Objective To study the effect of the intervention mode of MTP on use of antibacterials in upper respiratory infection.Methods Adopt retrospective method to select randomly prescriptions of upper respiratory infection from July to September in 2006 for baseline investigation in Outpatient Clinic of Respiratory Department of the First People's Hospital of the city of Zhuhai in Guangdong province.Then aim physicians was interfered by MTP and investigation of post-interference was carried out after a month.The process of intervention and investigation was carried out repeatedly until June in 2007.The ratio of antibacterials use,injection use percentage and average drug fee was observed in pre/post-interference.Results The ratio of antibacterials use in upper respiratory infection in our hospital was decreased from 81.33% to 0,and the ratio percentage of injection use and average drug fee decreased by 81.69% and 35.47% respectively after four MTP circulations.Conclusion The intervention mode of MTP is feasible and effective on promoting the rational use of antibacterials on upper respiratory infection in Outpatient Clinic of Respiratory Department of our hospital.

Objective : To evaluate the sleep quality of patients with chronic kidney disease (CKD) and to explore the related factors of sleep disorder in patients with CKD . Methods : The basic data of hospitalization patients with CKD without renal replacement therapy were prospectively collected , and the Pittsburgh sleep quality index (PSQI) scale was used to evaluate the sleep quality of patients . Patients with a PSQI score of ≤5 were divided into the nor mal sleep group , and patients with a PSQI score of > 5 were divided into the sleep disorder group . Logistic regres sion analysis was used to explore the related factors of sleep disorder in patients with CKD . Results: A total of 189 patients with CKD who did not receive renal replacement therapy were included , including 114 males (60.3% ) and 75 females (39.7% ) , aged 56.5 ±15.23 years . The PSQI score was 7.00 (5.00 , 8.00) , there were 58 ca ses in the normal sleep group and 131 cases in the sleep disorder group , and the prevalence of sleep disorder was as high as 69 3% . As the CKD stage progresses , the prevalence of sleep disorders gradually increases . There were differences between the sleep disorder group and the normal sleep group in subjective sleep quality , sleep latency , sleep duration , habitual sleep efficiency , sleep disorder superposition problems , and daytime dysfunction ( P < 0.05) , while there was no statistically significant difference in the scores of sleep medication use . Retirement or unemployed (OR = 6.509 , 95% CI:1.844 - 22.976) and women (OR = 4.561 , 95% CI: 1.241 - 16.767) were independent risk factors for sleep disorders , while e GFR (OR = 0.960 , 95% CI: 0.931 - 0.991) was a protective factor for sleep disorders , P < 0.05 . Conclusion The prevalence of sleep disorders in patients with chronic kidney disease without renal replacement therapy gradually increases with the decrease of e GFR and the increase of CKD stage , but they do not receive timely intervention with sleep improvement drugs . Clinicians need to focus on assess ing sleep quality in women versus unemployed or retired patients with CKD .