OBJECTIVE To systematically summarize the working model of pharmacy consultation in medical institutions in China， and to provide reference for the normalization of process， standardization of content and homogenization of services of pharmacy consultation. METHODS A systematic search of Chinese and English literature databases was conducted to incorporate the literature on the working model of pharmacy consultation published by medical institutions in China. Two researchers screened and extracted the key information， and ultimately conducted qualitative summary and descriptive analysis. RESULTS Based on the included 11 articles， the pharmacy consultation working models were explored by clinical pharmacists in China. The contents of consultation mainly involved anti-infection， parenteral nutrition， cancer pain， etc. The general concept of pharmacy consultation should refer to the constructed flowchart， specific consultation problems could refer to the pathway， mind map， or decision tree and other framework guidance to carry out the work. Finally， consultation opinions could be written according to the consultation system or specialty consultation templates， and the adoption of a new working model （such as pharmacist active consultation） could also promote the number and acceptance rate of pharmacy consultation. CONCLUSIONS A series of working models of pharmacy consultation have been initially explored in medical institutions in China. However， it is not yet perfect and lacks a unified quality control and evaluation system for pharmacy consultation， which should be the focus of future research and practice.

Objective: To examine the prevalence and factors influencing the inconsistency for knowledge and behavior in condom use among college students, so as to provide suggestions for AIDS prevention and education in universities. Methods: From October to December 2019, a multistage cluster sampling method was employed to collect data relating to inconsistency for knowledge and behavior in condom use and other related factors among 1 303 students from six colleges in Zhuhai, China. Chi square test and Logistic regression were performed to analyze the influencing factors and moderating effect. Results: The reporting rate of in consistency of knowledge and behavior in condom use among college students was 41.1%. Multivariate Logistic regression analysis showed that seeking sexual partners offline was negatively correlated with inconsistency for knowledge and behavior in condom use ( OR=0.70, 95%CI =0.51-0.95). However, condom nonuse during the first sexual experience (OR=7.11, 95%CI=5.23-9.67), smoking before sex ( OR=1.47, 95%CI =1.07-2.02), drinking before sex ( OR=1.44, 95%CI =1.09-1.91), history of intimate partner violence ( OR=1.53, 95%CI =1.13-2.07), and having multiple sexual partners ( OR=1.69, 95%CI =1.25-2.29) were positively correlated with inconsistency for knowledge and behavior in condom use ( P <0.05). The moderating effect analysis showed that condom use during the first sexual experience had a moderating effect on smoking before sex and inconsistency for knowledge and behavior in condom use ( β=0.92, P <0.05). Among students who did not use condoms during the first sexual experience, a positive correlation was observed between smoking before sex and inconsistency for knowledge and behavior in condom use ( OR= 2.76 , 95%CI=1.09-6.99, P <0.05). However, no correlation was found between smoking before sex and inconsistency for knowledge and behavior in condom use ( OR=1.32, 95%CI=0.92-1.88, P >0.05) among students who used condoms during the first sexual experience. Conclusion High levels of inconsistency for knowledge and behavior in condom use are found among college students in Zhuhai City. Colleges should carry out sex education activities as soon as possible, and explore new health education models to promote the transformation of their knowledge into behavior.

