Objective: To explore the mediating effect of self-efficacy for exercise on social support and kinesiophobia in patients with rheumatoid arthritis (RA), so as to provide insights into alleviating fear for exercise and formulating exercise intervention programs. Methods: RA patients hospitalized in a tertiary hospital in Harbin City from June to December 2023 were selected, and the levels of kinesiophobia, self-efficacy for exercise and social support were investigated using the Tampa Scale of Kinesiophobia (Chinese version), the Self-Efficacy for Exercise and the Social Support Rating Scale, respectively. The mediating effect of self-efficacy for exercise on social support and kinesiophobia was examined using a structural equation model. Results: A total of 216 people were investigated, including 45 males (20.83%) and 171 females (79.17%), with the median age of 54.00 (interquartile range, 13.75) years. There were 159 of patients living in the urban areas, accounting for 73.61%. There were 102 of patients with a disease course of 1 to 5 years, accounting for 47.22%. The median scores of kinesiophobia, self-efficacy for exercise and social support were 31.00 (interquartile range, 5.00), 5.00 (interquartile range, 2.00) and 39.50 (interquartile range, 17.00), respectively. Social support had a direct negative effect on kinesiophobia (effect value=-0.358, P<0.05) and a indirect negative effect on kinesiophobia through self-efficacy for exercise (effect value=-0.887, P<0.05), and the mediating effect contributed 93.86% to the total effect. Conclusion Social support can directly or indirectly influence kinesiophobia through self-efficacy for exercise among patients with RA.

Pharmaceutical excipients, as an indispensable part of drug preparation, play crucial roles as drug carriers, improving drug release, ensuring drug stability, and enhancing patient compliance. Traditional Chinese Medicine (TCM) boasts a rich developmental history. With the modernization of technology, the deep integration of pharmacy, chemistry, and materials science has provided broader opportunities for innovative research in TCM. Simultaneously, the demand for high-quality excipients has become increasingly critical.This paper aims to review current research and applications of excipients in TCM preparations, including pre-mixed and co-processed excipients, modified excipients, and the unification of drugs and excipients, such as flavoring agents, fillers, penetration enhancers, and delivery systems. A meticulous synthesis and analysis of existing research aims to provide a reference for selecting excipients in TCM preparations, stimulate innovation in excipient development for TCM, and advocate for the development of personalized excipients.

OBJECTIVE To study the unknown impurity in potassium aspartate and magnesium aspartate injection by heart-cutting two-dimensional liquid chromatography coupled with Quadrupole time-of-flight mass spectrometry (2D-LC-Q-TOF-MS). METHODS The Waters ACQUITY UPLC 2D system and Xevo G2-XS QTof-MS system were used. One- dimensional chromatographic conditions were as listed. An Agilent ZORBAX-NH2 column was used, and potassium dihydrogen thophosphate(0.05 mol·L-1)-acetonitrile(37∶63) as the mobile phase, at a flow rate of 1.3 mL·min-1. The detection wavelength was set at 200 nm. Two-dimensional chromatographic conditions were as listed. A Waters ACQUITY UPLC HSS T3 column was used, and 0.1% formic acid solution(ESI+)/5 mmol·L-1 ammonium formate(ESI-) as the mobile phase A, and acetonitrile as the mobile phase B, in gradient mode. The mass spectrometry used an electro spray ionization source(ESI) for positive and negative ion mode detection. RESULTS Combined the high resolution mass, MS2 fragment ions and the UNIFI software, the possible structure of the unknown impurity in potassium aspartate and magnesium aspartate injection was infered. CONCLUSION The 2D-LC-Q-TOF-MS method can be used to identify impurities in potassium aspartate and magnesium aspartate injection, which provides reference for the improvement of quality control and process optimization of potassium aspartate and magnesium aspartate injection.

OBJECTIVE To establish a method for the determination of fourteen fluorescent whitening agents in cosmetics by HPLC-MS/MS. METHODS Samples were extracted on a Waters ACQUITY UPLC ®BEH C18(2.1 mm×50 mm, 1.7 μm) column after ultrasonic extracted by DMF with the mobile phase consisted of methanol-0.1% ammonia water solution by gradient elution. The flow rate was 0.3 mL·min-1. The column temperature was 40 ℃. MS was performed using triple quadrupole mass spectrometry. Electrospray ionization source was operated in the positive/negative mode using multiple reaction monitoring scanning mode. RESULTS The results showed that there were good linear relationships for the fluorescent whitening agents in a certain concentration range with correlation coefficients(r) greater than 0.99. The limits of quantification were 0.01-20 μg·g-1 and the limits of detection were 0.004-8 μg·g-1. The average recoveries at three spiked levels were in the range of 85.4%-108.9%, and the relative standard deviation were in the range of 0.3%-7.2%. CONCLUSION The method has high sensitivity, strong specificity, simple and convenient operation, and is suitable for the detection of fourteen fluorescent whitening agents in cosmetics.

