OBJECTIVE To explore the effects of narrative pharmacy management on medication compliance， negative emotions， and quality of life in patients with cardiovascular disease complicated with negative emotions. METHODS A total of 49 patients with drug use problems and negative emotions attending the cardiovascular pharmacy clinic of Wuhan First Hospital from February to August 2023 were selected as the study objects， narrative pharmacy model was applied for patient management during their visits； pharmaceutical care and emotional management were performed after 2 weeks of treatment and a follow-up visit was conducted to evaluate and record the management effect one month later. RESULTS Adopting a narrative pharmacy management model， 49 patients were involved in 114 drug related consultation questions. Compared with the visit， after one month of management， the number of medication types taken by patients significantly decreased [4.00 （2.00， 6.00） vs. 3.00 （1.50， 5.00）， P＜0.05]， the incidence of adverse reactions significantly decreased （32.65% vs. 2.04%， P＜0.001）， the rate of blood pressure and lipid compliance significantly increased （30.61% vs. 95.92%， P＜0.001）， and the score of the patient’s medication compliance significantly improved （[ 3.94±2.44） vs. （6.78±2.07）， P＜0.01]. The depression score significantly decreased [3.00 （2.00， 4.50） vs. 2.00 （0.00， 3.00）， P＜0.001]， the anxiety score significantly reduced [3.00 （2.00， 4.50） vs. 1.00 （0.00， 2.00）， P＜0.001]， quality of life score was significantly improved [22.00 （19.00， 22.00） vs. 23.00 （23.00， 24.50）， P＜0.01]. In the satisfaction survey， there was a slight increase in the overall satisfaction proportion （91.84% vs. 97.96%， P＞0.05）. CONCLUSIONS The application of narrative pharmacy in cardiovascular pharmacy clinic can improve patient compliance， reduce adverse drug reactions， enhance the effectiveness of drug treatment， avoid drug interactions， effectively improve the anxiety and depression， and ultimately improve the quality of life.

OBJECTIVE To investigate the role of clinical pharmacists in the treatment of a patient with Epstein-Barr （EB） virus encephalitis. METHODS Clinical pharmacist participated in drug diagnosis and therapy for a patient with EB virus encephalitis. According to the physiological characteristics of the disease and the pharmacokinetic-pharmacodynamic characteristics of antibiotics， clinical pharmacists suggested that the dose should be adjusted as ceftriaxone 2 g， q12 h+meropenem 2 g， q8 h. Based on the uncontrolled infection of the patient， pharmacists suggested that ceftriaxone should be stopped and vancomycin 1 million U and q12 h should be used as alternative therapy. According to the results of etiology， pharmacists suggested that acyclovir should be discontinued and replaced with ganciclovir 5 mg/kg， q12 h. The electrolyte disturbance of the patient may be adverse drug reactions caused by Mannitol injection， it was recommended to stop the drug. RESULTS The clinician followed the advice of the clinical pharmacists. After treatment， the patient improved and was discharged. CONCLUSIONS Clinical pharmacists can carry out pharmaceutical care for patients with EB virus encephalitis， assist physicians in optimizing the treatment plan of patients， and ensure the effectiveness and safety of drug treatment.

Background: Benzo(a)pyrene (BaP) is a carcinogenic compound in contaminated foodstuffs.The effect of oral intake of the environmental carcinogen BaP under low doses and frequent exposure on a digestive system has not been thoroughly verified. Methods: In this regard, this study was conducted to prove the toxicity effects of BaP on the stomach and colon tissue after exposure to C57BL/6 mouse (3 and 6 µg/kg) following daily oral administration for 60 days. This study investigated acute gastric mucosal injury, severe gastric edema, cell infiltration, and mononuclear cells, multifocal cells, and tumoral inflammatory cells. Results: The results of ELISA showed that the expression of serum interleukin (IL)-6 and tumor necrosis factor-α in the BaP exposure group were significantly increased, and a high level of DNA adduct distribution in their stomach and colon. Moreover, this study has confirmed the expression of early carcinogenesis markers: nuclear factor (NF)-κB, p53, IL-6, superoxide dismutase 1 (SOD1), mucin (MUC1 and MUC2), and β-catenin in the stomach and colon, and showed that there was a significant increase in IL-6, NF-κB, SOD1, β-catenin, and MUC1 (P< 0.05). At the same time, there was a significant decrease in MUC2 and p53 (P < 0.05). Thus, even in low doses, oral intake of BaP can induce DNA damage, increasing the potential risk of gastrointestinal cancer. Conclusion This study will provide a scientific basis for researching environmental contaminated food and intestinal health following daily oral administration of BaP.

