OBJECTIVE:To provide references for the improvement of pharmaceutical service level in drugstore.METHODS:The concept of the Physical Evidence and its signification,the types and practice of the Physical Evidence in pharmaceutical service were expounded.RESULTS & CONCLUSIONS:The application of the Physical Evidence in drugstore can make the intangible service tangible,which can help improve the relation between drugstore and customers.

Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronary heart disease (CHD), to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI , compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group (P < 0.05). And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI(P < 0.05). The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group (P < 0.05). But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI(P < 0.05). Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.

The adhesion properties of tumor cells with extracellular matrix(ECM) are closely associated with their invasion and metastasis.Our work reported here was intended reveal the relevant biomechanical and biorheological manifestations of human lung cancer. Using micropipette aspiration technique, we investigated quantitatively the adhesive mechanics properties of high metastatic human giant cell carcinoma(PG) cells as well as low metastatic adenocarcinoma(PAa) cells of lung based on cell culture in vitro. The results showed that the adhesion forces of PAa and PG cells to collagen Ⅳ were significantly higher than those to glass surfaces, but at the lower concentrations(1.00μg/ml and 2.00μg/ml) of collagen Ⅳ, the amplitude for the increase of adhesion forces of PG cells were less than the amplitude for that of PAa cells, and most of the adhesion force values of PAa cells to the coated surfaces of incorporation of laminin along with 2 μg/ml collagen Ⅳ were significantly greater than those of PG cells. At the lower concentrations(0.625μg/ml for PAa cells,and 0.625 μg/ml, 1. 25 μg/ml for PG cells) of laminin tested,the adhesion force values of PAa and PG cells all decreased, but the amplitude and level for the decreased values of adhesion forces of PG cells were greater than those for the PAa cells. In conclusion, the adhesive and proteolytic behaviour of cancer cells to extracellular matrix might be mediated mainly by tumor cell membrane receptors such as integrin receptors and laminin receptors, it might affect the biological characteristics and the metastasis of the tumor cells. The results may benefit to explain some questions in biomechanical views about how the highly metastatic PG cells are prone to migration and invasion.

Objective To construct a grading nursing care system at public hospitals based on the severity of illness and activities of daily living ( ADL). Methods Multi-center stratified random sampling was used to investigate the general adult patients hospitalized in 12 wards of six tertiary-level hospitals in the eastern, central and western parts of China from January to December of 2016. The Barthel index and simple clinical score ( SCS) were used to evaluate their ADL and severity of illness, while a customized direct nursing hour scale was applied to record the direct nursing time needed by patients in 24 hours. Nursing grades were defined according to different conditions and ADL and to the difference of patient needs of 24 h direct nursing hours. Results 7 200 patients were investigated in total, and 7 073 effective questionnaires were collected (98. 24% ). Seven new grades of nursing care were defined based on patients′ severity of illness, ADL and different 24 h direct nursing time. These grades match the existing four grading nursing care levels to become refined sub-levels. Conclusions Patients can be graded according to their conditions, ADL and the 24 h direct nursing time needed. Such a new method is more objective, specific and quantitative than before, conducive to upgrading fine management level of nursing.

Based on the development trends of nursing care in the ongoing healthcare reform, the PEST model was called into play to analyze the macro-environment of nursing development in terms of such aspects as political, economic, social-cultural, and science and technology factors. Based on such, policy suggestions are raised to tackle the following challenges, namely incomplete political and legal environment for nursing, relative shortage of nursing resources, low social recognition, and poor capability of nursing technique innovation. These suggestions aim to further improve the political and legal system for nursing, explore highly efficient nursing resource allocation, enhance nursing service capability, and nurture nursing technique innovation talents.

PURPOSE: C-terminal binding protein 1 (CtBP1) is a transcriptional co-repressor that is overexpressed in many cancers. CtBP1 transcriptionally represses a broad array of tumor suppressors, which promotes cancer cell proliferation, migration, invasion, and resistance to apoptosis. Recent studies have demonstrated that CtBP1 is a potential target for cancer therapy. This study was designed to screen for compounds that potentially target CtBP1. METHODS: Using a structure-based virtual screening for CtBP1 inhibitors, we found protocatechuic aldehyde (PA), a natural compound found in the root of a traditional Chinese herb, Salvia miltiorrhiza, that directly binds to CtBP1. Microscale thermophoresis assay was performed to determine whether PA and CtBP1 directly bind to each other. Further, clustered regularly interspaced short palindromic repeats associated Cas9 nuclease-mediated CtBP1 knockout in breast cancer cells was used to validate the CtBP1 targeting specificity of PA. RESULTS: Functional studies showed that PA repressed the proliferation and migration of breast cancer cells. Furthermore, PA elevated the expression of the downstream targets of CtBP1, p21 and E-cadherin, and decreased CtBP1 binding affinity for the promoter regions of p21 and E-cadherin in breast cancer cells. However, PA did not affect the expression of p21 and E-cadherin in the CtBP1 knockout breast cancer cells. In addition, the CtBP1 knockout breast cancer cells showed resistance to PA-induced repression of proliferation and migration. CONCLUSION Our findings demonstrated that PA directly bound to CtBP1 and inhibited the growth and migration of breast cancer cells through CtBP1 inhibition. Structural modifications of PA are further required to enhance its binding affinity and selectivity for CtBP1.

