1.Application of narrative pharmacy in cardiovascular pharmacy clinic
Xiaochun YE ; Yan ZHANG ; Wei ZHU ; Siyuan GAO ; Shaohui ZHANG
China Pharmacy 2024;35(7):872-876
OBJECTIVE To explore the effects of narrative pharmacy management on medication compliance, negative emotions, and quality of life in patients with cardiovascular disease complicated with negative emotions. METHODS A total of 49 patients with drug use problems and negative emotions attending the cardiovascular pharmacy clinic of Wuhan First Hospital from February to August 2023 were selected as the study objects, narrative pharmacy model was applied for patient management during their visits; pharmaceutical care and emotional management were performed after 2 weeks of treatment and a follow-up visit was conducted to evaluate and record the management effect one month later. RESULTS Adopting a narrative pharmacy management model, 49 patients were involved in 114 drug related consultation questions. Compared with the visit, after one month of management, the number of medication types taken by patients significantly decreased [4.00 (2.00, 6.00) vs. 3.00 (1.50, 5.00), P<0.05], the incidence of adverse reactions significantly decreased (32.65% vs. 2.04%, P<0.001), the rate of blood pressure and lipid compliance significantly increased (30.61% vs. 95.92%, P<0.001), and the score of the patient’s medication compliance significantly improved ([ 3.94±2.44) vs. (6.78±2.07), P<0.01]. The depression score significantly decreased [3.00 (2.00, 4.50) vs. 2.00 (0.00, 3.00), P<0.001], the anxiety score significantly reduced [3.00 (2.00, 4.50) vs. 1.00 (0.00, 2.00), P<0.001], quality of life score was significantly improved [22.00 (19.00, 22.00) vs. 23.00 (23.00, 24.50), P<0.01]. In the satisfaction survey, there was a slight increase in the overall satisfaction proportion (91.84% vs. 97.96%, P>0.05). CONCLUSIONS The application of narrative pharmacy in cardiovascular pharmacy clinic can improve patient compliance, reduce adverse drug reactions, enhance the effectiveness of drug treatment, avoid drug interactions, effectively improve the anxiety and depression, and ultimately improve the quality of life.
2.TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children
Xi MING ; Liqun WU ; Ziwei WANG ; Bo WANG ; Jialin ZHENG ; Jingwei HUO ; Mei HAN ; Xiaochun FENG ; Baoqing ZHANG ; Xia ZHAO ; Mengqing WANG ; Zheng XUE ; Ke CHANG ; Youpeng WANG ; Yanhong QIN ; Bin YUAN ; Hua CHEN ; Lining WANG ; Xianqing REN ; Hua XU ; Liping SUN ; Zhenqi WU ; Yun ZHAO ; Xinmin LI ; Min LI ; Jian CHEN ; Junhong WANG ; Yonghong JIANG ; Yongbin YAN ; Hengmiao GAO ; Hongmin FU ; Yongkun HUANG ; Jinghui YANG ; Zhu CHEN ; Lei XIONG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(7):722-732
Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.