【Objective】 To investigate the effect of Qingkailing injection on platelet function preserved in vitro. 【Methods】 A total of 15 bags of plateletpheresis (≥250 mL/bag), adding Qingkailing injection(1.25 mL/bag) at the final concentration of 1%, were stored at 22 ℃ with gentle agitation as the experimental group, and samples were collected on day 1, 3, 5, 8, 10 and 14 to detect the thromboelastogram (TEG), CD62p expression rate and mitochondrial membrane potential (JC-1). The control group was set up synchronously, with the same volume and storage conditions as the experimental groups, and samples were taken on day 1, 3 and 5 after preservation to undertake the same test items as the experimental groups. The differences of detection indexes between the two groups were compared. 【Results】 1) In the experimental group, there was no significant change in K and α during day 1 to 14(P>0.05). The R value (min) increased from 6.12±1.58 to 11.02±2.26, and the CI value changed from 0.27±1.24 to -10.47±3.51 (P<0.05). The MA value (mm) had no significant change within 5 days (P>0.05), but decreased to 53.18±2.71 on day 8 and 22.88±3.45 on day 14 (P<0.05). In the control group during day 1 to 5, K(min) and α showed no significant change, while R(min) was significantly prolonged, MA (mm) decreased and CI increased significantly (P<0.05). 2) The expression rate of CD62p (%) was 70.50±9.12 in the experimental group on day 5 (vs 83.16±5.33 in the control groups, P<0.05) and 82.77±7.17 on day 14 (P<0.05). 3) There was no significant change in JC-1 (%) during regular preservation period between the experimental group and control group (P>0.05), but JC-1 (%) was 86.75±3.88 vs 70.36±19.8 on day 5 (P<0.05). In the experimental group, JC-1(%) was 81.04±9.50 vs 71.38±8.77 vs 82.77±7.17 on day 8, 10 and 14, respectively. 【Conclusion】 The activation and aggregation as well as anti-apoptosis function of plateletpheresis, adding Qingkailing injection at the final concentration of 1%, are similar to those of routine preservation.

Adoptive cell therapy (ACT) is an emerging powerful cancer immunotherapy, which includes a complex process of genetic modification, stimulation and expansion. During these

Objective To investigate the timing of administration of Conbercept in the treatment of proliferative diabetic retinopathy (PDR) before operation and its effect on neovascularization vascular endothelial growth factor (VEGF).Methods 90 patients (90 eyes) with PDR who underwent vitrectomy (PPV) were randomly divided into groups A,B and C,with 30 cases in each group.Group A received no intravitreal injection of Conbercept before operation,group B received intravitreal injection of Conbercept 3 days before operation,and group C received intravitreal injection of Conbercept 5 days before operation.The operation condition,visual acuity level,concentration of vascular endothelial growth factor in aqueous humor and positive expression of vascular growth factor in neovascularization membrane were compared in the three groups.Results There was no significant difference in the incidence of iatrogenic hiatus during operation,transient high intraocular pressure and hyphema after operation in the three groups (P ＞ 0.05).Compared with group A,group B and C had shorter the operation time,less electrocoagulation,lower LogMAR BCVA (best corrected visual acuity) three months after operation (P ≤ 0.05).There was no significant difference in the concentration of vascular endothelial growth factor between group B and group C before vitreous injection (P ＞ 0.05).The expression of VEGF in aqueous humor of group B and group C was lower than that of group A (P ≤ 0.05),and the total positive expression rate of VEGF in neovascularization membrane of group B and group C was 76.67％ and 73.33％ respectively,lower than that of group A (100.0％,P ≤0.05).The vitreous re-bleeding of group B and group C was 6.67％ and 10.0％,lower than that of group A (32.14％,P ≤ 0.05).While there was no significant difference between group B and group C (P ＞0.05).Conclusions Vitreous injection of Conbercept before PPV in PDR patients can reduce the concentration of VEGF in aqueous humor and the positive expression rate of VEGF in neovascularization membrane,significantly improve visual acuity and reduce the incidence of postoperative complications.The effect of vitreous injection 3 and 5 days before PPV is basically the same.