Objective To investigate the clinical practice of undergraduate nursing students in TCM and western medicine hospitals, and explore the gap between them, so as to provide targeted guidance for clinical teaching. Methods By convenience sampling method, 120 undergraduate nursing students from 12 hospitals in Jiangsu province were investigated and analyzed by self-designed questionnaire. Results There was no significant difference in the score of demand for nursing knowledge and skills in 7 dimensions in undergraduate nursing students of traditional Chinese medicine ( TCM ) and western medicine hospitals in clinical practice (P>0.05). The demand entry ranking ahead in western medicine hospitals was interpersonal communication knowledge and communication skills (3.60±0.53), the score of writing specification of medical nursing documents was (3.60±0.53). While the demand entry ranking ahead in TCM hospitals was the use of TCM theory in diagnosis and treatment based on symdrome differentiation (3.96±0.71) and the prevention of nursing errors (3.64±0.49). The demands for clinical practice knowledge and skills of students in TCM hospitals and western hospitals in the survey of 7 dimensions of demand satisfaction showed no significant difference ( P>0.05). The demands with high satisfaction in western medicine hospitals included the common western basic nursing skills and nursing professional thought and occupation moral education;in TCM hospitals, demands with high satisfaction included TCM rehabilitation, nursing professional thought and occupation moral education. Conclusions There are differences in the clinical practice of undergraduate nursing students in TCM and western medicine hospitals. Both TCM and western hospitals should pay more attention to the needs of nursing students in various aspects. Hospitals should understand the differences between nursing students and their needs, strengthen the management during the internship period and take effective measures to meet the needs of nursing students in clinical practice.

Objective:To study the value of coronary flow reserve (CFR) via dynamic single photon emission computed tomography (D-SPECT) in evaluating coronary microcirculation dysfunction (CMD) in patients with heart failure.Methods:A prospective research method was adopted. One hundred and ninety-four patients with heart failure from September 2019 to September 2020 in Zhongshan Hospital, Fudan University were selected. The patients were tested for CFR using D-SPECT, and CFR<2 was defined as CMD. The general data were recorded, including age, gender, body mass index (BMI), blood pressure, heart rate, smoking history, New York Heart Association (NYHA) heart function classification, comorbidities and medication situation. The laboratory test results were recorded, including blood urea nitrogen, blood creatinine, blood uric acid, estimated glomerular filtration rate (eGFR), high-sensitivity C-reactive protein (hs-CRP), cardiac troponin T (cTnT) and N terminal pro B type natriuretic peptide (NT-proBNP). The left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), interventricular septal thickness (IVST), pulmonary artery systolic pressure (PASP) and left ventricular ejection fraction (LVEF) were measured by cardiac ultrasound. After discharge, patients were followed up in outpatient or telephone contact, with the primary endpoint event being a composite endpoint consisting of cardiovascular death and heart failure readmission. Multiple linear regression analysis was used to analyze the risk factors of CFR. The Kaplan-Meier survival curve was draw, and the log-rank test was used to evaluate the effect of CFR on prognosis.Results:Among 194 patients, 133 patients had CMD (CMD group), and the incidence of CMD was 68.56%; 61 patients did not have CMD (non-CMD group). There were no statistical differences in gender composition, BMI, smoking history proportion, blood pressure, heart rate, hypertension rate, atrial fibrillation rate, diabetes mellitus rate, renal dysfunction rate, medication situation, LAD, LVEDD, IVST, PASP, blood urea nitrogen, blood creatinine, blood uric acid, eGFR and hs-CRP between two groups ( P>0.05). The age, rate of NYHA heart function classification Ⅲ to Ⅳ grade, rate of myocardial infarction or revascularization history, LVESD, cTnT and NT-proBNP in CMD group were significantly higher than those in non-CMD group: (60.7 ± 14.0) years old vs. (55.9 ± 15.8) years old, 54.89% (73/133) vs. 26.23% (16/61), 22.56% (30/133) vs. 1.64% (1/61), (48.8 ± 13.1) mm vs. (44.6 ± 11.4) mm, 0.023 (0.015, 0.046) μg/L vs. 0.015 (0.010, 0.023) μg/L and 1 591 (751, 3 409) ng/L vs. 1 132 (288, 1 860) ng/L, the LVEF was significantly lower than that in non-CMD group: (40.9 ± 14.2)% vs. (45.5 ± 14.1)%, and there were statistical differences ( P<0.05 or <0.01). Multiple linear regression analysis result showed that the cTnT was an risk factor of CFR ( β = - 0.18, 95% CI - 0.82 to - 0.06, P = 0.025). The median followed up time was 230 (136 to 330) d, 10 patients were lost to follow-up, with 58 patients in CMD group completing follow-up and 126 patients in the non-CMD group. The incidences of primary endpoint event and heart failure readmission in CMD group were significantly higher than those in non-CMD group: 23.02% (29/126) vs. 3.45% (2/58) and 15.87% (20/126) vs. 3.45% (2/58), and there were statistical differences ( P<0.01); there was no statistical difference in incidence of cardiovascular death between two groups ( P>0.05). Kaplan-Meier survival curve analysis result showed that the event free survival rate in CMD group was significantly lower than that in non-CMD group, and there was statistical difference (log-rank χ2 = 11.92, P<0.01). Conclusions:CMD is highly prevalent in patients with heart failure, and it is associated with poor prognosis. Improving CMD for improving coronary microcirculation may be potential targets for the treatment of heart failure.

