OBJECTIVE:To investigate the work status of clinical pharmacists in West China Hospital of Sichuan University and to provide rational suggestions for the development and improvement of clinical pharmacy. METHODS: The status of hospital clinical pharmacy and training of clinical pharmacy were studied by a questionnaire survey on 26 clinical pharmacists and an interview on 9 trainees majored in clinical pharmacy. RESULTS: The major tasks for hospital clinical pharmacists were to participate in clinical rounds, conduct pharmacy rounds alone, participate in patients’ treatment and outpatient pharmaceutical care, listen to case discussion, participate case consultation, coordinate with doctors to make medication plan, collect adverse drug reactions and give lecture among physicians etc. The pharmacists were welcome by most of the clinical departments. CONCLUSIONS: Clinical pharmacy in West Hospital of Sichuan University achieved a good beginning, but to achieve a further progress, the focus of clinical pharmacists’ work should be shifted to provide patient-centered pharmaceutical technical service, meanwhile, the support offered and the importance attached by the government as well as the efforts of clinical pharmacists are indispensible.

Medical insurance system plays a key role in China's social security system.In the social insurance system,medical insurance features the widest coverage and the most complex in mechanism,while China' s medical insurance system itself is found with many setbacks.This paper probed into such risks found in the county-level medical insurance system as excessive cost growth causing overpayment of the medical insurance fund and poor supervision of the fund.On such basis,the authors recommended such policy changes as payment reform,and enhanced supervision over the fund,the demand side,and the government,in an effort to optimize China' s medical insurance system for theoretical and decision reference of other county-level hospitals in their reforms.

Aim To explore micro RNAs-integrated pathogenic signaling to control endothelial-mesenchy-mal transition ( EndMT ) in pulmonary hypertension ( PH) by a network bioinformatic approach. Methods Literature-mining method was used to find PH-relat-ed genes and EndMT/EMT-related miRNAs. Bioinfor-matic prediction approach ( DIANA3 , Miranda4 , PicT-ar5 , TargetScan6 , miRDB7 and microT-CDS8 ) was used for miRNA target prediction. Hypergeometric a-nalysis was used to predict miRNAs related to EndMT in PH. The analysis of interactions between PH-rele-vant genes( PH network) was performed with the use of Biological General Repository for Interaction Datasets ( BioGRID ) . These miRNAs were ranked with the highest probability of substantial overlap among their gene targets in the PH-network, the relationship be-tween their targets and the PH functional categories which include hypoxia, inflammation, and transforming growth factor/BMP signaling. Then, the part of results was validated by animal experiment. Lastly the miR-NA-Target network was built using Cytocape 3 . Results List of 230 genes was compiled that were directly im-plicated in the development of PH and 189 miRNAs were related to EndMT in PH. Among 189 miRNAs, only 22 microRNAs(miR-let-7 family, miR-124, miR-130 family, miR-135, miR-144, miR-149, miR-155, miR-16-1, miR-17, miR-181 family, miR-182, miR-200 family, miR-204, miR-205, miR-21, miR-224, miR-27, miR-29 family, miR-301a, miR-31, miR-361 and miR-375) were related to hypoxia, inflamma-tion, and transforming growth factor/BMP signaling. Among these miRNAs, the levels of let-7g, miR-21, miR-124 and miR-130 family were significantly changed in the pulmonary artery in hypoxia-induced PH rats. Conclusions Among numerous miRNAs,22 of which may be involved in hypoxia, inflammation, and transforming growth factor/BMP signaling and re-lated to EndMT in PH by network bioinformatic ap-proach, which provides a theoretical basis for further investigation of EndMT in PH.

ObjectiveTo explore the risk factors of VAP among multiple injury patients in comprehensive ICU so as to provide the basis for prevention and cure of VAP.MethodsThe retrospective analysis was made to the clinical data from 126 patients with mechanical ventilation for over 48 hours in ICU at the Third People's Hospital of Zhenjiang,the Affiliated Hospital of Jiangsu University,from January 2014 to December 2015. The Logistic regression analysis was performed to research related data in order to identify the risk factors of VAP.ResultsIn 126 patients,there were 37 (29.37％) patients with VAP. Single factor analysis showed that the risk factors were the time of mechanical ventilation,score of the injury severity scale (ISS), time of being admitted to ICU,coma,sedation and analgesia,hormone use,medical history of chronic lung disease,combined antibiotic (>2 kinds),craniocerebral trauma,thoracic injury,spinal injury with significant differences (t/χ2=3.382,20.241,4.212,29.837,7.616,5.322,4.384,8.246,5.677,15.394,4.864;P<0.05). Logistic regression analysis revealed that the risk factors of VAP in multiple injury patients were the time of mechanical ventilation,score of ISS,coma,combined antibiotic (>2 kinds),medical history of chronic lung disease,craniocerebral trauma,thoracic injury (OR=3.897,6.697,5.506,5.104,10.984,4.911,6.046;P<0.05). ConclusionsThe incidence of VAP is high among multiple injury patients in comprehensive ICU. The monitor of risk factors of VAP in multiple injury patients should be enhanced. Moreover,the effective intervention on prevention and cure of VAP should be taken for patients with long time of mechanical ventilation,high score of ISS,coma,combined antibiotic (>2 kinds),medical history of chronic lung disease,craniocerebral trauma, thoracic injury and so on so as to reduce the incidence of VAP.

