30.0%) in the normal group (χ 2=12.630, P=0.002). In the thrombus group, there were 115 cases (57.5%) with the CC genotype of rs1801020, which was statistically different from 25 cases (25.0%) in the non-thrombus group and 16 cases (16.0%) in the normal group (χ 2=26.820, P<0.001). The activity levels of FXII of the TT genotype of rs17876030 in the thrombus group, non-thrombus group, and normal group were lower than those of the CC and CT genotypes, and the differences were statistically significant ( F=27.130, P<0.001; F=18.384, P<0.001; F=12.830, P=0.001; P<0.05). The activity levels of FXII of the CC genotype of rs1801020 in the three groups were lower than those of the TT and CT genotypes, and the differences were statistically significant ( F=38.631, P<0.001; F=23.562, P<0.001; F=25.829, P<0.001; P<0.05). The proportion of the TT genotype of rs17876030 was the highest in the thrombus group, and the activity level of FⅫ in patients with this genotype was lower. The TT genotype of rs17876030 was related to DVT ( r=-0.831, P=0.043). The proportion of the CC genotype of rs1801020 was the highest in the thrombus group, and the activity level of FⅫ in patients with this genotype was lower. The CC genotype of rs1801020 was related to DVT ( r=-0.784, P=0.040). Conclusion:Fg and D-Dimer are related to DVT. The activity level of FXII is negatively correlated with APTT. Prolonged APTT suggests the possibility of FⅫ deficiency, and the decreased activity level of FXII may be related to DVT.

Autoimmune thyroid disease(AITD)is a common organ-specific autoimmune disease.The pathological features are significantly increased titers of Thyroglobulin antibody(TgAb)and/or Thyroid peroxidase antibody(TPOAb),accompanied by lymphocyte infiltration in thyroid tissue.The incidence of this disease is increasing year by year,its pathogenesis is complex,and its complications such as Hashimoto's encephalopathy,infertility or abortion,and related nephropathy are harmful.Therefore,this disease has become one of the research hotspots in this field.Animal models play a crucial role in basic disease research.In recent years,many scholars have revealed the etiology,pathogenesis,complications,and therapeutic intervention mechanisms of traditional Chinese and Western medicine through different animal models of AITD.In this paper,animal selection,specific modeling methods and model evaluation of mouse models of AITD and its complications in recent years were summarized and analyzed,so as to provide a reference for the selection of animal models for AITD basic experimental research.

Objective:To explore the relationships among the activity level of coagulation factor XII (FXII), coagulation function indexes, polymorphisms of F12 gene loci rs17876030 and rs1801020, as well as their correlations with deep venous thrombosis (DVT) in fracture patients. Methods:A case-cohort control study was conducted. 200 fracture patients diagnosed and treated in the Department of Traumatic Orthopedics of Tianjin Hospital from September 2015 to September 2023 were included. They received routine anticoagulant prophylaxis for DVT treatment but still developed DVT during hospitalization (thrombus group). 100 fracture patients hospitalized during the same period without DVT under the same anticoagulant strategy were matched (non-thrombus group). 100 healthy people who underwent physical examinations in the outpatient department of Tianjin Hospital during the same period were also matched (normal group). Plasma samples of all subjects were collected. Laboratory tests were performed to measure activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), D-Dimer. The activity level of FXII was detected by the one-stage fixation method, the antigen of FXII was detected by enzyme-linked immunosorbent assay, and the polymorphisms of F12 gene loci rs17876030 and rs1801020 were detected by direct sequencing method. The relationships among various detection indexes and their correlations with DVT were analyzed. Results:There were no statistically significant differences in APTT, PT, and TT among the thrombus group, non-thrombus group, and normal group ( F=0.748, P=0.483; F=0.092, P=0.840; F=0.031, P=0.660). The Fg in the thrombus group was 4.5±2.4 g/L and D-Dimer was 786.2±234.9 mg/L, which were statistically different from 2.9±1.8 g/L and 261.3±165.5 mg/L in the non-thrombus group and 2.2±1.1 g/L and 198.1±96.4 mg/L in the normal group respectively ( F=3.473, P=0.046; F=34.960, P<0.001; P<0.05). The activity of FⅫ in the thrombus group was 78.3%±21.9%, which was statistically different from 97.8%±31.4% in the non-thrombus group and 94.5%±35.7% in the normal group ( F=3.581, P=0.032; P<0.05). The activity of FXII was negatively correlated with APTT ( r=-0.149, P=0.035). In the thrombus group, there were 122 cases (61.0%) with the TT genotype of rs17876030, which was statistically different from 34 cases (34.0%) in the non-thrombus group and 30 cases (30.0%) in the normal group (χ 2=12.630, P=0.002). In the thrombus group, there were 115 cases (57.5%) with the CC genotype of rs1801020, which was statistically different from 25 cases (25.0%) in the non-thrombus group and 16 cases (16.0%) in the normal group (χ 2=26.820, P<0.001). The activity levels of FXII of the TT genotype of rs17876030 in the thrombus group, non-thrombus group, and normal group were lower than those of the CC and CT genotypes, and the differences were statistically significant ( F=27.130, P<0.001; F=18.384, P<0.001; F=12.830, P=0.001; P<0.05). The activity levels of FXII of the CC genotype of rs1801020 in the three groups were lower than those of the TT and CT genotypes, and the differences were statistically significant ( F=38.631, P<0.001; F=23.562, P<0.001; F=25.829, P<0.001; P<0.05). The proportion of the TT genotype of rs17876030 was the highest in the thrombus group, and the activity level of FⅫ in patients with this genotype was lower. The TT genotype of rs17876030 was related to DVT ( r=-0.831, P=0.043). The proportion of the CC genotype of rs1801020 was the highest in the thrombus group, and the activity level of FⅫ in patients with this genotype was lower. The CC genotype of rs1801020 was related to DVT ( r=-0.784, P=0.040). Conclusion:Fg and D-Dimer are related to DVT. The activity level of FXII is negatively correlated with APTT. Prolonged APTT suggests the possibility of FⅫ deficiency, and the decreased activity level of FXII may be related to DVT.

Autoimmune thyroid disease(AITD)is a common organ-specific autoimmune disease.The pathological features are significantly increased titers of Thyroglobulin antibody(TgAb)and/or Thyroid peroxidase antibody(TPOAb),accompanied by lymphocyte infiltration in thyroid tissue.The incidence of this disease is increasing year by year,its pathogenesis is complex,and its complications such as Hashimoto's encephalopathy,infertility or abortion,and related nephropathy are harmful.Therefore,this disease has become one of the research hotspots in this field.Animal models play a crucial role in basic disease research.In recent years,many scholars have revealed the etiology,pathogenesis,complications,and therapeutic intervention mechanisms of traditional Chinese and Western medicine through different animal models of AITD.In this paper,animal selection,specific modeling methods and model evaluation of mouse models of AITD and its complications in recent years were summarized and analyzed,so as to provide a reference for the selection of animal models for AITD basic experimental research.