[Objective] To explore the incidence and risk factors of blood transfusion undergoing total knee revision (TKR) using a nationwide database. [Methods] A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2015 to 2019 with complete information. Patients under 18 years old and those using anticoagulants, antiplatelets, antithrombotic and non-steroidal were excluded. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics, length of stay (LOS), total charge of hospitalization, hospital characteristics, hospital mortality, comorbidities and perioperative complications by Wilcoxon rank test for continuous data and chi-square test for categorical data. Logistic regression was performed to identify risk factors of blood transfusion undergoing TKR. [Results] The NIS database included 63 359 patients who underwent TKR. Among them, 5 271 patients received blood transfusion, with an incidence of blood transfusion of 7.8%. There was a decrease in the incidence over the years from 2015 to 2019, dropping from 10.2% to 6.5%. TKR patients requiring transfusions had experienced longer LOS, incurred higher total medical expenses, utilized Medicare more frequently, and had increased in-hospital mortality rates (all P<0.001). Independent risk factors for blood transfusion included female gender, iron-deficiency anemia, rheumatoid disease, collagen vascular disease, chronic blood loss anemia, congestive heart failure, coagulopathy, diabetes with chronic complications, lymphoma, fluid and electrolyte disorders, peripheral vascular disorders, renal failure, valvular disease and weight loss (malnutrition). In addition, risk factors for transfusion in TKR surgery included sepsis, acute myocardial infarction, deep vein thrombosis, gastrointestinal bleeding, heart failure, pneumonia, urinary tract infection, acute renal failure, postoperative delirium, wound infection, lower limb nerve injury, hemorrhage, seroma, hematoma, wound rupture and non healing. [Conclusion] Our findings highlight the importance of recognizing the risk factors of blood transfusion in TKR and establishing corresponding clinical pathways and intervention measures to reduce the occurrence of adverse events.

Objective To investigate the status and developmental trends of clinical trials for weight control drugs in China,and to provide data support for sponsors,researchers,and regulatory authorities.Methods The drug clinical trial registration and information platform of the National Medical Products Administration was utilized to search for registered clinical trials of weight control drugs from November 2012 to June 2024.The search employed"overweight","obesity",and"weight loss"as keywords.The information collected included project registration time,drug name,dosage form,drug classification,indications,trial staging,study progress,design type,lead unit,and sponsor.Microsoft Office Excel software was employed for data entry,organization,and extraction.Results A total of 95 registered clinical trials of weight control drugs were identified,comprising 40 domestic multicenter trials,47 domestic single-center trials,and 8 international multicenter trials.Regarding trial phasing,46(48.4％)were phase Ⅰ clinical trials,17(17.9％)were phase Ⅱ clinical trials,19(20.0％)were phase Ⅲ clinical trials,and 13(13.7％)were bioequivalence trials.The drug categorization encompassed 22 chemical drugs,20 biological products,and 1 traditional Chinese medicine/natural drug.Concerning drug dosage forms,there were 32 items of injectable dosage forms,8 items of tablets,2 items of capsules,and 1 item of chewable tablets.Conclusions Registered clinical trials for weight-loss medications in China are predominantly concentrated in regions with developed medical resources.Injectable biologics constitute most test drugs,with most drugs in the early stages of research and development.The examination of the safety and efficacy of these drugs remains to be substantiated,and it is anticipated that a considerable period will elapse before their approval and market introduction.

Cerebral ischemia/reperfusion injury(CIRI)is a pathophysiological process affecting the prognosis of patients with acute ischemic stroke(AIS).Its mechanism is complex and remains unclear.Long non-coding RNA(LncRNA)are a class of non-coding RNA(ncRNA).Early studies of LncRNA focused on their relationship with tumor-related diseases,but recent studies have found that they are also closely related to the pathological process of CIRI.LncRNA participate in the damage and repair processes of CIRI by affecting oxidative stress,autophagy,and apoptosis of the nervous system,as well as the inflammatory response and other mechanisms.They can regulate the progression of CIRI in a positive or negative way,and they play an important role in the related signaling pathways.This review focuses on the mechanisms bv which LncRNA regulate CIRI.

