OBJECTIVE To explore the specific application and evaluation effect of objective structured clinical examination(OSCE)-guided scenario-based practical teaching mode in training clinical pharmacists. METHODS Fifty-six trainees who participated in the clinical pharmacist training program in the Second Xiangya Hospital of Central South University from October 2020 to September 2022 were selected as the research objects. OSCE-guided teaching was conducted, and the application effect of OSCE-guided teaching mode in clinical pharmacist training was explored and analyzed by using theoretical examination results and OSCE assessment results as evaluation indicators. RESULTS Through comparative analysis, it was found that the OSCE-guided teaching mode not only enabled students to better grasp the theoretical knowledge points required by the training outline, but also improved their clinical thinking ability, problem-solving ability, and communication and coordination skills to varying degrees. CONCLUSION For clinical pharmacist trainees, the OSCE teaching mode is conducive to the comprehensive improvement of clinical pharmacist skills and is suitable for cultivating clinical pharmacists who are capable of independently carrying out clinical pharmacy services in the new situation.

Objective This study aimed to investigate the protective effect and mechanism of carvacrol hydrogel on the alveolar bone in rats with periodontitis.Methods A thermosensitive hydrogel supported by carvacrol was pre-pared using poloxamer and hydroxypropyl methyl cellulose as matrix.SD rats were randomly divided into blank group,periodontitis group,blank hydrogel group,and low-,medium-,and high-dose hydrogel groups.The periodonti-tis symptoms and the CT structure of the alveolar bone were observed.The changes in liver,spleen,kidney,and peri-odontal tissues were observed.The related indexes of bone metabolism in serum were detected.The expression of os-teoprotegerin(OPG)and nuclear transcription factor-κB(NF-κB)pathway proteins was determined by Western blot.The levels of inflammatory factors were assessed by quantitative reverse transcription polymerase chain reaction(qRT-PCR).Results Carvacrol hydrogel had good slow release,biocompatibility,and cell adhesion.The periodontitis of rats in the carvacrol hydrogel group was significantly alleviated,the expression of OPG protein in gingival tissue was significantly increased(P<0.01),and the levels of receptor activator of NF-κB ligand(RANKL),receptor activator of NF-κB(RANK),NF-κB protein,and inflammatory factors were significantly decreased(P<0.01).Conclusion Car-vacrol hydrogel can regulate the OPG and NF-κB pathways,reduce alveolar bone absorption,and improve periodontal inflammation.

Objective:To analyze whether patients with myasthenia gravis (MG) have cognitive impairment and changes of brain structure, and explore the possible mechanisms of cognitive impairment in MG patients from the perspective of brain structure.Methods:Twenty-eight patients with MG admitted to Department of Neurology, First Affiliated Hospital of Soochow University from July 2019 to December 2021 were selected as MG group, and 30 family members from MG patients or healthy subjects who underwent physical examination in Physical Examination Center during the same period were selected as healthy control group. Neuropsychological test was used to evaluate the cognitive function. VBM was used to analyze the changes of brain structure on structural MRI (sMRI). Correlations of gray matter volumes of different brain regions with cognitive function between the two groups were analyzed.Results:Compared with the healthy control group, the MG group had significantly decreased scores of Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Painting Test (CDT), and Verbal Fluency Test (VFT), and significantly decreased Rey Auditory Verbal Learning Test (RAVLT) immediate memory and delayed memory scores, while statistically increased time consuming in Making Track Test Part A (TMT-A), and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores ( P<0.05). Compared with healthy control group, MG group had significantly decreased gray matter volumes of the left orbital superior frontal gyrus, right orbital middle frontal gyrus, right triangular inferior frontal gyrus, left insula, left middle frontal gyrus, right superior limbic gyrus, right anterior cingulate gyrus, right lateral cingulate gyrus, left medial cingulate gyrus, left lateral cingulate gyrus, left medial superior frontal gyrus, and left dorsalateral superior frontal gyrus ( P<0.05). Correlation analysis showed that gray matter volume in the left insula was negatively correlated with time consuming in Stroop Color-Word Test-A ( r=-0.407, P=0.035). Conclusion:Patients with MG may have cognitive decline and gray matter cortical atrophy of some brain regions, and brain areas with gray matter cortical atrophy correspond to areas of cognitive impairment.

