OBJECTIVE To summarize the current situation of pharmaceutical clinic service in our hospital over the past five years， and explore sustainable development strategies for service models of pharmaceutical clinics. METHODS A retrospective analysis was conducted on the consultation records of patients who registered and established files at the pharmaceutical clinic in our hospital from January 2019 to December 2023. Statistical analysis was performed on patients’ general information， medication- related problems， and types of pharmaceutical services provided by pharmacists. RESULTS A total of 963 consultation records were included， among which females aged 20-39 years accounted for the highest proportion （66.04%）； obstetrics and gynecology- related consultations accounted for the largest number of cases. Additionally， 80 patients attended follow-up visits at our hospital’s pharmaceutical clinic. A total of 1 029 medication-related issues were resolved， including 538 cases of drug consultations （52.28%）， 453 medication recommendations （44.02%）， 22 medication restructuring（2.14%）， and 16 medication education （1.55%）； the most common types of medication-related problems identified were adverse drug events（70.07%）. CONCLUSIONS Although the pharmaceutical clinic has achieved recognition from clinicians and patients， challenges such as low awareness among healthcare providers and the public persist. Future efforts should focus on strengthening information technology construction， enhancing pharmacist training， and establishing various forms of outpatient pharmaceutical service models.

Objective To obtain the range of anatomical parameters of healthy knee joints in Chinese males and validate a statistical shape model(SSM)based on the geometric shape of a healthy knee to provide references for the design of knee SSM-based prostheses.Methods Computed tomography(CT)images of knee joints from 112 healthy males were acquired to build three-dimensional(3D)knee joint models.Each model was the target model separately,and the remaining models were used as the training set for principal component analysis(PCA).The obtained knee SSM was fitted to the target model to predict the SSM.The exact anatomical measurement points were marked on the sample and SSM prediction models,and 17 linear and 3 angular parameters were derived.The values of the anatomical parameters were statistically tested using an independent samples t-test and Mann-Whitney U-test,and the validity of the SSM in terms of geometric shape was demonstrated if the resulting P-values were all greater than 0.05.Results Qualitative and quantitative comparative analyses of anatomical parameters showed that the mean deviation of linear parameters was less than 6 mm,and that of angular parameters was less than 2.5°.The results of statistical tests showed P＞0.05 for all anatomical parameters,proving that the knee SSM prediction model was not statistically different from the true healthy model in terms of geometric shape.Conclusions This study derived a reference range of anatomical parameters for a healthy knee and demonstrated that the knee SSM model was consistent with the real healthy model in terms of shape.The results provide a reference for the design of knee SSM-based prostheses.

Type B insulin resistance syndrome(TBIR)is a rare autoimmune disease caused by the presence of autoantibodies against insulin receptors in the human body,leading to severe refractory hyperglycemia or refractory hypoglycemia.This article reports a case of TBIR patient,summarizes and analyzes its epidemiological characteristics and diagnosis and treatment methods,providing a basis for clinical treatment.

The incidence rate of nonalcoholic fatty liver disease-related hepatocellular carcinoma (NAFLD-HCC) tends to increase worldwide, while its pathogenesis remains unclear. With reference to the literature in recent years, this article summarizes the role of adipose tissue inflammation, oxidative stress, gut microbiota, and insulin resistance in the pathogenesis of NAFLD-HCC and the advances in the prevention and treatment of the above mechanisms, so as to provide new ideas for the treatment of NAFLD-HCC.

Objective To investigate relative translations of the glenohumeral joint during abduction, scaption and forward flexion in normal Chinese, so as to provide references for diagnosis, treatment and follow-up of glenohumeral joint instability and subacromial impingement syndrome.Methods The biplanar fluoroscopy system combined with model-image registration technique were used to measure the humeral translation relative to the scapular in 13 healthy volunteers during abduction, scaption and forward flexion.Results The anterior-inferior glenohumeral translation during abduction, scaption and forward flexion was (4.0±1.3), (4.1±1.5),(4.8±1.9) mm, respectively. The superior-inferior glenohumeral translation was (3.0±1.0), (3.1±1.1), (3.3±1.5) mm, respectively. During the whole motion, there was a significant difference in superior-inferior translation at different arm elevation angles, while other significant differences were not found.Conclusions For normal Chinese, the humeral head was positioned posteriorly and superiorly on the glenoid. During forward flexion, the anterior-inferior and superior-inferior glenohumeral translation was the maxium. Therefore, in the process of clinical diagnosis, treatment and follow-up, patients performing the forward flexion may obtain a better evaluation effect.

