OBJECTIVE:To discuss the necessities and countermeasures of pharmaceutical care in the rural areas of China.METHODS:The existing difficulties of pharmaceutical care in the rural areas of China were analyzed realistically.RESULTS&CONCLUSION:In order to successfully carry out pharmaceutical care,firstly the state food and drug adminis-tration must strengthen the supervision,construct the supply network of drugs and ensure the quality of medication;secondly the pharmacists'ability must be enhanced and pharmacists'quantity increased through various of training and education;thirdly the consultation service should be carried out by specially assigned persons.Only in this way can we improve the quality of pharmaceutical care and ensure the secure,efficient and economic drug use.

Objective To study the different expression of complement receptors on neutrophils between bacterial and viral pneumonia. Methods Fifty-nine patients with CAP were studied prospectively. CR1 ,CR3 were measured by,using flow cytometer. ESR,CRP and WBC were also measured. Results Thirteen patients had pneumococcal pneumonia; 13 patients, A type of infuenza virus pneumonia ;5 patients, atypical pneumonia, and 28 patients, aetiologically undefined pneumonia. The mean expression of complement receptor 1 ( CR1 ) on neutrophils and aetiologically undefined pneumonia was( 19.4 ± 9.8 ) and ( 19.3 ± 8.8), which were significantly higher than those with A type of infuenza virus( t = 6.13,5.09 ,P < 0.01 ). Conclusion The expression of CR1 may be of value as an additional rapid tool in the aetiological diagnosis, bacterial or viral infection of CAP.

Objective To observe the effects of the compatibility of Radix Astragali and Radix Angelicae Sinensis in different proportion on hemodynamic and balance of Th1/Th2 cells of Qi deficiency and blood stasis rat model. Methods Qi deficiency and blood stasis rats were caused by restricted diet, forced swimming and norepinephrine subcutaneous injecting, and treated by compatibility of Radix Astragali and Radix Angelicae Sinensis in different proportion of 5∶1, 3∶1, 1∶1 and 1∶2 for 21 days. The indexes of hemorheology were detected with hemorheological analyser, and the level of IFN-γand IL-4 in serum were tested by ELISA. Results Compared with model group, the compatibility of Radix Astragali and Radix Angelicae Sinensis in proportion of 1∶1, 3∶1 and 5∶1 groups reduced the low shear blood viscosity. The spleen index of model group decreased, and compatibility of Radix Astragali and Radix Angelicae Sinensis in 5∶1 proportion group increased spleen index. The level of IL-4 increased and IFN-γ decreased in the serum of model group, the compatibility of Radix Astragali and Radix Angelicae Sinensis in proportion of 3∶1 group increased the level of IFN-γ. Astragalus angelica 5∶1 group decreased the level of IL-4 and increased the level of IFN-γ. Conclusion The compatibility of Radix Astragali and Radix Angelicae Sinensis can improve hemorheology, adjust the balance of Th1/Th2 cells of Qi deficiency and blood stasis rats. The effects were better when Radix Astragali’s dosage greater than that of Radix Angelicae Sinensis, and the group of 5∶1 proportion was the best.

Objective To analyze the data of Human Immunodeficiency Virus (HIV ) screening in Qinnan District of Qinzhou from 2013 to 2015 ,and to provide scientific evidences for the prevention and control of Acquired Immune Deficiency Syndrome (AIDS) .Methods HIV antibody data which was collected from the AIDS laboratory between 2013 and 2015 in Qinnan District of Qinzhou were analyzed .Results Of 3 955 cases of the HIV antibody detecting in the AIDS laboratory from 2013 to 2015 ,200 cases were HIV antibody positive ,and the positive rate was 5 .06% which was decreased compared with previously .The HIV antibody positive rate of man was 9 .26% ,which was higher than women .Among the HIV positive people ,the rate of the ages older than 50 was 25 .36% which was the highest compared to the other age groups .The positive rate of farmers was 30 .83% and the rate of di‐vorced or widowed was 30 .86% and the rate of the illiterate was 16 .08% .Conclusion Man ,farmers ,the age older than 50 years old ,the divorced or widowed and the low degree of education groups are the focus groups of health education and prevention of AIDS .If we can find HIV infectors earlier ,we can control the epidemic of AIDS and formulate the prevention and control strategies better .

Objective To survey the clinical ability of diagnosis and treatment of diabetic foot among district medical clinical staffs.Methods 55 medical staffs were questionnaired about the diabetic foot knowledge before and after a technical training course.Results (1) After training,the clinical ability of diabetes physical examination,the features of diabetic foot identification,diabetic foot prevention and treatment,diabetic foot health education and the muhidisciplinary team of diabetic foot organization improved.The medical staffs got to know how to organize a multidisciplinary team of diabetic foot.The difference was significant(P＜0.05).(2)The professional category of medical personnel(OR=19.464,95％ CI=1.837-206.243),the history collection and physical examination of diabetic foot (OR=34.825,95％ CI=3.486-347.875)were the influent factors of antibiotic selection when diabetic foot were infected.Conclusion Targeted diabetic foot training is effective to improve the clinical diagnosis and treatment level of district medical staffs.