Pulmonary fibrosis (PF) is a pathological change caused by repeated injuries and repair dysfunction of the alveolar epithelium. Our previous study revealed that the residues Asn3 and Asn4 of peptide DR8 (DHNNPQIR-NH₂) could be modified to improve stability and antifibrotic activity, and the unnatural hydrophobic amino acids α-(4-pentenyl)-Ala and d-Ala were considered in this study. DR3penA (DHα-(4-pentenyl)-ANPQIR-NH₂) was verified to have a longer half-life in serum and to significantly inhibit oxidative damage, epithelial-mesenchymal transition (EMT) and fibrogenesis in vitro and in vivo. Moreover, DR3penA has a dosage advantage over pirfenidone through the conversion of drug bioavailability under different routes of administration. A mechanistic study revealed that DR3penA increased the expression of aquaporin 5 (AQP5) by inhibiting the upregulation of miR-23b-5p and the mitogen-activated protein kinase (MAPK) pathway, indicating that DR3penA may alleviate PF by regulating MAPK/miR-23b-5p/AQP5. Safety evaluation showed that DR3penA is a peptide drug without obvious toxicity or acute side effects and has significantly improved safety compared to DR8. Thus, our findings suggest that DR3penA, as a novel and low-toxic peptide, has the potential to be a leading compound for PF therapy, which provides a foundation for the development of peptide drugs for fibrosis-related diseases.

Objective To synthesize the natural cyclopeptide auyuittuqamide A by Fmoc-based solid phase linear synthesis and liquid phase cyclization. Methods Using 2-chlorotriphenylmethyl chloride (CTC) resin as the solid support, 1,3-diisopropylcarbodiimide (DIC) and 1-hydroxybenzotriazole (HOBt) as the condensing agents, 9-fluorenylmethoxycarbonyl (Fmoc) to protect amino acids were assembled in sequence, and then the linear peptide bearing the protected groups was obtained in presence of trifluoroethanol (TFE) cutting reagent. The protected linear peptide was cyclized with the aid of benzotriazole hexafluorophosphate (PyBOP) and 1-hydroxybenzotriazole (HOBt) in dichloromethane (DCM) solution, followed by trifluoroacetic acid (TFA) deprotection to obtain the cyclic peptide, auyuittuqamide A that was purified by preparative HPLC and characterized by HR-MS and 500MHz ¹H-NMR. Results The purity of auyuittuqamide A was more than 95% and the total yield was 5.48%. Conclusion This method has simple synthesis steps and high yield. It is the first to establish a fully synthesis method for the natural cyclic peptide auyuittuqamide A, which lays the foundation for further research of auyuittuqamide A.

Objective:To explore the diagnostic value of 18F-deoxyglucose (FDG) PET/CT dual-time-point imaging (DTPI) in the diagnosis of aortic grafts infection (AGI). Methods:Forty-two patients with suspected AGI were prospectively recruited in this DTPI study from October 2014 to October 2021. There were 35(83%) males and 7 females, mean age (54±15) years old, range 22-79 years old. PET/CT image quality was scored as 5 grading scale. Semi-quantitative analysis of DTPI data was performed using maximum standardized uptake value (SUVmax) of suspected AGI lesions. The percentage of SUVmax change between initial and delayed images were recorded as retention index (RI). Management of Aortic Graft Infection Collaboration (MAGIC) criteria were used as the diagnostic reference criteria for AGI.Results:According to the MAGIC criteria, 27 patients (64%) were positive for AGI, and 15 patients (36%) were negative. The mean RI of AGI was higher than that of non-AGI ones[(26.7±18.9)% vs. (6.4 ±18.8)%, P<0.01]. The sensitivity, specificity, and accuracy of initial SUVmax ≥6 with the presence of AGI was 88.9%, 73.3%, and 83.3%, respectively. Delayed SUVmax ≥6 improved the sensitivity (96.3%) and accuracy (88.1%) for diagnosing AGI. DTPI with 15% increment as the optimal cut-off value of RI improved the specificity (93.3%) and accuracy (90.5%) for diagnosing AGI. Fifteen (56%, 15/27) AGI patients had improved image quality grading on the delayed images, leading to more accurately delineating the detailed extent of the infected aortic graft. Conclusion:18F-FDG PET/CT DTPI has better diagnostic performance for AGI than conventional Single-time-point PET/CT imaging by improving image quality as well as enhancing delineation of infected aortic graft extent.

