Objective To explore training programs for pharmacists in retail pharmacies to implement medication therapy management services for patients with chronic diseases.Methods Combined with national conditions in China,the expert consultation method was used to establish a training program for pharmacists in retail pharmacies on chronic disease medication therapy management in terms of curriculum setting,teaching mode,and teaching assessment,and to implement the training.Qualitative interviews were conducted to gain an in-depth understanding of pharmacists'evaluations and suggestions on the training program.Results The training curriculum covered practice skills of pharmaceutical care and pharmacotherapeutics.The teaching modes included online learning and Q&A,case writing,role-playing and standardized patient case practices,and teaching assessment was conducted through knowledge quizzes,objective structured clinical exams,practice tests and questionnaires.181 pharmacists attended and completed the training,and the score of their overall satisfaction with the training program was 4.7(out of a maximum score of 5.0).Through the training,pharmacists'knowledge and skill levels in medication therapy management as well as attitudes,confidence and perceptions of practice were significantly improved and demonstrated better pharmacy practice abilities.Most pharmacists expressed their learning needs for disease-based pharmacy service model and communication skills training with patients in qualitative interviews.Conclusion A training program suitable for retail pharmacists to improve the comprehensive ability of chronic disease medication therapy management has initially formed,and disease-based doctor-patient communication ability and pharmaceutical care process training should become the focus of learning in medication therapy management service ability of retail pharmacists.

OBJECTIVE To summarize and analyze the profile of the implementation of pharmaceutical service by community pharmacists for patients with chronic diseases in China. METHODS Literature was searched from CNKI， Wanfang database， PubMed （Medline）， Embase， and Scopus to collect studies about community pharmacists providing pharmaceutical services for patients with chronic diseases. The ways and contents of the implementation of pharmaceutical services for chronic diseases by community pharmacists were summarized descriptively. RESULTS A total of 75 studies were included， involving 49 trial studies and 26 cross-sectional studies. The study sites were mainly located in the developed regions of China， and the types of disease involved in the studies were mainly diabetes mellitus （n＝30） and hypertension （n＝28）； most studies used the following indexes to evaluate pharmaceutical services， such as changes in disease symptoms and related indicators（n＝35）， improvement of patient compliance（n＝34）， and the occurrence of adverse drug reactions （irrational drug use） （n＝25）. The pharmaceutical service provided by community pharmacists included medication education （84.0%）， monitoring and follow-up （64.0%）， and identifying and solving medication-related problems （58.7%）. Thirty-eight studies mentioned that pharmaceutical services were achieved through teamwork， 16 of which mentioned healthcare alliances. A few studies investigated stratified healthcare systems （n＝15） and internet-based pharmaceutical services （n＝10）. CONCLUSIONS In China， pharmaceutical services provided by community pharmacies for patients with chronic diseases are still mainly confined to economically developed areas， and the scope of services is limited to a few diseases and basic pharmaceutical practices. In the future， the implementation of precise pharmaceutical services for different diseases and patients’ disease status， the establishment of medical alliances， and the development of internet-based pharmaceutical services should become the focus of pharmaceutical services.

Objective:To explore the application effect of 5E nursing guided by empowerment theory in patients undergoing liver cancer resection.Methods:Using the purposive sampling method, a total of 88 patients who underwent liver cancer resection surgery in Zhumadian Central Hospital from July 2020 to July 2022 were selected as the research objects. They were divided into the control group ( n=44) and the observation group ( n=44) by the random number table method. The control group was given 5E nursing, while the observation group was given 5E nursing guided by empowerment theory. The improvement of gastrointestinal function between the two groups was compared by the first anal defecation time, the first anal exhaust time and the recovery time of bowel sound. Visual Analogue Scale (VAS) was used to evaluate postoperative pain, General Self-Efficacy Scale (GSES) was used to evaluate self-efficacy, and hope level was assessed by Herth Hope Index (HHI). After treatment, the compliance and occurrence of digestive tract discomfort were compared between the two groups. Results:The first anal defecation time, first anal exhaust time and bowel sound recovery time in observation group were less than those in control group ( P<0.05). Postoperative pain score of observation group was lower than that of control group 48 hours after operation ( P<0.05). After nursing, the GSES, HHI and compliance scores of the observation group were higher than those of the control group ( P<0.05), and the incidence of gastrointestinal discomfort symptoms in the observation group was lower than that in the control group ( P<0.05) . Conclusions:The 5E nursing guided by empowerment theory can effectively improve the compliance, self-efficacy and hope level of liver cancer resection patients, reduce pain, promote postoperative recovery and reduce the incidence of gastrointestinal discomfort symptoms.

