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.

BACKGROUND:Total hip and knee arthroplasty is widely used in the elderly population,but there is a lack of accurate prediction methods for unplanned readmission and postoperative complications. OBJECTIVE:To investigate the effect of the Rothman index on unplanned readmission and complications in elderly patients undergoing total hip and knee arthroplasty. METHODS:A total of 153 patients who underwent elective total hip and knee arthroplasty from December 2020 to December 2022 in Ward Area One,Department of Orthopedics,The First People's Hospital of Zunyi were selected as the study subjects.According to whether they were unplanned readmission within 90 days after discharge,they were divided into a readmission group(n=21)and a non-readmission group(n=132).The general data of all patients were collected through the electronic medical record system,including gender,age,body mass index,diabetes mellitus,hypertension,and surgical joint type.The Rothman index was evaluated according to the literature.Postoperative complications were counted. RESULTS AND CONCLUSION:(1)There was no significant difference in gender,body mass index,surgical joint type,and length of hospital stay between the readmission group and the non-readmission group(P>0.05).There were significant differences in the number of comorbidities,age,and Rothman score between the two groups(P<0.05).(2)The results of multivariate Logistics regression analysis showed that the number of comorbidities,age,and Rothman score were independent influencing factors for readmission 90 days after total hip and knee arthroplasty in elderly patients with hip and knee diseases(P<0.05).(3)The results of receiver operating characteristic curve analysis exhibited that the area under the curve of the Rothman index for predicting readmission 90 days after total hip and knee arthroplasty was 0.824;the sensitivity was 80.85%;the specificity was 78.85%;the maximum Youden index was 0.597,and the optimal cutoff value was 46 points.(4)The incidence of total complications in elderly patients with Rothman<46 was higher than that in elderly patients with Rothman≥46(P<0.05).(5)It is concluded that the Rothman index can accurately predict unplanned readmission after total hip and knee arthroplasty in elderly patients with hip and knee joint diseases.Simultaneously,patients with Rothman index of less than 46 points have a higher overall risk of complications and poor joint recovery,which can be used to improve postoperative management of patients in clinical practice.

Objective:To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants.Methods:This study was based on data from a subcohort of a study called ge-netic susceptibility to cow's milk allergy in Chinese children,including infants born in Peking University People's Hospital between March 1,2020,and December 31,2020.The infants were divided into a cow's milk protein allergy(CMPA)group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year.We retrospectively collected the clinical data of infants and their mothers before and during pregnancy,and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants.Results:A total of 278 infants were enrolled in this study,including 52 infants with CMPA and 226 infants without CMPA.Among them,there were 143 boys and 135 girls.The proportion of male infants in the CMPA group(69.2％)was higher than that in the control group(47.3％),and the difference was statistically significant(P=0.004).There were no significant differences in the distribution of birth weight,gestational age at birth,low-birth-weight in-fants,premature,umbilical cord entangle neck,and neonatal asphyxia between the CMPA group and the control group(P＞0.05).The proportion of mothers complicated with autoimmune diseases,anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group,and there were statistical differences between the two groups(P＜0.05).There was no significant difference in the distribution of other pregnancy complications between the two groups(P＞0.05),such as eclamp-sia/preeclampsia,chronic hypertension/gestational hypertension,diabetes/gestational diabetes,thyroid diseases,and so on.There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group(P＞0.05).Multivariate Lo-gistic regression analysis showed that male infant,mothers complicated with autoimmune diseases or ane-mia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.Conclusion:Male infant,mothers complicated with autoimmune diseases or anemia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.

