Enhancing Drug Management, Cost Savings, and Staff Satisfaction in Anesthesiology: A Quality Improvement Project in a Chinese Tertiary Hospital.

INTRODUCTION: In alignment with China's national directive for improved drug management in anesthesiology, the Affiliated Hospital of Qingdao University initiated a quality improvement project, aiming to tackle the prevailing challenges of inefficiencies in drug administration, escalating drug costs, and the notable communication gap between pharmacists and anesthesiologists. METHODS: We employed a Plan-Do-Study-Act methodology to establish a pharmacy team and execute a multidimensional pharmaceutical intervention. The interventions included the formulation of standard procedures, guidelines and regulations, assistance from an information system (including automatic dispensing cabinets and prospective prescription review system), communication feedback (via WeChat groups), and education for anesthesiology staff. The intervention spanned from April to September 2023, focusing on optimizing medication management, achieving cost savings, and enhancing the satisfaction of anesthesia team members, with an additional observation from October to December 2023. RESULTS: Following the interventions, improvements were observed in drug management practices. These enhancements included increased compliance with accounting procedures, more rigorous registration of controlled substances, and more effective disposal of liquid residues. There was no adverse events related to high-alert medications or look-alike drug usage errors. The introduction of automatic dispensing cabinets and a prospective prescription review system markedly improved work efficiency. The utilization of a WeChat group facilitated effective communication about unreasonable prescriptions and drug-related issues. Among the 29,061 patients who underwent surgery both before and after the interventions, significant reductions were observed both in the drug proportion and the per capita drug costs (P = 0.03, P = 0.014, respectively). The per capita drug cost decreased by 20.82%, from ¥723.43 to ¥572.78, consistently remaining below ¥600 throughout the 9-month observation period. The per capita cost of monitoring drugs including dezocine, butorphanol, haemocoagulase agkistrodon, penehyclidine, and ulinastatin experienced a significant reduction (P < 0.05). Additionally, in the satisfaction questionnaires returned, a remarkable 94.44% of anesthesiology staff expressed high satisfaction with the comprehensive pharmaceutical interventions. CONCLUSION: The quality improvement project has yielded remarkable positive outcomes, serving as a model worthy of reference and replication in similar healthcare settings.

Commelinadanxiaensis (Commelinaceae), a new species from Guangdong, China.

Commelinadanxiaensis (Commelinaceae), a remarkable new species from Mount Danxia, Guangdong Province, China, is described and illustrated. This species is similar to C.communis in inflorescences and flowers but readily distinguishable in its nearly erect stems, larger flowers, and different petal colouration.

Crown feature effect evaluation on wind load for evergreen species based on laser scanning and wind tunnel experiments.

The wind load a tree withstood is mainly applied to its crown, whose morphology and structure directly affect the degree of wind load given a certain wind condition. Though the features of tree crown are relatively easy to measure, however, among them which is/are the determining factor and how they contribute to wind load remain unknown. In order to figure out how crown features of different tree species influence the wind load, the wind tunnel experiment was performed for 7 most used urban greening tree species, and laser scanning was used to measure the accurate crown features. The results derived by multiple linear model showed (1) Ficus concinna, Dracontomelon duperreanum, Ormosia pinnata and Bischofia javanica are recommended in urban greening for suffering the smaller wind load under the same conditions, whereas Schefflera macrostachya, Acacia confusa and Khaya senegalensis are inadequate towards the view of crown features; (2) crown features like crown horizontal ratio, windward side projection and porosity ratio are important in estimating wind load. Our study demonstrated that evaluating the wind load via crown features is feasible, and provided valuable suggestion for selecting idealized decorative trees in urban environment with a smaller wind load due to the crown features.

Expression Level Dominance and Homeolog Expression Bias Upon Cold Stress in the F1 Hybrid Between the Invasive Sphagneticola trilobata and the Native S. calendulacea in South China, and Implications for Its Invasiveness.

