1.Analysis of the demands for pharmaceutical clinic service and influential factors based on Kano model
Han SHAN ; Xuan YE ; Zihan GUO ; Jing WU ; Jinwei HU ; Xiaopei TONG ; Yufei BIN ; Jiyong LIU ; Qiong DU ; Mengmeng WANG
China Pharmacy 2025;36(22):2850-2855
OBJECTIVE To explore the characteristics and influential factors of pharmaceutical clinic service demands, providing evidence for optimizing pharmaceutical service models and facilitating pharmaceutical service models of pharmacist role transformation. METHODS A cross-sectional survey design was adopted, and 410 outpatient participants were selected from Fudan University Shanghai Cancer Center through convenience sampling for questionnaire administration from February to May 2025. Kano model was applied to analyze the demand attributes of 25 pharmaceutical services, while questionnaires were used to assess patients’ awareness and demand status. Subgroup analyses were conducted based on key demographic variables such as gender, age, educational attainment, and economic burdens, to SACA- systematically examine the differences in Kano attribute classification among patients in each subgroup. RESULTS The awareness rate of pharmaceutical outpatient services among patients was only 14.63%, yet those who were aware demonstrated a significantly higher demand rate for such services compared to those who were unaware (P<0.001). The demand for pharmaceutical clinic services exhibited a hierarchical characteristic: twelve items were identified as attractive attributes (e. g., providing suggestions for more affordable treatment options, offering online consultation services, etc.), five items as expected attributes (e.g., having a good attitude and being able to patiently answer your questions, etc.), three items as must-have attributes (e.g., providing guidance on medication dosage and usage, providing guidance on medication precautions, etc.), five items as indifferent attributes (e.g., providing treatment plan recommendations based on the patient’s condition). There were zero items classified as reverse attribute. Subgroup analysis revealed that female patients showed greater concern for “neat and clean attire of medical staff” than male patients (P<0.001); patients under 60 years of age demonstrated stronger demand for “providing treatment plan recommendations based on patients’ conditions” compared to patients aged 60 or above (P=0.016); those with below high school education placed greater emphasis on “providing guidance on medication precautions” compared to those with a high school education or above (P=0.011); patients with lower economic burdens exhibited stronger preferences for “neat and clean attire of medical staff ” (P=0.002). CONCLUSIONS The public awareness rate of pharmaceutical clinic services is considerably low; however, those who are aware of such services demonstrate significantly higher demand. The medication safety-related services and convenience-oriented demands should be prioritized in the development of pharmaceutical clinics. Moreover, the study also revealed that factors such as gender, age, educational level, and economic burdens exert significant influences on patients’ service demands.
2.Correlation of serum creatinine, hemoglobin and BMI with osteoporosis and its predictive value in middle-aged and elderly Tibetan residents in Xizang
Kangzhi DING ; Peng WANG ; Jing ZHANG ; Yufei ZHANG ; Hai XIONG
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(6):1013-1019
[Objective] To analyze the correlation of serum creatinine (Cr), hemoglobin (HGB) and body mass index (BMI) with osteoporosis in middle-aged and elderly Tibetan residents in Xizang and its predictive value for osteoporosis. [Methods] Between November 2021 and August 2023, using multistage random cluster sampling method information on demographics, we collected blood indices and bone mineral density from 564 middle-aged and elderly Tibetan residents in Ali (Pulan, Zada, Ritu, and Rezhe counties), Nagchu (Nagchu, Nyima, Amdo, Shuanghu, and Bango counties), Shannan (Lunzi county), and Lhasa (Nimu county), Tibetan regions. They were divided into osteoporosis group (90 cases) and non-osteoporosis group (474 cases) according to whether they suffered from osteoporosis or not. Pearson correlation method was used to analyze the correlation between bone mineral density (BMD) and each variable. Binary Logistic regression was used to analyze the related influencing factors of osteoporosis in middle-aged and elderly Tibetan residents, and the regression equation model of predicting the risk factors of osteoporosis was constructed. The fitting degree of the model was tested by Hosmer-Lemeshow test model. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of serum Cr, HGB and BMI combined tests on osteoporosis in middle-aged and elderly Tibetan residents in Xizang. [Results] The prevalence of osteoporosis was higher in females than in males. Among the osteoporosis group, height and weight, alanine aminotransferase, glutamine aminotransferase, urea nitrogen, uric acid, total cholesterol, triglyceride, low-density lipoprotein cholesterol, homocysteine, serum Cr, HGB and BMI were significantly lower (P<0.05). Correlation analysis showed that age was negatively correlated with BMD, while body weight, serum Cr, HGB and BMI were positively correlated with BMD (P<0.05). Multivariate binary Logistic results showed that age (OR=1.085), serum Cr (OR=0.891), BMI (OR=0.475), and HGB (OR=0.966) were the influencing factors for the occurrence of osteoporosis (P<0.05). To establish a prediction model for the risk of osteoporosis, Logit(P)=6.265+ 0.086×age + (-0.109×Cr)+ (-0.020×HGB)+ (-0.213×BMI). The area under the ROC curve was 0.932, the sensitivity was 88.9%, and the specificity was 82.5%. Hosmer-Lemeshow test model had a good fit (P=0.960). According to Logit(P) model, L score=-29.413+ (-0.404×age)+ 0.512×Cr+ 0.094×HGB+ BMI could be calculated. When L score >8.9, the patient could be diagnosed with the disease. [Conclusion] The decrease in serum Cr, HGB and BMI is a risk factor for osteoporosis in Tibetan aged residents. Age was negatively correlated with BMD, while serum Cr, HGB and BMI were positively correlated with BMD. The combined model of age, serum Cr, HGB and BMI can significantly improve the diagnostic efficiency of osteoporosis in the elderly Tibetans in Xizang.
4.Effect of Huanglian Ejiaotang on 5-Hydroxytryptamine System and Gut Microbiota in Sleep-deprived Rats
Huaqiong DIAO ; Dan WEI ; Haiyue DING ; Jing ZHANG ; Yufei CHEN ; Min WANG ; Qingsheng ZHU ; Xiaoli LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(21):49-58
ObjectiveTo explore the mechanism of Huanglian Ejiaotang in intervening in insomnia based on 5-hydroxytryptamine (5-HT) system and gut microbiota. MethodFifty-five SPF-grade SD rats were randomly divided into normal group, model group, low-, medium-, and high-dose Huanglian Ejiaotang groups (1.925, 3.85, and 7.7 g·kg-1), and Estazolam group (0.1 mg·kg-1). Except for those in the normal group, the rats in the other five groups were subjected to sleep deprivation on a narrow platform for 12 hours daily for 21 consecutive days. After 14 days of drug intervention, the sleep, exploratory behavior, and depressive-like behavior of the rats were assessed using the pentobarbital sodium sleep synergistic test, the open field test, and the sugar preference test, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of 5-HT, 5-hydroxyindoleacetic acid (5-HIAA), tryptophan hydroxylase (TPH), and monoamine oxidase-A (MAO-A). Real-time polymerase chain reaction (Real-time PCR) was used to measure the mRNA expression of the 5-HT1A receptor (5-HT1AR) and 5-HT2A receptor (5-HT2AR). Differences in gut microbiota among the groups were assessed using 16S rRNA sequencing, and the correlation between the 5-HT system and microbiota was revealed using redundancy analysis. ResultCompared with the normal group, the model group showed a prolonged sleep latency (P<0.05), reduced sleep maintenance (P<0.01), decreased central area activity time in the open field (P<0.01), and reduced sugar preference rate (P<0.05). Moreover, the model group also showed decreased levels of 5-HT, 5-HIAA, TPH, and MAO-A (P<0.01), decreased 5-HIAA/5-HT ratio (P<0.01), downregulated mRNA expression of 5-HT1AR (P<0.01), and upregulated mRNA expression of 5-HT2AR (P<0.05). The proportion of Firmicutes decreased, while that of Bacteroidetes increased, leading to a decreased Firmicutes/Bacteroidetes (F/B) ratio (P<0.05). Compared with the model group, the high-dose Huanglian Ejiaotang group exhibited a shortened sleep latency (P<0.01), and increased sleep maintenance (P<0.01). The low-dose Huanglian Ejiaotang group showed increased central area activity time (P<0.01) and an increased sugar preference rate (P<0.05). The high-dose Huanglian Ejiaotang group exhibited increased levels of 5-HT, 5-HIAA, TPH, and MAO-A (P<0.01), increased 5-HIAA/5-HT ratio (P<0.05), upregulated mRNA expression of 5-HT1AR (P<0.01), and downregulated mRNA expression of 5-HT2AR (P<0.05). The low-dose Huanglian Ejiaotang group displayed an increased proportion of Firmicutes and a decreased proportion of Bacteroidetes, resulting in an increased F/B ratio. At the phylum level, 5-HT, 5-HIAA, and MAO-A were positively correlated with Firmicutes and negatively correlated with Bacteroidetes. At the genus level, 5-HT, 5-HIAA, TPH, and MAO-A were negatively correlated with Prevotella and Lactobacillus and positively correlated with Blautia and Bacteroides. ConclusionHuanglian Ejiaotang can improve sleep deprivation-induced insomnia and depressive-like behavior by regulating the activity of the 5-HT system and the composition of gut microbiota.
