OBJECTIVE To provide empirical basis for promoting the dynamic adjustment of the pharmaceutical care catalogue and the formulation of policies such as hierarchical payment of medical insurance. METHODS A multicenter cross- sectional survey method was adopted to conduct a questionnaire survey among 424 inpatients in 22 tertiary medical institutions in 12 prefecture-level cities of Hubei Province to evaluate their demand for pharmaceutical care， willingness to pay and preference for service forms. Combined with univariate and multivariate Logistic regression analysis， the influencing factors and key factors that affect patients’ willingness to pay for pharmaceutical care were identified. RESULTS Only 39.86% of the patients were aware of pharmaceutical care or pharmacists， and 89.62% of the patients hope to receive pharmaceutical care. Among the 16 types of pharmaceutical care， the patients surveyed had a relatively high recognition rate for guidance on drug usage and dosage， notification of medication precautions， and the identification， prevention and handling of adverse drug reactions. 96.70%， 95.30%， and 94.12% respectively expressed strong approval and approval. The demand for services such as insurance-related policy consultation， popular science on the mechanism of drug action， and assessment of the combined use of traditional Chinese and Western medicines was relatively low， with 61.65%， 68.47%， and 68.47% expressing strong approval and approval respectively. The positive influencing factors of willingness to pay were household monthly income ＞ 5 000 yuan （OR＝1.742）， awareness of pharmaceutical care or pharmacists （OR＝3.620）， and the desire to receive pharmaceutical care （OR＝4.686） （P＜0.05）， while self-rating health as “good” （OR＝0.390） was a negative influencing factor （P＜0.05）. Cardiovascular and cerebrovascular diseases （54.48%） and antihypertensive drugs （45.05%） were the service scenarios that the surveyed patients most hope to be covered. 85.14% of the patients preferred “service when xiaochnye@126.com needed”， with a single service duration of less than 10 minutes being appropriate （84.43%）， and the willingness to pay within 20 yuan being the main type （85.38%）. CONCLUSIONS Based on the characteristics of patients’ needs and payment behaviors， it is suggested that our country could consider establishing a hierarchical payment mechanism for pharmaceutical care， and focus on differentiated design in combination with diseases and medication situations. At the same time， the rights， responsibilities and service standards of resident pharmacists in the links such as medication reorganization and medical order review should be further clarified to comprehensively enhance the clinical value and policy operability of pharmaceutical care.

ObjectiveTo study the genetic diversity and genetic relationship of Pinellia ternata germplasm resources and provide the basis for germplasm identification， variety breeding， and resource conservation. MethodIn this study， 27 P. ternata were used as experimental materials to determine seven phenotypic characters， such as plant height， leaf length， and leaf width. Simple sequence repeats （SSR） primers were designed based on P. ternata transcriptome data， and polymerase chain reaction （PCR） amplification was performed on 27 P. ternata samples. The genetic diversity of P. ternata germplasm was analyzed by POPGENE32， PowerMarker V3.25， and NTSYS-PC 2.10e software. ResultA total of 10 pairs of highly polymorphic primers （PIC>0.5） and four pairs of moderately polymorphic primers （0.25