The role of hybridization is significant in biological invasion, and thermotolerance is a trait critical to range expansions. The South American Sphagneticola trilobata is now widespread in South China, threatening the native S. calendulacea by competition and hybridization. Furthermore, upon formation, their F1 hybrid can quickly replace both parents. In this study, the three taxa were used as a model to investigate the consequences of hybridization on cold tolerance, particularly the effect of subgenome dominance in the hybrid. Upon chilling treatments, physiological responses and transcriptome profiles were compared across different temperature points to understand their differential responses to cold. While both parents showed divergent responses, the hybrid's responses showed an overall resemblance to S. calendulacea, but the contribution of homeolog expression bias to cold stress was not readily evident in the F1 hybrid possibly due to inherent bias that comes with the sampling location. Our findings provided insights into the role of gene expression in differential cold tolerance, and further contribute to predicting the invasive potential of other hybrids between S. trilobata and its congeners around the world.

Customizing Heterointerfaces in Multilevel Hollow Architecture Constructed by Magnetic Spindle Arrays Using the Polymerizing-Etching Strategy for Boosting Microwave Absorption.

Heterointerface engineering is evolving as an effective approach to tune electromagnetic functional materials, but the mechanisms of heterointerfaces on microwave absorption (MA) remain unclear. In this work, abundant electromagnetic heterointerfaces are customized in multilevel hollow architecture via a one-step synergistic polymerizing-etching strategy. Fe/Fe3 O4 @C spindle-on-tube structures are transformed from FeOOH@polydopamine precursors by a controllable reduction process. The impressive electromagnetic heterostructures are realized on the Fe/Fe3 O4 @C hollow spindle arrays and induce strong interfacial polarization. The highly dispersive Fe/Fe3 O4 nanoparticles within spindles build multi-dimension magnetic networks, which enhance the interaction with incident microwaves and reinforce magnetic loss capacity. Moreover, the hierarchically hollow structure and electromagnetic synergistic components are conducive to the impedance matching between absorbing materials and air medium. Furthermore, the mechanisms of electromagnetic heterointerfaces on the MA are systematically investigated. Accordingly, the as-prepared hierarchical Fe/Fe3 O4 @C microtubes exhibit remarkable MA performance with a maximum refection loss of -55.4 dB and an absorption bandwidth of 4.2 GHz. Therefore, in this study, the authors not only demonstrate a synergistic strategy to design multilevel hollow architecture, but also provide a fundamental guide in heterointerface engineering of highly efficient electromagnetic functional materials.

The status and predictors of self-care among older adults with hypertension in China using the Chinese version of Self-Care of Hypertension Inventory - A cross-sectional study.

AIM: To investigate the status and predictors of self-care among older adults with hypertension in China by the Chinese version of Self-Care of Hypertension Inventory. DESIGN: A cross-sectional questionnaire survey. METHODS: A convenience sampling of 544 older adults with hypertension was surveyed using the Chinese version of Self-Care of Hypertension Inventory. SPSS25.0 software was used for statistical analysis of the data. Generalized liner model univariate analysis and the optimal scaling regression analysis were performed to investigate the predictors of self-care. RESULTS: The status of self-care was poor with the median and inter-quartile range of total scores of self-care (140.00 ± 67), the scores of self-care maintenance (50 ± 24.76), the scores of self-care management (56.25 ± 29.41) and the scores of self-care confidence (54.79 ± 29.17). Age, family model, primary caregiver, maximum systolic blood pressure, coverage of medical insurance, disease duration, receiving self-care education, education level, economic burden and family history of hypertension were the most powerful predictors of self-care among older adults with hypertension.

STAT1: a novel candidate biomarker and potential therapeutic target of the recurrent aphthous stomatitis.

