Diabetic nephropathy is the most serious complication of diabetes and a major cause of end-stage renal disease worldwide.Although hyperglycaemia is widely considered to be the main driving force for the progression of diabetic nephropathy to end-stage renal disease,inflammatory signaling pathways and inflammatory cells also play important roles in the pathogenesis and progression of the disease.Therefore,treatment strategies targeting the inflammation-related intracellular signaling pathways may become a new direction for the treatment of diabetic nephropathy.Currently,the development of anti-inflammatory drugs for diabetic nephropathy is also underway,and they have shown promising results in experimental models.This article focuses on the connection between inflammatory cells and inflammatory signaling pathways and diabetic nephropathy,as well as the current research progress on targeted anti-inflammatory treatment.

Gastrointestinal motility disorder is an important cause of digestive system diseases. Patients often suffer from nausea， vomiting， gastric retention， gastroparesis， constipation， and many other symptoms， and their quality of life is seriously reduced. Prokinetic agents are routinely used in clinical practice， but their long-term use is prone to problems such as reduced efficacy and increased adverse reactions. Since the incidence of gastrointestinal diseases has continued to rise globally in recent years， there is an urgent need for clinical development of safe and effective treatment strategies. Aurantii Fructus， a traditional Chinese medicine， has the effect of smoothing Qi and eliminating distention， and it has been used to treat gastrointestinal diseases for thousands of years. In modern clinical practice， it is mainly used for the treatment and auxiliary treatment of various gastrointestinal diseases such as functional dyspepsia， functional constipation， and irritable bowel syndrome. The efficacy is remarkable， and no adverse reactions have been reported at conventional doses. Therefore， it can greatly improve the symptoms of patients with gastrointestinal diseases and improve their quality of life. Modern research has revealed that there are many active components in Aurantii Fructus， among which flavonoids have the highest content and the most types. Flavonoids are the main active components in Aurantii Fructus to regulate gastrointestinal motility. Aurantii Fructus and its active components can affect gastrointestinal hormones， neural pathways， Cajal mesenchymal cells， and other multiple mechanisms. They can adjust gastrointestinal motility and correct gastrointestinal motility disorders， showing potential application value in the treatment of gastrointestinal motility disorders. However， a comprehensive analysis of Aurantii Fructus in this aspect is still lacking. This study summarized the pharmacological activities of active components of Aurantii Fructus extract and its flavonoids， volatile oils， alkaloids， and coumarin on the regulation of gastrointestinal motility and explored the latest research progress on its mechanism. Finally， the adverse reactions of Aurantii Fructus were summarized. It aims to provide a scientific basis for the research and clinical application of Aurantii Fructus and its active components in the regulation of gastrointestinal motility.

OBJECTIVE To investigate the development and current status of medication education in domestic medical institutions， aiming to provide reference and suggestions for better development of medication education. METHODS The online questionnaire survey was conducted in March 2023 to investigate the implementation of medication education in medical institutions at all levels nationwide； descriptive analysis and influencing factors analysis were conducted. RESULTS A total of 1 368 questionnaires were recycled， 1 304 of which were effective questionnaires， with the effective rate of 95.32%. The average rate of providing medication education was 73.62% in medical institutions nationwide， 76.05%， 67.68% and 73.76% respectively in Eastern， Central and Western regions， 87.11%， 60.57% and 46.32% respectively in tertiary， secondary and primary medical institutions. The commonest place and way of carrying out medication education were dispensing window and oral instructions， and both were more diverse in tertiary medical institutions， compared with second and primary medical institutions. The median annual service volume of medication education in medical institutions PUMCH-A- at all levels was 500 people； the higher the level of medical institutions， the larger the annual service volume of medication education （P＝0.023）. More than half of medical institutions didn’t have any form of compensation for medication education， which was mostly reflected in the workload of medical institutions with compensation. Grade of medical institutions， degree of information and automation were the major influencing factors of carrying out medication education. CONCLUSIONS The ratio of carrying out medication education is improved in the central region in China in recent years， compared with 2019； while that of primary institutions in all regions is at a low level and should be improved. The place of carrying out medication education should be set according to the characteristics of medical institutions， and medication education forms should be enriched as much as possible. The quantity and quality of medication education talents still need to be improved. Compensation for pharmaceutical care should be continually explored and implemented to prompt high-quality and sustainable development of medication education.