Objective:To observe the effect of pressure therapy on the formation of hypertrophic scars(HTS) and transforming growth factor beta 1 (TGF-β1) / Sma and Mad homolog proteins (Smad) signaling pathway.Methods:Twelve adult healthy New Zealand white rabbits(provided by the Animal Experiment Center of the Air Force Military Medical University) were wounded with 1 cm round punch on 4 sites of the ventral side of each ear. Round scalpels were used to make incisions along the marked lines, dissect the skin and perichondrium. The remaining tissue was scraped off to expose the wound surface. Scar formation was observed on the 28th day after surgery. After the establishment of rabbit ear HTS models, the right ears were used as self-controls, while the left ears were set as the experimental group. Two hypertrophic scars were randomly selected from each rabbit ear, 24 per group. Experimental group: 4-0 nylon silk thread was used to sew the pressure pad on the circular NdFeB magnets pad with a diameter of 1.5 cm to the rabbit ear cartilage. Flexiforce pressure sensor was used to measure the pressure, and the pads were adjusted to maintain a pressure of 20-25 mmHg (1 mmHg=0.133 kPa) for more than 23 h per day. Control group: no treatment. On the 40th day of pressure therapy, the general morphology of rabbit ear scars were observed, and the tissues were harvested for hematoxylin and eosin (HE) staining and Masson’s Trichrome staining for histological study. The scar elevation index (SEI), the number of fibroblasts, and the thickness of the stratum corneum were calculated. The relative mRNA expression levels of TGF-β1, Smad3, collagen type (Collagen )Ⅰ, Collagen Ⅲ, α-smooth muscle actin (α-SMA) were measured with qPCR; Western blotting was used to detect the relative protein expression levels of TGF-β1, Collagen Ⅰ, Collagen Ⅲ, α-SMA and the phosphorylation level of Smad3 (the ratio of p-Smad3 and Smad3 proteins). Statistical analysis was performed with Excel 2019 and GraphPad Prism 8.0. The measurement data conformed to normal distribution and was expressed as Mean±SD. Student’s t-test was used for the comparison between two groups. P<0.05 was considered statistically significant. Results:A total of 96 wounds were formed in 12 rabbits, 27 wounds had no obvious hyperplasia, and the remaining 69 wounds formed hypertrophic scar tissue blocks with a prominent skin surface, firm texture, and dark red appearance. The scars formation rate was 71.9% (69/96). On the 40th day after the application of pressure, the scars in the experimental group were significantly reduced, softer, and the color was slightly lighter compared with the control group. The results of HE staining and Masson’s Trichrome staining showed that the thickness of the stratum corneum, SEI, and the number of fibroblasts were (69.33±6.03) μm, 1.30±0.08, and (236.30±14.64) cells/field, respectively, which were significantly lower than those in the control group [(114.00±10.15) μm, 1.72±0.05, (320.30±14.57) cells/field] (all P<0.01). Abundance in capillaries, inflammatory cells, and fibroblasts were not observed in the dermal layer. The collagen fibers were orderly arranged and sparse. The results of fluorescence quantitative PCR showed that the relative expression levels of TGF-β1, Smad3, Collagen Ⅰ, Collagen Ⅲ, and α-SMA mRNA in the experimental group were 0.48±0.08, 0.58±0.05, 0.04±0.01, 0.15±0.02, 0.31±0.03, respectively, lower than those of the control group(1.00±0.07, 1.00±0.05, 1.00±0.08, 1.00±0.10, 1.00±0.06) (all P<0.01). The results of Western blotting showed that the relative protein expression of TGF-β1, Collagen Ⅰ, Collagen Ⅲ, α-SMA and the phosphorylation level of Smad3 in the experimental group were 0.65±0.03, 0.07±0.01, 0.43±0.03, 0.53±0.03, 0.54±0.03, all lower than the control group’s 1.02±0.06, 0.93±0.05, 0.92±0.03, 0.82±0.03, 0.92±0.03 (all P<0.01). Conclusions:Pressure therapy can significantly inhibit the hyperplasia of scars, improve the structure of HTS tissue, facilitate the normal arrangement of collagen fiber, and reduce the excessive deposition of collagen. Pressure therapy may inhibit scar proliferation by regulating the TGF-β1/Smad signaling pathway.

