OBJECTIVE:To compare the cost-effectiveness and quality of survival among different therapeutic regimens for diabetic patients with sulfonylureas secondary failure(SSF).METHODS:The cost-effectiveness and the effects on patients life quality of four therapeutic schemes(group A: mixed-human insulin;group B:repaglinide and metformin;group C:repaglinide and acarbose;group D:glipizide,metfonmin and novolin N) were compared using cost-effectiveness analysis in pharmacoeconomics and DSQOL(diabetic patients’ score on quality of life).RESULTS:Group A showed the best clinical efficiency,with cost-effectiveness ratio significantly lower,physiological and psychological dimension scores significantly higher and social dimension score significantly lower than in all the other 3 groups,and all were of significant differences,but no significant differences were noted in therapeutic dimension score as compared with the other 3 groups.CONCLUSION:Insulin is optimal among four schemes in the treatment of diabetic patients with sulfonylureas secondary failure in the cost-effectiveness analysis, and it has the best efficacy in the improvement of patients’ physiology and psychology.

To explore the clinical efficacy and possible mechanism of Tai Ji Quan for post-stroke depression (PSD), literature related to Tai Ji Quan and PSD were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full- text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), and PubMed, screened and then summarized. The results showed that Tai Ji Quan could effectively improve the depression and quality of life of stroke patients, and there were differences in the clinical efficacy among different training programs. Tai Ji Quan has the characteristics of "regulating mind", "regulating breath", and "regulating body". It may achieve the effect of "combined physique-spirit treatment" by improving social psychology, increasing the level of neurotrophin, regulating neuroendocrine, reducing inflammatory factors, and regulating neural circuits.

Taking Pharm .D .degree education in School of Pharmacy ,University of Pittsburgh as an example ,this pa-per introduced the American pharmacists training system ,degree setting for service-oriented pharmacy students ,training objec-tive ,course design ,teaching staff and other aspects .This paper also reviewed pharmacy education and professional develop-ments for licensed pharmacists in China .Based on the successful experience abroad ,proposals were made to modify the domes-tic pharmacy education .The process of personnel training should be emphasized to improve the quality and capability of licensed pharmacists in China .

Objective: To explore the biological characteristics of synovial fluid-derived mesenchymal stem cells (SF-MSCs) cultured in serum-free medium and the ability of in vitro reconstruction of three-dimensional cartilage combined with scaffold material. Methods: Human SF-MSCs were cultured in serum medium and mesenchymal stem cells medium-serum free (MSCM-sf) respectively, then the proliferative ability and morphology of SF-MSCs were compared; The third passage SF-MSCs cultured in MSCM-sf were identified by flow cytometry, three-way(chondrogenic, osteogenic, adipogenic)differentiation assay and induced for chondrogenic differentiation when combined with polyglycolic acid/polylactic acid (PGA/PLA). Results: SF-MSCs cultured in MSCM-sf had better morphology and proliferative ability than that cultured in serum medium. The expression levels of positive markers of the third passage SF-MSCs cultured in MSCM-sf, such as CD73 (99.5%), CD90 (98.9%) and CD105 (96.5%), were more than 95%. However, the overall negative markers (CD34, HLA-DR and CD11b) expressed less than 2%. Three-way differentiation staining was positive. The combination of SF-MSCs and PGA / PLA can be induced into cartilage in vitro. Conclusions SF-MSCs cultured in MSCM-sf can be amplified under the condition of maintaining the stem cell characteristics, and can be combined with PGA/PLA scaffold to construct three-dimensional cartilage in vitro.

This paper summarizes and analyzes the current conditions of Tanzania traditional medicine practitioners, organization structure, herbal medicine resources, and the exported pharmaceutic products and related companies. The result shows that Tanzania government gradually pays the attention to the development of its own traditional medicine industry. Due to the current TCM cooperation dilemma with Tanzania, coping strategies should be adopted to provide certain references for the next stage of China-Tanzania TCM cooperation, such as adjusting the professional fields of dispatched experts, adjusting cooperative fields, including the export and investigation of TCM companies to Tanzania.