BACKGROUND: The recurrent aphthous stomatitis (RAS) frequently affects patient quality of life as a result of long lasting and recurrent episodes of burning pain. However, there were temporarily few available effective medical therapies currently. Drug target identification was the first step in drug discovery, was usually finding the best interaction mode between the potential target candidates and probe small molecules. Therefore, elucidating the molecular mechanism of RAS pathogenesis and exploring the potential molecular targets of medical therapies for RAS was of vital importance. METHODS: Bioinformatics data mining techniques were applied to explore potential novel targets, weighted gene co-expression network analysis (WGCNA) was used to construct a co-expression module of the gene chip data from GSE37265, and the hub genes were identified by the Molecular Complex Detection (MCODE) plugin. RESULTS: A total of 16 co-expression modules were identified, and 30 hub genes in the turquoise module were identified. In addition, functional analysis of Hub genes in modules of interest was performed, which indicated that such hub genes were mainly involved in pathways related to immune response, virus infection, epithelial cell, signal transduction. Two clusters (highly interconnected regions) were determined in the network, with score = 17.647 and 10, respectively, cluster 1 and cluster 2 are linked by STAT1 and ICAM1, it is speculated that STAT1 may be a primary gene of RAS. Finally, genistein, daidzein, kaempferol, resveratrol, rosmarinic acid, triptolide, quercetin and (-)-epigallocatechin-3-gallate were selected from the TCMSP database, and both of them is the STAT-1 inhibitor. The results of reverse molecular docking suggest that in addition to triptolide, (-)-Epigallocatechin-3-gallate and resveratrol, the other 5 compounds (flavonoids) with similar structures may bind to the same position of STAT1 protein with different docking score. CONCLUSIONS: Our study identified STAT1 as the potential biomarkers that might contribute to the diagnosis and potential therapeutic target of RAS, and we can also screen RAS therapeutic drugs from STAT-1 inhibitors.

The complete chloroplast genome sequence of Begonia versicolor Irmsch. (Begoniaceae).

Begonia versicolor (Code: MK434325) is a perennial plant with unique and precious ornamental value, exhibiting gorgeous leaf morphology and graceful flowers, therefore, it is popular with many horticulturalists and plant hobbyist. The complete chloroplast genome of B. versicolor were reported in this article. It had a typical quarter structure as a circular of 169,506 bp, composed by a large single-copy region (LSC, 75,868 bp), a small single-copy region (SSC, 18,290 bp), and two inverted repeats (IRs, 75,258 bp each). Genome annotations showed that it contained total 185 genes, including 133 protein coding genes (PCGs), 44 transfer RNA (tRNAs), and 8 ribosome RNA (rRNAs). The percentage of total GC content was 35.57%. Phylogenetic analysis suggested that Begoniaceae was closely related to Cucurbitaceae family.

Re-lectotypification of Shivparvatia glanduligera, the type of the genus Shivparvatia (Alsineae, Caryophyllaceae).

The genus Shivparvatia Pusalkar & D.K. Singh was described in 2015 and the specimen J.D. Hooker 11 deposited in K (K000742193) was designated as the lectotype of its type species S. glanduligera (Edgew.) Pusalkar & D.K. Singh (≡ Arenaria glanduligera Edgew.). Nevertheless, J.D. Hooker 11 (K000742193) is actually the type of S. ciliolata (Edgew.) Pusalkar & D.K. Singh (≡ Arenaria ciliolata Edgew.). Thus the lectotypification of S. glanduligera was problematic and a re-lectotypification for this species is needed. One of the syntypes of S. glanduligera collected from Kashmir (H. Falconer s.n., K000742189) is selected here as its lectotype. Morphologically, S. ciliolata and S. glanduligera can be easily distinguished from each other by their different morphology of indumentum, disc gland and sepals, as well as the color of petals.

Pharmacokinetic, metabolic stability, plasma protein binding and CYP450s inhibition/induction assessment studies of N-(2-pyridylmethyl)-2-hydroxiymethyl-1-pyrrolidinyl-4-(3-chloro-4-methoxy-benzylamino)-5-pyrimidine-carboxamide as potential type 5 phosphodiesterase inhibitors.