【Objective】 To analyze the RBC products returned by hospitals due to positive direct antiglobulin test (DAT), and explore measures to reduce the discarding rate of blood products and ensure the safety of clinical blood use. 【Methods】 The data of RBC products, which were returned by hospitals due to positive-DAT, in Hebei Blood Center from 2018 to 2020 were retrospectively analyzed. The donation time, hospital, gender of blood donors, donation times and DAT typing results were searched through blood donation code, input into the statistical software SPSS17.0, and analyzed by linear trend χ² and Pearsonχ². 【Results】 1)The discarding rate of RBC products due to positive DAT in 2018, 2019 and 2020 accounted for 0.15‰, 0.32‰ and 0.26‰, respectively, of the overall RBC collection. The total concordance rate was 89.94% by our retest. 2)The concordance rate of returned blood from secondary hospitals and tertiary hospitals was 78.26% and 91.78%, respectively (P<0.05), with the latter higher than the former. 3)No statistical significance was noticed in the DAT-positive blood by months(P>0.05). 4)The DAT-positive rate of female donors was higher than that of male donors, and that of first-time blood donors was higher than that of repeated and regular blood donors with statistical differences (P<0.05). 5)DAT-positive typing results was mainly due to IgG incomplete antibody. 【Conclusion】 In order to reduce the discarding rate of RBC products, it is suggested to strengthen the consultation before blood collection, encourage healthy males to donate blood and increase the proportion of regular blood donors. Meanwhile, the quality management of Transfusion Department in secondary hospitals should be further improved to ensure the safety of clinical blood transfusion.

Objective:To investigate the efficiency, safety and complication of 0.7 mg dexamethasone sustained release agent (Ozurdex ?) vitreous cavity implantation for macular edema secondary to vitrectomy. Methods:A total of 15 patients (16 eyes) were included in this retrospective case series study. There were 7 males (8 eyes) and 8 females (8 eyes). Age ranged from 47 to 72 years old with an average age of (60.2±8.6)years. Among them, 8 cases were diabetic retinopathy (6 cases combined cataract surgery). 4 cases were silicone oil removal after retinal detachment surgery (all combined cataract surgery). 2 cases were epi-macular membrane (all combined with cataract surgery) and 1 case was vitreous hemorrhage (combined with cataract surgery). Ozurdex ? was implanted for macular edema after vitrectomy. The number of implantation was from 1 to 3 times (mean 1.67 times). The follow-up time was from 3 to 12 months, with an average of (7.33±3.50)months. Results:The best corrected visual acuity (BCVA) was improved in 10 cases (11 eyes), unchanged in 4 cases and decreased in 1 case within 3 months after Ozurdex ? implantation in the 15 cases (16 eyes). The macular edema was significantly improved in all cases. The central macular thickness (CMT) measured by optical coherence tomography (OCT) was from 350 to 1 370 γm before surgery with average thickness (621.60±235.48)γm, and the CMT postoperative was 118 to 556 γm with average thickness (269.87±118.14)γm, with statistically significant difference ( P<0.001). Cataract was not progressive after Ozurdex ? implantation. Macular edema was recurrent in 7 cases after first implantation and stable for additional 1-2 injections. Intraocular pressure elevation occurred in 3 cases 1 to 2 months after implantation with the highest intraocular pressure of 36 mmHg, which were controlled by local anti-glaucoma eye drops. Drugs entered into the anterior chamber in 2 cases and was taken out in 1 case. Conclusions:The efficiency of Ozurdex ? vitreous cavity implantation is definite and the complications are controllable, so it is a safe and effective method to treat macular edema after vitrectomy.

Objective:To introduce our experience on dealing with the internal carotid artery (ICA) during the resection of lateral skull base tumors, and to explore the reference values for using radiological findings to make a rational surgical plan.Methods:A retrospective study of patients who underwent resection of lateral skull base tumors involving ICA at Peking Union Medical College Hospital from May 2015 to May 2021 was conducted. The demographic information, preoperative examinations, diagnosis, surgical details and follow-ups were collected. A total of 41 patients were enrolled [24 (58.5%] females, 17 (41.5%) males], with an average age of 47.9 years. According to the preoperative imaging findings, the relationships between the tumors and ICA were divided into four types: adjacency, compression, invasion and ICA aneurysm.Results:The ICA was preserved in 32 (78.0%, 32/41) cases and was reconstructed in nine (22.0%, 9/41) cases. All the 27 (65.9%, 27/41) tumors adjacent to ICA were successfully separated from the artery. Among the 11 tumors compressing the ICA, six were resected with the involved ICA segment and vascular reconstruction was conducted. One (2.4%, 1/41) tumor invading ICA and two (4.9%, 2/41) ICA aneurysms required revascularization. The mean follow-up time was (26.1±2.9) months. There was no recurrence, except one case of adenoid cystic carcinoma which had brain metastases one year after surgery.Conclusions:According to the preoperative imaging, lateral skull base tumors adjacent to ICA can be detached from the vascular surface. Separation should be attempted first for tumors compressing ICA, and revascularization should be followed if separation failed. Vascular reconstruction is usually needed in the removal of tumors invading ICA and ICA aneurysms. Preoperative radiology can provide good references for planning a surgery for lateral skull base tumors.