Objective To evaluate the effect of an emollient containing Prinsepia utilis Royle oil extracts and other extracts on clinical symptoms and disease recurrence in children aged 2-12 years with atopic dermatitis (AD) in the remission period.Methods A multicenter,randomized,parallel-group,controlled clinical trial was conducted from December 2017 to September 2018.A total of 297 children aged 2-12 years with moderate AD were enrolled from 5 hospitals in China,and randomly divided into the test group (148 cases) and control group (149 cases).In the acute stage,the two groups were both topically treated with mometasone furoate cream once a day on the skin lesions,and with an emollient containing Prinsepia utilis Royle oil extracts and other extracts twice a day throughout the whole body for 2-4 weeks.The children would be enrolled into the remission stage if their Investigator's Global Assessment (IGA) score was ≤ 1 at following visits.In the remission stage,the test group was only topically treated with the emollient twice a day throughout the whole body,while mometasone furoate cream and the emollient were both withdrawn in the control group.At weeks 4,8 and 12 in the remission stage,the recurrence of AD,eczema area and severity index (EASI),children's dermatology life quality index (CDQOL) and adverse events were evaluated.Statistical analysis was carried out with SAS 9.4 software by using t test for comparison of normally distributed continuous data between two groups,chi-square test for comparison of unordered categorical data,Kaplan-Meier method for analysis of survival rates,Cox regression analysis for evaluating the effect of different therapies on AD recurrence in children in the remission stage,and Logistic regression analysis for analysis of odds ratio (OR) of EASI or CDQOL at week 4 in the remission stage between the test group and control group.Results Of the 297 children with AD,31 breached the clinical trial protocol,and 266 were included in the per protocol set (PPS),including 132 in the test group and 134 in the control group.In the PPS,114 and 106 patients completed the follow-up in the test group and control group respectively,and the recurrence rate was significantly lower in the test group (47,41.23％) than in the control group (84,79.25％;x2 =32.96,P ＜ 0.001).The time to recurrence was significantly longer in the test group(61.99 d ± 2.80 d)than in the control group(39.17 d ± 2.54 d,t =6.03,P ＜ 0.001),and the recurrence risk was significantly lower in the test group than in the control group (Log rank test,x2 =32.02,P ＜ 0.001).After adjustment for age and gender,Cox regression analysis showed that the recurrence risk in the test group was 0.35 times that in the control group (HR =0.35,95％ CI:0.24-0.51,P ＜ 0.01).At week 4 in the remission stage,the EASI score at P50-P75 and P75-P100 in the test group were 0.42,0.25 times that in the control group respectively (95％ CI:0.20-0.86,0.12-0.54 respectively;P =0.02,＜ 0.01respectively).Moreover,the CDQOL score at P75-P100 in the test group was 0.33 times that in the control group (95％ CI:0.17-0.65,P ＜ 0.01).No significant difference in the incidence of adverse events was observed between the two groups (P ＞ 0.05).Conclusion Maintenance treatment with the emollient containing Prinsepia utilis Royle oil extracts and other extracts can markedly reduce the recurrence risk in AD children,improve clinical symptoms,and enhance the quality of life.

Objective To investigate the clinical value of C-reactive protein (CRP) combined with prothrombin time (PT) and partially activated thromboplastin time (APTY) in the diagnosis of neonatal late-onset sepsis.Methods From January 2013 to January 2018,100 neonates with sepsis admitted to our department of neonatology in Lishui Maternal and Child Health-Care Center were collected.According to the results of blood culture,neonates with positive blood culture were classified as sepsis group A (53 cases),and neonates with negative blood culture were classified as sepsis group B (47 cases).Another 50 normal newborns born at the same period were included in the control group.The CRP,PT and APTT values of the three groups were detected and compared.The receiver-operating characteristic curves (ROC) were plotted to obtain the area under ROC curve (AUC) and the sensitivity,specificity,positive predictive value and negative predictive value.Another ROC curve was plotted to obtain the area under ROC curve (AUC) and the sensitivity,specificity,positive predictive value,and negative predictive value for a new variable,CPR + PT + APTT,which was established using a binomial logistic regression method.Results The results of CPR,PT and APTT in the control group,sepsis group A and sepsis group B all increased in turn (F=10.616,6.155,5.243,P =0.000,0.000,0.000).CPR + PT + APTT had the largest AUC (0.94),the highest sensitivity (93.42％),the highest specificity (91.66％),the highest positive predictive value (92.60％),and the highest negative predictive value (78.55％) in the four indicators.Conclusion When blood culture fails to diagnose late-onset neonatal sepsis,combined detection of CPR + PT + APTT can provide some clues for its early diagnosis,which is worthy of clinical attention.