N-(2-pyridylmethyl)-2-hydroxiymethyl-1-pyrrolidinyl-4-(3-chloro-4-methoxy-benzylamino)-5-pyrimidine-carboxamide (NHPPC) is a new potential of type 5 phosphodiesterase (PDE5) inhibitors, synthesized from the avanafil analogue for the treatment of erectile dysfunction. The targets of this article were to assess plasma protein binding, liver microsomal metabolic stability, inhibition and induction on cytochrome P450 isozymes and the pharmacokinetics of NHPPC. Equilibrium dialysis technique was applied to determine Plasma protein binding (PPB) and NHPPC was evaluated in male Sprague-Dawley rats and Beagle dogs in vivo pharmacokinetic. The NHPPC was highly bound to plasma proteins in rats, dogs and human tested and the mean values for PPB rate were 96.2%, 99.6% and 99.4%, respectively. After in vitro liver microsomes incubated for 60 min, the percent remaining of NHPPC was 42.8%, 0.8% and 42.0% in rats, dogs and human, respectively. In vitro intrinsic clearance was found to be 0.0233, 0.1204 and 0.0214 mL/min/mg protein in rat, dog and human liver microsomes of NHPPC, respectively. NHPPC showed no significant inhibitory effects on major CYP450 enzymes, and had no significant induction potential on CYP1A2 and CYP3A4. Following oral administration in rats and dogs, t max was 6 and 0.5 h, respectively. The clearance for NHPPC was 1.19 and 1.46 L/h/kg in rats and dogs, respectively. And absolute bioavailability in rat and dog were approximately 34.5% and 53.1%, respectively. These results showed that NHPPC has a good development prospect.

Hispidulin suppresses cell growth and metastasis by targeting PIM1 through JAK2/STAT3 signaling in colorectal cancer.

Colorectal cancer (CRC) accounts for over 600 000 deaths annually worldwide. The current study aims to evaluate the value of proto-oncogene PIM1 as a therapeutic target in CRC and investigate the anticancer activity of hispidulin, a naturally occurring phenolic flavonoid compound, against CRC. Immunohistochemistry analysis showed that PIM1 was upregulated in CRC tissue. The role of PIM1 as an oncogene was evidenced by the fact that PIM1 knockdown inhibits cell growth, induces apoptosis, and suppresses invasion. Our results showed that hispidulin exerts antitumor activity in CRC through inhibiting the expression of PIM1. Moreover, our findings revealed that hispidulin downregulated the expression of PIM1 by inhibiting JAK2/STAT3 signaling by generating reactive oxygen species. Furthermore, our in vivo studies showed that hispidulin can significantly inhibit tumor growth and metastasis in CRC. Collectively, our results provide an experimental basis for trialing hispidulin in CRC treatment. PIM1 can be considered a potential therapeutic target in CRC.

Synotis xinningensis (Asteraceae), a new species from Hunan, China.

BACKGROUND: Synotis is one of the several genera within Senecioneae (Asteraceae) with more than 40 species that are mainly distributed in China or in the Sino-Himalayan region. During a botanical expedition in central and southwestern China in 2011, we found an unusual population of Synotis in southwestern Hunan Province. To determine the taxonomic identity of the population, we carried out gross-morphological, floral micromorphological, and cytological observations. RESULTS: Our gross-morphological observations have shown that the population is most similar to Synotis changiana Y. L. Chen, but readily distinguishable in the discoid capitula (vs. radiate), and in the bracts of calyculus 9-10 (vs. 6-8), 6-7 mm long (vs. 3-4 mm). The floral micromorphological observations on the population and S. changiana agree with previous reports for other species of Synotis. The chromosomes of the population are counted to be 2n = 40 + 0-1B. Its karyotype is formulated as 2n = 22m + 14sm + 4st. CONCLUSIONS: The population is determined to represent a new species, i.e. Synotis xinningensis M. Tang & Q. E. Yang, which is described herein. The new species belongs to Synotis ser. Synotis.