Objective To explore the application effect of medication therapy management(MTM)services on the treatment of childhood asthma.Methods A total of 107 children aged 5-11 with asthma who visited the Cough and Asthma Pharmacy Clinic of Hebei General Hospital from July to December 2022 were selected,and randomly divided into the control group(50 cases)and the intervention group(52 cases).The control group of children only received single inhalation medication education services at the first visit.The intervention group received standardized MTM services throughout the entire process.The economic,clinical and human outcomes(ECHO)model was used to analyze the differences between the two groups of children in economic(medication costs,cost-effectiveness ratio),clinical(ACT score,correct rate of inhaled preparation,number of asthma attacks)and humanistic(EQ-5D-5L utility value,Morisky medication compliance,patient satisfaction)results before the intervention,3 months after the intervention,and 6 months after the intervention,evaluate the application effect of MTM services in children with asthma.Results Compared with the control group,there was no significant difference between the two groups before the intervention.After the intervention,the children in the intervention group showed statistically significant differences in economic,clinical,and humanistic outcomes(P<0.05).Conclusions The MTM service led by pharmacists can benefit children with asthma from multiple dimensions such as economy,clinical practice,and humanities.This not only enables long-term effective control of asthma in children,but also enhances pharmacist pharmacy specialist service capabilities.

OBJECTIVE To provide reference for constructing scientific and reasonable pharmaceutical service mode for hospitalized patients with chronic airway diseases. METHODS From October 2023 to March 2024， 250 patients with chronic obstructive pulmonary disease and acute exacerbation of asthma who were hospitalized in the respiratory department of Hebei General Hospital and received pharmaceutical care （PC） were randomly divided into control group （125 cases） and observation group （125 cases）. The control group received general pharmaceutical services throughout their hospitalization， while the observation group received standardized and graded pharmaceutical services throughout their hospitalization. The differences in clinical value indicators， humanistic value indicators， and quality management indicators were compared among different PC service models. RESULTS Among clinical value evaluation indicators， the observation group had better achievement rate of disease treatment goals， correct use score of inhalation devices， the incidence of adverse drug reactions， and the number of drug-related problems solved than the control group （P＜0.05）. Among the humanistic evaluation indicators， compared with the control group， the observation group had better medication compliance scores， pharmacist intervention success rates， and patient satisfaction scores （P＜0.05）. Among quality management evaluation indicators， the proportion of drug costs， the proportion of intravenous medication， the use rate of antibiotics， the intensity of antibiotic use， and the number of pharmaceutical services in the observation group were significantly better than the control group （P＜0.05）. CONCLUSIONS Standardized and graded pharmaceutical care services have improved the efficiency of pharmacists and service effectiveness， making it a new pharmaceutical service model worth promoting.

AIM: To study the protective effect and mechanism of rosuvastatin on cerebral ischemia-reperfusion injury. METHODS: (1) Cerebral infarction and OGD/R cell models were established to detect the effects of different concentrations of rosuvastatin on cell proliferation and apoptosis; (2) Different concentrations of rosuvastatin were used to treat OGD/R cell models and to observe rosuvastatin effects on cell morphology and expression and localization of UCP2-SIRT3 in cells; (3) UCP2 silent cell line was constructed to observe cell mitochondrial morphology and expression and localization of TOMM20 and SIRT3 molecules in cells, and to study the channels and mechanisms that play a protective role of rosuvastatin in OGD/R cell model; (4) The mitochondrial membrane potential, mitochondrial gene PGC1, Drp1 and Opa1 expression were detected to study the protective effect of rosuvastatin on mitochondria. RESULTS: (1) Rosuvastatin of different concentrations could significantly reduce OGD/R cell apoptosis and increase cell survival rate; (2) Rosuvastatin exerted cell protection by affecting the expression of UCP2 and SIRT3 in cells, thereby protecting cells from OGD/R injury; (3) Rosuvastatin affected the expression of TOMM20 by regulating UCP2, increased mitochondrial transmembrane transport and energy metabolism, enhanced mitochondrial function, and improved cell state and reduced apoptosis. CONCLUSION: Rosuvastatin inhibits mitochondrial damage of OGD/R cells by regulating UCP2/SIRT pathway, thereby exerting neuron protection.