Objective: To investigate the effects of remifentanil combined with propofol on hemodynamics, inflammatory stress response and immune function in patients with acute abdomen complicated with septic shock. Methods: From June 2017 to August 2018, 112 patients with acute abdomen complicated with septic shock who admitted to the First Affiliated Hospital of Xiamen University were enrolled in the study.They were randomly divided into observation group and control group according to the digital table, with 56 cases in each group.The control group was anesthetized with sevoflurane combined with propofol.The observation group was anesthetized with remifentanil combined with propofol.The hemodynamic parameters of the patients entering the operating room(T0₎, 0.5h(T₁), 1h(T₂) and awake(T₃) after anesthesia were recorded.The intraoperative norepinephrine dosage was recorded.The inflammatory response, stress response and immune function indicators at T₀, T₂ and T₃ were recorded. Results: Compared with T₀, T₁ and T₂, the MAP of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=4.834, 4.484, 5.378, t_{observation group}=6.420, 7.006, 6.152, all P<0.05). Compared with T₀, the HR of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=5.943, t_{observation group}=7.722, all P<0.05). Compared with T₁ and T₂, CO of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=4.276, 2.262, t_{observation group}=6.318, 5.132, all P<0.05). There were no statistically significant differences in MAP, HR and CO between the two groups at T₀, T₁, T₂ and T₃(all P>0.05). The doses of norepinephrine in the observation group and the control group were (1 587.7±287.5)μg and (1 937.9±397.6)μg, respectively, and the difference was statistically significant(t=5.341, P<0.05). The serum levels of C reactive protein(CRP), tumor necrosis factor alpha(TNF-α) and interleukin 6(IL-6) increased with time in the two groups, and the differences were statistically significant(t_{control group}=17.06, 36.13, 19.07, 3.822, 9.466, 2.874, 14.18, 26.87, 16.21, t_{observation group}=11.72, 20.79, 11.01, 2.810, 6.559, 3.716, 10.52, 24.56, 17.64, all P<0.05). At T₂ and T₃, the serum levels of CRP, TNF-α and IL-6 in the observation group[T₂: CRP (89.63±17.65)mg/L, TNF-α (51.16±10.16)ng/L, IL-6 (34.26±6.25)ng/L, T₃: CRP (136.15±26.25)mg/L, TNF-α (58.64±11.12)ng/L, IL-6 (67.56±12.67)ng/L]were lower than those in the control group[T₂: CRP (112.15±22.34)mg/L, TNF-α (59.56±11.58)ng/L, IL-6 (42.65±8.37)ng/L, T₃: CRP (175.16±34.75)mg/L, TNF-α (65.79±11.35)ng/L, IL-6 (79.02±14.56)ng/L], the differences were statistically significant(t=5.919, 6.703, 4.080, 3.367, 6.010, 4.443, all P<0.05). Compared with T0, serum levels of epinephrine(E), cortisol(Cor) increased in two groups at T₂ and T₃, and the differences were statistically significant(t_{control group}=10.03, 8.096, 8.679, 7.029, t_{observation group}=6.473, 4.728, 6.330, 4.727, all P<0.05). Compared with T₂, serum levels of E and Cor in two groups at T₃ were decreased, and the differences were statistically significant(t_{control group}=2.400, 2.638, t_{observation group}=2.260, 2.162, all P<0.05). At T₂ and T₃, the serum levels of E, Cor in the observation group[T₂: E (286.36±41.02)ng/L, Cor (262.52±29.89)μg/L, T₃: E (270.35±33.59)ng/L, Cor (253.23±30.28)μg/L]were lower than those in the control group[T₂: E (312.56±38.75)ng/L, Cor (287.56±38.76)μg/L, T₃: E (295.79±35.12)ng/L, Cor (270.25±30.15)μg/L], the differences were statistically significant (t=3.457, 3.917, 3.828, 2.981, all P<0.05). At T₀, T₂ and T₃, there were no statistically significant differences in CD₃⁺, CD₄⁺, CD₈⁺ and CD₄⁺/CD₈⁺ between the two groups(all P>0.05). Conclusion Remifentanil combined with propofol anesthesia can make hemodynamics more stable in patients with acute abdomen complicated with septic shock, and can alleviate inflammation and stress response.