Objective To evaluate the short -term efficacy and long-term efficacy of thoracic radiotherapy combined with gefitinib in the treatment of elderly patients with advanced non -small cell lung cancer . Methods From October 2012 to October 2015 , 120 elderly patients with advanced non -small cell lung cancer confirmed by histopathology as adenocarcinoma in the Third People's Hospital of Linyi were selected .Using envelope method,the patients were randomly divided into observation group and control group ,with 60 cases in each group .In the observation group ,IMRT was performed on pulmonary lesions ,and 125 mg of gefitinib was also given orally .The control group received IMRT .All patients were followed up , and the short -term efficacy , quality of life and the incidence of side effects in the two groups were observed .Results In terms of short-term efficacy,the RR of the observation group and the control group was 83.3％ vs.50.0％(χ2 =9.16,P=0.001),the disease control rate (DCR) of the observation group and the control group was 100.0％ vs.83.3％(χ2 =6.48,P=0.003),the PD of the observation group and the control group was 16.7％ vs.0.0％(χ2 =8.16, P =0.001 ).At 3 months after radiotherapy,the RR,DCR and PD of the observation group and the control group were 86.7％ vs.50.0％(χ2 =9.86,P=0.001),100.0％ vs.76.7％(χ2 =7.42,P=0.003),23.3％ vs.0.0％(χ2 =11.24,P=0.000).One year after radiotherapy,the RR of the observation group and the control group was 73.3％ vs.33.3％(χ2 =11.16, P=0.000),the DCR of the observation group and the control group was 54.0％vs.60.0％(χ2 =8.48,P=0.001), the PD of the observation group and the control group was 10.0％ vs.40.0％(χ2 =9.48,P=0.001).There was statistically significant difference between the two groups (P<0.05).As to the long-term efficacy,the progression-free survival (PFS) of the observation group and the control group was (17.64 ±1.86) months vs.(13.26 ± 1.82) months (t=7.28,P =0.000);overall survival (OS) was (26.16 ±2.14) months vs.(17.82 ± 2.02) months (t=10.62,P=0.000).The difference was statistically significant (P<0.05).The quality of life of the patients in the observation group was significantly better than that in the control group at 3 months,1 year and 2 years after radiotherapy (P <0.05).There was no statistically significant difference between the two groups in leukopenia,thrombocytopenia, anemia, esophagitis, radiation pneumonitis, gastrointestinal reaction, rash and other adverse reactions(all P >0.05).Conclusion Radiotherapy combined with gefitinib in the treatment of elderly patients with advanced non-small cell lung cancer has better short -term and long-term efficacy ,it can significantly improve the patients ' efficacy and DCR , prolong the patients ' disease PFS time and OS time , improve patients ' quality of life.And did not increase adverse reactions ,it is worthy of clinical application .

