The writing of pharmacist-managed clinics documents （hereinafter referred to as “outpatient medication record”） is a necessary part of pharmacist-managed clinics service. Outpatient medication record is an important carrier to reflect the quality of pharmacist-managed clinics service. The Chinese Hospital Association Pharmaceutical Specialized Committee was entrusted by the Pharmaceutical Administration Department of the National Health Commission to lead the formulation of the Guidelines for the Pharmacist-managed Clinics Service and Document Writing and Usage （Reference） （hereinafter referred to as Guidelines） according to the compilation method of group standards and the technical route of “documentation combing→framework establishment→draft writing→opinion collection→Guidelines formation”. The Guidelines standardizes the basic requirements of pharmacist-managed clinics record management and the basic content of record， and provides a general template and two specialized templates including pregnant and lactating pharmacist-managed clinics record template and cough and asthma pharmacist-managed clinics record template， which provides a reference for medical institutions to write pharmacist-managed clinics record. This paper introduces the formulation process of Guidelines and analyzes the key contents of Guidelines， which is helpful for the application practice of Guidelines and further improves the quality of pharmacist-managed clinics work.

Objective:To explore the barriers of online consulting services by dental specialist nurses, so as to provide theoretical basis for constructing an online service model of dental specialist nurses.Methods:This study was a qualitative study. Based on the theoretical domains framework (TDF), an interview outline was developed. From January to February 2023, purposive sampling was used to select 12 nurses from Shanghai Stomatological Hospital who participated in online consulting services for dental specialist nursing as the research subject, and semi-structured interviews were conducted on the nurses. According to the relevant fields of TDF, the transcribed data was sorted and the interview data was analyzed using the Colaizzi 7-step analysis method.Results:A total of three themes and eight sub-themes were extracted, including ability barriers (low level of dental knowledge, lack of written communication skills), environmental barriers (insufficient special publicity and promotion, inadequate standardized service standards and processes, limited online consulting platform functions, distributed appointment resources), and goal barriers (low sense of professional value, incomplete performance evaluation system) .Conclusions:The relevant management departments of hospitals should standardize the management system of online consulting services by dental specialist nurses and optimize the process of online consulting services by dental specialist nurses. At the same time, dental specialist nurses should enhance their abilities, provide high-quality online consulting services for patients, and improve patients ' satisfaction with online consulting.

This paper reports a case of recurrent peritoneal dialysis-associated peritonitis caused by Salmonella, as identified through metagenomic next-generation sequencing. This patient was treated regularly with peritoneal dialysis due to stage 5 chronic kidney disease. One month ago, she was hospitalized for peritoneal dialysis-associated peritonitis. The result of bacterial culture of the dialysate was Salmonella, and she was discharged after anti-infective treatment for 3 weeks. However, on the 12th day after discharge, the patient was readmitted to the hospital due to peritonitis.Both metagenomic next-generation sequencing and bacterial culture of the fluid confirmed the presence of Salmonella. After 3 weeks of intraperitoneal and intravenous anti-infection treatment, the patient underwent metagenomic next-generation sequencing to assess pathogen eradication before discharge.

This paper reports a case of peritonitis caused by Campylobacter fetus in a continuous ambulatory peritoneal dialysis (CAPD) patient. The patient was a middle-aged man, with chronic kidney disease stage 5 secondary to chronic glomerulonephritis, and had been on CAPD for 6 years. He was admitted to our department with a 7 day history of abdominal pain and cloudy effluent. Peritoneal effluent culture was negative and metagenomic next-generation sequencing suggested Campylobacter fetus. Intraperitoneal treatment with amikacin was failed. Peritoneal dialysis catheter was removed and hemodialysis treatment was performed. After treatment of erythromycin oral for 4 weeks, the patient's symptoms was improved and discharged.

In recent years, significant advancements in molecular biology have paved the way for novel targeted therapeutic strategies for gastric cancer treatment. Claudin18, which is an important structural protein involved in tight junctions between cells, and its subtype Claudin18.2 (CLDN18.2), which is specifically expressed in differentiated gastric epithelial cells, have emerged as novel therapeutic targets for patients with gastric cancer. This article aims to systematically review the latest developments in CLDN18.2 research in the fields of basic and clinical gastric cancer studies to provide a reference for clinical practice.

Objective:To study the teaching effect of traditional teaching combined with virtual simulation teaching in pharmaceutical content analysis using high performance liquid chromatography (HPLC).Methods:The students in two parallel classes of grade 2016 were divided into experimental group (44 students) and control group (38 students). Taking the content analysis and its related analytical methodology of Metronidazole by HPLC as an example, the experimental group adopted the traditional offline teaching combines with virtual simulation teaching, and the control group adopted the traditional offline teaching. The teaching effects of the two groups were compared. SPSS 22.0 was used to conduct independent-samples t-test. Results:According to the mid-term test results, the experimental group was superior to the control group in practical operation assessment [(17.98±6.75) vs. (14.03±5.92)], and the difference was statistically significant ( P < 0.05). But there were no differences between the two groups in the scores of theory, discussion report and presentation. There was no significant difference in the final exam scores between the two groups. Conclusion:The ability of practical training and the teaching effect can be improved by the teaching method of traditional offline teaching combined with virtual simulation. Through the training of this project, students have mastered the operation of HPLC, the content determination of pharmaceutical preparations, the verification of analytical methods, data processing, and the writing of analytical reports, and have certain practical analysis ability.

