Objective:To explore the therapeutic regimen and key points in the pharmaceutical care for the elderly patients with a-cute exacerbation of the chronic obstructive pulmonary disease ( AECOPD) . Methods: On the basis of clinical pharmacist work, one typical case was selected. Referring to the COPD treatment guidelines, the treatment rationality was analyzed. Meanwhile, an individu-alized pharmaceutical care plan was established and carried out in whole process of the treatment. Results:The pharmacotherapy was effective and rational. By providing the pharmaceutical care for the AECOPD patient, the related problems in the treatment were solved promptly, and the rational advice on the drug treatment was provided. Conclusion:It is very important to enhance integrated pharma-ceutical care in the elderly patients with AECOPD.

Objective:To study the wound healing effects of the extracts of Shengji Huayu Fang with different solvents and demon-strate their important role in wound healing for deep second degree burn wound. Methods:Sixty Sprague-Dawley rats were randomly di-vidied into six groups(ten rats in each group): the control group (saline), the positive control group (asiaticoside group), Shengji Huayu Fang group respectively with petroleum ether, chloroform, ethyl acetate and n-butanol as the extraction solvent. The extracts of Shengji Huayu Fang with different solvents were applied in the rats with deep second degree burn wound, and the wound healing was e-valuated by the healing rate judged by naked eyes and computer image analysis, DNA cell cycle analysis using a flow cytometry, patho-logical reports and the degree of re-epithelialization studied by the other methods. Results:The mean healing time of the chloroform ex-tracts group [(15. 67 ± 1. 12)d] was much shorter than that of the control group [(22. 87 ± 1. 01)d, P<0. 01]. The hydroxyproline content and the percentage of S-phase cells in wound tissue in the chloroform extracts group was obviously higher than those in the con-trol group (P<0. 01). Conclusion:The present study indicates that topical application of chloroform extracts of Shengji Huayu Fang is beneficial to burn wound healing, and the chloroform extracts of Shengji Huayu Fang is the main bioactive fraction.

Objective:To review and analyze the prescriptions for Chinese herbal pieces in an integrative traditional Chinese and western medicine hospital to explore the trend and problems in clinical application for Chinese herbal medicines and provide reference for dispensing in pharmacy of traditional medicine and rational drug use. Methods: Totally 1200 prescriptions for Chinese herbal pieces in our hospital were surveyed from January to December in 2014. The irrational use was analyzed, and reasonable suggestions were provided for the clinical application. Results:The problems in the prescriptions for Chinese herbal pieces included uncompleted diagnosis,incompatible diagnosis and medication,nonstandard Chinese name,unclear footnote,irrational usage or dosage and incompati-bility. The prescriptions including above 15 varieties of Chinese herbal pieces in one accounted for 65. 70%, and those with average dose above 250 g accounted for 40. 25%. Conclusion:Regular inspection and quality supervision on the prescription for Chinese herb-al pieces should be strengthened to improve the quality of prescriptions and guarantee the safety and economy of the medication.

Refractory wounds are the common complication of diabetes,and the therapeutic scheme and methods are paid more and more attention nowadays. The influence of traditional Chinese medicines on diabetic wound healing, such as promoting fibroblasts proliferation, enhancing granulation tissue formation, increasing the secretion of growth factors and reducing the wound scar, was re-viewed in the paper to provide scientific basis and reference for traditional Chinese medicines used in diabetic refractory wounds.

Objective:To investigate the characteristics of obesity in adolescents with major depressive disorder (MDD) and its association with the depressed severity.Methods:A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria. Their demographic data were collected and 24-item Hamilton depression scale (HAMD-24) was used to evaluate their severity of depression. According to the body mass index (BMI) classification standard of adolescents in China, all subjects were classified into four groups(wasting group, normal BMI group, overweight group and obesity group). SPSS 26.0 statistical software was used for data analysis. The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results:Among 278 adolescents with MDD, the prevalence of body abnormality was 32.4% (90/278), among which wasting, overweight and obesity were 9.0% (25/278), 14.4% (40/278) and 9.0% (25/278) respectively. There were statistically differences in gender ( χ2=17.018, P<0.001), HAMD-24 scores ( H=9.427, P=0.024) and depressed severity( H=8.508, P=0.037) among the four groups. Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group, that was the prevalence of obesity in males was higher than that in females ( χ2=13.631, P<0.001), and the level in HAMD-24 scores ( Z=2.956, P=0.003) and depressed severity ( Z=2.832, P=0.005) was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores ( r=-0.162, P=0.007). Conclusion:There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD. And the obese patients are less depressed than those with normal BMI.

