OBJECTIVE:To discuss the effect of performance management in medication consultation service in hospital,and to improve the service quality in medication consultation center. METHODS:The performance management mode of medication consultation center was implemented in our hospital through formulating consultation pharmacist performance evaluation content and accounting rules from four dimensions of business skills,cultural literacy,work attitude,workload,conducting daily evaluation and check,developing training,setting development plan,etc. The effects of the mode were evaluated. RESULTS:In performance evaluation,business skills,cultural literacy,work attitude and workload took up 20,15,15 and 50 points,respectively;they were subdivided into 16 specific items and extra point items. After the implementation of above performance management,average weekly clients increased from 104 persons to 247 persons (increasing by 138%);the proportion of patient medication education mainly provided by clinical pharmacists increased from 18.30% to 46.34%(increasing by 153%);the complex and professional problems of medication consultation such as drug interaction rose from 0.96% to 5.28%;the problem of drug usage and dosage in-creased from 6.73% to 23.17%. The performance management mode not only improved the service consciousness and the enthusi-asm of consultation pharmacists,but also improved the level of pharmaceutical care. CONCLUSIONS:Reasonable and effective performance management mode can promote the service quality and ability of medication consultation center,and play more impor-tant role in hospital pharmaceutical care.

OBJECTIVE:To investigate the correlation of gene polymorphism in peripheral artery disease(PAD)patients with antiplatelet efficacy of clopidogrel. METHODS:Reviewing related domestic and foreign literatures in recent years,the correlation of gene polymorphism in PAD patients with antiplatelet efficacy of clopidogrel was summarized and analyzed. RESULTS&CON-CLUSIONS:At present,a variety of genes associated with clopidogrel antiplatelet efficacy and major adverse cardiovascular events (MACE)have been identified,including cytochrome P450(CYP)2C19,adenosine three phosphate binding cassette B subfamily 1 (ABCB1),paraoxonase 1 (PON1) and adenosine diphosphate P2Y12 receptor (P2Y12),etc. CYP2C19*2,*3 allele may reduce the antiplatelet effect of clopidogrel. Their correlation has been confirmed by a number of studies,and study results are broadly con-sistent. Mutations in the ABCB1 C3435T and PON1 Q192R sites may lead to a lower response to clopidogrel and increase the risk of MACE;but there is a lack of large-scale prospective clinical studies,and the present results are inconsistent. P2Y12 gene poly-morphism in PAD patients has not been found to be significantly associated with clopidogrel efficacy.

The ongoing health reform encourages pharmacists of public hospitals to change their traditional role positioning to satisfy patients’urgent needs in medical dosage guidance.This calls for greater capacity of hospital pharmacy services.Pharmaceutical consultation constitutes a major means of quality service of pharmacists for the people.The paper introduced the standard of establishing the pharmaceutical consultation center and the content of assessment system which are jointly worked out by Beijing Municipal Hospital Authority and the hospitals under the administration of the Beijing Municipal Government,and share the practice & effect in assessing and improving their performance.

OBJECTIVE:To provide theoretical foundation for individualized treatment of aspirin in patients with cardiovascu-lar disease. METHODS:Domestic and foreign literatures in recent years were collected and summarized. RESULTS & CONCLU-SIONS:The gene polymorphism can significantly affect the platelet activity. GPIII a PLA2,PEAR1 and PTGS1 alleles are associat-ed with aspirin resistance,and cardiovascular events have significant difference in different genotype patients. Adjusting reasonably dosage regimen and conducting individualized treatment according to the genetic testing result and other factors can reduce aspirin resistance and the incidence of cardiovascular adverse events in the patients.