Objective:To serially characterize the myocardial perfusion, myocardial hibernation and left ventricular (LV) function as well as LV remodeling in progressive coronary artery stenosis in Chinese mini-pigs.Methods:In 8 Chinese mini-pigs (5 males, 3 females; age: 10 months), chronic progression of coronary stenosis and finally occlusion was established using Ameroid constrictor implantation at the 1 cm below the bifurcation of the first diagonal branch of the left anterior descending (LAD) artery. Serial gated 99Tc m-methoxyisobutylisonitrile(MIBI) SPECT/CT, gated 18F-FDG PET/CT imaging and coronary angiography (CAG) were performed before surgery and at the 1st, 4th and 8th week after surgery. Longitudinally, total perfusion defect (TPD), LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), summed motion score (SMS), summed thickening score (STS) and hibernating myocardium (HM) were analyzed. Repeated measures analysis of variance, Kruskal-Wallis rank sum test and Bonferroni correction method were used to analyze data. Results:One mini-pig died of infection after the Ameroid constrictor implantation. In the remaining 7 mini-pigs, TPD was progressively increased with time prolonged (0, 12.0%(0, 33.0%), (41.1±23.7)% and (49.3±24.5)%; H=17.03, P=0.001); Compared with HM before the surgery (100%), HM was gradually reduced from the 1st (21.0%(6.0%, 100%)) to the 4th (18.0%(3.0%, 33.0%)) week after surgery, and then increased to the 8th week after surgery ((23.0±15.4)%; H=13.09, P=0.004), but there was no significant difference between the 1st and 4th week, or between the 4th and 8th week after surgery (both P>0.05 (Bonferroni correction method)). Accordingly, LVEF gradually decreased ((73.7±8.4)%, (63.7±19.1)%, (53.7±14.6)% and (49.9±15.4)%; F=6.22, P=0.004). LVEDV (9.0(6.0, 21.0), (31.4±16.3), (32.9±17.4) and (36.4±17.5) ml; H=8.58, P=0.035)and LVESV ((3.8±3.2), (15.9±15.3), 12.0(10.0, 17.0)and (19.3±10.9) ml; H=10.51, P=0.015) gradually increased. SMS and STS continuously increased as well ( H values: 16.49, 13.33, P values: 0.001, 0.004). Conclusions:With the progression of coronary artery stenosis to occlusion, myocardial perfusion is gradually decreased, while the global and regional LV function, LV remodeling are gradually aggravated, and HM is gradually reduced. After the chronic coronary artery occlusion, myocardial perfusion has a trend to be improved and HM is gradually recovered.

Objective:To explore the protective factors of psychological resilience in patients with inflammatory bowel disease (IBD) , so as to provide a basis for improving the psychological resilience of patients.Methods:From December 2020 to March 2021, 16 IBD patients in the Department of Gastroenterology of Peking Union Medical College Hospital were selected as the research object by purpose sampling, and the semi-structured in-depth interview was conducted with them. The interview data was organized and analyzed using the directed content analysis method.Results:A total of 3 themes and 10 sub-themes were extracted, including internal characteristics of individuals, social support network, environmental perception and active transformation. Among them, the internal characteristics of individuals included calm acceptance of the disease, positive disease cognition, appropriate emotion regulation, and clear goal motivation. Social support network consisted of solid family support, professional medical care, stable relationships, normal work status. Environmental perception and active transformation comprised selective perception of the environment and active behavioral coping.Conclusions:Medical and nursing staff should cooperate with the patient's family, friends and other parties to implement cognitive intervention, perfect the support system, and promote positive behaviors, thereby improving the patients' psychological resilience.