Objective:To investigate the expression level of circular RNA circ_0020123 in ovarian cancer (OC) , and then to evaluate the diagnostic value of circ_0020123 level in ovarian cancer.Methods:Fifty-five ovarian cancer patients who were diagnosed and treated in Hangzhou Linping District Maternal and Child Health Hospital from Oct. 2016 to Mar. 2017 were selected, and serum was collected for high-throughput gene expression sequencing analysis. The circ_0020123 level in serum of ovarian cancer patients and healthy controls was determined by real-time quantitative PCR, and the diagnostic efficacy of circ_0020123 level on ovarian cancer was evaluated by drawing receiver operating characteristic curve (ROC) . The correlation between the expression of circ_0020123 and the clinical characteristics of ovarian cancer patients was investigated by t-test. The survival curve was drawn to analyze the relationship between the serum circ_0020123 level and the prognosis and survival of ovarian cancer patients. Western blot was used to detect the expression levels of autophagy-related proteins LC3-II/LC3-I and p62.Results:Compared with the serum of healthy people (1±0.25) , the expression of circ_0020123 was significantly up-regulated in the serum of ovarian cancer patients (1.24±0.23) ( t=5.23, P<0.001) . The ROC curve showed that circ_0020123 had high diagnostic performance for the detection of ovarian cancer specimens (AUC=0.7579, P<0.001) . Comprehensive analysis of t test and logistic analysis showed that the high expression of circ_0020123 was significantly correlated with FIGO stage ( t=5.46, P<0.001) and tumor size ( t=6.37, P<0.001) . The measurement of survival data showed that the 5-year overall survival of the circ_0020123 high expression group was significantly shorter than that of the circ_0020123 low expression group ( P=0.019) . Knockdown of circ_0020123 in cells down-regulated the expression of autophagy-related proteins LC3-II/LC3-I (0.45±0.05) ( t=9.31, P=0.001) , and up-regulated the expression of p62 (1.94±0.11) ( t=12.62, P<0.001) . Conclusion:The results of this study indicate that circ_0020123 is an important ovarian cancer-related circular RNA, which provides a potential diagnostic, prognostic biomarker and therapeutic target for ovarian cancer patients.

Objective To explore the influence of hook deflection angle and inclination angle on mechanical properties of the soft tissue suture passer hook. Methods Taking the end face far away from the tip of the needle (end face 1) as the study object, a mathematical model was established with the moment as dependent variable and the hook deflection angle and inclination angle as the independent variable. The moment was solved by the mathematical model with the deflection angle and inclination angle of 0°, 10°, 20° and 30°. Based on the finite element analysis method, 16 three-dimensional geometric hook models with deflection angle and inclination angle of 0°, 10°, 20° and 30° were established by SolidWorks. The stress analysis was carried out by ANSYS Workbench. Under the same puncture force, the maximum von Mises stress of each hook and the reaction moment of end face far away from the tip of the needle were calculated. Results The results from theoretical analysis and numerical simulation showed that the reaction moment of end face 1 increased with the increase of deflection angle, and increased with the decrease of inclination angle. The hook with deflection angle of 0° and inclination angle of 30° had the minimum reaction moment. The finite element analysis results showed that with the deflection angle of 0°, the maximum von Mises stress of the hook was the smallest and did not change with the inclination angle of the hook changing. Conclusions The established mathematical model can accurately explain the relationship between the moment at the end face of the hook and the deflection angle and inclination angle of the hook. This study provides the theoretical basis for designing hook geometry of the soft tissue suture passer, and improves the safety of the soft tissue suture passer in operation process.