Objective To investigate the expression of lncRNA SNHG8 in placenta accrete(PA)and its effect on trophoblast invasion and migration.Methods qRT-PCR was used to detect the expression of lncRNA SNHG8 in placenta tissue of 30 cases in PA group and 30 cases in control group,and the correlation between lncRNA SNHG8 expression and prenatal ultrasound score of 30 cases in PA group was analyzed.Transwell and scratch assay were used to detect the effect of lncRNA SNHG8 interference on the invasion and migration of human chorionic trophoblast cells(HTR8/SVneo cells),and western blot was used to detect the expression of MMP-2 and MMP-9.The downstream targets of lncRNA SNHG8 were predicted by StarBase software,and the expression of lncRNA SNHG8 was detected in placental tissues of the two groups.Dual luciferase reporter assay was used to detect the targeting relationship between lncRNA SNHG8 and miR-542-3p.Results Compared with that of the control group,the expression of lncRNA SNHG8 was up-regulated in the placenta tissue of the PA group(P<0.05),and it was positively correlated with prenatal ultrasound score.Interference with lncRNA SNHG8 inhibited the invasion and migration of trophoblast cells(P<0.05);the protein expression of MMP-9 and MMP-2 also decreased signifi-cantly(P<0.05).Biological prediction indicates that miR-542-3p had a binding site with lncRNA SNHG8,and miR-542-3p expression was down-regulated in PA placental tissue(P<0.05).Dual luciferase reporter assay confirmed that lncRNA SNHG8 could target miR-542-3p.Compared with si-SNHG8+inhibitor-NC,co-transfection of si-SNHG8 and miR-542-3p inhibitor enhanced the invasion and migration ability of trophoblast cells(P<0.05).Conclusion lncRNA SNHG8 is highly expressed in PA and is related to the severity of PA.LncRNA SNHG8 promotes the invasion and migration of trophoblast by regulating the level of miR-542-3p.The study suggests that lncRNA SNHG8 plays an important role in the invasion and migration of PA trophoblast cells,which is expected to be a clinical diagnostic biomarker and therapeutic target.

Objective To explore the value of pelvic CT angiography(CTA)digital three-dimensional reconstruction model(abbreviated as"three-dimensional model")in the diagnosis of female pelvic mass.Methods A total of 98 patients with pelvic mass who were hospitalized and operated in Xi'an People's Hos-pital(Xi'an Fourth Hospital)from January 2021 to April 2023 were selected.All patients underwent B-ultra-sound and CTA examination before operation,and the original data of CTA were collected.The digital three-dimensional model of pelvic mass was established by three-dimensional reconstruction software,and the source of pelvic mass was judged according to the blood supply of pelvic mass.Taking postoperative pathological di-agnosis as the gold standard,the coincidence rate between different preoperative diagnosis methods(B-ultra-sound,CTA examination and three-dimensional model)was compared.The receiver operating characteristic(ROC)curve was plotted to evaluate the efficacy of different preoperative diagnostic methods in judging the ovarian origin of pelvic tumors.Results A total of 130 pelvic masses were included in 98 patients,and the average maximum diameter of the mass was(71.61±3.03)mm,including 83 ovarian masses and 47 non-ovarian masses.Taking postoperative pathological diagnosis as the gold standard,the diagnostic coincidence rate of the preoperative three-dimensional model was 72.31％,which was higher than that of B-ultrasound(58.46％)and CTA(52.31％),and the differences were statistically significant(P＜0.001).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,Kappa value,and area under the ROC curve were 79.51％,91.49％,94.29％,71.67％,83.85％,0.67 and 0.855,respectively,when the three-dimensional model showed that the blood supply of the mass originated from ovarian artery or uterine artery-ovarian branch.Conclusion The three-dimensional model of pelvic CTA can directly display the blood supply source,characteristics of mass,and the relationship between mass and adjacent organs,which can guide the clinical treatment.It has certain clinical value to judge the ovarian origin of pelvic mass by using ovarian artery and uterine artery-ovarian branch.