Objective:To investigate the effect of P2X4R silencing on 6-hydroxydopamine (6-OHDA) induced Parkinson's disease (PD) cell model and its mechanism. Methods:(1) According to the 6-OHDA concentrations, the SH-SY5Y cells were divided into 0 μmol/L 6-OHDA group, 50 μmol/L 6-OHDA group, 100 μmol/L 6-OHDA group, and 150 μmol/L 6-OHDA group. CCK-8 was used to detect the cell survival rate, Western blotting was used to detect the P2X4R protein expression, and real time quantitative RT-PCR was used to detect the P2X4R mRNA expression. The optimal concentration of 6-OHDA was selected to induce PD cell model. (2) SH-SY5Y cells at logarithmic phase were transfected with P2X4R siRNA lentiviral plasmids of different sequences (P2X4R-siRNA540, P2X4R-siRNA792, and P2X4R-siRNA1401) and nonsense sequence normal control plasmid (NC-siRNA), respectively (P2X4R-siRNA540 group, P2X4R-siRNA792 group, P2X4R-siRNA1401 group, and NC-siRNA group); the P2X4R mRNA and protein expressions were detected by real time quantitative RT-PCR and Western blotting, and the P2X4R siRNA sequence with the best silencing effect was screened to establish P2X4R silencing cell line. (3) The PD cells induced by the optimal concentration of 6-OHDA were transfected by P2X4R-siRNA enjoying the best silencing effect, NC-siRNA, and P2X4R antagonist CORM-2 (PD+P2X4R-siRNA group, PD+NC-siRNA group, and PD+CORM-2 group); CCK-8 and flow cytometry were used to detect the survival rate and apoptosis rate of cells in each group, and Western blotting was used to detect the protein expressions of connexin (PANX1), toll-like receptor (TLR)-2, Caspase-3 and cleaved Caspase-3. (4) The PANX1 or TLR-2 over-expression plasmids (pCMV3-PANX1 and pCMV3-TLR2), and negative control plasmid (pCMV3-NCV) were transfected into cells from the PD+P2X4R-siRNA group (PD+P2X4R-siRNA+pCMV3-PANX1 group, PD+P2X4R-siRNA+pCMV3-TLR2 group, and PD+P2X4R-siRNA+pCMV3-NCV group); CCK-8 and flow cytometry were used to detect the survival rate and apoptosis rate of cells in each group; Western blotting was used to detect the TLR-2, Caspase-3 and cleaved Caspase-3 protein expressions. Results:(1) As compared with that in the 0 μmol/L 6-OHDA group, the cell survival rate in 50, 100, and 150 μmol/L 6-OHDA groups was significantly decreased in a dose-dependent manner, and the P2X4R protein and mRNA expression levels were significantly increased in a dose-dependent manner ( P<0.05); among them, 100 mol/L 6-OHDA was the most suitable concentration to induce PD cell model. (2) As compared with those in the NC-siRNA group, the P2X4R mRNA and protein expressions in P2X4R-siRNA540 group, P2X4R-siRNA792 group, and P2X4R-siRNA1401 group were significantly decreased ( P<0.05); P2X4R mRNA and protein expressions were the lowest in the P2X4R-siRNA540 group. (3) As compared with PD+NC-siRNA group, the PD+P2X4R-siRNA group and PD+CORM-2 group had significantly increased survival rate, significantly decreased apoptosis rate, and statistically decreased Caspase-3, cleaved Caspase-3, PANX1 and TLR-2 protein expression levels ( P<0.05). (4) As compared with PD+P2X4R-siRNA+pCMV3-NCV group, the TLR2 protein expression in PD+P2X4R-siRNA+pCMV3-PANX1 group was significantly lower ( P<0.05); as compared with PD+P2X4R-siRNA+pCMV3-NCV group, PD+P2X4R-siRNA+pCMV3-TLR2 group had significantly increased cell survival rate, significantly decreased apoptosis rate, and significantly decreased Caspase-3 and cleaved Caspase-3 protein expressions ( P<0.05). Conclusion:P2X4R silencing can significantly improve the survival rate of PD cell model induced by 6-OHDA, reduce apoptosis and expressions of apoptosis related proteins (Caspase-3 and cleaved Caspase-3), and play a neuroprotective role, whose mechanism may be related to PANX1/TLR-2 signal pathway.

