The writing of pharmacist-managed clinics documents （hereinafter referred to as “outpatient medication record”） is a necessary part of pharmacist-managed clinics service. Outpatient medication record is an important carrier to reflect the quality of pharmacist-managed clinics service. The Chinese Hospital Association Pharmaceutical Specialized Committee was entrusted by the Pharmaceutical Administration Department of the National Health Commission to lead the formulation of the Guidelines for the Pharmacist-managed Clinics Service and Document Writing and Usage （Reference） （hereinafter referred to as Guidelines） according to the compilation method of group standards and the technical route of “documentation combing→framework establishment→draft writing→opinion collection→Guidelines formation”. The Guidelines standardizes the basic requirements of pharmacist-managed clinics record management and the basic content of record， and provides a general template and two specialized templates including pregnant and lactating pharmacist-managed clinics record template and cough and asthma pharmacist-managed clinics record template， which provides a reference for medical institutions to write pharmacist-managed clinics record. This paper introduces the formulation process of Guidelines and analyzes the key contents of Guidelines， which is helpful for the application practice of Guidelines and further improves the quality of pharmacist-managed clinics work.

Objective:To investigate the effects of elesclomol-Cu(ES-Cu)on the proliferation and cuproptosis of human acute myeloid leukemia(AML)cells.Methods:The effects of ES-Cu on the proliferation of AML cells and the AML cells pre-treated with ammonium tetrathiomolybdate(TTM)were examined by CCK-8 assay.The Calcein/PI kit was used to detected the changes in activity and cytotoxicity of AML cells induced by ES-Cu.Flow cytometry and Cytation3 fully automated cell imaging multifunctional detection system were used to analyze DCFH-DA fluorescence intensity,so as to determine the level of reactive oxygen species(ROS).The GSH and GSSG detection kits were used to measure the intracellular GSH content.Western blot was used to detected the expression of cuproptosis-related proteins ATP7B,FDX1,DLAT and DPYD.Results:ES-Cu inhibited the proliferation of Kasumi-1 and HL-60 cells in a concentration-dependent manner(rKasumi-1=-0.99,rHL-60=-0.98).As the concentration of ES-Cu increased,the level of intracellular ROS also increased(P＜0.01-0.001).TTM could significantly reverse the inhibitory effect of ES-Cu on cell proliferation and its promoting effect on ROS.With the increase of ES-Cu concentration,the content of GSH was decreased(r=-0.98),and Western blot showed that the protein expressions of ATP7B,FDX1,DLAT and DPYD were significantly reduced(P＜0.05).Conclusion:ES-Cu can induce cuproptosis in AML cells,which provides a new idea for the treatment of AML.

Objective:This study analyzed the provincial policy on the"dual channel"management of drugs,provided suggestions for improving the"dual channel"management models.Methods:From May 10,2021 to April 10,2024,the official websites of the Healthcare Security Administration and the Health Commission of various provinces were searched for policy documents related to the"dual channel"management,and the text data were statistically analyzed.Results:The"dual-channel"management policies of various provinces coexisted with commonalities and differences.Conclusions:It is recommended to refine the access standards of the drug catalog,standardize the setting of the entry threshold of pharmaceutical institutions,scientifically determine the level of medical insurance treatment,and formulate differentiated drug identification and management methods,so as to further weaken the policy restrictive factors.

