OBJECTIVE To summarize the current status of position training for clinical pharmacists in China and provide references for the continuous optimization of such training programs. METHODS SinoMed， CNKI，VIP and Wanfang Data were electronically searched to collect position training of clinical pharmacists studies from the inception until November 5th 2024. After data extraction and quality evaluation， descriptive analysis was performed on the results of the included studies. RESULTS & A total of 68 pieces of relevant literature were included in the study. Among them， 50 studies reported on training content， 49 involved the allocation of teaching resources in the bases， 48 addressed training methods， and 39 focused on training evaluation； only 2 studies mentioned faculty development. There were notable variations in the clinical pharmacist training programs across different bases， particularly in the allocation of teaching resources， such as the composition of the teaching team and the utilization of auxiliary teaching tools. Additionally， differences existed in training approaches， such as those employing a single method versus a blended approach. Conversely， the core training content of each base generally revolved around clinical pharmacy practice， demonstrating a degree of consistency. Moreover， the overall emphasis on teacher training and assessment tended to be obviously insufficient. Each base can focus on enhancing the competence of clinical pharmacists by allocating teaching resources， selecting training methods， improving training content， and using evaluation tools， to further enhance the quality of clinical pharmacist training.

AIM: To quantify early changes of macular capillary parameters in type 2 diabetic patients using optical coherence tomography angiography(OCTA).METHODS: Retrospective case study. A total of 49 healthy subjects, 52 diabetic patients without retinopathy(noDR)patients, and 43 mild nonproliferative diabetic retinopathy(mNPDR)patients were recruited. Capillary perfusion density, vessel length density(VLD), and average vessel diameter(AVD)were calculated from macular OCTA images(3 mm×3 mm)of the superficial capillary plexus after segmenting large vessels and the deep capillary plexus. Parameters were compared among control subjects, noDR, and mNPDR patients. The area under the receiver operating characteristic curve estimated the abilities of these parameters to detect early changes of retinal microvascular networks.RESULTS: Significant differences were found in the VLD and AVD among the three groups(P<0.001). Compared with the control group, the noDR group had significantly higher AVD(P<0.05). VLD of both layers in patients of mNPDR group was significant decreased compared with that of noDR group(all P<0.01). Deep AVD had a higher area under the curve(AUC)of 0.796 than other parameters to discriminate the noDR group from the healthy group. Deep AVD had the highest AUC of 0.920, followed by that of the deep VLD(AUC=0.899)to discriminate the mNPDR group from the healthy group.CONCLUSIONS: NoDR patients had wider AVD than healthy individuals and longer VLD than mNPDR patients in both layers. When compared with healthy individuals, deep AVD had a stronger ability than other parameters to detect early retinal capillary impairments in noDR patients.

With the development of digital technology， an increasing number of artificial intelligence （AI） technologies are being applied in the field of public health， significantly improving the efficiency of healthcare systems. However， such technological advancement also introduces a series of ethical risks. In this article， we conducted a systematic review by searching nine domestic and international databases and analyzing the ethical issues related to AI in public health， ultimately including 158 articles. Based on the analysis of the included literature， ethical risks were categorized into four aspects： data， algorithms， rights and responsibilities， and social impact. A total of 15 key issues were identified， among which privacy and confidentiality， informed consent， data security， and fairness， justice and inclusion emerged as the most prominent issues. The ethical challenges posed by AI in the field of public health cannot be ignored， and it is necessary to formulate ethical guidelines and practical recommendations for AI in this field， establish sound regulatory and review mechanisms， thereby ensuring the healthy development of AI research in public health.