Objective:To evaluate the effect of remote ischemic conditioning (RIC) on left ventricular (LV) myocardial perfusion, myocardial viability, LV remodeling, regional and global LV function serially following acute myocardial infarction (AMI) in Chinese mini-pigs.Methods:AMI was established in 12 Chinese mini-pigs (8 males, 4 females; age: 6-8 months) and they were randomly divided into RIC group ( n=6) and non-RIC group ( n=6). RIC was performed in pigs by blood pressure inflation on the lower limbs for 5 min period and 4 cycles immediately after surgery. A series of myocardial perfusion imaging and gated 18F-fluorodeoxyglucose (FDG) myocardial metabolism PET/CT imaging were performed longitudinally at the 1st, 14th, 28th and 56th days after AMI, and parameters including total perfusion defect (TPD), hibernating myocardium (HM), Scar, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), summed motion score (SMS), summed thickening score (STS) and changes of these parameters were obtained. Independent-samples t test and Mann-Whitney U test were used to analyze data. Results:Nine Chinese mini-pigs survived after surgery and were performed imaging. Compared to non-RIC group ( n=4), HM at the 28th ((6.0±2.4)% vs (17.0±4.6)%; t=-4.158), TPD 14th-1st ((-11.8±5.4)% vs 9.0%(4.5%, 15.0%); z=2.449), TPD 28th-1st ((-15.3±3.9)% vs (12.0±3.0)%; t=-10.071), TPD 56th-1st ((-18.0±6.5)% vs 9.0%(4.5%, 12.0%); z=2.449), HM 28th-1st ((-10.5±6.9)% vs (8.3±2.1)%; t=-4.507), HM 56th-1st (-15.0%(-17.5%, -8.5%) vs 2.0%(0%, 7.0%); z=2.449) and LVEDV 14th-1st (-0.5(-2.5, 0) ml vs (13.0±4.4) ml; z=2.470) were reduced in RIC group ( n=5; all P<0.05). Conclusion:RIC can improve myocardial perfusion, delay LV remodeling in the acute stage and salvage hibernating myocardium in the subacute stage and chronic stage.

Objective:To explore the effect of plastic surgery suture technique and its proficiency in facial scar inhibition after trauma, and to explore the key factors to improve the suture proficiency of junior residents.Methods:The data of patients with facial trauma who underwent plastic surgery suture in the department of plastic and reconstructive surgery of Ningbo First Hospital from June 2017 to July 2019 were retrospectively analyzed. They were divided into senior group and junior group according to the seniority of chief surgeon. The general condition, scar appearance and local symptoms of the two groups were evaluated by SCAR Scale, including scar expansion, erythema, hyperpigmentation or hypopigmentation, suture marks, hyperplasia or atrophy, scar pruritus, scar pain, and the result were statistically analyzed.Results:A total of 83 patients (54 females and 29 males) were included in this study, the maximum age was 63, the minimum age was 3, and the average age was (31. 7±13. 3), including senior group (52 cases) and junior group (31 cases) . The differences were not statistically significant in gender, age, injury time, wound length and complications between the two groups. The total scores of SCAR Scale in the senior and junior groups were 2. 18±0. 98 and 2. 78±1. 30, respectively, the difference was statistically significant ( P=0. 020 ). The senior group was better than the junior group in inhibiting scar expansion ( P=0. 035 ), eliminating suture marks ( P =0. 018 ) , overall scar impression ( P=0. 038 ) and reducing pigment abnormality ( P =0. 045 ). However, in inhibiting erythema and inhibiting scar hyperplasia or atrophy, the differences were not statistically significant between two groups. In the senior group, 4 patients had pain within 24 hours, 3 patients had pruritus; in the junior group, 2 patients had pain, 3 patients had pruritus. Conclusions:Plastic surgery suture technique will effectively improve the appearance of facial scar after trauma, especially in inhibiting scar expansion, erythema, hyperplasia or atrophy, and overall impression. Junior doctors can be competent for this work to a certain extent, but thay need long-term training to master the technology, and skilled operation can further improve the curative effect.