OBJECTIVE To construct a pharmaceutical care framework suitable for elderly individuals in nursing homes， so as to provide standardized content guidance for relevant practice. METHODS The initial items of pharmaceutical care content in n ursing homes were drafted through literature research and semi-structured interviews. Delphi method was used to conduct correspondence consultation among 38 experts from related fields in Xinjiang. The expert positive coefficient， authority coefficient， and Kendall’s W were calculated， and the analytic hierarchy process was employed to determine the weight of each item. After thorough discussion among the research team members， the pharmaceutical care framework suitable for elderly individuals provided by hospital pharmacists collaborating with nursing homes was finalized. RESULTS The questionnaire recovery rates for both rounds of expert correspondence consultation were 100%， with an authority coefficient ＞0.8 and Kendall’s W ranging between 0.153 and 0.185 （ P ＜0.001）. A total of 7 primary items and 31 secondary items were ultimately determined， with the consistency ratio of the item weights all being less than 0.1. Based on the integration of importance and feasibility， among the primary items， “assessment of pharmaceutical care needs” was assigned the highest weight. Among the secondary items， highly practical items such as “survey of pharmaceutical care needs”“guidance on usage and dosage”“methods for correctly reading drug package inserts”， and “self-management of common chronic diseases in the elderly” were assigned relatively high comprehensive weights. CONCLUSIONS The pharmaceutical care framework suitable for elderly individuals provided by hospital pharmacists collaborating with nursing homes， which was constructed based on the Delphi method， demonstrates good scientific validity and reliability， and can serve as a reference for pharmacists to provide pharmaceutical care in nursing homes.

OBJECTIVE To investigate the prevalence and influencing factors of potentially inappropriate medication （PIM） among the elderly in nursing homes in Urumqi based on three PIM screening tools， and to compare the applicability of different tools. METHODS A cross-sectional study design was adopted. Elderly individuals from six nursing homes in Urumqi were selected as the research subjects from May 2021 to September 2023. Demographic characteristics， disease burden and medication records of the elderly were collected. PIM screening was performed using the Chinese PIM criteria （2024 edition）， the American Geriatrics Society （AGS） Beers criteria （2023 edition）， and the Screening Tool of Older Person’S Prescriptions（STOPP）/Screening Tool to Alert to Right Treatment（START） （2023 edition）. Fleiss’s Kappa test was used to assess the consistency among the three screening tools， and multivariate Logistic regression was used to analyze the influencing factors of PIM. RESULTS The prevalence of PIM screened by the Chinese PIM criteria was 47.4% （323/682）， by the AGS Beers criteria was 43.4% （296/682）， and by the STOPP criteria was 50.9% （347/682）. The consistency among the three screening tools was low （Fleiss’s Kappa＝0.12， P ＜0.001）. Multivariate Logistic regression analysis showed that all three screening tools indicated that polypharmacy， aspirin use and psychotropic drug use were independent risk factors for PIM among elderly in nursing houses （all OR＞1， P ＜0.05）. CONCLUSIONS The prevalence of PIM among the elderly in nursing homes in Urumqi is relatively high. Polypharmacy， aspirin use and psychotropic drug use are common independent risk factors for PIM. There are differences in screening results among the three tools with low consistency. The Chinese PIM criteria can serve as a first-line tool for PIM screening in nursing homes.

IgG4-related disease (IgG4-RD) is a rare autoimmune fibrosis disease characterized by elevated serum IgG4 and tissues as well as organs infiltrated with IgG4-positive cells, resulting in swelling and damage.It is currently treated as first-line treatment with glucocorticoids. Autoimmune hemolytic anemia (AIHA) is also a relatively rare disease that caused by autoreactive erythrocyte antibodies. Although both are autoimmune-related diseases, they rarely overlap. The relationship between them is not clear. A case of IgG4-RD combined with AIHA is reported. The patient has shortness of breath, cough, and sputum after physical activity. Physical examination showed appearance of anemia, yellow staining of skin and sclera, palpable neck and multiple swollen lymph nodes. Laboratory examination, bone marrow biopsy, and lymph node biopsy confirmed the diagnosis. Therefore, clinicians should develop ideas and raise awareness of such diseases.
Anemia, Hemolytic, Autoimmune ; diagnosis ; drug therapy ; Autoimmune Diseases ; complications ; Biopsy ; Humans ; Immunoglobulin G ; Immunoglobulin G4-Related Disease ; complications ; diagnosis

OBJECTIVETo investigate the operation timing of newborns with rectosigmoid Hirschsprung's disease (HD).