Objective:To evaluate the effect of tumor volume on the radiation dose and efficacy of locally advanced cervical cancer patients undergoing radical radiotherapy and chemotherapy.Methods:Clinical data of 126 patients who were diagnosed with cervical cancer (stage ⅡB-ⅣA) and underwent radical concurrent chemoradiotherapy in Guangxi Medical University Cancer Hospital from November 2019 to November 2022 were retrospectively analyzed. The cut-off values of tumor volume before (pre-TV) and after (post-TV) external radiotherapy and tumor volume reduction rate (TVRR) were calculated by Jamovi software. The effects of pre-TV, post-TV and TVRR on short-term efficacy, progression-free survival (PFS), brachytherapy (BT) mode , high-risk clinical target volume (HR-CTV) and organs at risk (OAR) dose were investigated by univariate and multivariate analyses.Results:Pre-TV≥67.03 cm 3 and post-TV≥14.88 cm 3 were poor prognostic factors for 6-month PFS and objective response rate (ORR) (both P<0.05), and post-TV was an independent prognostic factor. In the TVRR≥73.0% and <73.0% groups, no statistical differences were observed in the 6-month PFS and ORR. In the pre-TV≥67.03 cm 3 group, the cases number of intracavitary brachytherapy (ICBT) and intracavitary / interstitial brachytherapy (IC/IS-BT) was 36 (50.0%), while in the pre-TV<67.03 cm 3 group, the cases number of ICBT and IC/IS-BT was 41 (76%) and 13 (24%), respectively ( P=0.003). In the post-TV≥14.88 cm3 group, the cases number of ICBT and IC/IS-BT was 28 (47%) and 32 (53%), while 49 (72%) and 17 (26%) in the post-TV<14.88 cm3 group, respectively ( P=0.002). The dose of HR-CTV D 90% in the TVRR≥73.0% group was significantly higher than that in the TVRR<73.0% group ( P=0.014), but there was no significant difference in the dose of bladder D 2 cm3, rectal D 2 cm3 and small intestine D 2 cm3 (all P>0.05). The dose of HR-CTV D 90% in the post-TV<14.88 cm 3 group was significantly higher than that in post-TV≥14.88 cm 3 group ( P<0.001), and the dose of bladder D 2 cm3 in the post-TV≥14.88 cm 3 group was higher than that in the post-TV<14.88 cm 3 group ( P<0.05). There was no significant difference in the dose of rectal D 2 cm3 and small intestinal D 2 cm3 between two groups (both P>0.05). The number of concurrent chemotherapy (≥4 times vs.<4 times) had no statistical difference for 6-month PFS and TVRR. Conclusions:Pre-TV and post-TV are the influencing factors of short-term efficacy and BT mode selection for locally advanced cervical cancer. Post-TV is an independent prognostic factor and also indirectly affects the dose of HR-CTV D 90% and bladder D 2 cm3 Increasing the number of concurrent chemotherapy (≥4 times) does not improve TVRR and short-term efficacy.

Objective To investigate the epidemiological characteristics and diagnosis of imported Plasmodium malariae and P. ovale malaria cases in Anhui Province, Hubei Province, Zhejiang Province, Guangxi Zhuang Autonomous Region and Henan Province from 2014 to 2021, so as to provide insights into malaria control in these five provinces. Methods All data pertaining to malaria cases reported in five provinces of China were captured from Chinese Disease Control and Prevention Information System from 2014 to 2021, and the epidemiological characteristics of imported P. malariae and P. ovale malaria cases were analysed using a descriptive epidemiological method. The duration from onset of malaria to initial diagnosis, duration from initial diagnosis to definitive diagnosis, institutions of initial and definitive diagnoses, and proportion of correct malaria diagnosis at initial diagnosis were statistically analyzed. Results A total of 1 223 imported P. malariae and P. ovale malaria cases were reported in Anhui Province, Hubei Province, Zhejiang Province, Henan Province and Guangxi Zhuang Autonomous Region from 2014 to 2021, there were 158 P. malariae malaria cases (12.92%) and 1 065 P. ovale malaria cases (87.08%). Totally 98.53% (1 205/1 223) of the imported malaria cases were from Africa, with Angola (18.99%, 30/158), Nigeria (11.39%,18/158), Cameroon (10.76%, 17/158), Ghana (10.13%, 16/158) and the Democratic Republic of the Congo (10.13%,16/158) as predominant countries where P. malariae malaria cases were from, and Ghana (23.19%, 247/1 065), Cameroon (14.74%, 157/1 065), Nigeria (9.39%, 100/1 065) and Angola (6.95%, 74/1 065) as predominant countries where P. ovale malaria cases were from. There were significant differences in the duration from onset of malaria to initial diagnosis (χ² = 27.673, P = 0.000) and duration from initial diagnosis to definitive diagnosis of P. malariae and P. ovale malaria cases (χ² = 29.808, P = 0.000), and the proportions of correct initial diagnosis of P. malariae and P. ovale malaria cases were 38.61% (61/158) and 56.53% (602/1 065). There were 74.69% (118/158) of P. malariae malaria cases with definitive diagnosis in county-, city-, and province-level medical institutions, and 79.25% (844/1 065) of P. ovale malaria cases with definitive diagnosis in county- and city-level medical institutions and county-level centers for disease control and prevention. Conclusions The imported P. malariae and P. ovale malaria cases in Anhui Province, Hubei Province, Zhejiang Province, Henan Province and Guangxi Zhuang Autonomous Region from 2014 to 2021 were mainly returned from Africa and the proportion of correct diagnosis of P. malariae and P. ovale malaria was low at initial diagnosis. Persistent improvements in the diagnostic capability of malaria are required in medical institutions.

