OBJECTIVE:To investigate the status quo of clinical hospital pharmacy in hospitals in Fujian province.METHODS:A total of 575 questionnaires were given out in 10 general hospitals to investigate the status quo of clinical pharmacy and the role of physicians and nurses(primary nurses)in the pharmaceutical care.RESULTS:The hospitals in Fujian attached great importance to clinical pharmacy,but physicians and nurses(primary nurses)had a poor knowledge on the clinical pharmaceutical care and lacked trust in pharmacists' capability.CONCLUSION:The status quo of clinical hospital pharmacy in hospitals in Fujian province is far from perfect,the key to improve clinical hospital pharmacy level is to improve pharmacists' professional quality.

Objective To observe the efficacy of biofeedback behavioral cognitive and vestibular re-habilitation treatment in patients with chronic subjective dizziness( CSD) . Methods 60 patients with chro-nic subjective dizziness were divided into two groups: study group ( 30 cases) treated with drug,vestibular rehabilitation and biofeedback behavioral cognitive therapy,and the control group (30 cases) was treated with drug treatment by random number table method,and all the 60 patients in the study were assessed by DHI,HADS and SF-36. Results After four and six weeks of treatment,the DHI and HADS scale scores of the study group were(4 weeks:DHI(9.07±3.18),HADS(3.17±1.56);6 weeks:DHI(4.67±3.08),HADS (2.03±1.10)),and the scores of the control group were(4 weeks:DHI(13.20±4.48),HADS(4.90±2.40);6 weeks:DHI(12.13±3.60),HADS(4.57±2.06)),and the differences were statistically significant(all P<0.05).After 6 weeks treatment,SF-36 scores in eight aspects about physiological function,role-physical,bodi-ly pain,general health,vitality,social-functioning,role-emotional,and mental health,in the study group were (96.17±5.20),(95.00±5.72),(96.67±4.79),(95.17±5.33),(95.50±5.14),(94.58±9.10),(88.90± 18.21),(96.67±4.59)and the control group were(85.33±11.29),(82.67±9.07),(88.53±8.63),(80.83± 7.44),(88.00±8.47),(80.00±14.90),(64.44±27.60),(81.73±14.04),the differences were statistically significant(P<0.05).Conclusion The study indicates that vestibular rehabilitation and biofeedback behav-ioral cognitive therapy can significantly improve symptoms of dizziness,anxiety,depression and quality of life.

With the decline in cognitive ability, loss of ability to live, the demand of care for the Alzheimer's patients gradually increased. Caregivers tended to bear a greater physical and mental burden. In this study, we found that the caregivers of senile dementia were prone to psychological problems such as depression and anxiety, which may be related to the caregiver's age and caregiving time, and the positive intervention can relieve the psychological problems of the caregivers. This article aims to provide a theoretical basis for nursing workers to explore more effective nursing measures, so as to improve the quality of life of dementia patients and caregivers.

Sepsis is one of the serious illnesses leading to high mortality in ICU.Some animal experiments and clinical trails show that target temperature management has a protective effect on target organ function in sepsis,but the optimal timing,length of targeted temperature managment continued,intervention measures,and optimal target temperature obtained in sepsis remains in the great controversy.Whether the patients with sepsis would be truly benefited from the body temperature management is still worthy issue for further study.The aim of this article reviews is to trace the recent research progress on the body temperature management in sepsis.

Objective To observe the effect of SIRT1 on the proliferation of ovarian cancer CAOV3 cells and its possible mechanism. Methods Ovarian cancer CAOV3 cells were transfected the Lipofectamine 2000 and were divided into normal control group,negative control group and SIRT1-siRNA group.The mRNA and protein expression levels of SIRT1 were detected by RT-PCR and Western blot.MTT method was used to detect the proliferation of RNA interference at 24h,48h and 72h,respectively.The distribution of CAOV3 cell cycle phase after RNA interference of SIRT1 for 72 hours was detected by flow cytometry.SIRT1,p53,p21 protein expression and p53 acetylation status were detected by Western blot with RNA interference of SIRT1 after 72 hours.The interaction between SIRT1 and p53 protein was verified by immunoprecipitation in CAOV3 cells.Results Compared with negative control group,the expression of mRNA and protein of SIRT1 in SIRT1-siRNA group decreased after transfection of SIRT1 for 72 hours.The survival rate of CAOV3 cells in SIRT1-siRNA group decreased significantly at 48 hours and 72 hours (P<0.01).The proportion of Sphase cells in CAOV3 cells transfected with SIRT1-siRNA for 72h was significantly decreased (P<0.01),while the G1 phase cells were significantly increased (P<0.01),and the cells arrested in the G1 phase.The expression of p53 and p21 proteins were significantly increased and the p53 was in higher acetylation status after transfection with SIRT1-siRNA for 72 hours ( P<0.01 ) .SIRT1 was interacted with p53 protein in CAOV3 cells confirmed by co-immunoprecipitation. Conclusion Downregulation of SIRT1 expression can inhibit the proliferation of ovarian cancer CAOV3 cells, which maybe connected with p53 at high acetylation status,and enhancing p53-dependent p21 transcriptional activation,thus blocking the cell cycle and inhibiting the cell proliferation.