METHODSFrom March 2013 to September 2015, 35 newborns diagnosed as rectosigmoid HD in our department were prospectively and randomly divided into 2 groups: less than 3 months treatment group (18 cases) and more than 3 months treatment group (17 cases, conservative treatment for 3 months). They all underwent laparoscopic-assisted transanal endorectal pull-through (LATEP) (modified Soave) procedure. Clinical data, perioperative conditions, postoperative complication, postoperative anal function evaluated by Wingspread score and barium enema were compared between two groups.

RESULTSThe baseline data of two groups were comparable (all P>0.05). All the cases completed single-stage LATEP procedure successfully without conversion to open operation. Compared with more than 3 months treatment group, preoperative bowel preparation time and operation time were significantly shorter [(6.2±3.3) vs. (9.3±4.1) days, P=0.042; (95±15) vs.(121±23) minutes, P=0.029, respectively], intra-operative blood loss was significantly less [(13±3) ml vs. (22±5) ml, P=0.036], length of resected bowel was significantly shorter [(16±5) cm vs.(23±8) cm, P=0.033], and bowel movement recovery time, parenteral nutrition time, hospital stay were also significantly shorter [(2.3±0.5) vs. (2.9±0.6) days, P=0.046; (5.1±2.1) vs. (5.9±2.3) days, P=0.048; (12.9±3.3) vs. (15.8±4.3) days, P=0.049, respectively] in less than 3 months treatment group. No short-term complications, such as anastomotic leak, interlayer infection and abdominal infection occurred in both groups. The follow-up period ranged from 2 months to 24 months. Only the incidence of perianal excoriation was significantly higher in less than 3 months treatment group compared with more than 3 months treatment group [50.0%(9/18) vs. 23.5%(4/17), P=0.045]. Wingspread score results at 6 and 12 months after operation showed excellent rate of postoperative anal function, which was not significantly different between two groups[ <3 months group : 81.3%(13/16) and 92.9%(13/14); >3 months group: 85.7%(12/14) and 92.3%(12/13), all P>0.05]. Postoperative barium enema results at 6 and 12 months after operation all showed normal shape of colon without residue of barium.

CONCLUSIONSFor newborns with rectosigmoid HD, single-stage definitive operation performed at the age less than 3 months has the advantages of shorter preoperative preparation time, less operating injury, shorter resected bowel, and faster postoperative recovery as compared to the age more than 3 months. If rectosigmoid HD is definitively diagnosed, early operation is suggested to perform at the age less than 3 months.

Anastomotic Leak ; Barium Enema ; Blood Loss, Surgical ; Defecation ; Digestive System Surgical Procedures ; Female ; Hirschsprung Disease ; surgery ; Humans ; Infant ; Infant, Newborn ; Intraabdominal Infections ; Laparoscopy ; Length of Stay ; Male ; Operative Time ; Parenteral Nutrition ; Parenteral Nutrition, Total ; Postoperative Complications ; Postoperative Period ; Treatment Outcome

OBJECTIVE: To explore the relationship between main pulmonary artery diameter and process of chronic pulmonary disease.
 METHODS: We retrospectively reviewed 9 cases without pulmonary diseases (control group) and 100 cases with chronic pulmonary diseases, which were divided into 3 groups: the simple chronic pulmonary disease (A group, 37 cases), the compensatory period of chronic cor pulmonale (B group, 20 cases) and the decompensatory period of chronic cor pulmonale (C group, 43 cases). Main pulmonary artery diameter (MPAD) was measured by chest CT. The differences of MPAD among these 4 groups were analyzed.
 RESULTS: There was a strong positive correlation between pulmonary artery diameter and process of chronic pulmonary disease. Mean MPAD in the group C was higher than that in the group B (P<0.05), and mean MPAD in the group B was higher than that in the group A (P<0.05). Mean MPAD in control group was the smallest one among all groups (P<0.05).
 CONCLUSION Main pulmonary artery diameter could reflect the process of chronic pulmonary disease.
Case-Control Studies ; Chronic Disease ; Humans ; Hypertension, Pulmonary ; physiopathology ; Pulmonary Artery ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Objective:To explore the mediating effect of attitudes going into the of undergraduates world or leaving the mundane world between internet addiction disorder (IAD) and undergraduates' well-being. Methods:603 undergraduate students were surveyed with the Scale of Going into the World and Leaving the World, the Scale for Internet Addiction and the Multiple Happiness Questionnaire. Correlation, regressions and structural equation were adopted. Results:The rate of IAD in our sample was 9.1%, which was higher in male (47persons, 13.2%) than in female (8persons, 3.2%)(?2=16.47,P