OBJECTIVE To provide reference for the adjustment of antibiotic treatment regimens， identification of adverse reactions， and individualized pharmaceutical care for melioidosis sepsis （MS）. METHODS Clinical pharmacists participated in the intensive and eradicating therapeutic processes for an MS patient by using blood concentration and gene detection. Based on the literature， antibiotic treatment regimens of MS were adjusted by determining the blood concentrations of β-lactam and trimethoprim/ sulfamethoxazole （TMP/SMZ） and calculating PK/PD parameters. The causes of adverse drug reactions were analyzed and addressed by detecting drug-related gene polymorphisms through high-throughput sequencing. RESULTS Clinical pharmacists used blood concentration and genetic testing methods to propose adjustments to imipenem-cilastatin sodium dosage and analyze the causes of various adverse drug reactions. PK/PD targets were calculated by measuring the blood concentrations of β-lactam and TMP/SMZ. Clinical pharmacists explained to clinical doctors the compliance status of patients with melioidosis in sepsis and non- sepsis stages through reviewing guidelines and literature； the results of blood concentration and genetic test were used to analyze the correlation of neurotoxicity of MS patients with B14） IMP cmin， and it was found that nephrotoxicity was not related to the cmax of TMP/SMZ， but to the patient’s water intake. After whole-process antibiotic treatment， the patient’s condition improved and was discharged， and the adverse reactions were effectively treated. CONCLUSIONS Clinical pharmacists use blood concentration and genetic tests to assist clinicians in formulating MS treatment regimens， and provide whole-course pharmaceutical care for a MS patient. This method has improved the safety and effectiveness of clinical drug therapy.

OBJECTIVE To prepare progesterone-2-chloro-4-nitroaniline cocrystal （CNA） so as to improve the solubility of progesterone and primarily evaluate the safety of the progesterone cocrystal in vivo. METHODS Using progesterone as the main body and CNA as the ligand， progesterone-CNA cocrystal was prepared with solvent evaporation method. The cocrystal was characterized by X-ray single crystal diffraction， X-ray powder diffraction （XRPD）， differential scanning calorimetry （DSC） and Fourier transform infrared spectroscopy （IR）. The dissolution rate of cocrystal was compared with those of progesterone and physical mixture. Forty-eight female KM mice were randomly divided into normal group （phosphate buffer containing 0.1% dimethyl sulfoxide）， progesterone group （16 mg/kg）， CNA group （9 mg/kg）， progesterone-CNA cocrystal low-dose， medium- dose and high-dose groups （6， 12.5， 25 mg/kg）， with 8 mice in each group. They were given relevant medicine/solvent intramuscularly， once a day， for consecutive 14 d. The safety of cocrystal was evaluated primarily by determining/observing the changes in body weight， organ index， tissue morphology， blood routine indicators， and liver and kidney function indicators. RESULTS The new crystal structure in the X-ray single crystal diffraction results， the new characteristic peak in the XRPD pattern， the change of melting point in the DSC results， and the change of the characteristic peak position in the range of 3 500- 2 750 cm－1 and 1 700-1 250 cm－1 in the infrared spectrum all Δ 基金项目国家重点研发计划项目（No.2022YFC3502100） indicated that progesterone-CNA cocrystal was successfully ＊第一作者 硕士研究生 。研究方向 ：药物制备技术与工艺 。 prepared， and the dissolution rate of cocrystal was more than E-mail：SWB_1221@163.com # 通信作者教授，硕士生导师，博士。研究方向：药物制备技术与 twice that of the progesterone raw material drug. The results of 工艺。E-mail：wuxx-415@126.com in vivo safety experiments showed that the mortality rate of all 中国药房 2023年第34卷第13期 China Pharmacy 2023 Vol. 34 No. 13 · 1567 · groups was zero. Compared with normal group， uterine indexes of mice in progesterone group and progesterone-CNA cocrystal groups were significantly increased （P＞0.05）， and endometrium was also thickened； there was no statistical difference in the changes of body mass， liver and kidney function， liver index， kidney index， the number of leukocyte， lymphocyte and neutrophil in routine blood test among those groups （P＞0.05）， and the morphology of liver and kidney tissue has also no significant difference. However， the number of plasma red blood cells in the progesterone group decreased significantly （P＜0.05）， and there was no statistical significance in the number difference of red blood cells among progesterone-CNA cocrystal groups （P＞0.05）. CONCLUSIONS The progesterone-CNA cocrystal is successfully prepared with good safety in vivo， which significantly improve the solubility of progesterone.