Objective:To explore the application effect of lower limb strength training based on "Internet +" in the home rehabilitation of knee osteoarthritis (KOA) patients.Methods:Using the convenient sampling method, a total of 80 KOA patients who visited Pain Outpatient Department of Beijing Friendship Hospital, Capital Medical University from May 2021 to December 2022 were selected. They were randomly divided into the observation group and the control group by the random number table method, with 40 cases in each group. The control group adopted routine home rehabilitation nursing, and the observation group implemented lower limb strength training based on "Internet +" on the basis of the control group. Both groups were intervened for 3 months, and the knee joint pain degree (VAS score), knee joint function (KOOS score) and exercise compliance of the two groups were compared.Results:After intervention, the VAS score of the observation group was lower than that of the control group and the KOOS score was higher than that of the control group, and the differences were statistically significant ( P<0.05). There were 26 cases of high compliance, 11 cases of partial compliance and 3 cases of low compliance in the observation group, and 19, 10 and 11 cases in the control group, respectively. The exercise compliance of the observation group was better than that of the control group, and the difference was statistically significant ( Z=1.997, P=0.046) . Conclusions:The implementation of lower limb strength training rehabilitation management based on "Internet +" can effectively alleviate knee pain in knee osteoarthritis patients, improve knee function, and improve their compliance with home exercise.

Abstract Flood disasters are the common public health emergencies, mainly leading to environmental damage, water pollution, food pollution, vector breeding, infectious disease epidemic and other risk factors of sanitary and anti epidemic work. The guideline has been formulated with reference to the technical documents such as Guideline for Environmental Sanitation Disposal and Preventive Disinfection in Flooded Areas and Technical Proposal for Sanitary and Anti epidemic Measures after Flood Disasters, as well as the latest research progress at home and abroad. In order to guide the sanitary and anti epidemic measures in flooded areas, protect the health and safety of students and teachers and ensure the normal educational and teaching order, the guideline introduces the key measures that should be taken by schools, teachers and students in flood striken areas.