Objective To simulate the process of thrombus removal from the open-type stent retrievers, so as to provide theoretical references for the design and clinical application of the open-type stent retrievers. Methods Finite element models of the open-type stent retrievers with 3,4,5 supporting units (K3,K4,K5), the crimping tools, simulated vessels and simulated thrombus (three types) were established. Radial displacement load was applied on the crimping tool until the stent was crimped to 0.5 mm, and the maximum principal strain (MPS) peak and radial force (RF)of the stent were analyzed. When displacement of the crimping tool was restored, the stent self-expanded and contacted with blood vessels, and MPS of the stent and von Mises stress (VMS) of blood vessels were analyzed. Axial displacement was applied to proximal end of the stents to allow the stent to drive the clots to migrate, and the blood vessel VMS and withdrawal force of the stents (the ability to capture thrombus) were analyzed. ResultsThe MPS peaks for 3 types of stent retrievers during crimping process were 6.94%, 8.30% and 5.48%, which were all smaller than the 12% fracture limit. When the outer diameter of the stent was 3 mm (equal to the inner diameter of blood vessels), the K4 stent had the largest RF. The results of self-expanding release process showed that the larger the number of support units, the greater the VMS of blood vessels. At the stage of thrombus migration and removal,the VMS of blood vessels was generally small and concentrated on the thrombus. The withdrawal force of the stent reached the maximum at the initial stage of thrombus migration and removal, then gradually decreased. The peak withdrawal force of the K4 stent was larger than that of the K5 and K3 stent. Conclusions Although the MPS and VMS for 3 types of open-type stent retrievers were within the safe range, the K4 stent showed better performance in RF and withdrawal force with the three types of thrombus. The research findings can provide the analysis methods and ideas for optimizing the open-type stent retrievers, to avoid clinical complications such as vascular injury and improve safety and effectiveness of the stent retrievers.

Objective To simulate the biomechanical characteristics of pelvic-ligament-muscle during vaginal delivery and rest, and to explore the injury of levator ani muscles during vaginal delivery, pelvic organ prolapse and stress urinary incontinence. Methods The three-dimensional (3D) nonlinear finite element model of pelvis-ligament-muscle was established to calculate the stress and strain distributions and injury of levator ani muscles under different abdominal pressures and loads. The stress and strain distributions as well as damage of type I, Ⅱ, Ⅲ stress urinary incontinence and pelvic organ prolapse were also calculated. Results The highest equivalent stresses of levator ani were 14, 29, 43, 86, 144, 230 kPa, respectively, when the abdominal pressure was 1 kPa under the load of 3, 5, 8 kPa and the abdominal pressure was 1.5 kPa under the load of 3, 5, 8 kPa. The stresses of type I, Ⅱ, Ⅲ stress urinary incontinence and pelvic organ prolapse were 1.69, 1.01, 0.70, 1.58 MPa. Conclusions Vaginal delivery would result in the damage to the puborectalis and the middle of the pubococcipital muscle, which was consistent with the damage of the anal levator muscle with pelvic floor dysfunction. This study uses scientific method to find out the exact location of pelvic floor injury during vaginal delivery, which can provide references for clinicians to prevent pelvic floor disease and formulate post natal rehabilitation training.

The corona virus disease 2019 (COVID-19), which started in Wuhan in December 2019, is a new infectious disease. The disease is highly contagious, and the correct selection of effective disinfectants is essential. This article analyzed the environmental resistance of coronavirus and its sensitivity to commonly used disinfectants by reviewing domestic and foreign literatures, and concluded that coronavirus has strong survivability in the environment, but it can be efficiently inactivated by most disinfectants. However, it should be noted that the commonly used concentration of chlorine-containing disinfectants (effective chlorine concentration of 500 mg/L) cannot quickly kill coronavirus, and a concentration of 1 000 mg/L or higher is required. Other biocidal agents, such as benzalkonium chloride and chlorhexidine digluconate, are less effective. This article aimed to provide references for selecting the appropriate disinfectants and disinfection methods to cut off the spread of the virus.