Amid the progress of public hospitals reform,the paper probed into the influences and opportunities of the health reform on the development the hospital pharmacy.They discussed the roles of pharmacists in medical service,and recommended on building the pharmaceutical service system in view of the current caliber of the pharmacists.

Objective:The regulatory effects of ethyl acetate extract of Herba Eclipta EAEE on immune function were studied.Methods: The experimental immunosuppressive models were induced by injection of Cyclophosphamide or hydrocortisonc.Results: The index of thymus gland spleen in immunosuppressive mice was increased significantly. when large and small dose of EAEEP were given. EAEE remarkably enhanced the delayed type hypersensitivity in immunosuppressive mice. Conclusions: EAEE possesses notable immunomodulatory action on immune system in mice.

Objective To explore the image quality and diagnostic efficiency of coronary CTA (CCTA) in patients without heart rate (HR) control by optimizing acquisition phase with auto-ECG-gating technology using 256-row wide-volume detector.Methods Totally 200 patients with suspected coronary artery disease (CAD) were selected and underwent CCTA with auto-ECG-gating on a 256 row wide detector CT (Revolution CT).Patients were divided into 4 groups according to the real-time HR,group A (n=50):HR≤69 bpm;group B (n=50):HR 70-80 bpm;group C (n=50):HR 81-90 bpm;group D:HR≥91 bpm (n=50).CCTA images quality and diagnostic rate were assessed by two experienced radiologists blindly,and effective radiation dose were compared among 4 groups.Results There were no significant differences of age,sex,and body mass index among 4 groups (all P＞0.05),and there was significant difference of image quality score among 4 groups (P＜0.05).Totally,800 coronary arteries and 2 575 segments in 200 patients were assessed.There had no significant difference of diagnostic rate among four groups derived from the segment,coronary artery and patients (all P＞0.05).The effective radiation dose in A D groups were (1.05t0.48)mSv,(2.41± 1.20)mSv,(1.27±0.55) mSv,(2.66±1.12)mSv,and the difference was significant (F=29.22,P＜0.001).Conclusion It is feasible to perform CCTA in single cardiac cycle in patients with arbitrary heart rate by auto-ECG-gating using Revolution CT equipped widevolume detector.And it can improve image quality and success ratio in patients with moderate and high heart rate.

Objectives To explore the clinical diagnosis and treatment of Dieulafoy disease in children. Method The clinical features, endoscopic features and treatment of Dieulafoy disease in a child were reviewed. Results The 2-year-5-month old girl was admitted due to hematemesis for 7 hours. She was diagnosed of Dieulafoy disease by the typical endoscopic appearance. Gastroscopy showed that the lesion was located in gastric angle which was the predilection position of Dieulafoy disease. The small red blood vessels in the central part of the erosion area was exposed on the mucosal surface. The high frequency electrocoagulation under gastroscope was performed and effect was definite. Conclusion Dieulafoy disease is rare in children and lacks obvious clinical features. Endoscopic treatment has definite effect with little trauma and is the first choice of treatment.

Objective:To explore the effect of health education model based on intelligent medical in patients who undergoing surgery with lumbar degenerative changes.Methods:A total of 80 patients with lumbar degenerative changes, who met the inclusion criteria, in the Orthopedics Department of Zhuhai People's Hospital from January 2019 to December 2020 were recruited as the research subjects by convenient sampling method. According to the order of admission, they were divided into control group and intervention group, with 40 cases in each group. The control group was given routine health education. A health education model relying on intelligence medical treatment was constructed and implemented in the intervention group, by making full use of their respective functional modules with the help of three intelligent medical tools: intelligent pad in the nurse station, electronic display screen and hand-held electronic devices. The pain, lumbar function, functional exercise compliance, satisfaction, anxiety and sleep quality and constipation of the two groups were compared by Visual Analog Score (VAS) , Japanese Orthopaedic Association (JOA) score, functional exercise compliance evaluation form for patients undergoing surgery for lumbar degenerative diseases, patient satisfaction questionnaire, Hamilton Anxiety Scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI) .Results:The pain score and lumbar function score on the 7th day after surgery in the intervention group were (2.57±0.73) and (15.00±1.89) respectively, and those scores in the control group were (3.10±0.61) and (12.80±1.75) respectively. The differences were statistically significant ( P<0.05) . The compliance of functional exercise in the intervention group was better than that in the control group, and the satisfaction was higher than that in the control group, with statistical significance ( P<0.05) . The postoperative anxiety of patients in the intervention group was lighter than that in the control group, and the sleep quality and defecation were better than those in the control group, with statistical significance ( P<0.05) . Conclusions:Health education based on intelligent medical treatment can reduce the pain in patients who undergoing surgery with lumbar degenerative changes, at the same time improve the compliance of exercise and satisfaction, reduce anxiety, sleep disorder and constipation, which is worthy of clinical application.

Objectives:To explore the risk factors for recurrent in-stent restenosis(R-ISR)in patients with coronary heart disease after percutaneous coronary intervention(PCI)and to develop a risk prediction model for R-ISR using a nomogram. Methods:All patients treated for ISR at the Fuwai Hospital,Chinese Academy of Medical Sciences from January to December 2017 were eligible for this study.A total of 1 102 ISR patients were included for analysis.Based on the recurrence of ISR after PCI,patients were divided into R-ISR group and non-R-ISR group.Univariate Cox regression analyses,LASSO regression analyses,and the combination of clinical experience were used to select predictors of R-ISR.A multivariate Cox regression model was used to analyze the independent risk factors of R-ISR and to develop a risk prediction model. Results:The median follow-up duration for participants was 1 264(1 169,1 334)days,the incidence rate of R-ISR after PCI was 10.1%.Multivariate Cox regression analysis showed that age(HR=0.98,95%CI:0.96-0.99),total bilirubin(HR=0.95,95%CI:0.91-0.99),apolipoprotein A1(HR=0.08,95%CI:0.02-0.42),high-sensitivity C-reactive protein(HR=1.05,95%CI:1.01-1.10),and reference vessel diameter(HR=0.65,95%CI:0.44-0.98)were independent determinants of R-ISR.Accordingly,the R-ISR risk prediction model was developed with a nomogram,the AUC of this model to predicto R-ISR was 0.70(95%CI:0.64-0.77). Conclusions:Coronary heart disease patients with younger age,lower levels of total bilirubin and apolipoprotein A1,smaller vessel diameter,and higher levels of high-sensitivity C-reactive protein are at higher risk of R-ISR.The developed visual risk prediction model for R-ISR shows promising predictive performance but still requires further optimization and validation.