OBJECTIVE： To systematically evaluate the effects of Shenqi fuzheng injection combined with conventional chemotherapy on the immune function of patients with advanced non-small cell lung cancer （NSCLC）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from Cochrane Library， PubMed， Medline， Embase， CNKI， Wanfang database， VIP and CBM， Shenqi fuzheng injection combined with conventional chemotherapy （trial group） versus conventional therapy （control group） for advanced NSCLC were collected. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0 risk evaluation tool， Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS： A total of 16 literatures were included， involving 1 324 cases. Results of Meta-analysis showed that there were no statistical significance in the difference of objective remission rate （ORR） [RR＝1.14， 95％CI（0.91，1.43）， P＝0.25] and the level of  CD8+ [MD＝－1.26，95％CI（－4.10， 1.59），P＝0.39] between 2 groups. The levels of CD3+ [MD＝17.48， 95％CI（13.40， 21.56）， P＜0.000 01 ]， CD4+[MD＝12.26， 95％CI（8.39 16.13）， P＜0.000 01]， CD4+/CD8+ [MD＝0.33，95％CI（0.27， 0.39），P＜0.000 01] and the percentage of NK cells [MD＝9.33， 95％CI（5.72， 12.94）， P＜0.000 01] in trial group were significantly higher than control group. Results of subgroup analysis for medication duration of Shenqi fuzheng injection showed that after 1-14 d treatment of Shenqi fuzheng injection， the levels of CD3+ [MD＝17.11， 95％CI（12.37 ，23.17），P＜0.000 01]， CD4+[MD＝13.28，95％CI（8.33， 18.23），P＜0.000 01]， CD4+/CD8+[MD＝0.36，95％CI（0.28，0.43），P＜0.000 01] and the percentage of NK cells [MD＝12.06，95％CI（7.52，16.61），P＜0.000 1] in trial group were significantly higher than control group. After 21 d treatment of Shenqi fuzheng injection， the levels of CD3+[MD＝14.88， 95％CI（7.51，22.26），P＜0.000 01]， CD4+[MD＝10.56，95％CI（5.57，15.56），P＜0.000 01]， CD8+[MD＝3.02， 95％CI（1.80， 4.23），P＜0.000 01]， CD4+/CD8+[MD＝0.29，95％CI（0.23， 0.35），P＜0.000 01] and the percentage of NK cells [MD＝5.58，95％CI（2.49， 8.67），P＝0.000 4] in trial group were significantly higher than control group. There was no statistical significance in the level of CD8+ between 2 groups after 7-14 d treatment of Shenqi fuzheng injection [MD＝－4.26，95％CI（－12.60， 4.09），P＝0.32]. The incidence of leukopenia， nausea and vomiting， and renal dysfunction in trial group were significantly lower than control group. There was no statistical significance in the incidence of hemoglobin decreased and thrombocytopenia between 2 groups. The results of publication bias showed that there was a greater possibility of publication bias in this study. CONCLUSIONS： Shenqi fuzheng injection combined with conventional chemotherapy may improve the immune function of patients with advanced NSCLC and improve the safety after chemotherapy. But more large-scale， milltiple-center and high-quality RCT are needed to validate this conclusion.