BACKGROUND: Various etiological mechanisms are involved in cerebral infarction. Both free radicals and lipid peroxidation participate in the atherosclerosis and damage of neural cells after cerebral ischemia. Compound danshen(Radix Salviae Miltiorrhizae) is a common prescribed Chinese herb, acting on activating blood circulation and removing stasis for cerebral infarction and coronary heart disease, but its mechanism has been unknown in many aspects.OBJECTIVE: To observe the effect of compound danshen on neural function defect and free radicals in patients with cerebral infarction so as to probe into its possible mechanisms.DESIGN: A randomized controlled trial.SETTING: Neurological Internal Department of a hospital affiliated to one university.PARTICIPANTS: Totally 538 inpatients were collected in Neurological Internal Department of First Hospital affiliated to Jinzhou Medical College from February to December 2002, their diagnosis compiled with "Diagnostic Keys on Every Type Cerebral Vascular Disorders" adopted on the 4th National Acadenic Meeting on Cerebral Vascular Disorders, and determined by cerebral CT scan. All of those were the first attack of atherosclerosis cerebral infarction in 72 hours. The patients with cardiac infarction, heart failure, auricular fibrillation, insufficiency of liver and kidney function,hemorrhage of digestive tract, vascular dementia and bulbar paralysis and the patients who could not be well cooperated were not included. A total of 68 patients compiled with the standards, of which, 38 patients were male and 30 patients female, aged varied from 52 to 78 years, at the average of (64. 62 ±5.80) years. The patients selected were randomized into study group and the control by lot-drawing nethod according to the hospitalized sequence and volunteer principle of the control.METHODS: The basic treatment was same in two groups. In study group,compound danshen injection was added together with physiological saline 250 mL for intra-venous drip, once daily, continuous 14 days made one course. In the control, thrombosis removing injection 15 mL was added together with physiological saline 250 mL for intra-venous drip, once daily,continuous 14 days made one course.Level of serum lipoperoxide(LPO) and activity of superoxide dismutase (SOD).RESULTS: Statistical differences presented in declined scores of severity of neural function defect after treatment in two groups compared with their own controls(in study group: 28.62 ±6.76 vs 13.84 ± 8.16; in the control:28.58±7.05 vs 21.52±8.24, t=8.134, t=3.796 respectively, P＜ 0. 001 ). The score in study group was declined more obviously compared with the control after treatment, indicating very significant difference ( t = 3. 861, P ＜ 0. 001 ). The effective rate of compound danshen injection was 88.24% in treatment of cerebral infarction, which significantly superior to that in the control(67.65% ) (x2 =4.19, P ＜ 0.05). Compound danshen remarkably reduced serum LPO level[ (8.69 ± 1.28) nmol/L vs (5.86 ± 1.42) nmol/L, t =8. 628, P ＜ 0. 001 ] and statistical differences presented compared with the result in the control after treatment[(5.86±1.42) nmol/L vs(8.56±0.95) nmol/L, t=9.125, P ＜0.001] . Simultaneously, SOD activity in serum was significantly increased, [ (26. 25±4. 64) mkat/g vs(30. 01 ± 3.87) mkat/g, t = 3. 629, P ＜ 0. 001] indicating statistical differences compared with the result in the control after treatment[ (30. 01 ±3.87) mkat/g vs(26.33 ±4. 14) mkat/g, t =3. 778,P ＜ 0.001].CONCLUSION: Compound danshen improves significantly neural function defect in patients with cerebral infarction, with definite therapeutic effects on the treatment. It can reduce serum LPO content and increase serum SOD activity in patients with cerebral infarction. It is predicted that removing free radicals and anti-lipid peroxidation damage is probably one of the important mechanisms of it, which provides a further theoretic evidence for the treatment of cerebral infarction clinically.

Objective: To explore the relationship between parents’ unstable marital status and offspring’s suicide attempts and the possible mediating factors, and to provide reference for suicide prevention among off spring grom unst able families. Methods: From 2017 to 2018, 2 766 valid questionnaires were collected from freshmen in a university in Hunan province. Students completed questionnaires of childhood trauma and depression traits,and reported their parents’ marital status and suicide attempts etc. Results: Compared to college students with parents of stable marital status,students with parents of unstable marital status showed higher reported rate of suicide attempts and higher scores of depression trait and childhood trauma (t/χ2=2.78, 5.83, 20.30, P<0.05). Controlling possible confounding factors,unconditional Logistic regression showed that childhood trauma,unstable marital status of parents and depressive traits were positively correlated with suicide attempt(OR=1.05, 1.45, 1.08, P<0.05). The 95% confidence interval of the Bootstrapping method with four mediation pathways (parental marital status→childhood trauma→depressive trait,childhood trauma→depressive trait→suicide attempt,parental marital status→childhood trauma→suicide attempt and parental marital status→childhood trauma→depressive trait→suicide attempt) does not include zero. Conclusion Childhood trauma and depressive traits mediate the relationship between parental instable marriage and suicide attempts in off spring.

Objective Acute aortic dissection occurs when a tear in the inside of the aorta causes blood to flow between the layers of the wall of the aorta,forcing the layers apart.In most cases this is associated with a sudden onset of severe chest or back pain,often described as "tearing" in character.The main management includes medication,endovascular repair and surgery.Medical management plays an very important role in the management of acute aortic dissection.Aortic dissection generally presents as a hypertensive emergency.Individuals can benefit from blood pressure control and anti-impulse therapy in perioperative period.

