OBJECTIVE:To evaluate the improvement and rectification effects about prescription checking and intervention skills of pharmacists. METHODS:By retrospective investigation,2417 outpatient prescriptions and 1698 outpatient prescriptions were respectively selected from some one hospital during Oct.-Dec. 2015 (before improvement and rectification) and Jan.-Mar. 2016 (after improvement and rectification). According to standards,guidelines and references as Prescription Administrative Poli-cy,Prescription Review Management Standard(trial)and drug instructions,irrational drug use and prescription checking and inter-vention skills of pharmacists were compared before and after the implementation of rectification measures as optimizing hospital in-formation system,improving comprehensive skills of pharmacists,strengthening pharmacists'concept,establishing feedback mech-anism. RESULTS:After the implementation of rectification measures,unsuitable indications,clinical diagnosis inconsistent with medication,antibiotics use without indications,unsuitable usage and dosage,unsuitable drug combination and irrational drug use were all decreased,but repeated drug use was increased,without statistical significance (P>0.05). The number of non-standard prescriptions and unsuitable prescriptions checked by pharmacists were decreased,without statistical significance(P>0.05). The in-cidence of checking missing,excessive checking and checking error were all increased from 2.40%,0.99%,3.39% before im-provement and rectification to 0.47%,0.29%,0.77%,with statistical significance(P<0.05). CONCLUSIONS:The improvement and rectification measures of the hospital can improve comprehensive prescription checking and intervention skills of pharmacists. Ir-rational drug use should be further standardized.

Chronic hepatitis B(CHB)is one of the most commom cause of liver fibrosis. Accurate assessment of liver fibrosis is essential for the strategy of treatment and judgement of prognosis . Liver biopsy is the gold standard for staging fibrosis,but it is invasive with high cost,low reproducibility and poor acceptance by patients. Therefore,it is urgent to explore a noninvasive modality for the assessment of liver fibrosis. Recent evidence highlights that elastographic techniques, biochemical markers and the diagnostic model consisted of several serum markers have the potential for the diagnosis of liver fibrosis. This article reviewed the progress in noninvasive assessment of liver fibrosis in patients with CHB.

Community-based rehabilitation (CBR) is positioned to provide various strategies for people with disabilities for achieving the embracing development of the community. CBR is also the terminal of the three-level rehabilitation service system. This paper analyzed the status of domestic community-based rehabilitation based on the document, discussed the possible problems referred to the international concepts about CBR, and suggested a new service pattern of CBR based on the internet and information technology.

Objective To observe the changes of the cells of human hepatocellular carcinoma (HepG2)using RNA for silencing the expression of COMMD7 gene,and investigate related mechanism of COMMD7 gene promoting HepG2 proliferation.Methods COMMD7 gene shRNA was designed and constructed into COMMD7-shRNA plasmid.HepG2 cells were divided into the HepG2 group,control-shRNA group (empty vectors were infected) and COMMD7-shRNA group (positive vectors were infected).Cells shapes were observed by fluorescence microscope after infecting.The expression of COMMD7 and expression and phosphosylation of extracellular regulated protein kinase1/2 (ERK1/2) and MEK1/2 protein were measured by Western blot.The cell vitality was measured by cholecystokinin octapeptide (CCK-8),and the apoptosis of cell was detected by flow cytometry.The measurement data with normal distribution were presented as (x) ± s.The comparisons among groups were evaluated with the one-way ANOVA,and pairwise comparison was analyzed by the LSD-t test.Results The cells were oval or spindle shapes and displayed green fluorescent after infected successfully.The results of Western blot showed that the relative quantitative expression of COMMD7 protein in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 0.90 ±0.18,1.03 ±0.05 and 0.23 ±0.03,respectively,with a significant difference among the 3 groups (F =152.08,P ＜ 0.05),and the expression of COMMD7 protein in the COMMD7-shRNA group was significantly lower than those in the other 2 groups (t =20.74,21.16,P ＜ 0.05).The results of CCK-8 showed that the scores of the HepG2 vitality in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 1.193 ±0.024,1.225 ±0.034 and 1.147 ±0.021,respectively,with a significant difference among the 3 groups (F =6.90,P ＜ 0.05),and the HepG2 vitality in the COMMD7-shRNA group was significantly lower than those in the other 2 groups (t =3.53,3.69,P ＜ 0.05).The results of flow cytometry showed that the apoptosis rate of HepG2 in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 6.1％ ± 0.3％,7.8％ ± 0.5％ and 20.9％ ± 1.4％,showing a significant difference among the 3 groups (F =270.80,P ＜0.05),and the apoptosis rate of HepG2 in the COMMD7-shRNA group was significant higher than those in the other 2 groups (t =21.77,19.36,P ＜0.05).The results of Western blot showed that the relative quantitative expression of phosphorylation (p)-ERK1/2 and p-MEK1/2 in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 0.932 ±0.046,0.945 ±0.017,0.553 ±0.052 and 0.452 ±0.031,0.468±0.027,0.263 ± 0.022,respectively,showing significant differences among the 3 groups (F =93.61,49.16,P ＜ 0.05),and the relative quantitative expression of p-ERK1/2 and p-MEK1/2 in the COMMD7-shRNA group were significantly lower than those in the other 2 groups (t =11.94,12.17,9.33,8.65,P ＜ 0.05).Conclusions COMMD7 gene can promote HepG2 proliferation via activating ERK/mitogen-activated protein kinase (MAPK) signaling pathway,and its mechanism may be promoting the phosphorylation of expression of ERK1/2 and MEK1/2.