3.Establishment and verification of a prognostic Nomogram for middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer
Guoyu ZHU ; Yang WU ; Chen QIN ; Xiaochun ZHANG ; Wenji LI
Journal of Clinical Medicine in Practice 2024;28(17):27-34
Objective To construct and validate a Nomogram prediction model for overall survival (OS) in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer. Methods The clinical, pathological, and follow-up data of middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer in the Affiliated Hospital of Yangzhou University, Northern Jiangsu People's Hospital, and Yangzhou City Hospital of Traditional Chinese Medicine from March 1, 2012 to December 1, 2022 were retrospectively analyzed. Based on univariate and multivariate Cox regression analyses, the independent risk factors for OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer were identified, and a Nomogram prediction model was further constructed and validated. The diagnostic performance of the model was evaluated by the receiver operating characteristic (ROC) curve and calibration curve, and the clinical effect of the model was assessed by decision curve analysis (DCA). Results A total of 382 patients were included. A total of 282 cases were as training sets and 100 cases were as validation sets. Univariate and multivariate Cox regression analyses indicated that family history of gastric cancer, vascular invasion, nerve invasion, T stage, and N stage were independent risk factors for OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer (
4.Effect of implant materials on postoperative complications during rhinoplasty
Yunhao TIAN ; Lei LIU ; Xiaochun ZHU
Chinese Journal of Medical Aesthetics and Cosmetology 2023;29(5):356-359
Objective:To investigate the effect of autologous cartilage and artificial material implants on the occurrence of postoperative complications during rhinoplasty.Methods:This study included 447 patients who underwent cosmetic rhinoplasty at Hanmei Cosmetic Hospital in Dongguan. The age of enrolled patients was 18-52 years, and the mean age was 26.8±6.9 years. They were divided into an autologous cartilage group (334 patients in total) and an artificial material group (113 patients in total) according to the implant material used; the differences in postoperative complications were compared between the two groups and the influencing factors related to the occurrence of complications were analyzed.Results:The follow-up time of all patients was 3-24 months, and the mean time was 19.4 months. 51 (11.4%) of the 447 patients developed postoperative complications during the follow-up period, and the rate of functional failure in the artificial material group (16.8%) was significantly higher than that in the autologous cartilage group (9.6%) (χ 2=4.17, P=0.037). In the autologous cartilage group, the most frequent complications were irregular nasal contour, a total of 10 cases (3.0%), and infection, 8 cases (2.4%); while the most frequent complications in the artificial material group were infection, 6 cases (5.3%) and prosthesis exposure, 3 cases (2.7%). At 2-year follow-up, 32 cases of the postoperative complication rate occurred (16.8%) in the autologous cartilage group, which was significantly higher than that of 19 cases (9.6%) in the artificial material group, and the difference between the two groups was statistically significant (log-rank χ 2=4.37, P=0.039). The results of the multifactorial COX risk factor analysis showed that history of smoking ( HR=1.78, 1.21-2.29, P=0.004), previous history of rhinoplasty ( HR=2.89, 2.08-3.97, P<0.001) and use of artificial materials ( HR=1.34, 1.17-2.08, P=0.013) and external incision (protective factor, HR= 0.92, 0.78-0.98, P=0.037) were independent risk factors for the development of functional complications. Conclusions:Neither the use of autografts nor artificial implants in rhinoplasty prevents the occurrence of complications, and the types of complications occurring in both differ, with artificial grafts having a higher rate of postoperative complications.
5.Management and prognosis of congenital chylous ascites in 20 infants
Jialiang ZHOU ; Juan ZHU ; Xiaochun ZHU ; Rong HUANG ; Yuanlong FANG ; Qingyuan WANG ; Wuping GE
Chinese Journal of Perinatal Medicine 2022;25(8):615-619
Objective:To summarize the perinatal management and prognosis of congenital chylous ascites (CCA).Methods:Clinical data of 20 infants diagnosed with CCA and treated in Guangdong Women and Children Hospital from June 2015 to November 2020 were retrospectively analyzed and described.Results:There were ten patients with isolated CCA and ten with non-isolated CCA. In isolated CCA cases, seven were cured after conservative treatment and three after postoperative conservative treatment following an ineffective surgery. Non-isolated CCA cases were complicated by intrauterine cytomegalovirus infection ( n=1), malrotation of intestine ( n=4) or bilateral chylothorax ( n=5). In addition to conservative treatment for CCA, non-isolated CCA patients also received antiviral therapy, Ladd's procedure or intrauterine/extrauterine closed thoracic drainage. Of eight patients who were firstly diagnosed with ascites before 30 gestational weeks, including four isolated and four non-isolated cases, only one underwent surgical intervention. During hospitalization, serious infections occurred in three infants with isolated CCA and two with non-isolated CCA, and were all controlled by anti-infection treatment. During a follow-up to median age of 29 months (15-82 months), none of the patients had any abnormalities except for the one with intrauterine cytomegalovirus infection who was deaf at the age of two. Conclusions:Conservative management is effective and the prognosis is generally good for most cases with isolated CCA. Treatment and prognosis of non-isolated CCA depend on its comorbidities. Gestational age at diagnosis may not be a prognostic predictor.