Cerebral ischemia/reperfusion injury(CIRI)is a pathophysiological process affecting the prognosis of patients with acute ischemic stroke(AIS).Its mechanism is complex and remains unclear.Long non-coding RNA(LncRNA)are a class of non-coding RNA(ncRNA).Early studies of LncRNA focused on their relationship with tumor-related diseases,but recent studies have found that they are also closely related to the pathological process of CIRI.LncRNA participate in the damage and repair processes of CIRI by affecting oxidative stress,autophagy,and apoptosis of the nervous system,as well as the inflammatory response and other mechanisms.They can regulate the progression of CIRI in a positive or negative way,and they play an important role in the related signaling pathways.This review focuses on the mechanisms bv which LncRNA regulate CIRI.

Objective To investigate the status and developmental trends of clinical trials for weight control drugs in China,and to provide data support for sponsors,researchers,and regulatory authorities.Methods The drug clinical trial registration and information platform of the National Medical Products Administration was utilized to search for registered clinical trials of weight control drugs from November 2012 to June 2024.The search employed"overweight","obesity",and"weight loss"as keywords.The information collected included project registration time,drug name,dosage form,drug classification,indications,trial staging,study progress,design type,lead unit,and sponsor.Microsoft Office Excel software was employed for data entry,organization,and extraction.Results A total of 95 registered clinical trials of weight control drugs were identified,comprising 40 domestic multicenter trials,47 domestic single-center trials,and 8 international multicenter trials.Regarding trial phasing,46(48.4％)were phase Ⅰ clinical trials,17(17.9％)were phase Ⅱ clinical trials,19(20.0％)were phase Ⅲ clinical trials,and 13(13.7％)were bioequivalence trials.The drug categorization encompassed 22 chemical drugs,20 biological products,and 1 traditional Chinese medicine/natural drug.Concerning drug dosage forms,there were 32 items of injectable dosage forms,8 items of tablets,2 items of capsules,and 1 item of chewable tablets.Conclusions Registered clinical trials for weight-loss medications in China are predominantly concentrated in regions with developed medical resources.Injectable biologics constitute most test drugs,with most drugs in the early stages of research and development.The examination of the safety and efficacy of these drugs remains to be substantiated,and it is anticipated that a considerable period will elapse before their approval and market introduction.

Objective To standardize the management of clinical trials in our hospital,reduce the incidence of protocol deviations,and provide a reference for improving the quality of clinical trials.Methods The healthcare failure mode and effect analysis(HFMEA)method was used to determine the potential failure modes of the current protocol deviation.The frequency,severity and detectability of failure modes were quantified and evaluated.The risk priority number(RPN)was calculated and the corresponding improvement measures were proposed.The RPN values before and after the implementation of HFMEA were statistically analyzed to evaluate the improvement effect.Results After the implementation of HFMEA activities,the RPN values of 14 potential failure modes decreased significantly(P<0.05);The risk level of 12 potential failure modes decreased.The HFMEA team members'ability in finding and solving problems,communication and cooperation were significantly improved.Conclusions The implementation of HFMEA activities contributes to the management of protocol deviation in clinical trials,can effectively reduce the occurrence of protocol deviation,and provides experience for improving the quality of drug clinical trials.

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.