Objective To explore the care burden and its influencing factors of primary caregiver of patients with spinal cord injury. Methods A total of 120 primary caregiver of spinal cord injury patients were selected as research object. The general information of SCI patients and their primary caregiver were investigated by SCI patient general data questionnaire and primary caregiver in SCI patient general data questionnaire, caregiver burden of spinal cord injury were investigated bycaregiver burden inventory. The relationship between the general information of patients and caregivers and the care burden analyzed. Results Caregiver burden of elderly patients was significantly lower than that of younger ones (F=54.053,P<0.01). The more serious of spinal cord injury, the higher of care burden (F=315.104,P<0.01). The patients with neck and multiple segmental spine injury and postoperative complications had a higher care burden (F=199.203,t=6.462, 32.195,P<0.01). When the caregivers were female, spouses or children, with poor health condition, with higher education degree, and as cadres or workers, caregiver burden was higher (t=6.061,F=22.073-52.392,P<0.01). Multiple linear regression analysis showed that the degree of spinal cord injury, complications, gender, and the relationship between the patients were the main factors that influenced the care burden. Conclusions The main factors influencing the care burden are spinal cord injury degree, complications, gender, and the relationship between the patients. Clinical managers needs to develop appropriate social support system for the factors which affect the caregiver, in order to ease the caregiver′s care burden.

0bjective To study the potency of Entecavir Maleate(ETVM),Entecavir(ETV) and Adefovir(ADV) on suppressing duck hepatitis B virus (DHBV) replication.Methods DHBV DNA positive ducks were used as experimental animal model.Ail these ducks were randomized to different arms and respectively given high,medium and low dosage of ETVM,ETV and ADV.ETVM and ETV were given orally daily respectively for six weeks and ADV orally 3 times every week for six weeks.The serum DHBV DNA levels were tested every 2 weeks at day 0 and,after that,at week 2,4.6 and 8 respectively by real-time fluorescent quantitative polymerase chain reaction(PCR).The results were analyzed by paired-samples t test.Results The treatment resulted in the reduction of viral load among all ETVM.ETV or ADV treated groups.The viral load of DHBV DNA at pretreatment and week 6 in the ETVM high dosage group were(7.34±1.33)and(2.12±2.50)lg copy/mL,respectively(P

Objective To explore related factors of amputation in patients with diabetes foot ulcer(DFU) and provide the evidence of reducing amputation rate.Methods A total of 307 inpatients with DFU in this hospital from October 2013 to December 2015 were collected and divided into amputation group(n=28) and non-amputation group(n=279).The clinical data and laboratory data were treated with single variable analysis and multivariate Logistic regression analysis.Results Single variable analysis showed that hospitalization time,hyper-sensitive C-reactive(hs-CRP) and fibrinogen(FIB) level were significantly increased in amputation group(P＜0.05) when compared with non-amputation group,and the hemoglobin (Hb) level,high-density lipoprotein cholesterol(HDL) and serum albumin (ALB) level in amputation group were markedly lower than in non-amputation group(P＜0.05).Amputation rate was significantly different among different Wagner grades (P=0.000).Multivariate Logistic regression analysis showed that hospitalization time,Wagner grade were independent risk factors of amputation in patients with DFU,OR values were 1.024(95％CI:1.009-1.039) and 2.779 (95％CI:1.753-4.404),respectively.While HDL was a protective factor of amputation in patient with DFU (OR=0.161;95％CI:0.036-0.729).Conclusion The higher the rank of Wanger in DFU patients are,the longer hospital stay and the higher amputation risk become.HDL is the protective factor of DFU amputation.

Objective:To construct a reasonable and efficient clinical nursing pathway for elderly patients with acute chest pain in the emergency department, and to provide a standardized and rapid treatment process for such patients.Methods:Through literature review and theoretical analysis, the basic framework of clinical nursing pathway was preliminarily drawn up. Twenty one clinical medical and nursing experts from all over the country were selected to conduct two rounds of expert consultation with Delphi method, and the clinical nursing path was finally determined.Results:The recovery rates of the two rounds of questionnaires were 100.00% and 95.24%, and the rates of submission expert suggestions were 61.90% and 45.00%, the authority coefficients of experts were 0.85 and 0.88, and the coordination coefficients were 0.23 and 0.30. Finally, the clinical nursing pathway was constructed after two rounds of consultation.Conclusion:The positive coefficient and authority coefficient of the two rounds of experts were both high, and the variable coefficient and coordination coefficient were in line with the statistical requirements, so the clinical nursing path of the elderly patients with acute chest pain had high scientificity and reliability.

Objective To investigate the status and influencing factors of core competence of diabetes specialist nurses in Chongqing. Methods 118 diabetes specialist nurses from Chongqing were selected by convenience sampling and were surveyed by questionnaires. Results The ability of clinical nursing and health education were in an advanced level; the ability of nursing management, guidance, consultation and clinical research were in a medium level;the ability of ethical decision-making was in an inferior level. Hospital types, departments they belong and professional titles may to some degree influence core competence of diabetes specialist nurses.Conclusions The core competence training for diabetes specialist nurses in Chongqing meets requirements of specialist nurses′ training; according to factors influencing core competence, training units should take targeted intervention measures to effectively promote core competence of the nurses.