Objective:To evaluate insulin sensitivity(IS)and pancreatic β-cell secretion function in the elderly, analyze the influencing factors, and compare these parameters with those observed in adults.Methods:A total of 301 participants were selected from the health examination population at the Geriatrics Endocrinology Department of Jiangsu Provincial People's Hospital, all of whom had no history of diabetes, between December 2018 and June 2021.Participants were categorized into elderly and adult groups based on age.Personal and medical histories were recorded, and various measurements, including height, weight, waist circumference, hip circumference, blood lipids, and nutritional metabolic indicators, were obtained.Body composition was assessed using dual-emission X-ray absorptiometry(DXA).The oral minimal model(OMM)method was utilized to derive the insulin sensitivity index(ISI), dynamic insulin secretion(Φd), static insulin secretion(Φs), total insulin secretion(Φt), and disposition index(DI).Participants were grouped according to the results of oral glucose tolerance tests.Finally, the factors influencing IS and pancreatic β-cell function were analyzed in both elderly and adult populations, as well as to identify any differences between the two groups.Results:Following adjustments for gender and body mass index(BMI), partial correlation analysis indicated a decrease in Φd, DI-Φd, and DI-Φt with advancing age( r=-0.219, -0.210, -0.187; P=0.005, 0.015, 0.017).In contrast, ISI, Φs, Φt, and DI-Φs showed no significant correlation with age.Although ISI levels were comparable between the elderly and adult groups, individuals newly diagnosed with diabetes in the elderly cohort exhibited higher DI-Φd, DI-Φs, and DI-Φt compared to those in the adult group after ISI correction.When incorporating age, high-density lipoprotein cholesterol(HDL-C), total muscle mass, the android to gynoid ratio(A/G), and fat mass index(FMI)into a binary Logistic regression model, the findings underscored FMI as a common risk factor for both elderly and adult cohorts concerning the ISI( OR=2.324, 1.773; P=0.032, 0.005).The A/G ratio was identified as a risk factor for DI-Φd in both age groups( OR=69 252.464, 407.653; P=0.012, 0.001).Furthermore, HDL-C was recognized as a protective factor for ISI( OR=0.024, P=0.012)in the elderly, while advancing age( OR=1.454, P=0.039)was found to be a risk factor for DI-Φs in this demographic.Total muscle mass and the A/G ratio were also acknowledged as risk factors for ISI( OR=1.054, 15.725; P=0.021, 0.026), with FMI serving as a risk factor for DI-Φs in the adult cohort( OR=1.826, P=0.035). Conclusions:The secretion function of pancreatic β-cells declines with age, whereas ISI remains unchanged.The factors affecting ISI, DI-Φd, and DI-Φs in elderly and adult populations show notable differences.This indicates that implementing targeted lifestyle interventions for distinct age groups may be more effective in preserving both ISI and pancreatic β-cell function.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative fatigue syndrome in patients with Parkinson′s diseases undergoing bilateral deep brain electrical stimulation.Methods:Sixty patients with Parkinson′s disease, aged 60-80 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with body mass index of 18.5-29.9 kg/m 2, undergoing elective bilateral deep brain electrical stimulation, were divided into transcutaneous electrical acupoint stimulation group (TEAS group) and sham stimulation group (Sham group), with 30 patients in each group, using the random number table method. The TEAS of bilateral Zusanli and Sanyin points was performed on admission to the operating room with alternative stimulation at a frequency of 2/10 Hz and an intensity of 6-15 mA. The stimulation was stopped when the neurosurgeon performed the microelectrode recording, and TEAS was continued until the end of operation after the microelectrode recording was finished. In Sham group, electrode pads were only placed at the acupoint with no stimulation. The Christensen score was assessed at 1 day preoperatively (T 0) and 1, 3 and 7 days postoperatively (T 1-3) to evaluate the occurrence of postoperative fatigue syndrome. The 15-item Quality of Recovery scale score, emergence agitation and rescue analgesia within 48 h after surgery were recorded. Results:Compared with Sham group, Christensen scores were significantly decreased at T 1-3, 15-item Quality of Recovery scale scores were increased, and the incidence of postoperative fatigue syndrome and emergence agitation and rate of rescue analgesia were decreased in TEAS group than in Sham group ( P<0.05). Conclusions:TEAS can reduce the development of postoperative fatigue syndrome in the patients with Parkinson′s diseases undergoing bilateral deep brain electrical stimulation.