Objective To retrospectively analyze the clinical distribution and changes in antimicrobial resistance profiles of Staphylococcus aureus (S. aureus). Methods We collected clinical specimens of S. aureus from The First Hospital of China Medical University. The Vitek-2 and BD Phoenix 100 were performed for bacterial identification and drug sensitivity tests,and WHONET 5.6 was used to analyze the data. Results From 2007 to 2016,there were 3 377 unrepeatable strains of S. aureus,including 1 705 that were methicillin resistant S. aureus (MRSA). The isolation rate of S. aureus was 9.4 ％ and of these,50.5 ％ were MRSA. There were 776 S. aureus specimens from outpatients or the emergency department,including 16.8 ％ MRSA,and 2 011 S. aureus from inpatient departments,including 60.2 ％ MRSA. The main sources of specimens were sputum (41.8 ％),pus (17.9 ％),and body secretions (17.5 ％). The average resistance rates of MRSA for erythromycin,ofloxacin,ciprofloxacin,gentamycin,and tetracycline were higher than 75.0 ％. The average resistance rate of methicillin sensitive S. aureus (MSSA) for erythromycin was up to 76.8 ％,and for tetracycline,gentamycin,ciprofloxacin,and ofloxacin,were less than 25.0 ％. In 10 years,the average resistance rates of MRSA and MSSA for 11 kinds of common antibiotics had no obvious change. Conclusion The constituent rate of MRSA was high in The First Hospital of China Medical University,especially from the areas that were not sterile,suggesting that clinicians should pay attention to the identification of infection and sources for MRSA,which were from such areas. Hospital infection control should be focused on at the same time,in order to reduce the incidence of MRSA.

Objective To observe the influences of Shenzhi Huoxue capsule to prognosis of patients with hypertensive intracerebral hemorrhage after hard channel puncture and drainage.MethodsTo divide 106 patients with hypertensive intracerebral hemorrhage from May 2013 to April 2015 into two groups.The observation group with 53 cases received Shenzhi Huoxue capsule after hard channel puncture and drainage, the control group did not receive Shenzhi Huoxue capsule.To observe the complications rate, the number of deaths during hospitalization, the number of persons with disabilities after treatment, GOS score, BI index, SSS score and NCSE score of two groups.Results(During treatment, the infection, liver and renal dysfunction and rebleeding rates of observation group were lower than control group, and the infection ratio was significant (P<0.05).(During treatment, the proportion of deaths of observation group was 18.87%,lower than control group with 26.42%, but the differences were not statistically significant.The proportion of disabilities of observation group was 26.42%,lower than control group with 45.28%, and the differences were statistically significant (P<0.05).After treatment, GOS score and BI index of two groups were higher than before treatment(P<0.05).GOS score and BI index of the observation group were (12.85±0.81,83.95±4.37)score, higher than the control group with (10.05±0.73,74.95±4.06)score, and the differences all were statistically significant (P<0.05).After treatment, the SSS score and NCSE score of two groups were higher than before treatment(P<0.05),the SSS score and NCSE score of observation group were (47.10±4.18,66.72±3.99)score, higher than the control group with (38.42±3.05,59.34±3.45)score, and the differences were statistically significant (P<0.05).ConclusionAdding Shenzhi Huoxue capsule to patients with hypertensive intracerebral hemorrhage after hard channel puncture and drainage can reduce the number of persons with disabilities and improve life self-care ability and cognitive ability.