Metformin improves glycemic control mainly due to improved insulin sensitivity.Dipeptidyl peptidase-4(DPP-4) inhibitor,which suppresses degradation of glucagon-like peptide-1 (GLP-1) and maintains the bioactivity of endogenous GLP-1,improves islet dysfunction.Moreover,recent studies suggested that metformin enhanced the biological effect of GLP-1 via different mechanisms and that DPP-4 inhibitor enhanced insulin sensitivity in type 2 diabetes.Therefore,the combination therapy of DPP-4 inhibitor and metformin could simultaneously ameliorate the two major defects of type 2 diabetes and obtain complementary and synergistic benefits for glycemic control.

Objective To observe the therapeutic effect of eucalyptol limonene and pinene enteric soft capsules on elder community acguired pneumonin (CAP) patients.Methods Use the retrospective cohort study methods,233 patients,above 65 year old,were breught into the study,101 patients were in the eucalyptol limonene and pinene enteric soft capsules group and 132 patients were in the control group.The clinical symptoms and length of stay in hospital were recorded.Results The improvement of clinical symptoms on the fifth day of the eucalyptol limonene and pinene enteric soft capsules group was better than that of control group (U =2.37,P ＜ 0.05).And the length of stay in hospital of the eucalyptol limonene and pinene entetic soft capsules group was shorter(U =3.06,P ＜ 0.05).Conclusion Eucalyptol limonene and pinene enteric soft capsules can quickly improve the elder CAP patients clinical symptoms and shorten the length of stay in hospital.

Objective To investigate antimicrobial susceptibility of Klebsiella pneumoniae (K .pneumoniae )to aminoglycosides and detection of 16S rRNA methylase genes in K .pneumoniae .Methods Ninety-six non-repetitive clinical K .pneumoniae isolates were collected from Xiangya hospital of Central South University from January to Ju-ly 2009,minimal inhibitory concentrations (MICs)of gentamycin,amikacin and tobramycin were determined by agar dilution method ;genotype of 16S rRNA methylase genes (armA,rmtA,rmtB ,rmtC,rmtD ,npmA)were detec-ted by polymerase chain reaction(PCR).Results MIC50 of amikacin,gentamycin and tobramycin was 256μg/mL, 512μg/mL and 512μg/mL respectively;and MIC90 were all>512μg/mL;antimicrobial resistance rate was 21 .88%, 63.54%,and 41 ,67% respectively.68 isolates (70.83%)were resistant to at least one kind of antimicrobial agent, 21 isolates(21 .88%)were resistant to three kinds of antimicrobial agents.22 isolates(22.92%)carried armA,but rmtA,rmtB ,rmtC,rmtD and npmA were not detected;of 22 isolates harboring armA 16S rRNA methylase genes, 17(77.27%)were highly resistant to gentamicin,amikacin and tobramycin,the homology of armA positive isolate and armA (FJ410928.1 )was 100%.Conclusion armA 16S rRNA methylase gene harbored in K .pneumoniae plays an important role in aminoglycoside resistance.

Objective To investigate the concentration on clinical service of both medical workers and patients,for the purposes of better quality of care and concentration of medical workers,and better mental feelings of the patients′ and doctor-patient relationship.Methods 1 000 medical workers and patients were sampled from 8 hospitals of four regions in Jiangsu province by stratified randomization for questionnaire survey.The purpose is to study the clinical concentration of medical workers in terms of interpretation,listening,emotion and empathy,and compare the differences between doctors and patients regarding clinical concentration.Results 48.5% of the medical workers and 44.8% of the patients said that medical workers would interrupt the patients within 2 minutes.Time constraints of clinical consultation contribute to poor disease information collection,medical explanation and informing.The investigation found the difference between doctors and patients in clinical concentration is significant statistically(χ2=104.329,P=0.000),while medical workers were unaware of their lack of concentration to patients.18.2% of the patients complained that medical workers could hardly or refuse to understand their feelings.Conclusions Medical workers are advised to respect their patients by offering total concentration on diagnosis and treatment;to respect their career with sufficient concentration on diagnosis and treatment;and to respect medical science to offer medical humanistic care.