OBJECTIVE To investigate the current situation of pharmaceutical clinic service in medical institutions in China and provide experience and suggestions for promoting the development of pharmaceutical clinics. METHODS Questionnaire survey was used to investigate the development of pharmaceutical clinics in medical institutions of 31 provinces （autonomous regions and municipalities directly under the central government） in March to April 2023， and the descriptive analysis was conducted. The regression analysis was carried out for the influential factors of pharmaceutical clinic service. RESULTS A total of 1 368 questionnaires were distributed in this survey and 1 304 valid questionnaires were collected with the effective response rate of 95.32%. A total of 463 medical institutions carried out pharmaceutical clinic service， the rate of which was 35.51% （463/1 304）； the rates of pharmaceutical clinics in tertiary， secondary， primary and other medical institutions were 52.80%， 17.18% and 5.88%， respectively. The frequency of opening pharmaceutical clinics was 3.17 days per week on average， with an average of 5.99 visiting pharmacists in each medical institution. Among the visiting pharmacists， clinical pharmacists accounted for the vast majority （88.68%， 2 459/2 773）. There were various categories of pharmaceutical clinics， including joint clinics and pharmacist-independent clinics； among pharmacist-independent clinics， pharmaceutical specialty/specialty disease clinics were the main ones， accounting for 89.72% of the total number of pharmaceutical clinics. The value of pharmacists in pharmaceutical clinics was manifested in various forms， among which the proportion of medical institutions charging pharmaceutical clinics was 10.80%. The main experiences in developing pharmaceutical clinics were to attach importance to discipline construction and personnel training. The main difficulties in developing pharmaceutical clinics were low compensation levels and a shortage of talent.The number of clinical pharmacists， the number of visiting pharmacists in pharmaceutical clinics and additional compensation were positively correlated with the amount of pharmaceutical clinic services（P＜0.05）. CONCLUSIONS In recent years， pharmaceutical clinics have made significant progress； in the future， it is still necessary to further strengthen discipline construction and talent cultivation， pay attention to the value embodiment of pharmacists， to promote the healthy development of pharmaceutical clinics.

Objective:To evaluate the effects of different types of psychological interventions on the fear of cancer recurrence through a network Meta-analysis.Methods:Randomized controlled trials on the effects of different types of psychological interventions on the fear of cancer recurrence were retrieved from PubMed, PsycINFO, Web of Science, The Cochrane Library, Embase, EBSCO, China Biomedical Literature Database, CNKI, Wanfang Database and Vip Database. The retrieval period was from the establishment of the database to December, 31 2022. Two researchers conducted literature screening, extraction and quality evaluation, and used Stata14.0 software to conduct network Meta-analysis.Results:A total of 29 pieces of research involving 3 068 cancer patients and 11 psychological intervention measures. The results of network Meta-analysis showed that narrative therapy, PERMA(Positive, Engagement, Relationship, Meaning, Accomplishment) happiness theory model, acceptance and commitment therapy and cognitive behavior therapy had statistically significant differences in the intervention effect on the fear of cancer recurrence compared with conventional nursing ( SMD values were -1.93--0.83, all P<0.05); there was no significant difference among narrative therapy, PERMA happiness model, acceptance and commitment therapy and gratitude-expansion behavior theory (all P>0.05). The results of the cumulative probability map showed the best intervention was narrative therapy. Conclusions:The results of this study suggest that narrative therapy, acceptance and commitment therapy, and cognitive behavior therapy may be effective psychological intervention measures to improve the fear of cancer recurrence. However, more studies are still needed for further verification.

Objective:To study the clinical characteristics and risk factors of nephrocalcinosis in preterm infants.Methods:From March 2021 to August 2021, all preterm infants admitted to NICU of our hospital were retrospectively analyzed. The infants were assigned into nephrocalcinosis group and non-nephrocalcinosis group according to urinary tract ultrasound. Clinical data including gestational age, birth weight(BW), nutritional support strategy and complications were reviewed.Results:A total of 40 preterm infants (<34 weeks) were enrolled. 9 cases were in the nephrocalcinosis group and 31 cases in the non-nephrocalcinosis group. The nephrocalcinosis group had lower BW[(1 167±214) g vs.(1 586±215) g], higher calcium [6.9 (5.1, 8.7) g vs.3.3 (2.1, 6.8) g] and vitamin D intake [3.2(2.5, 4.2)×10 4U vs.1.7(1.1, 3.2)×10 4U] during hospitalization. No significant differences existed between the two groups on the following items:blood calcium and phosphate, 25-hydroxyvitamin D, feeding strategy, time to reach full enteral feeding(TFF), furosemide dosage and respiratory support duration ( P>0.05). In the nephrocalcinosis group, the median age of diagnosing nephrocalcinosis was 40.0(30.0, 52.5)d after birth. 5 cases showed bilateral nephrocalcinosis. 5 cases in the nephrocalcinosis group received renal tubule function examination,4 cases had increased urine β2 microglobulin and 2 cases had increased urine α1 microglobulin. 7 cases had elevated urine calcium in the nephrocalcinosis group. Follow-up showed that nephrocalcinosis disappeared 3-9 months after birth. Conclusions:BW, total calcium and vitamin D intake are risk factors for nephrocalcinosis in preterm infants. Increased urine β2 microglobulin and calcium levels are common co-morbidities in preterm infants with nephrocalcinosis.