In past two decades, understanding of the role of the orexin system in regulating sleep and wakefulness has increased rapidly. Lemborexant, as a dual orexin receptor antagonist, has been approved in some countries for the treatment of insomnia disorders. Existing studies have shown that its safety and tolerability are significantly superior to traditional hypnotic drugs, and it will be new option for treating insomnia disorders. This article reviews the pharmacology, clinical efficacy and safety of lemborexant.

The anastomotic vessels between the superior mesenteric artery and the inferior mesenteric artery are vital to maintain the blood supply of the anastomosis and residual colon after colectomy. However, current studies of anastomotic vessels are facing four major obstacles: confusing nomenclature, large variability in data, diversification of research methods and incomplete information records. The existence of marginal artery has been widely proved, and its significance for blood supply is well recognized by relevant studies. In contrast, the Riolan′s arch, whose connotations constantly changed over history, can not refer to a specific structure accurately. Researchers should abolish the controversial names such as Riolan′s arch, select appropriate research methods and record the anastomotic vessels in detail, so as to improve the comparability between different results. The study of anastomotic vessels can help us to identify potential vascular disease, select the appropriate surgical approach, and provide appropriate treatment of the vessels in the operating area, so as to provide a theoretical foundation and practical basis for fine surgical maneuvers.

The anastomotic vessels between the superior mesenteric artery and the inferior mesenteric artery are vital to maintain the blood supply of the anastomosis and residual colon after colectomy. However, current studies of anastomotic vessels are facing four major obstacles: confusing nomenclature, large variability in data, diversification of research methods and incomplete information records. The existence of marginal artery has been widely proved, and its significance for blood supply is well recognized by relevant studies. In contrast, the Riolan′s arch, whose connotations constantly changed over history, can not refer to a specific structure accurately. Researchers should abolish the controversial names such as Riolan′s arch, select appropriate research methods and record the anastomotic vessels in detail, so as to improve the comparability between different results. The study of anastomotic vessels can help us to identify potential vascular disease, select the appropriate surgical approach, and provide appropriate treatment of the vessels in the operating area, so as to provide a theoretical foundation and practical basis for fine surgical maneuvers.

Objective: To evaluate the application of the central lymph node dissection (CLND) for papillary thyroid carcinoma (PTC) in cN0 T1/T2. Methods: Retrospective analysis of 532 cases with PTC in cN0 T1/T2 who underwent CLND between October 2014 and September 2016 in the Department of Thyroid Surgery, the First Affiliated Hospital of the Kunming Medical University. The incidence of central lymph node (CLN) metastasis and risk factors were analyzed. Results: CLN metastasis rates: 41.2% (42/102) in males vs 34.9% (150/430) in females, P=0.252; 33.9% (116/342) in single focal carcinoma vs 40.4% (74/183) in multifocal carcinoma, P=0.157; 44.0% (125/284) in patients with 45 years old or less vs 27.0% (67/248) in patients more than 45 years old, P=0.000; 30.3% (113/373) in microcarcinoma vs 50.9% (81/159) in non-microcarcinoma, P=0.000.In unilateral lesions, ipsilateral CLN metastasis was correlated with the tumor diameter (P=0.012), but not with the number of lesions (P=0.653). also contralateral CLN metastasis was correlated with the tumor diameter (P=0.000), but not with the number of lesions (P=0.815). For the left or right unilateral single focal lesion, the tumor diameter was not correlated with the metastasis of the posterior to right recurrent laryngeal nerve central lymph nodes (LN-prRLN-CLN) (P=0.652, P=0.088). But in bilateral multifocal carcinoma the tumor diameter was correlated with metastasis of LN-prRLN-CLN (P=0.039). Conclusions Prophylactic CLND is reasonable for PTC in cN0 T1/T2. A bilateral CLND should be conducted for patients with bilateral multi-focus cancer and unilateral or bilateral non-microcarcinoma, especially in patients more than 45 years old. For unilateral single focal microcarcinoma on the right, the content of CLND should be from laryngeal nerve on right center to posterior branche; for unilateral single focal microcarcinoma on the left side, the left CLND should be conducted. An ipsilateral CLND can be considered in patients with unilateral multifocal microcarcinoma, and generally a routine dissection of the LN-prRLN-CLN is not required, however for bilateral non-microcarcinoma and the the non-microcarcinoma on the right side, the LN-prRLN-CLN dissection should be conducted.