Objective:To compare the effects of concentrated growth factors (CGF) and lower-level laser therapy (LLLT) on alveolar bone changes at the extraction site in orthodontic patients.Methods:Twenty-one patients who underwent orthodontic treatment at the Department of Stomatology, Tianjin Beichen Hospital, from June 2020 to May 2022 were enrolled and randomly divided into the control group, LLLT group, and CGF group, with 7 patients in each group and 28 extraction sites. The control group received natural healing with tooth extraction (minimally invasive healing with tooth extraction). The LLLT group received diode laser treatment on the 1st, 2nd, and 7th days after minimally invasive tooth extraction (wavelength 808 nm, average output power 0.25 W, energy density 4 J/cm 2, spot area 0.28 cm 2), with each site irradiated for 20 seconds. After minimally invasive tooth extraction in the CGF group, immediately place the CGF membrane in the extraction socket. The changes in alveolar bone height and width before and after tooth extraction and bone density and bone contour after alveolar bone healing were measured. Meanwhile, the concentration changes of growth factors osteopontin (OPN) and transforming growth factor-β1 (TGF-β1) in gingival crevicular fluid at tooth extraction were measured and statistically analyzed. Results:Compared with the control group, the height and width of the alveolar bone at the tooth extraction wound in the LLLT group and CGF group decreased significantly (all P < 0.05). Compared with the LLLT group, the height and width of the alveolar bone at the tooth extraction wound in the CGF group decreased, and the differences were statistically significant (all P < 0.05). The bone contour score and bone density grading of the LLLT and CGF groups after tooth extraction wound healing were better than those of the control group (all P < 0.05). There was no statistically significant difference in bone contour score and bone density grading between the LLLT group and the CGF group after tooth extraction wound healing ( P > 0.05). At 1 and 6 months after tooth extraction, there was no statistically significant difference in the concentration of OPN in the gingival crevicular fluid at the extraction site among the control group, LLLT group, and CGF group (all P > 0.05). One month after tooth extraction, compared with the control group, the concentration of TGF-β1 in the gingival crevicular fluid of the tooth extraction wound increased in the LLLT group and the CGF group, and the differences were statistically significant (all P < 0.05). Six months after tooth extraction, there was no statistically significant difference in TGF-β1 concentration among the three groups (all P > 0.05). Conclusions:Both LLLT and CGF treatments can effectively reduce the height and width of alveolar bone in tooth extraction wounds, promote the recovery of alveolar bone contour and bone density in tooth extraction wounds and provide clinical data support for how to delay the atrophy of alveolar bone in tooth extraction wounds.

In view of the high incidence of malignant diseases such as malignant arrhythmias in the elderly population, accidental injuries such as falls, and the problem of no witnesses when danger occurs, the study developed a human vital signs and body posture monitoring and positioning alarm system. Through the collection and analysis of electrocardiogram (ECG), respiration (RESP) and acceleration (ACC) signals, the system monitors human vital signs and body posture in real time, automatically judges critical states such as malignant arrhythmias and accidental falls on the local device side, and then issues alarm information, opens the positioning function, and uploads physiological information and patient location information through 4G communication. Experiments have shown that the system can accurately determine the occurrence of ventricular fibrillation and falls, and issue position and alarm information.
Humans ; Aged ; Arrhythmias, Cardiac/diagnosis* ; Ventricular Fibrillation ; Electrocardiography ; Accidental Falls ; Vital Signs ; Posture ; Monitoring, Physiologic

Objective:The aim of the present study was to observe the effects of liralutide on body composition and muscle function in adult obese patients with type 2 diabetes.Method:A total of 63 adult obese type 2 diabetic patients who were (52.6±9.7) years of age and with body mass index (BMI) of ≥28 kg/m 2 were enrolled. The patients were randomly assigned into two groups. On the basis of maintaining the original hypoglycemic regimen, patients in the control group ( n=24) were given dietary guidance only, and those in the treatment group ( n=39) were injected with liraglutide. All patients were followed up for a period of 12 weeks. Blood glucose, glycosylated hemoglobin(HbA1c) and insulin levels, liver and kidney function, body composition assessed with electrical impedance methods, and grip strength measured by a grip meter for muscle function were detected at the baseline and the end of the study. Results:Compared with those in the control group, the reductions in HbA1c [(-1.54±2.10) % vs.(-0.53±0.84) %], body weight [(-3.46±4.2) kg vs.(-0.34±3.66) kg], body fat mass [(-1.97±2.98) kg vs.(-0.01±2.16) kg] and visceral fat area [(-0.01±2.16) cm 2 vs.(0.34±6.39) cm 2] were more pronouced in liraglutide treated group (all P<0.05). However, no changes could be observed in muscle mass and grip strength after liraglutide treatment. Conclusions:In addition to reducing blood glucose, body weight and fat mass, treatment with lilaluptide had no impact on muscle mass and muscle function. Therefore, liralutide is suitable for obese patients with type 2 diabetes, especially for weight management patients who are at risk of muscle loss.