Objective: To explore the characteristics and related factors of adolescent executive function, so as to provide theoretical basis for promoting the development of adolescent executive function. Methods: A total of 5 018 adolescents aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi were selected by convenient cluster random sampling method from September to December 2022, and their basic information, family status, lifestyle behavior, physical fitness and executive function were investigated by questionnaire survey. Considering the heterogeneity between schools, a multilevel Logistic model was established to analyze the related factors of adolescent executive function. Results: The inhibitory function of high school students was better than that of middle school students (Z=-2.69). In terms of refreshment function, high school students were superior than middle school students (1-back:Z=-11.32; 2-back:Z=-11.36), and male students were superior than female students (2-back:Z=-2.18); in terms of shifting function, high school students were superior than middle school students (Z=-2.63), and boys were superior than girls (Z=-7.10)(P<0.05). The results of multilevel model analysis showed that the executive function of adolescents was clustered at the school level. At the individual level, junior high school refreshment function (1-back:β=56.94; 2-back:β=127.00), and shifting function (β=35.64) were worse than that of high school students; the refreshment function 2-back (β=-21.24) and shifting function (β=-28.42) of male students were better than those of female students; the refreshment function 2-back of nononly child was better than that of only child (β=-19.36); refreshment function of low fitness was worse than that of high fitness (β=37.35); the shifting function of the video screen time not up to standard was better than that of the standard (β=-14.30)(P<0.05). Conclusions The executive function of high school students is better than that of middle school students, the refreshment function and shifting function of boys are better than that of girls. Family environment, lifestyle and physical health are significant factors related to executive function of Chinese adolescents. By raising awareness of the major supporting and impeding factors for executive functioning in adolescents, it can help to develop effective intervention programs for adolescents.

Objective To explore the effects of Tanganjianwan(TGJW)combined with abdominal massage(AM)on glucose and lipid metabolism and inflammatory factors in obesity and type 2 diabetes mellitus(OT2DM)patients with metformin treatment.Methods Patients with OT2DM diagnosed in Wuhan Hospital of Traditional Chinese Medicine from June 2021 to June 2023 were included as study subjects,and were divided into the AM group(metformin combined with AM)and the TGJW group(metformin combined with AM+TGJW)according to the random number table method.The treatment efficacy and safety were assessed by continuous intervention for 3 months.Obesity-related indices[waist-hip ratio(WHR)and body mass index(BMI)],glycemic and lipid metabolic indices[glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),postprandial 2-hour glucose(P2hG),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)],insulin sensitivity indexes[homeostasis model insulin resistance index(HOMA-IR)and homeostasis model pancreaticβ-cell function index(HOMA-β)],and inflammation indexes[interleukin-6(IL-6),tumor necrosis factor α(TNF-α),and C-reactive protein(CRP)]changes were compared before and after treatment between the TGJW group and the AM group.Results A total of 100 OT2DM patients were included in the study,with 50 cases each in the TGJW group and AM group.After the intervention,the treatment efficiency of the TGJW group was significantly higher than that of the AM group(P＜0.05),and no malignant adverse events occurred during treatment.Compared with the pre-treatment period,the levels of WHR,BMI,FBG,P2hG,HbA1c,TC,TG,LDL-C,HOMA-IR,IL-6,TNF-α,and CRP decreased in both groups(P＜0.05),while the levels of HDL-C and HOMA-β increased significantly(P＜0.05).After the intervention,the levels of WHR,BMI,FBG,P2hG,HbA1c,TC,TG,LDL-C,HOMA-IR,IL-6,TNF-α,and CRP in the TGJW group were lower than those in the AM group(P-＜0.05),while the levels of HDL-C and HOMA-β were higher than those in the AM group(P＜0.05).Conclusion Compared with AM treatment alone,TGJW combined with AM can improve glucose-lipid metabolism,insulin sensitivity and inflammation indexes in OT2DM patients,enhance the therapeutic effect of metformin treatment in OT2DM patients,and is safe,it has certain clinical promotion significance.

