Objective: To explore therapeutic effect of carvedilol combined valsartan on chronic heart failure (CHF), and its influence on cardiac function and level of high sensitive C reactive protein (hsCRP).Methods: A total of 78 CHF patients, who were treated in our hospital from Jul 2011 to Jul 2015, were selected.According to therapeutic method, they were divided into valsartan group (n=38, received valsartan based on routine treatment) and combined treatment group (n=40, received carvedilol based on valsartan group).Therapeutic effect, cardiac function, serum hsCRP level and quality of life (QOL) score before and after treatment were observed and compared between two groups.Results: Total effective rate of combined treatment group was significantly higher than that of valsartan group (92.50% vs.71.05%), P=0.022.Compared with before treatment, there were significant reductions in heart rate, cardiothoracic ratio (C/T), left ventricular end-diastolic dimension (LVEDd) and serum hsCRP level, and significant rise in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), emotional index, health index and life satisfaction score in both groups after treatment except C/T of valsartan group, P<0.01 all;compared with valsartan group after treatment, there were significant reductions in heart rate [(124.39±10.07) beats/min vs.(101.18±8.72) beats/min], C/T [(0.63±0.15) vs.(0.53±0.12)], LVEDd [(43.32±4.02)mm vs.(40.38±3.76)mm] and serum hsCRP level [(32.12±3.99) pg/ml vs.(10.29±2.08) pg/ml], and significant rise in LVEF [(45.59±9.99)% vs.(59.97±10.02)%], LVFS [(24.58±5.67)% vs.(31.89±6.68)%], scores of emotional index [(70.20±10.02) scores vs.(86.58±12.28) scores], health index [(73.36±8.08) scores vs.(85.58±11.01) scores] and life satisfaction [(74.34±8.39) scores vs.(88.12±13.35) scores] in combined treatment group,P<0.05 or <0.01.Conclusion: Carvedilol combined valsartan possesses significant therapeutic effect on chronic heart failure.It can significantly reduce hsCRP level, improve cardiac function and quality of life in these patients, which is worth extending.

Objective To develop a simple and patient-reported scoring system for evaluating the efficacy of functional reconstruction of adult hip diseases.Methods A candidate indicators list to evaluate hip function was established through literatures review and panel discussion.Using two rounds of Delphi method,experts were invited to judge and score the importance of screening indicators including pain,daily living ability,activity level,labor ability and self-assessment score of the overall hip status,with explanation of the degree of similarity and the basis for determination.In the second round of consultation,the content of integrity and rationality of the scale were added for evaluation.The final indexes of the scale were determined according to the boundary value of the indexes (average value,full frequency,coefficient of variation).The positive coefficient,authoritative coefficient,and coordination coefficient of the two rounds were calculated,and then the weights of each index was identified to form the final rating scale.Results Two rounds of Delphi reclaimed 25 and 24 experts' responses,which from 28 and 25 questionnaires,and the positive coefficients of the two rounds experts were 89.3％ and 96％,respectively.The authoritative coefficient of the first and second level indicators were generally above 0.85;and both of the expert coordination coefficient with the index importance (so called as Kendall coefficient) were above 0.3,and the second round of the coefficient was higher than the first one,and it indicated the final one was better at the consistency.The candidate index of "by bus" in the mobility was rejected in accordance with the threshold of the boundary value on the importance.Finally,it was determined that the hip scoring system (Shanghai Sixth People's Hospital,SSPH) consisted of two parts:the first part had ten indicators out of four dimensions such as pain,daily living ability,activity level,and labor ability;and the weight scores of these four aspects were 45,25,21,9,respectively.The second part was the patient's self-evaluation score for the overall status of the hip (VAS,out of 100 points);the total score was the sum of the two parts,and the final weights accounted for 85％ and 15％ between the two parts respectively.Conclusion The SSPH hip score based on patient-reported outcomes formed by the Delphi is simple and feasible,and it can be used as a reference for evaluating the clinical efficacy of hip functional reconstruction.

OBJECTIVE To explore and establis h a general pharmacist system suitable for China ’s national conditions ，and to improve the rational use of drugs in primary medical institutions . METHODS Under the leadership of Tianhe District Health Bureau of Guangzhou ，relying on the regional pharmaceutical specialty alliance ，general pharmacist system of medical consortium was established ，and the general pharmacist was responsible for the overall planning of pharmaceutical care in the medical consortium. The joint management office of pharmaceutical care was established ，and the training of the pharmacists in the medical consortium was organized. A regional audit center was established to realize the prescription review of 13 community health service centers in the medical consortium. “Internet plus ”home pharmaceutical care was carried out ，and science popularization education was provided for communities ，schools，enterprises and institutions. RESULTS After systematic training and assessment ，three pharmacist teams had been successfully established in the medical consortium to provide prescription review ，science popularization and education and family pharmacist services for community residents ；the regional audit center successfully intercepted 17.17％ of unreasonable prescriptions ，reducing the amount of unreasonable drug use by a total of 6.56 million yuan. After the intervention of prescription review system ，the qualified rate of outpatient prescriptions in community health service centers was ≥95％，and the qualified rate increased by an average of 6％. The department of pharmaceutical science popularization and education held 35 science popularization and free clinic activities ，of which 71.20％ of the residents believed that the activities had improved their understanding of drugs. In addition ，111 cases patients serviced by home pharmaceutical care were carried out successfully by pharmacist team ，and the patients ’acceptance of pharmacist intervention was 91.89％ . CONCLUSIONS Under the new medical reform ，it is feasible to implement a regional general pharmacist system within the medical consortium ， which improves the pharmaceutical administration and pharmaceuticalcare capabilities of m edical institutions in the medical consortium，as well as the level of rational drug use ，and reduces the me dical burden.

【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.