OBJECTIVE To investigate the development and current status of medication education in domestic medical institutions， aiming to provide reference and suggestions for better development of medication education. METHODS The online questionnaire survey was conducted in March 2023 to investigate the implementation of medication education in medical institutions at all levels nationwide； descriptive analysis and influencing factors analysis were conducted. RESULTS A total of 1 368 questionnaires were recycled， 1 304 of which were effective questionnaires， with the effective rate of 95.32%. The average rate of providing medication education was 73.62% in medical institutions nationwide， 76.05%， 67.68% and 73.76% respectively in Eastern， Central and Western regions， 87.11%， 60.57% and 46.32% respectively in tertiary， secondary and primary medical institutions. The commonest place and way of carrying out medication education were dispensing window and oral instructions， and both were more diverse in tertiary medical institutions， compared with second and primary medical institutions. The median annual service volume of medication education in medical institutions PUMCH-A- at all levels was 500 people； the higher the level of medical institutions， the larger the annual service volume of medication education （P＝0.023）. More than half of medical institutions didn’t have any form of compensation for medication education， which was mostly reflected in the workload of medical institutions with compensation. Grade of medical institutions， degree of information and automation were the major influencing factors of carrying out medication education. CONCLUSIONS The ratio of carrying out medication education is improved in the central region in China in recent years， compared with 2019； while that of primary institutions in all regions is at a low level and should be improved. The place of carrying out medication education should be set according to the characteristics of medical institutions， and medication education forms should be enriched as much as possible. The quantity and quality of medication education talents still need to be improved. Compensation for pharmaceutical care should be continually explored and implemented to prompt high-quality and sustainable development of medication education.

OBJECTIVE To investigate the basic situation of developing pharmacy outpatient departments in Chinese tertiary medical institutions and analyze the influencing factors. METHODS The research targeted the pharmacy outpatient department managers of hospitals and conducted a survey through Sojump in March 2023. Various independent variables were selected from the hospital’s own characteristics， the management of the pharmacy outpatient departments， and the construction of the pharmacist team for Logistic and linear regression analysis， with the aim of separately analyzing the factors influencing the establishment of pharmacy outpatient departments and the factors affecting the total number of patients served by these departments throughout the year 2022. RESULTS & CONCLUSIONS A total of 1 304 medical institutions of different levels nationwide participated in this survey， with 714 tertiary hospitals. Among the tertiary hospitals， 377 （52.80%） had established pharmacy outpatient departments， including 321 grade-A tertiary hospitals， 48 grade-B tertiary hospitals and 8 other tertiary hospitals. The 377 tertiary hospitals collectively operated 1 739 pharmacy outpatient departments， covering 19 specialized fields， with the highest proportion found in the cardiovascular field （including anticoagulation） at 16.45%. Tertiary hospitals in North China， Central China， East China and South China regions had more pharmacy outpatient departments. The establishment of pharmacy outpatient departments was found to be influenced by tertiary grade-B status （P＝0.010） and the annual outpatient volume of the hospital （P＝0.008）， although the impact was relatively small. The factors influencing the number of patients served by pharmacy outpatient departments were the annual outpatient volume of the hospital （P＝0.042） and the number of pharmacists engaged in clinical pharmacy work （P＝0.004）. The proportion of tertiary hospitals in China that have established pharmacy outpatient departments is insufficient. It is necessary to further accelerate the construction of pharmacy outpatient departments and appropriately expand the talent pool of hospital pharmacy teams based on the needs of pharmacy outpatient departments and patients， in order to meet the requirements of medical practice and patient care.