ObjectiveTo understand the incidence and death of female breast cancer patients and the premature death caused by breast cancer in Putuo District of Shanghai， and to reduce the incidence of breast cancer， mortality and the probability of early death， and to provide reference for realizing the control target of the probability of early death of major chronic diseases. MethodsThe incidence and death data of the registered female residents with breast cancer in Putuo District of Shanghai from 2004 to 2019 were collected using Shanghai Population-based tumor registration management system. The crude incidence rate， standardized incidence rate， crude mortality rate， standardized mortality rate， age-specific incidence rate， age-specific mortality rate and other indicators were calculated. The Joinpoint regression model was used to calculate the annual percentage change （APC） and average annual percentage change （AAPC） of breast cancer incidence， mortality and premature death probability， and to analyze the changing trend. ResultsFrom 2004 to 2019， the crude incidence of breast cancer in Putuo District of Shanghai increased from 75.76/10⁵ to 95.77/10⁵ （APC=2.26%， t=6.05， P<0.01）， while the standardized incidence did not decrease significantly during 2004‒2008 （APC=-4.83%， t=-1.81， P=0.10） and showed an upward trend after 2008 （APC=1.67%， t=2.84， P=0.02）. The crude mortality rate changed from 18.52 per 10⁵ to 21.63 per 10⁵ （APC= 1.51%， t=1.52， P=0.15）， and the standardized mortality rate decreased from 9.91/10⁵ to 7.44/10⁵ （APC=-1.46%， t=-2.43， P=0.03）. The incidence rate in the group of 30‒69 years increased from 98.39/10⁵ to 111.75/10⁵ （APC=1.14%， t=3.05， P=0.01）， and the mortality rate increased from 16.13/10⁵ to 19.30/10⁵ （APC=0.48%， t=0.84， P=0.41）. The incidence rate of patients aged ≥70 years varied from 165.68/10⁵ to 139.53/10⁵ （APC=1.54%， t=1.25， P=0.23）， and the mortality rate changed from 85.08/10⁵ to 56.64/10⁵ （APC=-0.18%， t=-0.08， P=0.94）. The probability of premature death from breast cancer decreased from 7.73‰ to 6.61‰ （APC=-1.56%， t=-2.30， P=0.04）. ConclusionThe risk of female breast cancer morbidity and death can not be ignored， and the control pressure of premature death probability is still large. Attention should be paid to the age group of 30‒69 years old， and further measures should be taken to control the increase of incidence and to reduce mortality， so as to reduce the probability of premature death of female breast cancer， and promote the realization of the overall control goal of premature death probability.

Objective:To understand the psychological experience of tumor radiotherapy patients after participating in acceptance and commitment therapy (ACT), and to provide reference and supplement for the development of ACT psychological intervention plans for tumor radiotherapy patients.Methods:This study was a qualitative study. Using the purposive sampling method, a total of 17 tumor radiotherapy patients treated at Shanghai Proton and Heavy Ion Center from January to March 2023 were selected as the research objects. Phenomenological research method was used to conduct semi-structured in-depth interviews with patients, and the interview data were analyzed by Colaizzi 7-step analysis method.Results:Three themes were extracted, namely, positive physical and mental experience (including improving physical symptoms, relieving negative emotions and cooperating with particle therapy), gaining personal growth (including learning flexible and varied psychological coping strategies, gaining mutual help and friendship, feeling valuable family affection and drawing a better future life) and recommendations for optimizing the ACT intervention program (including building teams according to the patients' conditions, increasing the frequency of activities, trying to experience relief exercises outdoors and increasing the continuity of the intervention program) .Conclusions:ACT can help cancer radiotherapy patients improve their physical and mental health, cope with psychological problems, so that patients can face the disease, treatment and life more positively.