Objective To explore the efficacy and safety of lung recruitment maneuver(LRM)on postoperative hypoxemia in patients with acute type A aortic dissection(ATAAD).Methods A total of 56 ATAAD patients with postoperative hypoxemia in the First Affiliated Hospital of Guangxi Medical University from November 2019 to May 2022 were selected and randomly divided into LRM group(n=36)and conventional treatment group(n=20).Patients in conventional treatment group received routine mechanical ventilation on the basis of lung protective ventilation.The patients in LRM group were treated with incremental positive end expiratory pressure(PEEP).Arterial blood gas analysis,respiratory parameters,hemodynamics parameters and serum interleukin(IL)-6 and IL-10 levels were compared between two groups before and after treatment.Results At 12h and 24h after treatment,arterial partial pressure of oxygen(PaO2),oxygenation index(OI),static compliance(Cstat)and dynamic compliance(Cdyn)in two groups were significantly higher than before treatment,the alveolar-arterial gradient of oxygen[PO2(A-a)],respiratory index(RI),peak inspiratory pressure(Ppeak)and plateau pressure(Pplat)were significantly lower than before treatment(P<0.05).PaO2,OI,Cstat and Cdyn in LRM group were significantly higher than those in conventional treatment group,PO2(A-a),RI,Ppeak and Pplat were significantly lower than those in conventional treatment group(P<0.05).Systolic blood pressure and mean arterial pressure decreased and central venous pressure increased during pulmonary reexpansion in LRM group(P<0.05),and all patients returned to baseline level after pulmonary reexpansion.At 12h after treatment,serum IL-6 and IL-10 levels in both groups were significantly lower than before treatment(P<0.05).Conclusion Incremental PEEP can improve oxygenation and lung compliance in patients with hypoxemia after ATAAD surgery,but it has transient effects on hemodynamics,and should be closely monitored during treatment.

Objective:To analyze the effect of biofeedback electrical stimulation on the prevention of stress urinary incontinence and pelvic floor muscle strength during postpartum rehabilitation.Methods:A total of 200 parturients who gave birth in Ningde Municipal Hospital of Ningde Normal University from October 2021 to April 2022 were included as research objects and divided into the control group and the observation group according to different rehabilitation programs, with 100 cases in each group. The control group was given routine rehabilitation, and the observation group was given biofeedback electrical stimulation on the basis of the control group, the parturients in the two groups were treated for 3 months. The occurrence of stress urinary incontinence in the two groups was compared, and the pelvic floor muscle strength before and after treatment were compared between the two groups. The scores of International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) were compared between the two groups.Results:The total incidence of stress urinary incontinence in the observation group was lower than that in the control group: 4.00%(4/100) vs. 15.00%(15/100), there was statistical difference( χ2 = 9.00, P<0.05). After treatment, the muscle strength grade, class Ⅰ muscle fiber, class Ⅱ muscle fiber and average voltage of pelvic floor muscle in the observation group were higher than those in the control group: (3.85 ± 0.27) grades vs. (3.74 ± 0.32) grades, (10.23 ± 1.17) μV vs. (8.84 ± 1.13) μV, (11.56 ± 0.19) μV vs. (10.98 ± 0.24) μV, (18.12 ± 3.24) μV vs. (14.69 ± 3.01) μV, there were statistical differences ( P<0.05). After treatment, the scores of ICI Q-SF and PFIQ-7 in the observation group were lower than those in the control group: (7.02 ± 1.26) scores vs. (8.26 ± 1.15) scores, (18.96 ± 4.31) scores vs. (24.17 ± 5.62) scores, there were statistical differences ( P<0.05). Conclusions:The application of biofeedback electrical stimulation in postpartum rehabilitation can reduce the incidence of stress urinary incontinence, improve postpartum pelvic floor muscle strength, and reduce the impact of stress urinary incontinence and pelvic floor muscle disorder on daily life.

Objective To evaluate the teaching performance of the traditional Chinese medicine(TCM)course for the first three grades of the"4+4"reform pilot class in clinical medicine at Peking Union Medical College.Methods An anonymous survey was conducted using Questionnaire Star and the responses from TCM Teaching Questionnaire completed by students were statistically analyzed and summarized.Results Most students expressed interest in TCM and deemed it necessary to study TCM course.They believed that teachers well prepared for teach-ing performance and the teaching content was well-aligned with the textbooks,syllabus,and lecture slides.The teaching content was closely integrated with clinical practice,and students were satisfied with the teaching methods and approaches.Conclusions Teaching evaluations help teachers to summarize their teaching experiences and im-prove the teaching quality of the TCM course.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.