6.Gastrointestinal lipolysis and trans-epithelial transport of SMEDDS
Fei XIA ; Zhongjian CHEN ; Quangang ZHU ; Jianping QI ; Xiaochun DONG ; Weili ZHAO ; Wei WU ; Yi LU
Acta Pharmaceutica Sinica B 2021;11(4):1010-1020
Self-microemulsifying drug delivery systems (SMEDDSs) have recently returned to the limelight of academia and industry due to their enormous potential in oral delivery of biomacromolecules. However, information on gastrointestinal lipolysis and trans-epithelial transport of SMEDDS is rare. Aggregation-caused quenching (ACQ) fluorescent probes are utilized to visualize the
7.Distribution and drug resistance of pathogens causing bloodstream infection in patients with pancreatic neoplasms
Jie ZHENG ; Jun ZHU ; Yun LIU ; Yuxiang WAN ; Yazhou LI ; Shuo ZHAO ; Xiaochun HUANG
Chinese Journal of Pancreatology 2021;21(3):183-186
Objective:To investigate the distribution and drug resistance of pathogens causing blood stream infection in patients with pancreatic neoplasms.Methods:Clinical data of patients with pancreatic neoplasms complicated with bloodstream infection with confirmed pathological evidence admitted in the First Affiliated Hospital of Naval Medical University from January 2016 to June 2019 were collected. Bacteria were isolated from blood culture, and microbial sensitivity tests were analyzed by minimum inhibitory concentration and Kirby-Bauer methods. The distribution and drug resistance of pathogens causing blood stream infection in patients with pancreatic neoplasms were analyzed.Results:There were 116 cases (8.5%) with bloodstream infection in 1 372 patients with pancreatic neoplasms. A total of 156 bacterial strains were isolated from blood culture, of which 127 strains (81.4%) were gram negative aerobic bacteria, mainly including Escherichia coli (42 strains), Klebsiella pneumoniae (34 strains), Pseudomonas aeruginosa (12 strains), and 25 strains (16.0%) were gram positive aerobic bacteria, mainly including Enterococcus faecium (11 strains), Enterococcus faecalis (3 strains), Streptococcus angina (3 strains). 4 strains (2.6%) were anaerobic bacteria. The results of antibiotic susceptibility showed that the resistance rate of Escherichia coli to ampicillin was 90.5%, and to cefoperazone-sulbactam was 2.4%. The resistance rate of Klebsiella pneumoniae to piperacillin was 20.6%, and to cefoperazone-sulbactam was 5.9%. The resistance rate of Pseudomonas aeruginosa to imipenem was 41.7%, and no resistant strain was found to cefoperazone-sulbactam. The resistance rate of Enterococcus and Streptococcus pharyngitis to erythromycin were 85.7% and 33.3%, and no strains were resistant to vancomycin.Conclusions:The rate of blood stream infection in patients with pancreatic neoplasms was relatively high. In clinical practice, the distribution of pathogenic bacteria should be understood, the drug resistance should be monitored and antibiotics should be reasonably used, in order to maximally prevent and interfere with the occurrence of blood stream infection.
8.Recommendations for the diagnosis and treatment of Beh?et′s syndrome in China
Wenjie ZHENG ; Na ZHANG ; Xiaochun ZHU ; Shuhong CHI ; Wen ZHANG ; Wei WEI ; Yan ZHAO ; Yi DONG
Chinese Journal of Internal Medicine 2021;60(10):860-867
Beh?et′s syndrome (BS) is classified among variable vessel vasculitis with unknown etiology and extensively heterogeneous clinical features. It is easily missed or misdiagnosed due to the lack of a specific laboratory diagnosis index. Based on the evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed the standardization of diagnosis and treatment of BS. The purposes are: (1) To standardize the detection and interpretation of key indicators for BS; (2) To standardize rational management for BS patients with topical and systemic organ involvement to reduce complications and improve outcomes.