Malaria still threatens global health seriously today. While the current discoveries of antimalarials are almost totally focused on single mode-of-action inhibitors, multi-targeting inhibitors are highly desired to overcome the increasingly serious drug resistance. Here, we performed a structure-based drug design on mitochondrial respiratory chain of

Objective:To evaluate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with subanesthetic dose of ketamine on anxiety and depression in the patients with advanced cancer pain.Methods:Sixty patients of either gender with advanced cancer pain, aged 24-82 yr, with poor analgesic effect or obvious adverse reactions after three-step analgesic treatment, were selected and randomly divided into 2 groups ( n=30 each) using a random number table method: routine treatment group (group R) and dexmedetomidine mixed with ketamine group (group DK). The initial dose of morphine for PCIA was 1/3 of the oral dose in group R. In group DK, ketamine 5.4 mg/kg (90 μg·kg -1·h -1) and dexmedetomidine 6 μg/kg (0.1 μg·kg -1·h -1) were added on the basis of group R. Tropisetron 8 mg was added to analgesics and diluted to 200 ml with normal saline in both groups.The analgesic pump was programmed to deliver 4 ml with an initial dose of 4 ml, lockout interval of 15 min and background infusion at 4 ml/h.The numerical rating scale score, Ramsay sedation score, Chinese version of State-Trait Anxiety Inventory score and Beck Depression Inventory-Ⅱ score were recorded before PCIA and at 4, 12, 24 and 48 h of PCIA.The development of effective analgesia and satisfactory sedation, occurrence and degree of depression, score for patient's quality of life and satisfaction score, consumption of morphine and adverse reactions such as constipation, nausea and vomiting, agitation and respiratory depression were recorded within 48 h of PCIA. Results:Compared with group R, the NRS score was significantly decreased, the rate of effective analgesia was increased, Beck Depression Inventory-Ⅱscore and Chinese version of State-Trait Anxiety Inventory score were decreased, the incidence and degree of depression were decreased, incidence of nausea and vomiting and constipation, consumption of morphine and pressing times of PCIA pump were decreased, and the score for patient's quality of life and satisfaction score were increased in group DK ( P<0.05). Conclusion:PCIA with dexmedetomidine mixed with subanesthetic dose of ketamine can significantly enhance the analgesic effect, improve anxiety and depression, and raise the quality of life when used for the patients with advanced cancer pain.

Objective:To investigate the value of nomogram predictive model established by the risk factors of upper extremity venous thrombosis risk associated with peripherally venous inserted central catheter (PICC) in cancer patients.Methods:A total of 1 032 patients who underwent PICC insertion between January 2016 and March 2017 in Zhejiang Cancer Hospital were selected by using prospective cohort study and convenience sampling. Risk factors of upper extremity venous thrombosis risk associated with PICC in cancer patients were evaluated by using Cox regression model. The nomogram predictive model of upper extremity venous thrombosis risk associated with PICC insertion was constructed. Bootstrap method was used to complete the inside check, and figure calibration was used to verify the nomogram.Results:A multivariate Cox regression analysis showed that trombosis history ( HR = 27.82, 95% CI 8.17-94.88, P < 0.01) and hyperlipidemia ( HR = 3.01, 95% CI 1.31-6.93, P = 0.009) were independent risk factors for upper extremity venous thrombosis associated with PICC. The nomogram model C-index was 0.71 (95% CI 0.63-0.80) based on the above risk factors, which indicated that the nomogram had a good differentiation. The calibration curve for predicting the probability of upper extremity venous thrombosis risk associated with PICC within one week, two weeks and one month deviated slightly from the standard curve, suggesting that the model might overestimate the risk of upper extremity venous thrombosis associated with PICC in cancer patients. Conclusions:The nomogram model has a good predictive value and strong operability, which can be used to predict the probability of upper extremity venous thrombosis associated with PICC in cancer patients after PICC insertion. It can provide a reference for identifying the high-risk cancer patients and formulating proper therapeutic strategies.