Objective To probe into the gaps between the inpatient care needs at public tertiary hospitals and existing nursing services,for measures to improve the quality of nursing service.Methods The simple clinical score(SCS),Barthel index scale,patient care needs questionnaire,and actual service status questionnaire were used in a multi-centered stratified random sampling survey, covering the adult inpatient wards of 72 departments at six tertiary hospitals.The results were subject to a stratified analysis of patient care needs, and a comparative analysis between patient care needs and the actual status of the service.Results Statistically significant differences were found between the nursing needs of patients from among different departments,self-care abilities and those with different conditions(P<0.05); the patient care needs and actual service status in cleaning, eating, excretion, activities, health education, basic treatment and nursing of traditional Chinese medicine in terms of the differences were statistically significant (P<0.05); the comparative analysis found differences between patient care needs and actual service status.The top five patient care needs which were greater than the actual service status were namely temperature measuring,rehabilitation guidance,routine inspection,observation and psychological care.The top five areas with actual service status greater than patient care needs were namely turnover /back flapping, toilet assistance,temperature measuring,hands washing before and after meals,and herbal fumigation.The top five areas with minimal gap between needs and service were namely oral care, moxibustion, perineal care,assistance in using toilet in bed and manicure.Conclusions Departments, self-care abilities and conditions of patients vary with their needs of nursing.Based on the existing problems between patient care needs and the actual service status,nurses should increase their care in such soft indicators as rehabilitation guidance,routine inspection and disease observation, and fully meet the needs of patients.On the other hand,they are expected to enhance patients′health education and health literacy in such hard indicators as temperature measuring,turnover and back flapping.

Objective To investigate the changes of short chain fatty acids (SCFA) induced by tacrolimus (FK506) in rats and evaluate its effect on blood glucose levels. Methods Ten SD rats were divided into the FK506 group and control group (n=5 in each group). In the FK506 group, the rats were received a subcutaneous injection of FK506 (3 mg/kg) +sunflower oil solution containing 10% ethanol daily for consecutive 4 weeks. In the control group, the rats were received a subcutaneous injection of an equivalent amount of sunflower oil solution containing 10% ethanol for consecutive 4 weeks. During the drug injection period, the body mass of rats was measured every week in two groups. After the drug injection period, blood glucose level, SCFA content in the blood and feces samples were measured in two groups. Results Compared with the control group, the relative body mass of rats in the FK506 group was significantly lower at the 2nd, 3rd and 4thweeks (all P<0.01). Compared with the control group, the blood glucose levels of rats in the FK506 group were significantly increased at 0, 30, and 60 min after giving glucose (P<0.01-0.05). Compared with the control group, the contents of acetic acid, propionic acid, isobutyric acid, butyric acid, isovaleric acid and valeric acid in the feces sample were significantly lower in the FK506 group (P<0.01-0.05). Conclusions FK506 can upregulate the blood glucose level in rats, which is probably induced by the decrease of SCFA content in rat feces.