Purpose To construct a nomogram model based on ultrasonographic features and to evaluate its value in differentiating benign from malignant bladder neoplasms.Materials and Methods A total of 538 consecutive bladder neoplasm patients(including 84 benign cases and 454 malignant cases)confirmed by surgery or biopsy pathology from January 2016 to January 2022 were retrospectively enrolled,the ultrasonographic features(including lesion number,location,maximum diameter,echogenicity,morphology,basement,calcification,color Doppler flow imaging signal)and brief clinical data(gender,age,urinary tract malignant tumors history and gross haematuria)were all collected for univariate and multivariate Logistic regression analysis.Independent predictors for malignant bladder neoplasm were screened and nomogram model based on univariate Logistic regression analysis was constructed.Internal validation was performed by Bootstrap resampling.Meanwhile,the receiver operating characteristic curve,calibration curve and decision curve were drawn.Results Univariate and multivariate Logistic regression analysis showed patient gender(OR=1.822,P=0.038),age(OR=1.044,P=0.000),lesion location(OR=0.359,P=0.000)and color Doppler flow imaging signal(OR=2.052,P=0.007)were independent factors in predicting the malignancy of bladder lesions.Area under the curve of the nomogram prediction model based on univariate Logistic regression analysis were 0.780,the sensitivity,specificity and accuracy of the prediction model were 72.91%,71.43%and 72.68%,respectively.The calibration curve and decision curve showed good consistency and clinical practicability of the model.Conclusion The nomogram model based on ultrasonographic features and simple clinical characteristics shows good predictive accuracy in differentiating bladder neoplasms and has potential clinical application value.

The objective of this study was to analyze the effects on cell viability, apoptosis, and cell cycle of non-small cell lung cancer (NSCLC) A549 cells after intervention with Agrimonia pilosa (AP) and investigate Agrimonia pilosa anti-tumor activity in vitro. Meanwhile, liquid chromatography mass spectrometry (LC-MS) metabolomics technology was used to analyze the changes of cellular metabolites and metabolic pathways. The results of this study will provide a theoretical and experimental basis for investigating the mechanism of the effect of Agrimonia pilosa on non-small cell lung cancer A549 cells. The results showed that the cell nucleus of A549 cells crumpled and apoptosis occurred with the increase of drug concentration. The survival rate of the cells decreased, and the inhibition rate reached 21.5% and 91.74% under the low and high dose conditions, respectively. Lactate dehydrogenase (LDH) content increased (P < 0.05). Metabolomics results showed significant differences in metabolism between groups, thirty-three distinct metabolites including LysoPC(24:0/0:0), LysoPC(17:0/0:0) and PC(O-40:5) were deduced. The pathway enrichment showed that the Agrimonia pilosa plays an anti-tumor role mainly by regulating the metabolism of glycerophosphate and purine in A549 cells, in which the effect on glycerophosphate metabolism pathway was most significant. The results of combined pharmacodynamics suggested that Agrimonia pilosa might induce apoptosis and inhibit the growth of A549 cells by regulating LysoPC(24:0/0:0), LysoPC(17:0/0:0) and PC(O-40:5) metabolites in A549 cells.