Objective:To explore the effect of supportive-expressive group psychological intervention on the fear of recurrence in cancer patients receiving radiotherapy.Methods:From September 2022 to February 2023, convenience sampling was used to select 72 tumor inpatients from Shanghai Proton and Heavy Ion Center. According to the random number table method, patients were divided into an intervention group and a control group, with 36 cases in each group. The control group received routine nursing, while the intervention group carried out supportive-expressive group psychological intervention. The fear of recurrence, meaning in life, and perceived social support scores of two groups of patients before and after intervention were compared using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Cancer-Meaning in Life Scale (C-MiLS), and Perceived Social Support Scale (PSSS) .Results:A total of 7 cases were lost, with 33 cases in the intervention group and 32 cases in the control group completing the study. Before intervention, there was no statistically significant difference in the general information, fear of recurrence, meaning in life, and perceived social support scores between the two groups of patients ( P>0.05). After supportive-expressive group psychological intervention, the total score of cancer recurrence fear, physical health dimension, and social family dimension scores of the intervention group were (30.42±8.31), (15.58±4.12), and (14.82±4.83), respectively, which were lower than the control group's (36.19±5.64), (18.84±3.48), and (17.09±3.27), and the differences were statistically significant ( t=-3.260, -3.446, and -2.216; P<0.05). After intervention, the total score of the intervention group's meaning in life was (63.42±6.37), which was higher than the control group's (54.91±6.53), and the difference was statistically significant ( t=5.325, P<0.05). After intervention, the perceived social support score of the intervention group was (67.64±7.93), which was higher than the control group's (62.38±10.25), and the difference was statistically significant ( t=2.318, P<0.05). After intervention, the level of fear of recurrence in the intervention group was lower than that before intervention, and the level of meaning in life and perceived social support were higher than those before intervention, with statistical differences ( P<0.05) . Conclusions:Support-expressive group psychological intervention can help cancer patients deal with survival, emotional, and interpersonal issues they face, reduce their fear of recurrence, improve their meaning in life, and perceived social support.

Objective To analyze the effect of Meleis transition theory in the intervention of family caregivers of advanced lung cancer patients.Methods From January 2022 to June 2023,94 patients with advanced lung cancer and their family caregivers treated in 4 hospitals of a tertiary A hospital in Zhejiang Province were selected by convenience sampling method,and they were divided into a control group(n=47)and an experimental group(n=47)according to random number table method.The family caregivers of the experimental group received a four-week intervention based on the Meleis transition theory on the basis of routine nursing education,including role recognition,disease knowledge,life care,psychological support,and social resource connection.Family caregivers in the control group received routine nursing education,caregiving education and guidance.The differences in the readiness,caring ability,psychological burden and patients'quality of life were compared between the 2 groups.Results There was no lost follow-up cases in the control group and experimental group.After intervention,the preparation,ability,and quality of life of family caregivers in the experimental group were better than those in the control group,and the psychological burden of caregivers was significantly lower than that in the control group(P＜0.05).Conclusion The intervention of caregiving ability of family caregivers based on Meleis transition theory can effectively improve the caregiving ability of caregivers,reduce the psychological burden of caregivers,improve the quality of care,and improve the quality of life of patients.

Objective:To retrospectively analyze clinical characteristics and treatment of pemphigus/bullous pemphigoid (BP) complicated by herpes simplex virus (HSV) infection.Methods:Inpatients with pemphigus/BP complicated by HSV infection were collected from Wuhan No.1 Hospital from 2016 to 2021, and their clinical characteristics, treatment and follow-up results were retrospectively analyzed.Results:Among the 8 patients with pemphigus/BP complicated by HSV infection, there were 2 males and 6 females, and their age was 50.6 ± 8.3 years. Five of them were diagnosed with pemphigus vulgaris (PV), 1 with pemphigus foliaceus (PF), and 2 with BP. Seven were infected with HSV-1, and 1 with HSV-2. All the 8 patients were given systemic glucocorticoids and immunosuppressive agents for the treatment of pemphigus or BP, and were admitted to the hospital due to resistance to the treatment. Seven patients presented with exacerbation or recurrence of primary lesions, and 1 presented with enlarged lesions all over the body. HSV infection-induced lesions were located on the trunk in 4 cases, on the oral mucosa in 4, on the scalp in 3, and on the face in 2; lesions mainly manifested as irregular erosions with blood crusts, and some centrally umbilicated pustules; 7 patients had obvious pain at the lesional sites. During HSV infection, anti-desmoglein 1 antibody levels decreased in all the 6 patients with pemphigus, and anti-desmoglein 3 antibody levels decreased in 4 of the 5 patients with pemphigus vulgaris; anti-BP180 antibody levels decreased in 1 patient with BP, but increased in the other one with BP. After antiviral therapy at adequate doses for adequate durations (7- to 14-day treatment with valacyclovir alone or in combination with ganciclovir), HSV infection was controlled, the autoimmune bullous skin disorder intensity scores decreased compared with those before the antiviral therapy, and pain was significantly relieved in all the patients. No dose adjustment of glucocorticoids or other immunosuppressive agents was made during antiviral therapy in all patients.Conclusion:HSV infection should be considered when patients with pemphigus/BP suffer from recurrence or exacerbation and poorly respond to conventional treatment; for patients with pemphigus/BP complicated by HSV infection, systemic antiviral therapy at adequate doses can be used to control the disease condition without modifying the conventional immunosuppressive regimen.