Emerging research suggests a potential association of progression of Alzheimer's disease(AD)with al-terations in synaptic currents and mitochondrial dynamics.However,the specific associations between these pathological changes remain unclear.In this study,we utilized Aβ42-induced AD rats and primary neural cells as in vivo and in vitro models.The investigations included behavioural tests,brain magnetic resonance imaging(MRI),liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)analysis,Nissl staining,thioflavin-S staining,enzyme-linked immunosorbent assay,Golgi-Cox staining,trans-mission electron microscopy(TEM),immunofluorescence staining,proteomics,adenosine triphosphate(ATP)detection,mitochondrial membrane potential(MMP)and reactive oxygen species(ROS)assess-ment,mitochondrial morphology analysis,electrophysiological studies,Western blotting,and molecular docking.The results revealed changes in synaptic currents,mitophagy,and mitochondrial dynamics in the AD models.Remarkably,intervention with Dengzhan Shengmai(DZSM)capsules emerged as a pivotal element in this investigation.Aβ42-induced synaptic dysfunction was significantly mitigated by DZSM intervention,which notably amplified the frequency and amplitude of synaptic transmission.The cognitive impairment observed in AD rats was ameliorated and accompanied by robust protection against structural damage in key brain regions,including the hippocampal CA3,primary cingular cortex,prelimbic system,and dysgranular insular cortex.DZSM intervention led to increased IDE levels,augmented long-term potential(LTP)amplitude,and enhanced dendritic spine density and length.Moreover,DZSM intervention led to favourable changes in mitochondrial parameters,including ROS expression,MMP and ATP contents,and mitochondrial morphology.In conclusion,our findings delved into the realm of altered synaptic currents,mitophagy,and mitochondrial dynamics in AD,concurrently highlighting the therapeutic potential of DZSM intervention.

Objective To investigate the effects of acute sleep deprivation on the behavior and synaptic protein expression of rats.Methods Seventy healthy male Wistar rats were randomly divided into seven groups,a Control group and sleep deprivation groups(24,48,72,96,120 and 144 hours).The sleep deprivation rat model was established by the modified multiplatform water environment sleep deprivation method.Spatial learning and memory were assessed by the Morris water maze.Anxiety was assessed by the open field test.The morphology and quantity of hippocampal neurons were observed by Nissl staining.Western blot and Real-time PCR were used to determine the expression of synaptophysin(SYN),post-synaptic density protein-95(PSD-95),and brain-derived neurotrophic factor(BDNF)in rats.Results Compared with the Control group,the numbers of standing and modification were significantly increased by prolongation of the sleep deprivation time(P＜0.05).The escape latency and path length were significantly increased in 120 and 144 h groups(P＜0.05),whereas the number of platform crossings and the percentage of the target quadrant time were significantly decreased(P＜0.01)and negatively correlated to the sleep deprivation time.The expression levels of BDNF,SYN,and PSD-95 were significantly decreased with the prolongation of sleep deprivation time(P＜0.01).Conclusions With the increase in sleep deprivation time,cognitive dysfunction and anxiety gradually deteriorated,which may be related to decreases in the expression of synaptic biomarkers.

Objective To investigate the current situation of preoperative nursing trust in total knee replacement patients and analyze the influencing factors.Methods Using convenience sampling method,138 patients who underwent total knee ar-throplasty in our department from October 2020 to September 2021 were selected as the research objects.The patients were inves-tigated by general information questionnaire,nurse-patient relationship trust scale(NPTs),self-rating Anxiety Scale(SAS)and knee American Special Surgery scale(HSS),to explore the current situation and influencing factors of patient-nurse trust in pa-tients undergoing total knee arthroplasty.Results The total score of preoperative trust of patients(136.75±7.93);Pearson correlation analysis showed a negative correlation with total anxiety score(r =-0.419,P＜0.01)and no correlation with knee function score(r=0.063,P＞0.05).The results of the multiple linear regression analysis showed that the educational level,previous experience of hospitalization,and preoperative anxiety entered the regression equation(P＜0.05)explained 66.9% of the total variation.Conclusion In this group,the trust between nurses and patients in patients undergoing total knee arthroplas-ty is at the upper middle level,and is affected by education level,previous hospitalization experience and preoperative anxiety.Nurses should focus on patients with low education level,no previous hospitalization experience and high anxiety level,and carry out targeted intervention for theme,so as to reduce postoperative anxiety and improve postoperative function,Promote doctor-pa-tient relationship,reduce medical disputes and help patients recover as soon as possible.