9.Prognosis and treatment of fetal/neonatal ovarian cysts: clinical analysis of 35 cases
Yuanlong FANG ; Wuping GE ; Yan ZHANG ; Jialiang ZHOU ; Rong HUANG ; Qingyuan WANG ; Song TIAN ; Like YUAN ; Xiaochun ZHU
Chinese Journal of Perinatal Medicine 2021;24(9):671-676
Objective:To explore the prognosis and treatment experience of fetal/neonatal ovarian cyst.Methods:Clinical data of 35 cases of fetal/neonatal ovarian cyst (38 ovarian cysts) admitted to Guangdong Women and Children Hospital from June 2014 to December 2019 were retrospectively collected, including the cyst size before and after birth, ultrasonic features, intraoperative conditions, and pathology. According to the ultrasonic features at the first prenatal detection, the ovarian cysts were divided into two groups: simple cyst group (25 cysts) and complex cyst group (13 cysts). Two independent samples t-test and Fisher exact test were used to compare the characteristics of cysts between the two groups. The outcomes and treatment experience were summarized. Results:(1) The ratio of intraoperative torsion in the complex cysts group was higher than that in the simple cysts group [10/13 vs 32% (8/25), Fisher exact test, P<0.05]. (2) Twenty-five simple cysts were found on the first prenatal ultrasound scan, and 32% (8/25) of them eventually transformed into complex cysts. Among these eight cysts, the maximum diameter of five cysts was >4 cm before the transformation. (3) Postnatal ultrasound found one cyst regressed spontaneously and among the remaining 37 cysts, simple and complex type cysts were accounted for 16 and 21, respectively. Among the complex type cysts, 90% (19/21) were consistent with prenatal ultrasound. (4) Out of the 21 complicated cysts, 19 were surgically removed; the remaining two cysts (maximum diameter <3 cm) were observed conservatively and disappeared spontaneously within one year. During the operation, 81% (17/21) of the complicated cysts were found with torsion and 24% (5/21) with ovarian loss. Conclusions:Simple cysts can transform into complex cysts, especially the biggest diameter >4 cm. Complex fetal/neonatal ovarian cysts indicated by ultrasonography were more prone to torsion, which required postnatal operation.
10.Influence of SARS-CoV-2 vaccination on the epidemiological and clinical characteristics of imported COVID-19 cases in Chengdu
Yong YUE ; Xian LIANG ; Yi MAO ; Min HU ; Delin HAN ; Liyuan SU ; Heng CHEN ; Shuangfeng FAN ; Xiaochun ZHANG ; Fei YANG ; Qiwu YUAN ; Zhu LIU
Chinese Journal of Epidemiology 2021;42(8):1365-1370
Objective:To analyze the epidemiological and clinical characteristics of imported COVID-19 cases after SARS-CoV-2 vaccination and to provide evidence for the prevention and control of COVID-19.Methods:The imported COVID-19 cases in Chengdu as of April 15, 2021 were divided into the vaccinated group and unvaccinated group according to the history of SARS-CoV-2 vaccination. The epidemiological and clinical data of the cases were collected retrospectively, and the differences in epidemiological and clinical characteristics of the two groups were compared. Laboratory tests consisted of nucleic acid test, clinical index test, serum antibody test and lymphocyte test. Software WPS2019 was used for data management and software R 4.0.3 was used for statistical analysis.Results:A total of 75 COVID-19 cases were included in the analysis, in which 20 had received SARS-CoV-2 vaccination and only 4 with clinical symptoms, 55 patients did not receive SARS-CoV-2 vaccination, and 16 had clinical symptoms. In vaccinated group, the first injection time of vaccination ranged from July to November 2020, and 10 cases received two doses of vaccine simultaneously and 10 cases received two doses of vaccine at intervals of 14-57 days. The intervals between the completion of vaccination and the onset ranged from 87 days to 224 days. The differences in classification and clinical type between the two groups were significant. Significant differences were observed in case classification and clinical type between vaccinated group and unvaccinated group ( P<0.05). The vaccinated group had a relatively high proportion of asymptomatic infections (40.00%, 8/20), while mild infections were mainly observed in the unvaccinated group(76.36%,42/55). The differences in Ct values (ORF1ab gene and N gene) at the diagnosis were not significant between vaccinated group and unvaccinated group ( P>0.05), similar results were also observed in lymphocyte subtypes, procalcitonin and C-reactive protein level comparisons. Serum amyloid A level was higher in unvaccinated group than in vaccinated group ( P<0.05). However, the SARS-CoV-2 related serum antibody of IgM, IgG and total antibody levels were significantly higher in vaccinated group ( P<0.05). Conclusions:Risk of infection still exists with SARS-CoV-2 after vaccination, which can facilitate the production of specific serum antibody of IgM and IgG when people are exposed to the virus. It has a certain protective effect on SARS-CoV-2 infected persons. Vaccination can reduce the clinical symptoms and mitigate disease severity.


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