Objective To evaluate the efficacy of the ratio of the fetal cardiac diameter to biparietal diameter( CBR) as a predictor of homozygous α-thalassemia-1 . Methods Single mid-pregnancies ( 15-22weeks) at risk of homozygous α-thalassemia-1 were enrolled . A total of 251 singleton pregnancies were recruited ,in which 63 cases were homozygous α-thalassemia-1 fetuses and the rest were unaffected . The CBR and cardiothoracic ratio(CTR) were measured by two-dimensional ultrasound . Then the accuracy of these variables were analyzed and compared with each other by ROC curves . Results ①The CBR and CTR in affected fetuses were significantly higher than those in the unaffected( P ＜0 .01) . ②With CBR＞0 .43 and CTR ＞ 0 .52 as the best cut off values ,the sensitivity and specificity of predicting homozygous α-thalassemia-1 fetuses in 15-22 gestational weeks were 95 .74% , 92 .06% and 94 .15% , 85 .71% , respectively ;the area under ROC curve were compared with Z test and there was no significant difference between them ( Z ＝ 1 .500 , P ＝ 0 .1335) . ③ When CBR and CTR were combined ,the sensitivity and specificity of the prediction were significantly increased ( the sensitivity of series experiment : 99 .75% ,the specificity of parallel experiment : 98 .87% ) . Conclusions CBR is a novel , effective and noninvasive predictor of homozygous α-thalassemia-1 in mid-pregnancy whose prediction efficiency is the same as traditional CTR . The measurement of CBR is easier to standardize and is not affected by thoracic lesions such as pleural cavity ,pericardial effusion and skeletal dysplasia . If combined with CTR ,it may play an important role in improving the prenatal detection rate of homozygous α-thalassemia-1 fetuses .

OBJECTIVEThe aim of this study was to analyze the clinical features and prognostic factors in patients with brain metastasis from colorectal cancer (CRC).

METHODSClinical materials of 45 colorectal cancer patients who developed brain metastasis were collected, and the data and follow-up data of those patients were retrospectively analyzed.

RESULTSMost brain metastases were from rectal cancer (64.4%), and 80.0% of the 45 cases had extracranial metastases. The most common extracranial metastatic site was the lung (57.8%), followed by the liver (35.6%). All the brain metastases in patients with liver metastases were supratentorial, while in contrast, 44.8% of the patients without liver metastasis had subtentorial metastasis, showing a significant difference between them (P<0.05). The interval time from diagnosis of CRC to the development of brain metastases in case of Dukes D stage was 12.0 months, significantly shorter than that in the cases of Dukes A stage (24.0 months), B (36.0 months) and C (29.0 months) (P<0.05). The interval time was also shorter in the patients who developed extracranial metastasis within one year than those more than one year (12.0 months vs. 38.0 months)( P<0.05). The median survival time of patients with brain metastasis from colorectal was 6.0 months, with a 1-year survival rate of 21.1% and 2-year survival rate of 3.3% only. Univariate analysis showed that the median survival of patients with a KPS score of ≥70 was 8.0 months, significantly higher than 2.0 months in those with a KPS score of <70 (P<0.05). The median survival of patients with one or two brain metastases was 8.0 months, significantly higher than 4.0 months of those with >2 brain metastases (P<0.05). The median survival time after diagnosis of brain metastasis was 4.0 months for those who received monotherapy (only steroids, only chemotherapy or only radiotherapy), significantly shorter than 10.0 months of patients who received chemoradiotherapy, and 12.0 months of those who underwent surgery (P<0.05). Comparing each two differently treated groups, the survival time of surgery combined with chemotherapy or radiotherapy group was significantly different from that of all of other groups (P<0.05). The median survival time of chemoradiotherapy group was longer than that of monotherapy, but the difference was not significant (P>0.05). Multivariate analysis showed that brain metastases >2 and treatment modality type are independent prognostic factors for survival.

CONCLUSIONSPatients initially diagnosed with a Dukes D stage primary colorectal tumor and occurrence of extracranial metastasis (especially, pulmonary metastasis) within one year are associated to an increased risk of brain metastases and have a shorter survival time. Most brain metastases in patients with liver metastases are supratentorial, while many patients without liver metastasis have subtentorial metastasis. Brain metastases >2 and the type of treatment modality are independent prognostic factors for survival. The prognosis of patients who received chemoradiotherapy is better than those treated only with chemotherapy or radiotherapy. Some subsets of patients may benefit from surgery plus chemotherapy/radiotherapy.

Brain Neoplasms ; mortality ; secondary ; therapy ; Chemoradiotherapy ; Colorectal Neoplasms ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Neoplasm Staging ; Prognosis ; Rectal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate ; Time Factors