OBJECTIVE To ascertain the substance benchmarks of the classic prescription Huangqi Guizhi Wuwu Decoction(HGWD),examine the quantitative value transfer throughout the entire process of HGWD,from herb pieces to decoction,concentrated solution and finally freeze-dried powder,and provide a valuable reference for the preparation method and scientific evaluation of bench-mark samples of classic prescriptions containing volatile substances.METHODS According to the Key information table of Ancient Classic Prescriptions(25 prescriptions)released by China,15 batches of HGWD were prepared.The multi-index content determination and characteristic chromatogram analysis methods were established,and the characteristic peak attribution and similarity evaluation were carried out.The multi-index contents of HGWD and its freeze-dried powder were investigated and compared,and the quantitative value transfer in the preparation process of decoction-concentrated solution-freeze-dried powder was analyzed.The physical form of the benchmark samples were scientifically and reasonably determined,and the content and transfer rate range of each component in the HGWD benchmark samples were determined,and the HGWD substance benchmarks were established.RESULTS The contents of cinnamaldehyde and cinnamyl alcohol in HGWD decreased significantly during the concentration and drying process,and the other in-dex components could be transferred more completely between the decoction,concentrated solution and freeze-dried powder.The simi-larity of the characteristic chromatograms of 15 batches of HGWD benchmark samples were all over 0.9,and 8 characteristic peaks were identified,which were from Paeoniae γadix Alba,Cinnamomi γamulus and Ginger.The paste-forming rate ranged from 8.0%to 11.0%.The content of Astragaloside Ⅳ was 0.04%-0.07%and the transfer rate was 9.0%-18.0%.The content of paeoniflorin was 1.5%-3.0%and the transfer rate was 33.0%-62.0%.The content of cinnamyl alcohol was 0.02%-0.04%,and the transfer rate was 25.0%-47.0%.The content of cinnamic aldehyde was 0.02%-0.05%and the transfer rate was 0.7%-1.5%.The content of cinnamic acid was 0.03%-0.06%and the transfer rate was 17.5%-34.0%.The content of 6-gingerol was 0.04%-0.08%and the transfer rate was 7.0%-14.0%.CONCLUSION The physical form of the decoction as the HGWD benchmark sample is deter-mined,which provides reference for the scientific selection of the physical form of the benchmark sample of classic prescriptions contai-ning volatile substances.The quality indexes of HGWD substance benchmarks are established,and the quantitative value transfer is an-alyzed,which provides the basis for the development of the classic prescription compound preparation.

Objective:To analyze the histopathological features of primary aldosteronism(PA) based on the histopathology of primary aldosteronism(HISTALDO) consensus classification in patients undergoing unilateral adrenalectomy and explore its correlation with clinical characteristics and postoperative outcomes.Methods:A retrospective study was conducted on 105 unilateral PA patients treated at the First Affiliated Hospital of Nanjing Medical University between April 2017 and April 2022. Postoperative histopathology was classified according to the latest HISTALDO consensus and compared with traditional classifications. Differences in clinical features and primary aldosteronism surgical outcomes(PASO) were analyzed across classifications.Results:HISTALDO classification showed that 67.6% of patients were classical subtype and 32.4% were non-classical subtype. Compared to the non-classical group, the classical group showed lower age, body mass index, serum potassium concentration, fasting blood glucose, HbA 1C, and proportion of CYP11B2 negative nodules as well as higher systolic blood pressure, diastolic blood pressure, prevalence of hypokalemia, and 24-hour urine potassium(all P<0.05). Based on PASO criteria, complete clinical and biochemical success were achieved in 41.7% and 83.3% subjects respectively. A significantly higher proportion of classical group displayed complete clinical and biochemical success than nonclassical group(all P<0.05). Multivariate logistic regression analysis showed that lower serum potassium concentration( OR=0.15, 95% CI 0.03-0.84, P<0.05) and proportion of CYP11B2 negative nodules( OR=0.20, 95% CI 0.05-0.86, P<0.05) were related to classical pathological type, and classical pathological type was independently related to clinical and biochemical remission(all P<0.05). Conclusion:Standardized HISTALDO histopathological classification enhances diagnostic accuracy and predicts postoperative outcomes in unilateral PA, providing a foundation for precise stratified management of PA patients.