Objective:To investigate the diagnostic value of diffusion weighted imaging and 1H magnetic resonance spectroscopy for the neonatal hypoxic ischemic encephalopathy (HIE).Methods:37 cases of patients with neonatal hypoxic ischemic encephalopathy admitted in our hospital were selected as the study group,another 40 healthy neonates were selected as the control group,both groups of neonates underwent diffusion-weighted imaging and 1H magnetic resonance spectroscopy,ordinary MR1 and diffusion weighted imaging findings of neonates in the study group were observed,the neonatal cerebral metabolic compounds relative concentration were observed and compared between two groups.Results:The detection rate of diffusion-weighted imaging was significantly higher compared with the ordinary MRI (P＜0.05).The relative ratio of brain metabolic compounds NAA/Cr of study group were obviously lower than those of the control group,while the Cho/Cr,MI/Cr,Glu-Glr/Cr,Lac/Cr were significantly higher (P＜0.05).Conclusion:Diffusion weighted imaging combined with 1H magnetic resonance spectroscopy could improve the diagnostic accuracy of neonatal hypoxic ischemic encephalopathy,the analysis of the concentrations of brain metabolic compounds could contribute to evaluate the severity of HIE.

Objective The efficacy and safety of rectal instillation with formula for clearing heat, eliminating phlegm and relaxing bowel on treating encephalopathy complicated with pulmonary infection were evaluated by randomized controlled clinical trials. Methods Eighty eligible cases of encephalopathy complicated with pulmonary infection were randomly divided into treatment group and control group. Control group was given conventional treatment and treatment group was given rectal instillation treatment with formula for clearing heat , eliminating phlegm and relaxing bowel. The changes of index were observed before and after treatment in two groups including temperature,antifebrile time,white blood cell count,neutrophils ratio,C-reactive protein,procalcitonin, pneumonia severity index,and the efficacy score of TCM syndrome. Results Rectal instillation with formula for clearing heat and eliminating phlegm to relax bowel can be better improved encephalopathy complicated with pulmonary infection with syndrome of phlegm-heat obstructing in which the patients have yellow sputum, constipation,yellow urinary and other symptoms. It can reduce TCM syndrome score and level of serum calcitonin, relieve inflammation,enhanc antibacterial effect,and improve the clinical curative effect. Conclusions The curative effects of rectal instillation with formula for clearing heat and eliminating phlegm to relax bowel on treating encephalopathy complicated with pulmonary is definite which has no adverse reaction and safety use. It is worthy of further popularizing in clinic.

Objective:To evaluate the safety of cardiac catheterization intervention therapy and transthoracic small incision surgery in the occlusion bydomestic occluder under echocardiography guiding in patients with atrial septal defect (ASD).Methods:A total of 1 080 patients with ASD in the occlusion by domestic occluder were analyzed retrospectively,and the interventional treatment were performed in 734 cases through cardiac catheterization intervention therapy and 346 cases through transthoracic small incision surgery.The patients undergone cardiac catheterization intervention therapy were guided under the digital substraction angiography (DSA) and were monitored by transthoracic echocardiography (TTE) in the whole interventional process,and the efficacy was evaluated with TTE.The occlusion of transthoracic small incision surgery was guided under the transesophageal echocardiography (TEE),which was used to monitor the position of occluder and evaluate the efficacy immediately.Results:Two kinds of intervention in the occlusion by domestic occluder had achieved satisfactory results in patients with ASD.There was no statistically difference in the longest size of ASD between the 2 intervention methods,while there were statistically differences in the ratio between ASD longest diameter and atrial septal length,and the size of the occlusion,and the disparity between the size of the occluder and ASD longest diameter (D value),respectively (all P＜0.05).When the size of arithmetic mean of the ASD was ＜30 mm,the success rate of the 2 methods was both 100％.When the size of arithmetic mean of the ASD was ≥ 30 mm,the success rate was 100％ in the transthoracic small incision surgery and 50％ in the cardiac catheterization intervention therapy.Conclusion:Domestic occluder is safe.Compared with the imported one,its cost is lower.When the size of the defects is same,the occlusion is smaller in the transthoracic small incision surgery compared with that in the cardiac catheterization intervention therapy.When the size of arithmetic mean of the ASD is ≥ 30 mm,the success rate of the transthoracic small incision surgery is higher compared with the cardiac catheterization intervention therapy.When the cardiac catheterization intervention therapy fails,the transthoracic small incision surgery may be a better choice.