To explore the effect of Ginkgo biloba extract (GBE) on anticoagulation of 4 new oral anticoagulants (NOACs), dabigatran, apixaban, rivaroxaban and edoxaban in vitro, thrombin time (TT), prothrombin time (PT), activated partial thrombin time (APTT) and the activity of coagulation factor Xa (FXa) of rat plasma were measured at different concentrations of NOACs, GBE or NOACs combined with GBE, respectively. The results showed that TT, PT and APTT were prolonged with the increase of NOACs concentration in the range of 0-500 ng/mL; that except for TT of rivaroxaban, other results showed a good linear correlation with NOACs concentration (r2= 0.78-0.98); and that FXa activity decreased with increased concentration of FXa inhibitors (apixaban, rivaroxaban and edoxaban), with a good linear correlation with concentration of FXa inhibitors in the range of 0-250 ng/mL (r2= 0.85-0.94). GBE had no significant effect on TT, PT and APTT (P>0.05) in the concentration range of 0-500 μg/mL, but FXa activity had a positive linear correlation with GBE concentration (r2= 0.840 4). TT was prolonged with increasing GBE concentration when dabigatran was combined with GBE. When the above FXa inhibitors were combined with GBE, TT shortened and FXa activity increased with rising GBE concentration. There were no significant changes in PT and APTT (P>0.05) when NOACs were combined with GBE. The study results suggest that GBE may synergize with the anticoagulant activity of dabigatran and antagonize the anticoagulant activity of FXa inhibitors, possibly due to its role in increasing FXa activity.

Objective To investigate the epidemiological and etiological characteristics of foodborne diseases in Shiyan City, and to provide targeted measures for the prevention and control of foodborne diseases. Methods The surveillance data of foodborne diseases reported by Taihe Hospital of Shiyan City from 2013 to 2018 was collected and analyzed. Results A total of 1 742 cases of foodborne diseases were analyzed. The incidence peaked twice during the year, May to August and October to November. The pre-school children (≤6 years old) were at the highest risk of contracting foodborne diseases, and were mainly those in kindergartens, as well as those not in school. Grain and grain products accounted for the highest proportion of the presumably exposed foods． The main location of eating contaminated foods was in households. A total of 1 217 samples were tested, and 92 were positive, of which 71 strains were detected with Salmonella, accounting for the highest proportion. Preschool children and the elderly (≥66 years old) had higher detection rates than others. The food of infants and young children was found to have the highest detection rate. Conclusion According to the epidemiology and etiological characteristics of foodborne diseases in Shiyan City, the publicity and education of food safety should be strengthened and the surveillance network system of foodborne diseases should be further improved.

Objective To investigate the change rule of common coagulation indicators and platelet parameters in the patients with chronic viral hepatitis,liver cirrhosis and liver failure.Methods One hundrend and twenty patients with liver diseases in our hospital from January 2015 to June 2016 were selected and divided into chronic viral hepatitis group (46 cases),liver cirrhosis group (Child-Pugh class A,B,C,44 cases) and liver failure group (30 cases).Contemporaneous 30 persons undergoing healthy physical examination served as the healthy control group.The coagulation indicators (PT,PTA,APTT,TT, Fg,D-D) and platelet parameters (PLT,MPV,PDW, PCT) were detected in all subjects.Results Except TT,Fg and D-D had no statistical difference between the healthy control group and chronic viral hepatitis group (P>0.05),PT,APTT and TT in the chronic viral hepatitis group,liver cirrhosis group (Child-Pugh class A,B,C) and liver failure group were gradually extended,PTA and Fg were decreased and D-D value was increased,the difference in pairwise comparison was statistically significant (P<0.05).The PLT value in the chronic viral hepatitis group,liver cirrhosis group (Child-Pugh class A,B,C) and liver failure group was decreased gradually,while the MPV and PDW values were gradually increased,showing significantlystatistically significant difference (P<0.05),the PCT value in the liver cirrhosis group and liver failure group was lower than that in the chronic viral hepatitis group(P<0.05).Conclusion The regularity change of coagulation indicators and platelet parameters occurs in different periods of chronic liver disease progression,which provides some reference for clinical diagnosis,treatment and prognosis judgment.