5.Effects of Naikan cognitive-music reminiscence therapy on coping style for female patients with chronic schizophrenia
Hui YU ; Yufei YIN ; Guiping PAN ; Wei LUO ; Guijun MA ; Jing SHAO ; Shuping TAN ; Fude YANG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(3):350-355
Objective To explore the effect of Naikan cognitive-music reminiscence therapy on coping style in female patients with chronic schizophrenia.Methods In May, 2020, 72 female patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into control group (n = 48) and music group (n = 24) after trait matching. Both groups accepted routine medicine, while the control group accepted Naikan cognitive therapy, and the music group accepted Naikan cognitive therapy combined music reminiscence, for twelve weeks. They were blind assessed with Simplified Coping Style Questionnaire, Self-rating Depression Scale and Self-rating Anxiety Scale before and after intervention.Results There were five cases in the control group removed for erroneous response. The main effects of group were not significant for all the assessments (F < 0.567, P > 0.05). The main effect of time was significant for negative coping style score (F = 6.968, P = 0.01), and the interaction effects were significant for positive coping style score and Self-rating Depression Scale score (F > 4.227, P < 0.05).Conclusion Combining with music reminiscence, Naikan cognitive therapy may be advantageous for the coping style of female patients with chronic schizophrenia.
6.Construction and validation of the physical fitness age model for community-dwelling elderly people
Jing XU ; Jiaojiao LI ; Ya CHEN ; Dan XU ; Yufei CHEN ; Minhao SHI ; Hongyan MENG ; Li WANG
Chinese Journal of Modern Nursing 2022;28(34):4725-4731
Objective:To construct and validate the physical fitness age model for community-dwelling elderly people, so as to provide new methods and reference for the health assessment and rehabilitation guidance of the elderly.Methods:From March to September 2021, 794 community-dwelling health people in six districts of Suzhou (Wuzhong District, Gusu District, Xiangcheng District, Wujiang District, Huqiu District and Industrial Park) were selected by multi-stage stratified sampling. Postgraduates who received unified training used unified monitoring tools to assess the physical function and physical fitness of the subjects in the designated community health service centers. Principal component analysis was used to construct a physical fitness age model. According to the scores of Short Physical Performance Battery, people with high physical function and people with low physical function were divided to verify the effectiveness of the model evaluation.Results:A total of four indicators, including 2-min step test, 30 s chair stand test, biceps flexion and lift test, and time up and go test (TUGT) , were finally included to build a physical fitness age model. The model formula was physical fitness age=-0.126×2-min step test-0.612×biceps flexion and lift test-0.625×30 s chair stand test+1.855×TUGT+0.51×age+55.29. The model validation showed that the physical fitness age of the community-dwelling elderly people of the high physical function group was lower than the age, and the difference was statistically significant ( P<0.01) . The physical fitness age of the community-dwelling elderly people of the low physical function group was higher than that of the age, and the difference was also statistically significant ( P<0.01) . The research results were consistent with the research assumptions, suggesting that the model was reasonable and effective. Conclusions:The construction of the physical fitness age model for community-dwelling elderly people can reflect the decline of the elderly's physical function, can be used for the elderly's health assessment and rehabilitation guidance, and can provide evaluation indicators for the elderly to provide community and home medical care services.