Objective To investigate the targeting effect of TLS9a nucleic acid aptamer on mice hepatic cancer cells.Methods The liposome modified with maleimide and loading doxorubicin(DOX) was prepared,then TLS9a nucleic acid aptamer modified by FITC fluorescence and sulfydryl was synthesized,which was coupled to the liposome surface.The entrapment efficiency of DOX was detected by UV spectrophotometry.The dynamic light scattering(DLS) was applied to measure the particle size of nanoparticles and the potential distribution.The uptake of DOX in mice hepatic cancer cells was detected by the Nikon inverted microscope and the mean fluorescence intensity of liposome/DOX and TLS9a-liposome/DOX was detected by flow cytometry.The cells activity was detected by MTT.Results Flow cytometry assay showed that the binding rate of TLS9a nucleic acid aptamer with BNL.1ME.A.7R.1 mice hepatic cancer cells was 54.1％.TLS9a-liposome particle size distribution was in (116.0 ± 5.0)nm.TLS9a-liposome/DOX released DOX quickly at pH 5.0,and the release amount in 72 h was more than 70 ％ of the total release amount.TLS9a-liposome/DOX effectively inhibited the growth of mice hepatic cancer cells BNL.1ME.A.7R.1.Conclusion TLS9a nucleic acid aptamer could specifically combined with mice hepatic cancer cells BNL.1ME.A.7R.1,which could be used to detect mice hepatic cancer cells.

Percutaneous coronary intervention(PCI)is one of the most important therapeutic measures for coronary heart disease.It can quickly and effectively relieve coronary artery obstruction.Patients with coronary heart disease often suffer from the complication of emotional disorders like anxiety and depression.The incidence of anxiety and depression in patients having undergone PCI is significantly higher in those having not.But anxiety and depression can remarkably increase the major adverse cardiac events(MACE)in patients after PCI.This article reviews the associations,mechanisms and treatments of anxiety and depression after PCI.

The aim of this study was to investigate the effect of amentoflavone(AF)on airway inflammation in asthmatic young rats and its mechanism.The asthmatic model of young SD rats was established by intraperitoneal injection combined with nebulization of ovalbumin(OVA).The rats were randomly grouped into asthma model(M)group,dexamethasone(DXMS)group,AF low(AF L),AF medium(AF M),AF high(AF H)dose group and normal control group(CT)group.After administration,the airway reactivity was detected with non-invasive lung function instrument and the inflammatory cell types in bronchoalveolar lavage fluid(BALF)were analyzed and counted by Giemsa staining.Furthermore,hematoxylin-eosin(HE)staining was applied to evaluate the pathological morphology of lung and bronchial tissues,enzyme-linked immunosorbent assay(ELISA)kits were used to detect the content of inflammatory factors in serum,Western blot was applied to detect the protein expression of GMP-AMP synthase(cGAS),interferon gene stimulator(STING),phosphorylated interferon regulatory factor 3(p-IRF3)and interferon regulatory factor 3(IRF3)in lung tissue of rats.Compared with the CT group,the asthma model group showed obvious pathological damage of bronchial tissue and lung tissue,higher level of airway reactivity,higher pathological scores of lung tissue and bronchial tissue,increased total number of inflammatory cells and the number of monocytes,eosinophils,neutrophils and lymphocytes in BALF,higher levels of inflammatory factors in serum,and higher expression levels of cGAS,STING and p-IRF3/IRF3 proteins in lung tissue(P<0.05).Compared with the M group,the pathological damage of lung and bronchus tissue in asthmatic rats was relieved after treatment with DXMS and high-dose AF,the airway reactivity,pathological score of lung tissue and bronchial tissue,total number and classification of inflammatory cells in BALF,inflammatory factors in serum and expression of cGAS,STING,p-IRF3/IRF3 proteins in lung tissue were obviously lower(P<0.05).In conclusion,AF can alleviate airway inflammation in asthmatic young rats,possibly by inhibiting cGAS-STING signal pathway.

This paper intends to summarize the disaster nursing in recent 10 years, including the content of clinical research, educational research information, theoretical research results, academic exchange organizations, periodicals and magazines,aiming to provide a reference for the development of disaster nursing in China. Compared with developed countries, China Disaster Nursing Research started relatively late and is still in its infancy, there are many projects to be studied and developed in disaster nursing.

Objective To investigate the management of Graves' disease in Jiangsu province. Methods According to the 2011 management of GD survey from American Thyroid Association and the 2013 survey from European Thyroid Association, a questionnaire was designed for this survey to acquire the diagnosis, treatment, and follow-up of Graves' disease among endocrinologists from 35 tertiary hospitals in Jiangsu province. Results A total of 476 valid questionnaires were collected. For patients with symptoms of hyperthyroidism, a large majority of respondents monitored serum FT3 , FT4 , TSH, thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody, and finding of thyroid ultrasound, accounted for 95. 6％, 95. 0％, 95. 4％, 95. 8％, 90. 3％, 90. 5％, and 93. 9％physicians, respectively. 91.2％ of physicians preferred anti-thyroid drugs as the first-line treatment, and 92. 6％ of them gave priority to the use of methimazole. For the duration of anti-thyroid drugs therapy, 41.2％of endocrinologists chose 24 months, while 20％ chose 18 months. When patients have moderate and active ophthalmopathy, most respondents with medium or senior professional titles preferred anti-thyroid drugs, while most resident physicians chose radioactive iodine plus corticosteroids. When pregnancy was confirmed in the patients of Graves' disease, 88％ of respondents preferred propylthiouracil during the first trimester of pregnancy, and 58. 4％ of them would continue propylthiouracil into the second trimester. Conclusions The mastering of basic perception of Graves' disease knowledge is satisfactory among the endocrinologists. But by comparing to the American and European survey results and related guidelines, there are still some differences in diagnosis and treatment. Therefore, physicians should notice those differences and make improvement on standardized treatment for patients to raise the response ratio while reducing the recurrent events.