Objective:To analyze the histopathological features of primary aldosteronism(PA) based on the histopathology of primary aldosteronism(HISTALDO) consensus classification in patients undergoing unilateral adrenalectomy and explore its correlation with clinical characteristics and postoperative outcomes.Methods:A retrospective study was conducted on 105 unilateral PA patients treated at the First Affiliated Hospital of Nanjing Medical University between April 2017 and April 2022. Postoperative histopathology was classified according to the latest HISTALDO consensus and compared with traditional classifications. Differences in clinical features and primary aldosteronism surgical outcomes(PASO) were analyzed across classifications.Results:HISTALDO classification showed that 67.6% of patients were classical subtype and 32.4% were non-classical subtype. Compared to the non-classical group, the classical group showed lower age, body mass index, serum potassium concentration, fasting blood glucose, HbA 1C, and proportion of CYP11B2 negative nodules as well as higher systolic blood pressure, diastolic blood pressure, prevalence of hypokalemia, and 24-hour urine potassium(all P<0.05). Based on PASO criteria, complete clinical and biochemical success were achieved in 41.7% and 83.3% subjects respectively. A significantly higher proportion of classical group displayed complete clinical and biochemical success than nonclassical group(all P<0.05). Multivariate logistic regression analysis showed that lower serum potassium concentration( OR=0.15, 95% CI 0.03-0.84, P<0.05) and proportion of CYP11B2 negative nodules( OR=0.20, 95% CI 0.05-0.86, P<0.05) were related to classical pathological type, and classical pathological type was independently related to clinical and biochemical remission(all P<0.05). Conclusion:Standardized HISTALDO histopathological classification enhances diagnostic accuracy and predicts postoperative outcomes in unilateral PA, providing a foundation for precise stratified management of PA patients.

【Objective】 To explore the mediating effect of different organizational climate on volunteer service motivation and work engagement among volunteers during the COVID-19 epidemic. 【Methods】 The Volunteer Service Motivation Scale, Organizational Climate Scale, and Work Input Scale were used to investigate relevant contents among volunteers from Shaanxi, Hubei and Henan provinces who participated in prevention and control of the COVID-19 epidemic by convenient sampling method. Pearson correlation analysis was applied to explore the correlation among volunteer service motivation, organizational climate and work engagement. The Bootstrap method was used to analyze the mediating role of organizational climate between volunteer service motivation and work engagement. 【Results】 The scores of volunteer service motivation, organizational climate, and work engagement of the 834 volunteers were 72.45±13.66, 24.03±4.65, and 51.59±10.04, respectively. Volunteer service motivation was positively correlated with work engagement (r=0.556, P<0.001) and organizational climate (r=0.604, P<0.001). Organizational climate was positively correlated with work engagement (r=0.632, P<0.001). Organizational climate played a mediating role between volunteer service motivation and work engagement (effect value=0.278, accounting for 47.0% of the total effect). 【Conclusion】 Volunteer service motivation indirectly affects work engagement through organizational climate, indicating that volunteer team managers can improve their work engagement level by improving the organizational climate.

Objective To investigate the correlation between the residual cholesterol(RC)level and vertebrobasilar dilatation(VBD)in elderly patients with acute cerebral infarction(ACI).Methods A total of 325 elderly ACI patients admitted to Department of Neurology,Changzhou Second People's Hospital of Nanjing Medical University from January 2020 to July 2021 were recruited retrospectively.All of them underwent cranial MRI,CTA and biochemical test for plasma levels of TC,TG,LDL-C and HDL-C and other biochemical indicators.According to the imaging diagnostic criteria,they were divided into VBD group(52 cases)and non-VBD group(273 cases).Their clini-cal data were compared between the two groups,and the relationship between RC level and VBD was analyzed in the elderly ACI patients.Results Significant differences were observed in age,sex,hypertension,history of smoking and TC and RC levels between the VBD group and non-VBD group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that after adjus-ting the potential confounding factors,age(OR=1.126,95％CI:1.065-1.191,P=0.000),male(OR=4.163,95％CI:11.173-10.120,P=0.002),and RC level(OR=1.270,95％CI:1.151-1.401,P=0.000)were independent risk factors for VBD in elderly ACI patients.Conclusion Age,male and RC level are independent risk factors for VBD in elderly ACI patients.High RC lev-el may increase the risk of VBD.