7.Effect of tropisetron on pyroptosis in cardiomyocytes subjected to hypoxia-reoxygenation: relationship with α7nAchR
Di YU ; Yufei ZHANG ; Jing LYU ; Xingrui GONG ; Chen MENG ; Qing LI
Chinese Journal of Anesthesiology 2021;41(1):96-100
Objective:To evaluate the effect of tropisetron on pyroptosis in cardiomyocytes subjected to hypoxia-reoxygenation (H/R) and the relationship with α7 nicotinic acetylcholine receptor (α7nAChR).Methods:Routinely cultured H9C2 cardiomyocytes were divided into 4 groups ( n=6 each) using a random number table method: control group (C group), H/R group, tropisetron plus H/R group (Tro+ H/R group), and α7nAchR antagonist MLA plus tropisetron plus H/R group (MLA+ Tro+ H/R group). H/R was produced by 12 h exposure of cells to hypoxia followed by 6 h reoxygenation in the other three groups except group C. Tropisetron at the final concentration of 10 nmol/L was added at 1 h before hypoxia in group Tro+ H/R.In group MLA+ Tro+ H/R, MLA was added at 2 h before hypoxia, and then 1 h later tropisetron at the final concentration of 10 nmol/L was given.At 6 h of reoxygenation, the pyroptosis rate of cardiomyocytes was determined by fluorescence immunostaining of caspase-1-AlexaFluor 488/DAPI, the concentrations of interleukin-1beta (IL-1β) and IL-18 in the supernatant were determined by enzyme-linked immunosorbent assay, the activity of LDH in the supernatant was measured by 2, 4 dinitrophenylhydra-zine colorimetric method, and the expression of α7nAchR, NLRP3 and caspase-1 in cardiomyocytes was detected by Western blot. Results:Compared with group C, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly increased, the expression of NLRP3 and caspase-1 was up-regulated, and the expression of α7nAchR was down-regulated in group H/R ( P<0.05). Compared with group H/R, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly decreased, the expression of NLRP3 and caspase-1 was down-regulated, and the expression of α7nAchR was up-regulated in group Tro+ H/R ( P<0.05). Compared with group Tro+ H/R, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly increased, the expression of NLRP3 and caspase-1 was up-regulated, and the expression of α7nAchR was down-regulated in group MLA+ Tro+ H/R ( P<0.05). Conclusion:α7nAchR is involved in the process of tropisetron inhibiting pyroptosis in cardiomyocytes subjected to H/R.
8.Research progress of pesticide poisoning detection technology
Qing TANG ; Xiaoli YANG ; Zhenghui WANG ; Yufei WANG ; Jing ZHANG ; Rui FENG ; Tao SUN ; Zhenxue SUN ; Wenyao HUANG
Journal of Public Health and Preventive Medicine 2021;32(4):1-6
In order to meet the needs of detection of poisoning-inducing pesticides occurring in poisoning emergency events, this article introduces and discusses the characteristics, scope of application, and advantages and disadvantages of two types of detection technologies: laboratory detection and on-site rapid detection. The sample pre-processing technology suitable for on-site detection is also elaborated.
9.Optimization Design of Emergency Quick Fixation Device Based on ANSYS Workbench.
Yufei JING ; Hong CHEN ; Xiaoqiang ZHANG ; Zhan ZHAO ; Xudong YU ; Wei WANG
Chinese Journal of Medical Instrumentation 2021;45(5):512-516
OBJECTIVE:
A rapid fixation device is developed to solve the problems of emergency fixation and transportation of patients with spinal injury.
METHODS:
Through the analysis of the function,3D modeling design, finite element analysis and optimization design based on ANSYS Workbench, tensile strength verification experiment, we produced the prototype, and tested it, conducted a simulated rescue experiment.
RESULTS:
The fixation device designed can meet the demand of spinal injury patients for safe rescue after accidents, and the quality of the rapid fixation device was lighten by about 30% without reducing the intensity.