Objective To construct trajectory models of care-seeking patterns for type 2 diabetes mellitus(T2DM)patients,analyze the influencing factors of different trajectories,and explore the fasting blood glucose control levels of T2DM patients with different trajectories.Methods A retrospective cohort study was carried out on 18088 T2DM patients who had health records and been involved in the diabetic management in Community Health Service Center of Minhang District,Shanghai from 2006 to 2009.Starting from Jan 1,2010,participants were followed up until Dec 31,2019,with complete follow-up information.Group-based trajectory modelling(GBTM)was employed to identify and construct the fluctuation trajectory of fasting blood glucose in the patients.Bayesian information criterion(BIC),average posterior probability(AvePP)and other evaluation indicators were used to select the optimum subgroup number model.Then the differences in demographic characteristics,health status,family history,fasting blood glucose,BMI,etc were compared among different categories.Multinational logistic regression model was constructed to explore the influencing factors of different fluctuation trajectories.Cox regression analysis was used to examine the relationship between the long-term trajectories of care-seeking patterns and fasting blood glucose control level.Results Using GBTM analysis,we constructed the optimal Model 4 to categorize 18088 T2DM patients with community health records into five distinct trajectory subgroups:continuous non-attendance group(22.29%),low-level increasing group(15.09%),high-level slowly decreasing group(14.18%),high-level rapidly decreasing group(14.90%),and continuous regular attendance group(33.54%).With the continuous regular attendance group serving as the reference,gender,age,place of residence,baseline comorbidity of hypertension,baseline fasting plasma glucose level,and BMI were found to influence the community attendance trajectories of T2DM patients(P<0.05).After adjusting for confounding factors,Cox regression analysis revealed that compared to the continuous non-attendance group,the low-level increasing group,high-level slowly decreasing group,and continuous regular attendance group had better glycemic control,with HRs of 0.37(95%CI:0.34-0.39),0.72(95%CI:0.67-0.78),and 0.78(95%CI:0.73-0.84),respectively.The glycemic control level in the high-level rapidly decreasing group was comparable,with an HR of 1.06(95%CI:0.99-1.12).Conclusion Based on the optimal model,the community medical treatment trajectories of T2DM patients showed different dynamic characteristics.Factors such as gender,residence,hypertension,and weight loss may influence these varying trajectories.Regular community visits and follow-up may help control blood glucose levels.

Objective:To investigate the therapeutic effect of enteral nutrition on improving ice stimulation for postoperative dysphagia after craniocerebral injury. Methods:Patients with dysphagia after craniocerebral injury admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Bengbu Medical University from May 2021 to November 2022 were included. The patients were randomly divided into treatment group (31 cases) and control group (30 cases) by random number table method. The treatment group adopted the method of infusion of enteral nutrition and ice stimulation through nasoenteral nutrition tube;the control group adopted oral diet and ice stimulation. Comparison of the two groups with the recovery of swallowing function,the occurrence of complications during the treatment period,and changes in nutritional indexes (hemoglobin,serum albumin,pre-serum protein) before and after the treatment of the two groups of patients. Results:After treatment,no significant difference was observed in the comparison of the scores of Swallowing Function Scale (SSA and VFSS) between the two groups (P>0.05),but the levels of hemoglobin,serum albumin and pre-serum protein of the treatment group were significantly higher than those of the control group after treatment (P<0.05). The treatment group of complications (aspiration,choking and lung infection) during treatment in the observation group was significantly lower than that in the control group (P<0.05). Conclusion:In ice stimulation treatment of postoperative swallowing dysfunction after craniocerebral injury,the combined use of nasoenteral tube-fed enteral nutrition can improve the nutritional status and reduce the occurrence of complications such as misaspiration,although it cannot significantly enhance the recovery of swallowing function.

Carboxylated pillar[5]arene functionalized silver nanoparticles(CP5A-AgNPs)were successfully prepared by Creighton method.The prepared CP5A-AgNPs composites were characterized by ultraviolet-visible absorption spectroscopy(UV-Vis),infrared spectroscopy(FT-IR)and transmission electron microscopy(TEM),etc.TEM results showed that when the molar ratio of CP5A to AgNO3 was 1:10,the prepared CP5A-AgNPs had good dispersion and uniform particle size,with an average particle size of 4.05 nm.The catalytic degradation ability of CP5A-AgNPs toward two kinds of organic dyes,Rhodamine B(RhB)and methyl orange(MO)was further investigated.The results showed that the degradation rates of these two dyes by CP5A-AgNPs were 99.91%and 98.83%respectively,and CP5A-AgNPs exhibited good cyclic catalytic ability.The catalytic efficiencies in the fifth cycle were 91.06%and 98.45%,respectively.In addition,the performance of functionalized silver nanoparticles using monomer compound of CP5(CMA)as stabilizer(CMA-AgNPs)was compared.The results showed that CP5A-AgNPs had strong catalytic degradation activity to RhB and MO,and had good recycling catalytic ability.