Under the background of deepening the medical and health system reform, it is necessary to explore the measures of fine and rational drug use management and strengthen the rational drug use. Through giving full play to the management functions of pharmacy administration and pharmacotherapeutics committee, formulating the performance evaluation index system of pharmacy affairs in the hospital, adhering to the prescription doctor′s advice review and prescription pre audit, continuing to carry out drug dynamic monitoring, implementing standardized-path antimicrobial drug management, the hospital implemented refined and rational drug use management. Before and after the management, the average drug cost, prescription unqualified rate, auxiliary drug amount and antibacterial drugs related indicators were significantly improved, suggesting that fine pharmacy management could promote the rational use of drugs in the whole hospital, promote the transformation of pharmacists′ work, and control the unreasonable growth of drug costs.

Objective:To analyze the association between the rs562556 polymorphism of the proprotein convertase subtilisin/kexin type 9(PCSK9)gene and the degree of coronary artery stenosis in the patients with acute myocardial infarction(AMI).Methods:A total of 200 patients diagnosed with AMI from January 2021 to December 2022 were selected as AMI group,and 200 healthy individuals during the same period were selected as control group.According to the Gensini scoring standard,the patients in AMI group were divided into low risk group(Gensini score≤40,n=78)and medium-high risk group(Gensini score>40,n=122).The levels of lipid metabolism indicators in serum of the patients in two groups were detected by fully automatic biochemical analyzer;enzyme linked immunosorbent assay(ELISA)method was used to detect the PCSK9 levels in serum of the patients in two groups;ultraviolet spectrophotometry was used to detect the single nucleotide polymorphism(SNP)of PCSK9 gene of the patients in two groups;Spearman correlation analysis was used to detect the correlation between the rs562556 polymorphism of the PCSK9 gene and the degree of the disease and the levels of lipid metabolism indicators in serum of the patients.Results:Compared with control group,the percentage of smokers of the patients in AMI group was significantly increased(P<0.01).Compared with control group,the levels of low-density lipoprotein cholesterol(LDL-c)and PCSK9 in serum of the patients in AMI group were significantly increased(P<0.05).Compared with low risk group,the levels of LDL-c and PCSK9 in serum of the patients in medium-high risk group were significantly increased(P<0.05).The distribution of PCSK9 gene rs1800487 genotype in both control and AMI groups conformed to the Hardy-Weinberg(H-W)equilibrium(χ2=0.677,P=0.713;χ2=0.970,P=0.831).Compared with control group,the distribution frequencies of PCSK9 gene rs562556 genotype AA and allele A of the patients in AMI group were significantly increased(P<0.05).In the AMI patients,the distribution of PCSK9 gene rs562556 genotype in both low risk and medium-high risk groups conformed to the H-W equilibrium(χ2=0.045,P=0.978;χ2=1.290,P=0.525).Compared with low risk group,the distribution frequencies of genotype AA and allele A of PCSK9 gene rs562556 of the patients in medium-high risk group were significantly increased(P<0.05).The PCSK9 gene rs562556 genotype AA was positively correlated with the degree of AMI(r=0.193,P=0.006)and LDL-c level(r=0.301,P<0.01).Allele A was positively correlated with the LDL-c level(r=0.168,P=0.017).Conclusion:The PCSK9 gene rs562556 genotype AA is positively correlated with the degree of coronary artery stenosis of the AMI patients,and its polymorphism may promote the development of AMI by upregulating the LDL-c level.

Objective:To investigate the prognostic significance of high sensitivity-C reactive protein (Hs-CRP) in patients with peripher-al T-cell lymphoma (PTCL). Methods:A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retro-spectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index (IPI), were determined. Af-ter a median follow-up of 23 months, the relationship between Hs-CRP and overall survival (OS) was observed. Results:Serum Hs-CRP level positively correlated with IPI score (r=0.132, P<0.001), tumor stage (r=0.183, P=0.005), B symptoms (r=0.225, P=0.001), and lactic dehydrogenase (r=0.169, P=0.009), but negatively correlated with plasma albumin levels (r=?0.343, P<0.001), hemoglobin concentra-tion (r=?0.239, P<0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion:The baseline Hs-CRP level can serve as a major indicator of prognosis in PT-CL patients.