Objective To evaluate therapeutic roles of parenteral and enteral nutrition in patients with dysphagia complicating stroke. Method Seventy-two patients with dysphagia after stroke were randomly divided into group A (parenteral and enteral nutrition in sequence) and group B (parenteral nutrition) who were respectively given nutritional support 48 hours after the illness,measured hospital nutrition parameters,and observed the incidence rate of complications including tympanites,diarrhea and stress-induced ulcer,aspiration pneumonia.Death rate were compared between two groups at the end of the third week after admitted in hospital. Results Nutrition parameters in group A were higher than that in group B.There was significant difference (P0.05). Conclusion Parenteral and enteral nutrition in sequence for patients with dysphagia after stroke are safe and effective.

A consensus remains unsettled yet for basic medical insurance and common protocols on managing patients seeing doctors out of their hometown.This results in such setbacks as difficulty in seeing doctors elsewhere for those covered and in unaffordable financial burden,as well as medical insurance fraud,lack of information sharing among social insurance authorities,and difficulty of supervision.This study described the status quo of seeding doctors elsewhere under China's basic medical insurance system,and analyzed problems found in the management framework.On such basis,authors proposed such recommendations as unified management system for seeding doctors elsewhere,network information sharing for medical insurance information,and networked settlement for medical expenses for basic medical insurance.These measures should be carried out as per general requirements for health reform stage by stage.

OBJECTIVE:To explore the ways and methods for pharmacists to participate in community pharmaceutical care, and to provide reference for guaranteeing safe use of drugs in the elderly. METHODS:Questionnaire survey about medication situa-tions and pharmaceutical care demands was conducted among the elderly randomly selected from some communities of Guangzhou Yuexiu District and Liwan District. The investigation data was analyzed statistically. RESULTS:Totally 300 questionnaires were sent out,and 283 were recycled with effective recovery rate of 94.33%. Among respondents,64.66% geriatric people had a high school education or above and 87.99% elderly people enjoyed medical insurance for urban residents;the major health problems of the elderly were chronic diseases like hypertension,osteoporosis,hyperlipidemia,diabetes. 55.48% interviewees preferred to pur-chasing drugs from governmental hospitals and 40.28% interviewees used to purchase drugs from community hospitals;in terms of understanding of drug information,72.08% interviewees tended to consult doctors about drug use but only 12.72% intervieweestended to consult hospital pharmacists about drug use. Interviewees often took various kinds of drugs,there were 72.44%interview-ees taking drugs according to the doctor's advice. 44.88%interviewees accustomed to storing drugs at discretion. 68.20%interview-ees deemed that the responsibilities of the pharmacists were drug dispensing,but only 28.27% interviewees thought that pharma-cists could provide medication guidance and consultation;in terms of community pharmaceutical care,interviewee had much great-er demands to daily care and rational drug use of lectures. CONCLUSION:Geriatric people take many different drugs to treat their diseases in those communities,there are many problems that are not conducive to safe drug use. Those reflected urgent need for community pharmaceutical care,and then higher requirements are put forward for the professional quality of pharmacists.

OBJECTIVE To identify an d analyze chemical cons tituents of Pleione yunnanensis with origin of Pleione yunnanensis. METHODS UPLC-Q-Exactive-Plus-Orbitrap-MS was adopted. The determination was performed on Hyperdil GOLD column with mobile phase consisted of 0.1％ formic acid solution-0.1％ formic acid acetonitrile solution （gradient elution ）at the flow rate of 0.3 mL/min. The column temperature was set at 40 ℃，and sample size was 2 µL. The electrospray ion source was adopted，and the scanning range was m/z 100-1 500，and the scanning mode was positive and negative ion exchange mode of full scan+ddMS2. The structure of chemical constituents were determined by using Compound Discoverer 3.1 software，comparing with mzCloud，PubChem network database and OTCML ，on the basis of reference substance and published literatures. RESULTS & CONCLUSIONS A total of 42 chemical constituents were identified （positive ion mode has 24，negative ion mode has 27）， including 13 benzyl succinate glycosides （such as dactylorhin C ，coelovirin A ，militarine），4 phenol glycosides （such as adenosine ， guanosine，gastrodin），3 alkaloids（choline，betaine，berberine），and one flavonoid （nobiletin），7 aromatics（such as DL-lysine ， DL-arginine，DL-glutamine），one sugar （sucrose），3 benzenes（shancigusin H ，shancigusin H isomer ，batatasin Ⅲ）and 10 others （such as p-methoxybenzoic acid ，monomethyl dodecanedioate ，diphenylamine）. Glucose oxybenzyl and some small mole cules are easy to be lost in the cleavage of benzyl succinate glycosides；glycosyl is easy to be lost in the cleavage of phenol glycosides；the cleavage of alkaloids mainly manifest as the cleavage and loss of small molecular substituents ；demethyla- tion reaction is occurred in most flavonoids.