Objective:To study the related factors of pressure ulcer in liver transplantation patients, to understand the occurrence of postoperative pressure sores in liver transplantation patients, and to propose corresponding nursing strategies to provide theoretical basis for clinical nursing work.Methods:A total of 93 patients with liver transplantation were investigated for postoperative pressure ulcers using a general data sheet and a Braden risk assessment form.Results:The Braden risk score of liver transplantation patients was significantly positively correlated with pressure ulcers ( t value was -3.512, P<0.01). Among the risk factors affecting patients with surgical pressure sores, low pressure ulcer score, postoperative hypotension and low serum albumin were pressure ulcers. The risk factors, OR value were 1.185 (1.037-1.354), 9.443 (2.273-39.237), 1.325 (1.119-1.570), and the short operation time was the protective factor of pressure ulcer. The OR value was 0.729 (0.542-0.981). Conclusions:Clinical medical staff should take comprehensive measures to treat patients with liver transplantation in different situations, reduce the incidence of pressure ulcers and improve the quality of life of patients.

OBJECTIVEThis study was to investigate the clinical and pathological characteristics, curative effect and prognosis of primary central nervous system lymphoma (PCNSL).

METHODSThe clinical and pathological features, diagnosis and treatment, curative efficacy and survival rate of 20 cases of primary central nervous system lymphoma were retrospectivaly analyzed.

RESULTSThe indicated that the clinical manifestations included headache, paralysis, seizures, dizziness and mental acuity, etc. There were 7 cases with single focus of lesion, 13 cases with multiple foci of lesions. The pathologic examimation showed 1 case of peripheral T-cell lymphoma and 19 cases of diffuse large B cell lymphoma, they all were from non-germinal center. Out of 20 cases, 11 cases with Ki-67>75%,6 cases with Ki-67 50%-75%, 2 cases with Ki-67 25%-50% and 1 case with Ki-67 10%. Therapeutic evaluation were as follows: 10 cases with CR, 2 cases with PR, 6 cases with PD in 18 patients recieved treatment. The use of ritusimab in treatment or no use and number of lesion foci in cranium were related to survival time (P < 0.05) . The survival time in group with Ki-67(+)<75% was longer than that in group with Ki-67(+)>75% (P = 0.042). Age and CSF-TP level were related to curative effect (P < 0.05) .

CONCLUTIONThere is no specific clinical manifestation. The physical examination and imageological diagnosis of PCNSL, as well as pathological biopsy are necessary for diagnose of PCNSL. The factors for poor prognosis include age > 60 years, CSF-TP > 600 mg/L, multiple lesions and Ki-67(+)>75%. PCNSL has high malignancy and poor prognosis. The chemotherapy based on high dose of MTX (among which MTX combined with rituximab) and HSCT after CR are the best treatment regimen for DLBCL.

Objective:To investigate the medical narrative competence of pediatric staff, and analyze its influencing factors and correlation with psychological resilience, and to discuss strategies to improve narrative competence.Methods:From January 11 to February 25, 2022, by convenience sampling, we sampled pediatric personnel and those on refresher training at Children's Hospital, Zhejiang University School of Medicine for a questionnaire survey involving general information, the narrative competence scale, and the 14-item resilience scale. With the use of SPSS 26.0, the narrative competence of different populations was compared, and factors affecting narrative competence were determined through Pearson correlation analysis and multiple regression analysis.Results:A total of 361 valid questionnaires were included in this study, and there was significant differences in the narrative competence score between different ages, professional titles, working years, income levels, and whether they wrote parallel charts ( P<0.05). The total score of narrative competence of pediatric staffs was (147.13±18.76), and positively correlated with the total resilience score and the score of each dimension ( P≤0.001). The regression analysis showed that writing parallel charts and resilience could explain 53.10% of the variation in narrative competence ( P<0.001). Conclusions:Pediatric staff's narrative competence is at low or intermediate levels. Parallel chart writing and resilience training can improve narrative competence and promote a harmonious doctor-patient relationship.