Objective To evaluate the effect of sevoflurane preconditioning on autophagy in the operated lung tissues of the patients undergoing one-lung ventilation.Methods Forty patients of both sexes,with American Society of Anesthesiologists physical status Ⅰ-Ⅲ,aged 30-80 yr,weighing 45-84 kg,scheduled for elective radical operation for lung cancer performed via video-assisted thoracoscope under general anesthesia,were divided into control group (C group) and sevoflurane preconditioning group (SP group),with 20 patients in each group.In SP group,sevoflurane was inhaled for 30 min with the final concentration of 2.0％,followed by washout.The normal lung tissues (the distance from the edge of the lump＞2 cm) around the lump were obtained for detection of the expression of microtubule-associated protein 1 light chain 3 Ⅱ by Western blot.Results Compared with C group,the expression of microtubule-associated protein 1 light chain 3 Ⅱ in lung tissues was significantly up-regulated in SP group (P＜0.05).Conclusion Sevoflurane preconditioning can enhance autophagy in the operated lung tissues of the patients undergoing one-lung ventilation,which may be related to the lung protective effect.

OBJECTIVETo provide basis for effects of an early psychological intervention on parents of children with cleft lip/palate, and investigate the effects of an early psychological intervention to them.

METHODSOne self-administered questionnaire (SCL-90) was applied in 102 parents of children with cleft lip/palate, compared to 126 parents of healthy individuals on the day of admission. They were given the psychological intervention during hospitalization and 3 months after discharge. The questionnaire (SCL-90) was again applied to them on the day of discharge and 3 months after discharge.

RESULTSUsing the questionnaire (SCL-90), the answer scores of somatization, obsessive-compulsive, depression and anxiety etc. were significantly higher than those of the control group (P < 0.05). There were no statistical differences during 3 subgroups in the case group (P > 0.05). There were no statistical differences on the day of admission and on the day of discharge (P > 0.05), but there were statistical difference on the day of admission and 3 months after discharge (P < 0.05).

CONCLUSIONIn this study, the psychosomatic states of parents of children with cleft lip/palate is poor. It's important and greatly significant that we conduct early psychological intervention to parents of children with cleft lip/palate and to the children's psychosomatic health.

Objective: To explore the efficacy of thematic health education on breast cancer patients with whole course of disease management. Methods: According to the order of admission into the hospital, 100 breast cancer patients were randomly divided into two groups: the control group and the observation group. In the control group, clinical nursing pathway was adopted when health education was conducted. In the observation group, thematic health education based on the whole course of disease management was carried out. Mastery of disease knowledge, health-promoting behaviors and degree of anxiety were compared between the two groups. Results: The total score of the survey on the observation group and the scores of Disease Risk Factors, Functional Training and Observation and Protection of Complication (90.00±11.75, 18.05±4.33, 19.01±4.20, 18.68±0.07) were all higher than those of the control group (86.68±9.340, 16.12±2.86, 17.22±2.83, 15.43±6.78); the differences were statistically significant (t=2.641-9.171, P<0.05) .The total score of the observation group in The Healthy Living Style Scale and the scores in different dimensions were all higher than those of the control group; the differences were statistically significant (t=2.347-6.653, P<0.05 or 0.01) .The score of the Self-rating Anxiety Scale of the observation group after completing all the chemotherapy periods (48.20±4.03) was lower than that of the control group after three chemotherapy periods (53.56±2.84) ;the differences were statistically significant (t=7.028, P<0.05) ; in these two tests, the group differences in scores between the two groups are also statistically significant (t=2.050, 11.560, P<0.05 or 0.01) . Conclusion Conducting thematic health education on the breast cancer patients based on the whole course of disease management can effectively improve the patients′ mastery of disease knowledge, improve their health-promoting behaviors, relieve their anxiety and help them recover physically and mentally.

Objective: To investigate the status of immunization of National Immunization Program (NIP) and its adverse reaction rate in children with tuberous sclerosis. Method: Questionnaire survey was adopted to identify the vaccination coverage and its adverse events; 72 cases of children with tuberous sclerosis and 78 normal controls (healthy children completing age-appropriate NIP) admitted to Chinese People′s Liberation Army General Hospital from December 2014 to November 2015 were involved into this study. Result: The age-appropriate NIP coverage rate of tuberous sclerosis was 36%(26/72). The coverage rate of bacillus calmette-guerin (BCG), hepatitis B vaccine 1^st to 3^rd doses (HepB1-3), oral poliovaccine 1^st dose (OPV1), diphtheria, pertussis and tetanus 1^st dose (DPT1), DPT1-3, meningococcal polysaccharide vaccine group A (MPVA), measles amd rubella vaccine/measles vaccine 1^st dose (MRV/MCV1), and Japanese encephalitis vaccine 1^st dose (JEV1) were 100%(72 cases), 75%(51 cases), 97%(66 cases), 91%(62 cases), 82%(56 cases), 66%(45 cases), 69%(42 cases), and 61%(37 cases) respectively. The reasons why the children did not complete the vaccination plan were that parents were concerned about vaccination-induced seizures or seizures had not been controlled. Among 72 children with TSC, the rate of adverse events or suspected adverse events after vaccination was 17% (12 cases), which was higher than the normal control children (2 cases, 3%) (χ²=8.799, P<0.05). The main adverse events were seizure events, which accounted for 92%(11 cases). Conclusion The age-appropriate NIP coverage rate among children with tuberous sclerosis is low. The high incidence of adverse events may be associated with a fact that there are some nervous system abnormalities in cases with tuberous sclerosis. TSC children vaccination is relatively safe, with no serious adverse events.

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4⁺T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4⁺T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.