Objective:To explore the effects of mechanical tension on the formation of hypertrophic scars in rabbit ears and transforming growth factor-β 1 (TGF-β 1)/Smad signaling pathway. Methods:The experimental research method was adopted. Six New Zealand white rabbits, male or female, aged 3-5 months were used and 5 full-thickness skin defect wounds were made on the ventral surface of each rabbit ear. The appearance of all rabbit ear wounds was observed on post surgery day (PSD) 0 (immediately), 7, 14, 21, and 28. On PSD 28, the scar formation rate was calculated. Three mature scars in the left ear of each rabbit were included in tension group and the arch was continuously expanded with a spiral expander. Three mature scars in the right ear of each rabbit were included in sham tension group and only the spiral expander was sutured without expansion. There were 18 scars in each group. After mechanical tension treatment (hereinafter referred to as treatment) for 40 days, the color and texture of scar tissue in the two groups were observed. On treatment day 40, the scar elevation index (SEI) was observed and calculated; the histology was observed after hematoxylin eosin staining, and the collagen morphology was observed after Masson staining; mRNA expressions of TGF-β 1, Smad3, collagen Ⅰ, collagen Ⅲ, and α-smooth muscle actin (α-SMA) in scar tissue were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction; and the protein expressions of TGF-β 1, collagen Ⅰ, collagen Ⅲ, and α-SMA, and phosphorylation level of Smad3 in scar tissue were detected by Western blotting. The number of samples of each group in the experiments was 3. Data were statistically analyzed with independent sample t test. Results:On PSD 0, 5 fresh wounds were formed on all the rabbit ears; on PSD 7, the wounds were scabbed; on PSD 14, most of the wounds were epithelialized; on PSD 21, all the wounds were epithelialized; on PSD 28, obvious hypertrophic scars were formed. The scar formation rate was 75% (45/60) on PSD 28. On treatment day 40, the scar tissue of rabbit ears in tension group was more prominent than that in sham tension group, the scar tissue was harder and the color was more ruddy; the SEI of the scar tissue of rabbit ears in tension group (2.02±0.08) was significantly higher than 1.70±0.08 in sham tension group ( t=5.07, P<0.01). On treatment day 40, compared with those in sham tension group, the stratum corneum of scar tissue became thicker, and a large number of new capillaries, inflammatory cells, and fibroblasts were observed in the dermis, and collagen was more disordered, with nodular or swirling distribution in the scar tissue of rabbit ears in tension group. On treatment day 40, the mRNA expressions of TGF-β 1, Smad3, collagen Ⅰ, collagen Ⅲ, and α-SMA in the scar tissue of rabbit ears in tension group were respectively 1.81±0.25, 5.71±0.82, 7.86±0.56, 4.35±0.28, and 5.89±0.47, which were significantly higher than 1.00±0.08, 1.00±0.12, 1.00±0.13, 1.00±0.14, and 1.00±0.14 in sham tension group (with t values of 5.36, 9.82, 20.60, 18.26, and 17.13, respectively, all P<0.01); the protein expressions of TGF-β 1, collagen Ⅰ, collagen Ⅲ, and α-SMA, and phosphorylation level of Smad3 in the scar tissue of rabbit ears in tension group were respectively 0.865±0.050, 0.895±0.042, 0.972±0.027, 1.012±0.057, and 0.968±0.087, which were significantly higher than 0.657±0.050, 0.271±0.029, 0.631±0.027, 0.418±0.023, and 0.511±0.035 in sham tension group (with t values of 5.08, 21.27, 15.55, 16.70, and 8.40, respectively, all P<0.01). Conclusions:Mechanical tension can inhibit the regression of hypertrophic scars in rabbit ears through stimulating the hyperplasia of scars, inhibiting the normal arrangement of dermal collagen fibers, and intensifying the deposition of collagen fibers, and the mechanism may be related to the activation of TGF-β 1/Smad signaling pathway by mechanical tension.