BACKGROUND:There is no effective drug for idiopathic pulmonary fibrosis (IPF), because of a lack of the animal model imitating the complete pathogenesis of human IPF. Therefore, it is critical to establish an ideal animal IPF model used for investigating the underlying pathogenesis and developing a kind of effective drug. OBJECTIVE:To establish an animal model that can mimic more characters of human IPF. METHODS:Seventy male C57BL/6 mice were randomly divided into two groups, fol owed by subjected to the intraperitoneal injection of bleomycin (35 mg/kg) on days 1, 4, 8, 11, 15, 18, 22, and 25, twice (group A) or once (group B) a week. Mice were sacrificed at 2, 4, 6, 8, and 10 weeks after the eighth injection, and the lung tissues were moved used for hematoxylin-eosin, Masson and immunohistochemical stainings. RESULTS AND CONCLUSION:There were various degrees of alveolitis and pulmonary fibrosis in the two groups at different time points after the last injection. The scores of alveolitis and pulmonary fibrosis in the group A began to gradual y increase from the 2nd week and reached the highest level at the 6th-8th weeks until the 10th week. In contrast, the scores of alveolitis and pulmonary fibrosis in the group B peaked at the 2nd week, then fluctuately decreased, and were significantly lower than those in the group A at the 6th week (P<0.05). Immunohistochemistry showed that type I col agen deposition was mainly distributed in the subpleural region, peri-vascular region and alveolar septa, which was consistent with Masson staining findings. The expression levels of transforming growth factorβ1 (TGF-β1) andα-smooth muscle actin (α-SMA) in the regions developing alveolitis and pulmonary fibrosis were significantly increased. In the group A, the expression levels of type I col agen, TGF-β1,α-SMA, and the hydroxyproline content in the lung tissues reached the peak level at 6-8 weeks. However, in the group B, al above indicators reached the highest level at the 2nd week, but gradual y decreased thereafter. At the 4th week, the expression Levels of TGF-β1 andα-SMA in the group B were significantly lower than those in the group A (P<0.05). At the 6th week, the hydroxyproline and type I col agen levels in the group B were significantly lower than those in the group A (P<0.05). In conclusion, the mouse model of pulmonary fibrosis induced by intraperitoneal injection of 35 mg/kg bleomycin twice weekly can be used to mimic the repetitive wound healing process, pathological morphology and cytokine changes of human IPF, which is prone to administration, with better stability and repeatability. This model is of great significance for the study on IPF. Subject headings:Disease Models, Animal;Pulmonary Fibrosis;Bleomycin

The article reviewed three aspects of hemiplegic shoulder pain after stroke-introduction, rehabilitation nursing and prospect, in order to provide references for developing effective nursing interventions in the future. We obtained literature from the Cochrane Library, JBI Evidence-based Nursing, PubMed, Wanfang and CNKI Databases between January 2000 and May 2016. According to the principle of three relevant aspects, priority to latest five years and critical appraisal, 39 studies were included. Literature analysis showed that rehabilitation nursing mainly consists of position nursing, supportive devices using, manipulative care and psychological support. Also, it put forward that comprehensive rehabilitation nursing measures have become major means, the combination of Chinese traditional and Western medicine is characteristic therapy in our nation, and nursing practice based on evidence should be set up early to relieve the symptom of hemiplegic shoulder pain and promote quality of life for stroke patients.

Objective To observe and analyze the medium and long term follow-up data of arrhythmias after transcatheter closure of children with ventricular septal defect (VSD). Methods Retrospectively analyzed the clinical data of 1071 children with VSD, who successfully underwent transcatheter device closure, at l, 3, 6, 12 months and ev-ery year post procedure from March 2002 to December 2010. Results Of all 1071 children, 272 cases (25.4%) were ob-served of having arrhythmias within 1 month after intervention, mainly including atrioventricular block (AVB), branch block, junctional tachycardia, atrial and ventricular tachycardia, frequent contractions, etc. Among them, 22 cases (2.1%) had above II degree AVB, complete left bundle branch block (CLBBB) and other causes of serious arrhythmias. After treatment, all cases got better and no permanent pacemaker was necessary. After 1 to 107 months (2.8±1.7 years) fol-low-up, 161 cases (18.2%) were observed of having persistent abnormal ECG mainly caused by AVB and branch block, including 10 cases (1.1%) with serious arrhythmias. In 4 cases with late-onset AVB, 3 cases had already appeared AVB in early postoperative, 1 case had recurrence CLBBB, left ventricle enlarge, and died of heart failure during follow up. Four cases were implanted permanent pacemaker. Conclusion During follow-up, serious arrhythmias after VSD closure, such as AVB or CLBBB, have high risk of recurring. Conduction block arrhythmias may reappear or worsen, while arrhythmias like tachycardia and premature heart rhythm mostly return to normal.

Objective To investigate the effect of comprehensive psychological intervention on cooperation degree with intravenous infusion of preschool children. Methods 240 children patients with intravenous infusion were divided into the observation group and the control group with 120 cases in each group.Children patients in two groups were all given venipuncture by two nurses who had more than 5 years of working experience,skilled venipuncture technique and were good at doing mental work for children.The control group was given intravenous infusion directly after venipuncture without giving any psychological intervention.The observation group was given comprehensive psychological intervention before venipuncture.The different psychological behavioral reactions during the venipuncture were evaluated.The cooperation degree and the first-time success rate of venipuncture for the two groups were taken for statistics. Results The psychological behavioral reactions of the observation group were as followed:the active type was 51.67％,the tension type was 30.83％,and 7.50％ for the type of fear,the compulsive type was 10.00％.Compared with the control group,the difference was significant.The cooperation degree with intravenous infusion was 82.50％,the difference was significant compared with the control group.The first-time success rate in the observation group was 86.67％,higher than 75.83％ in the control group. Conclusions Psychological interventions according to the behavior and psychological reaction of preschool children with intravenous infusion can alleviate the negative emotions and improve the cooperation degree of preschool children.