Objective To evaluate opioids utilization of cancer ached inpatients in the integrative traditional Chinese and western medicine hospital and provide suggestion for the rational utilization of opioids .Method DDDs ,DUI ,the distribution of cancer pain ,pain scores of the discharged patients and the utility of opioids were evaluated and analyzed by retrieving the medi-cal records from January in 2013 to December in 2014 .Results 292 medical records were selected and analyzed .Among them , 89 patients′pain score≥3 .The top opioids of DDDs were sufentanil citrate injection and fentanyl derivatives ,which is the main medication in treating the cancer pain patients .And the irrationaluseof fentanyl transdermal system was a common phenomenon among different departments .Conclusion Theutilization of opioids was basically rational ,but there still had some deficiencies . The intervention and management of narcotic drugs should be strengthened and deepened .

Objective:To summarize the clinical characteristics and therapeutic efficacy of central nervous system (CNS) aspergillosis.Methods:The clinical manifestations, laboratory examination, neuroimaging features, treatment and prognosis of 37 cases of CNS aspergillosis diagnosed and treated in the First Medical Center of People′s Liberation Army General Hospital from January 2000 to January 2021 were retrospectively analyzed. According to the correlation between intracranial lesions and paranasal sinus lesions, they were divided into two groups: rhino-cerebral aspergillosis (RA, n=21) group and cerebral aspergillosis (CA, n=16) group. Results:Only 16.2% (6/37) of CNS aspergillosis patients had a clear background of immunosuppression, but 35.1% (13/37) were complicated with diabetes. The most common clinical manifestations were headache (73.0%, 27/37), cranial nerve involvement (59.5%, 22/37) and fever (37.8%, 14/37). Cerebrospinal fluid characteristics included increased pressure (53.8%, 14/26), increased white blood cell count (46.7%, 14/30), decreased glucose (30.0%, 9/30), increased protein (70.0%, 21/30), and high positive results of the metagenomic next-generation sequencing (mNGS) of pathogenic microorganism (7/10). Cranial magnetic resonance imaging showed that commonly involved sites were sinus, orbital apex, posterior orbit, cavernous sinus (43.2%, 16/37) and cerebral lobes (27.0%, 10/37). Treatment options included antifungal drugs alone (64.9%, 24/37), combination of drugs and surgery (27.0%, 10/37) and surgery alone (8.1%, 3/37). Compared with the CA group, RA group had fewer males [47.6% (10/21) vs 14/16, χ2=6.34, P=0.012] and older age [(54.2±19.4) years vs (38.4±18.4) years, t=2.50, P=0.017], and was more prone to headache [85.7% (18/21) vs 9/16, χ2=4.00, P=0.046) and cranial nerve involvement [81.0% (17/21) vs 5/16, χ 2=9.31, P=0.006]. The misdiagnosis rate of these patients in the early stage was 73.0% (27/37). A total of 29 patients (85.3%, 29/34) were treated with voriconazole successively, and the course of treatment was 3.0 (0.5, 10.4) months. Compared with salvage therapy, the mortality of primary therapy was lower (4/17 vs 9/12, χ2=7.54, P=0.006). All patients were followed up to December 2021, and 17 patients died, with a mortality rate of 45.9% (17/37). Conclusions:CNS aspergillosis may have no definite immunosuppressive background. Some of CNS aspergillosis patients are complicated with diabetes, and the clinical manifestations of the disease lack specificity, with high misdiagnosis rate in the early stage, no inflammatory changes in cerebrospinal fluid, and high positive rate of mNGS for pathogenic microorganism. Early and long-term application of voriconazole can significantly reduce the mortality rate.

Active exploration for building a model of medical alliances fitting local needs, proves imperative for the functional positioning of medical institutions, promoting inter-institutional cooperation and enhancing the capacity of primary medical services. The authors described experiences and insights of the No.1 Affiliated Hospital and the People′s government of Quangang District in their partnership, and building a brand new model of medical alliance between a hospital and a local government. Also presented are characteristics of such a model, and analysis of operational data in benefiting the people. They held that such a partnership is a worthy attempt in the healthcare reform, by means of building medical alliances between local government and provincial hospitals. Such a practice can provide valuable references for promoting government-hospital synergy, elevating primary healthcare capacity and advancing the hierarchical medical system.