CONCLUSIONS
The method based on optimal design can obviously improve the structure design, and has reference significance for other related rescue equipment design.
Equipment Design
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Finite Element Analysis
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Humans
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Tensile Strength
10.Correlation analysis between vitamin A, D and E levels with the altitude, seasonal variation and other factors in children with 0-6 years old in Tibetan Plateau of Ganzi Prefecture
Ping HUANG ; Xinmei LIN ; Quansheng WANG ; Gang KE ; Zhengrong WEI ; Duping GUO ; Xueguo BA ; Yongxiao YUAN ; Qun WANG ; Hongyan DING ; Maoyun HE ; Ligui XIAN ; Liping ZHANG ; Yufei WANG ; Lianhui YU ; Kehong KUANG ; Qingping LUO ; Zhu CHEN ; Hongmei LI ; Jing LUO ; Yilan XU
Chinese Journal of Applied Clinical Pediatrics 2021;36(22):1736-1741
Objective:To detect serum levels of vitamin A (Vit A), vitamin D(Vit D)25-hydroxy vitamin D[25-(OH)D] and vitamin E(Vit E) in children aged 0-6 years in Tibetan Plateau of Garzi Prefecture, thus providing references for physical examinations and prevention of 4 key diseases (rickets, malnutrition anemia, pneumonia and diarrhea) in children in plateau areas by relevant government departments.Methods:A total of 2 122 children who participated in physical examination in 12 townships of Xiangcheng County and 14 townships of Daocheng County, Garzi Tibetan Autonomous Prefecture, Sichuan Province from April 2017 to April 2019 with 0-6 years old were recruited for surveying physical measurements and collection of venous blood.Serum Vit A and Vit E levels were detected by high performance liquid chromatography.Serum levels of 25-(OH)D were detected by high performance liquid chromatography tandem mass spectrometry.The relationship between Vit A, Vit E and 25-(OH)D levels with the gender, age, seasonal change and altitude was analyzed.Results:The serum Vit A level, subclinical Vit A deficiency rate and marginal vitamin A deficiency rate were(1.05±0.27) μmol/L, 8.15%(173/2 122 cases) and 45.99%(976/2 122 cases), respectively in 2 122 children with 0-6 years old.There were significant differences in the serum Vit A level, the subclinical Vit A deficiency rate and the marginal vitamin A deficiency rate in children with different ages, seasons and altitudes (all P<0.05). The serum level of 25-(OH)D and 25-(OH)D deficiency rate insufficient rate were (24.65±6.45) ng/L, 6.03%(128/2 122 cases) and 16.59%(352/2 122 cases), respectively.There were significant differences in the serum level of 25-(OH)D, 25-(OH)D deficiency rate and 25-(OH)D insufficient rate in children with different ages and seasons (all P<0.05). The mean serum Vit E level, Vit E deficiency rate and Vit E insufficient rate were (7.81±1.74) mg/L, 2.78%(59/2 122 cases) and 29.59%(628/2 122 cases), respectively.There were significant differences in serum Vit E level, Vit E deficiency rate and Vit E insufficient rate in children with different ages and seasons (all P<0.05). The mean serum levels of Vit A and Vit D remained the lowest before the age of 1 year, and their deficiencies at this age were the most significant.The mean serum level of Vit E remained the lowest in >1-2 years old, and its deficiency and insufficient at this age were the most significant.Vit A, D and E levels were significantly affected by seasonal changes, which were significantly higher in the summer than in the spring, autumn and winter.In addition, Vit A and 25-(OH)D were significantly affected by the altitude, which were the lowest above 4 km altitude. Conclusions:The overall serum levels of Vit A, 25-(OH) D and E in children with 0-6 years old in Tibetan Plateau areas of Ganzi Prefecture are lower than those in plain areas.Vit A, 25-(OH) D and Vit E levels significantly differed in the age, season and altitude, which are related to the lack of local resources, insufficient maternal nutrition during pregnancy and insufficient intake after birth, as well as temperature and light caused by changes in local seasons and altitude.Therefore, it is necessary to make reasonable supplements during pregnancy to prevent vitamin deficiency.


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