OBJECTIVE To construct a predictive model of ultrasound(US),analyze and compare with its diagnostic efficacy in different forms of combination with CT of the neck in predicting central district lymph node metastasis(CLNM)of papillary thyroid carcinoma.METHODS Lesions confirmed as PTC by surgical pathology in our hospital from January 2021 to December 2021 were included for study,The lesions were scored according to the American college of radiology thyroid imaging reporting and data system(ACR TI-RADS),the risk model to predict CLNM was constructed based on the training set and verified internally in the testing set.The model was combined with CT to diagnose CLNM using both serial and parallel modes.The receiver operating characteristic(ROC)curves of CT,model,and model combined with CT for the diagnosis of CLNM was drawn separately,and then calculated and compared the area under the curve(AUC).RESULTS A total of 470 lesions were included in 440 patients.The model can be presented as Y=-4.664+0.171 ×maximum diameter+0.685×gender+0.600×multifoca lity+0.251×ACR TI-RADS score.After ROC curves analysis,the optimal diagnostic cut-off value of the model was 0.407.When Y≥ 0.407(optimal diagnostic cut-off point),CLNM was considered to be positive.In the training set,the C-index of model was 0.780(95％CI:0.661-0.756).In the testing set,the C-index was 0.778(95％CI:0.682-0.874).The Homsmer-Lemeshow goodness-of-fit test showed that the calibration of the model was good(P=0.294,P=0.879).In the testing set,compared with CT,model and the serial mode,the sensitivity(77.5％),diagnostic coincidence rate(80.6％),and negative predictive value(84.6％)of parallel mode were higher,whereas specificity(83.0％)was relatively lower.On diagnostic CLNM,the parallel mode had a higher AUC than the series mode(0.803 vs.0.669,Z=-2.931,P=0.003).CONCLUSION The model combined with CT in parallel mode can improve the clinical accuracy of diagnosis in CLNM and compensate for the shortcomings of traditional imaging techniques such as US and CT,which has specific clinical applicability.

Objective To explore the effect of low-frequency electroacupuncture (EA) on neuropathic pain induced by spinal nerve injury and its underlying mechanism.Methods Thirty-two male Sprague-Dawley rats were randomly divided into a normal group,a sham spared nerve injury (SNI) group,an SNI group and an SNI+EA group,each of 8.The rats in the SNI and SNI+EA groups were given SNI surgery,while those of the sham-SNI group only had the sciatic nerve and its branches exposed without any lesion.EA at 2 Hz was applied over the ipsilateral Zusanli and Kunlun acupoints daily for 14 days after the surgery.The ipsilateral paw withdrawal threshold (PWT) was measured,along with protein kinase A (PKA) levels in the dorsal horn of the spinal cord,calcitonin gene-related peptide (CGRP) and substance P (SP) levels along with transient receptor potential V1 (TRPV1).Results Compared to the normal group,the SNI groups all showed significant decreases in their PWTs on the affected side and significant increases in PKA,TRPV1,CGRP and substance P on the affected side.Compared to SNI group,the average ipsilateral PWT in the SNI+EA group increased significantly after EA treatment,while PKA levels,TRPV1,CGRP levels and SP expression all decreased significantly.Conclusion Electroacupuncture at low frequency can effectively relieve neuropathic pain,perhaps through down-regulation of PKA in the spinal cord and by decreasing pain hypersensitivity related to CGRP and SP.

Objective To explore the application of Oxybuprocaine Hydrochloride Gel in colonoscopy examination. Methods 1000 patients received colonoscopy examination were randomly divided into experimental group and control group, 500 cases in each. Oxybuprocaine Hydrochloride Gel was applied on anal region in the experimental group before endoscopy for perianal anesthesia and lubrication. Paraffin oil was used in the control group to lubricate perianal and enteroscopy. The success rate of primary insertion, visual analogue pain score (VAS) score, examination time and postoperative complications were compared between the two groups. Results In the experimental group, the success rate of primary insertion (95%) was higher than that of the control group (76%), and the pain score was lower than that of the control group.The examination time was shortened, and the difference was statistically significant (P < 0.05). Conclusions Oxybuprocaine Hydrochloride Gel applied to colonoscopy can effectively reduce the patient's pain and discomfort, improve the success rate of primary insertion, shorten the examination time. And the method is worthy of clinical popularization and application.

Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.