Objective To assess the effects of pre-operative measurement of proximal tibia varus angle (PTA) on predicting condylar twist angle (CTA) in total knee arthroplasty (TKA).Methods The CT-scan of lower limb was performed in sixty-one health female volunteers aged 31.5 (18-38) years with 160 (153-170) cm heights from March 2016 to August 2016.The PTA,medial proximal tibial angle (MPTA) and CTA were determined.The PTA was defined between a line perpendicular to the mechanical axis of the tibia and the tangent on the internal tibial plateau.The MPTA was the medial angle between the mechanical axis of the tibia and the tangent on the internal tibial plateau.The CTA was the angle between the sTEA and the posterior condylar line.The correlations between these parameters were analyzed statistically by linear regression.Results The PTA,MPTA and CTA parameters were conformed to the normal distribution.The PTA was 2.30°± 1.86°,ranged from 1.40° to 6.50°.The MPTA was 87.7°± 1.86°,ranged from 83.50° to 88.60°.The CTA was 3.4°± 1.27°,ranged from 0.50° to 5.80°.The linear regression analysis showed a strong positive correlation between the CTA and PTA in health female knees (r=0.58,P=0.048),while negative correlation was found between the CTA and MPTA in health female knees (r=-0.58,P=0.048).There were fifty-two (85.2％) volunteers with PTA that was more than 2° and less than 4°.Six (9.8％) volunteers had PTA less than 2°,while three (4.9％) had PTA more than 4°.There were eight (13.1％) volunteers with CTA less than 3°.Forty-three (70.5％) volunteers had CTA more than 3° and less than 4°.CTA more than 4° was found in ten volunteers (16.4％).Based on these above results,two formulas were demonstrated for predicting the CTA:CTA=2.52+0.395PTA,CTA=38.06-0.390MPTA.Conclusion The CTA can be predicted by calculating the PTA by CT-scan and standard long-leg standing radiographs before TKA.Using the present method could reduce the risk of femur component malrotation and the flexion gap balancing during TKA.

Objective:To investigate the current status of social support and mental health among residents in Weifang and analyze the impact of social support on mental health,thus to provide reference for improving the mental health status of residents.Methods:A sample of 6174 residents in Weifang was investigated using Social Support Rate Scale (SSRS) and Kessler Psychological Distress Scale (K10).The data was analyzed statistically with Chi-square test,Kruskal-Wallis test and Multiple Logistic regression analysis.Results:About 0.3％ residents in Weifang reported low social support and 93 ％ residents showed good mental health.Gender,age,social support level and 3 dimensions of social support were associated with mental health respectively in the correlation analysis.In the multiple analyses,social support,subjective support,availability of support and mental health were positively correlated in the model of Good mental health and General mental health.Conclusion:The mental health status of residents in Weifang is not optimistic.The social support level has beneficial effect on mental health starus.Subjective support,objective support and the utilization of these supports imposes different degrees of inflnence on mental health status.

Objective:To understand cognition and satisfaction degree of mental health service among residents in Weifang,and provide reference for further development of mental health work.Methods:6174 residents were selected with random sampling method and a cognition survey was conducted using a self-designed questionnaire.Among them,553 residents were selected to investigate their satisfaction with mental health service.Results:The residents have unscientific cognition on mental health service,and they did not understand the delivery of community mental health services.Residents who have received mental health service were more satisfied with informed consent and patient privacy protection,and had low satisfaction with the clinic environment and the charge of inspection items.Conclusions:To improve residents' cognition and satisfaction of mental health service,we should further perfect the professional mental health institutions and personnel recruiting,and forcefully carry out mental health education.

Objective:This article is to study the quality of life and the situation of social support for the elderly in Weifang while analyzing the correlation between them.Methods:This study was undertaken among elderly aged over 60 followning the European five D health scale and Social Support Rating Scale.The results were analyzed statistically.Results:On the living quality of elderly in Weifang,the EQ-SD index was (0.78 ±0.12) and the EQ -VAS index was (76.42 ± 14.67).The result from each scale shows a tremendous health issue among the elderly in Weifang.On the other hand,the situation of social support for the elderly in Weifang appeared optimistic.Still,this situation can be improved in practical supports.Also,there was significant negative correlation between EQ-5D and SSRS (r =0.260,P ＜ 0.05).Results of multiple linear regression show that the subjective support and objective support may enter the regression equation.Conclusion:To conclude,the city of Weifang awaits improvements in aged care and social support for the elderly.Only by this chance the quahty of life of the elderly may be improved.