Objective:To observe the effect of pressure therapy on the formation of hypertrophic scars(HTS) and transforming growth factor beta 1 (TGF-β1) / Sma and Mad homolog proteins (Smad) signaling pathway.Methods:Twelve adult healthy New Zealand white rabbits(provided by the Animal Experiment Center of the Air Force Military Medical University) were wounded with 1 cm round punch on 4 sites of the ventral side of each ear. Round scalpels were used to make incisions along the marked lines, dissect the skin and perichondrium. The remaining tissue was scraped off to expose the wound surface. Scar formation was observed on the 28th day after surgery. After the establishment of rabbit ear HTS models, the right ears were used as self-controls, while the left ears were set as the experimental group. Two hypertrophic scars were randomly selected from each rabbit ear, 24 per group. Experimental group: 4-0 nylon silk thread was used to sew the pressure pad on the circular NdFeB magnets pad with a diameter of 1.5 cm to the rabbit ear cartilage. Flexiforce pressure sensor was used to measure the pressure, and the pads were adjusted to maintain a pressure of 20-25 mmHg (1 mmHg=0.133 kPa) for more than 23 h per day. Control group: no treatment. On the 40th day of pressure therapy, the general morphology of rabbit ear scars were observed, and the tissues were harvested for hematoxylin and eosin (HE) staining and Masson’s Trichrome staining for histological study. The scar elevation index (SEI), the number of fibroblasts, and the thickness of the stratum corneum were calculated. The relative mRNA expression levels of TGF-β1, Smad3, collagen type (Collagen )Ⅰ, Collagen Ⅲ, α-smooth muscle actin (α-SMA) were measured with qPCR; Western blotting was used to detect the relative protein expression levels of TGF-β1, Collagen Ⅰ, Collagen Ⅲ, α-SMA and the phosphorylation level of Smad3 (the ratio of p-Smad3 and Smad3 proteins). Statistical analysis was performed with Excel 2019 and GraphPad Prism 8.0. The measurement data conformed to normal distribution and was expressed as Mean±SD. Student’s t-test was used for the comparison between two groups. P<0.05 was considered statistically significant. Results:A total of 96 wounds were formed in 12 rabbits, 27 wounds had no obvious hyperplasia, and the remaining 69 wounds formed hypertrophic scar tissue blocks with a prominent skin surface, firm texture, and dark red appearance. The scars formation rate was 71.9% (69/96). On the 40th day after the application of pressure, the scars in the experimental group were significantly reduced, softer, and the color was slightly lighter compared with the control group. The results of HE staining and Masson’s Trichrome staining showed that the thickness of the stratum corneum, SEI, and the number of fibroblasts were (69.33±6.03) μm, 1.30±0.08, and (236.30±14.64) cells/field, respectively, which were significantly lower than those in the control group [(114.00±10.15) μm, 1.72±0.05, (320.30±14.57) cells/field] (all P<0.01). Abundance in capillaries, inflammatory cells, and fibroblasts were not observed in the dermal layer. The collagen fibers were orderly arranged and sparse. The results of fluorescence quantitative PCR showed that the relative expression levels of TGF-β1, Smad3, Collagen Ⅰ, Collagen Ⅲ, and α-SMA mRNA in the experimental group were 0.48±0.08, 0.58±0.05, 0.04±0.01, 0.15±0.02, 0.31±0.03, respectively, lower than those of the control group(1.00±0.07, 1.00±0.05, 1.00±0.08, 1.00±0.10, 1.00±0.06) (all P<0.01). The results of Western blotting showed that the relative protein expression of TGF-β1, Collagen Ⅰ, Collagen Ⅲ, α-SMA and the phosphorylation level of Smad3 in the experimental group were 0.65±0.03, 0.07±0.01, 0.43±0.03, 0.53±0.03, 0.54±0.03, all lower than the control group’s 1.02±0.06, 0.93±0.05, 0.92±0.03, 0.82±0.03, 0.92±0.03 (all P<0.01). Conclusions:Pressure therapy can significantly inhibit the hyperplasia of scars, improve the structure of HTS tissue, facilitate the normal arrangement of collagen fiber, and reduce the excessive deposition of collagen. Pressure therapy may inhibit scar proliferation by regulating the TGF-β1/Smad signaling pathway.

Objective:To summarize the anesthesia management of living small bowel transplantation.Methods:Severn patients undergoing living and allogeneic small bowel transplantation for the first time were selected.The intraoperative hemodynamics, indexes of blood gas analysis, body temperature and blood transfusion and volume of liquid infused were analyzed.Postoperative outcomes were tracked.Results:Six cases survived and were successfully discharged from hospital successfully, and one patient died.In the operation room, 71% patients were successfully extubated after surgery.Compared with the values during anatomical separation period, Hb during vascular anastomosis and intestinal reconstruction periods and concentration of Ca 2+ during intestinal reconstruction period were significantly decreased, and the blood glucose concentration during vascular anastomosis period were increased ( P<0.05 or 0.01). Compared with the values during vascular anastomosis period, the blood glucose concentration was increased significantly during intestinal reconstruction period ( P<0.05). Crystalloid solution (57±30) ml/kg and colloid solution which mainly containing 20% albumin (15±13) ml/kg were infused mainly during anatomical separation and vascular anastomosis periods in all the patients. Conclusion:The condition of successful living small bowel transplantation is fully evaluation and preparation before surgery.Intravenous-inhalational anesthesia combined with transverses abdominis plane block and rational infusion of colloid solution with vasoactive drugs to maintain hemodynamics stability and monitor blood gas, body temperature, active adjustment of electrolytes and internal environment and stable body temperature can be helpful in maintaining perioperative stable vital signs during the perioperative period, removing the tracheal tube early at the end of surgery, and reducing the development of postoperative complications in patients undergoing living small bowel transplantation.

Preparation of maternal strain A/PR/8/34 HA antiserum for influenza virus classical reassortment. A/PR/8/34 virus was digested by bromelain after inactivation and purification. 5%-20% sucrose continuous density gradient centrifugation method was used to purify HA protein. SIRD method was used to select the target protein. SDS-PAGE method was used to identified HA protein. High Immunogenic A/PR/8/34 HA protein was successfully prepared and HI titer reached 10240. High purity HA antiserum was identified by SIRD method. The key reagent in the classical reassortment of influenza virus was prepared, and the complete set of technical methods were explored, which laid the foundation for the independent research and development of seasonal influenza vaccine strains of China.
Animals ; Antibodies, Viral ; immunology ; Electrophoresis, Polyacrylamide Gel ; Female ; Hemagglutination Inhibition Tests ; Hemagglutinin Glycoproteins, Influenza Virus ; analysis ; immunology ; Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; immunology ; Influenza, Human ; immunology ; virology ; Rabbits ; Reassortant Viruses ; genetics ; immunology

Objective To evaluate the auxiliary diagnostic value of viral load test for samples with indeterminate HIV antibody detection results.Methods Thirty-two samples with indeterminate HIV antibody detection results collected from MSM were used for two viral load tests in Tianjin in 2015.Follow up was conducted for this population to confirm their HIV infection status.Results Virus loads were detected in the 2 viral load tests.In the follow-up survey,the results of HIV antibody test of all the samples were positive.The results of viral load test were completely consistent with those of HIIV antibody confirmation test.Conclusion The viral load test was effective in the auxiliary diagnosis of HIV infection in window phase,which can be used for the samples with indeterminate HIV antibody detection results.

Abdominal aortoenteric fistula (AAEF) is a rare but life-threatening complication of abdominal aortic aneurysms, and is also an uncommon cause of gastrointestinal hemorrhage. We report a case of primary abdominal aortoduodenal fistula in a 74-year-old male patient, whose main clinical manifestations were abdominal pain, hematochezia, and hematemesis. Colonoscopy, abdominal enhanced computed tomography (CT) and three-dimensional reconstruction angiography confirmed the diagnosis. The patient recovered well after emergent surgical management.
Abdominal Pain ; Aged ; Angiography ; Aortic Aneurysm, Abdominal ; complications ; Aortic Diseases ; Colonoscopy ; Duodenal Diseases ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Fistula ; Male ; Tomography, X-Ray Computed