OBJECTIVE To analyze the factors influencing patient satisfaction in the outpatient pharmacy of tertiary maternity and child specialist hospitals in Chongqing， and provide a reference for improving the pharmaceutical management capability of tertiary maternity and child specialist hospitals and enhancing patients’ medical experience. METHODS Utilizing KANO model， a questionnaire was developed and data were analyzed. Key influencing factors were identified through the categorization of requirement attributes， Better values， Worse values， and two-dimensional matrix analysis. The impact of these categorized demand factors on overall satisfaction was further validated through Structural Equation Modeling （SEM）. RESULTS Cronbach’s α coefficient for the survey questionnaire was 0.855， exceeding the acceptable threshold of 0.7； Bartlett test for sphericality yielded a value of 5 538.56 with P＜0.01， indicating good reliability and validity of the survey results. Through the KANO model’s factor selection process， the top four key factors influencing patient satisfaction in outpatient pharmacies were determined to be： medication pick-up time （r＝0.45）， pharmacist service attitude （r＝0.45）， rational medication consultation （r＝0.41）， self-service calling system （r＝0.40）， all of which were subsequently validated through SEM. CONCLUSIONS The four factors of medication pick-up time， self-service calling system， pharmacist service attitude， and rational medication consultation significantly influence patient satisfaction in the outpatient pharmacies of tertiary maternity and child hospitals in Chongqing.

OBJECTIVES: To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication. METHODS: Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups. RESULTS: After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05). CONCLUSIONS The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.
Humans ; Facial Paralysis/therapy* ; Moxibustion ; Acupuncture Therapy ; Bell Palsy/therapy* ; Face

Humans ; Adolescent ; Fractures, Avulsion ; Fractures, Bone ; Fracture Fixation, Internal ; Ischium/surgery*

Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three⁃dimensional finite element model of the C

The early response of plant auxin gene family Aux/IAA (auxin/indole-3-acetic acid) and its interaction with auxin response factor (ARF) are important pattern to regulate plant growth and development. This work identified 28 StoIAA and 24 StoARF members based on the whole genome data of the medicinal plant Senna tora L., which were classified into 10 and 8 subfamilies, respectively. Phylogenetic tree and collinearity analysis showed that S. tora has close evolutionary relationship with the IAA and ARF homologous genes of Glycine max, Medicago truncatula, and the segment duplication events dominate the expansion of StoIAA and StoARF. Gene structure analysis showed that the vast majority of StoIAA and StoARF contain characteristic conserved domain. Transcriptome data showed that StoIAAs and StoARFs were expressed in leaves, roots and seeds, some members had tissue specific expression. The StoIAA and StoARF promoter region most contain functional elements related to stress response, growth and development, hormone induction and secondary metabolism. In addition, gene expression analysis showed that many StoIAAs and StoARFs can quickly respond to drought and salt stress and exhibited same expression patterns under both stress condition. The yeast two-hybrid experiment confirmed that StoARF8 and StoARF10 exhibit varying degrees of interaction with multiple StoIAA proteins, respectively. The above results provide a basis for further biological functional analysis of the Aux/IAA and ARF gene family of S. tora.

Objective To discuss the clinical efficacy and safety of bilateral internal iliac artery Fogarty balloon occlusion in uterine curettage for patients with cesarean scar pregnancy(CSP).Methods The clinical data of a total of 80 CSP patients,who were admitted to the Fuyang People's Hospital of China between January 2021 and September 2022 to receive treatment,were retrospectively analyzed.The patients were divided into the observation group(n=40)and the control group(n=40).For the patients of the observation group,the hysteroscopic uterine curettage was carried out under the situation of bilateral internal iliac artery Fogarty balloon occlusion and during the operation the internal iliac artery was intermittently blocked.The embryo was removed,and the hemostasis was accomplished by electrocoagulation or surgical suture.For the patients of the control group,the hysteroscopic uterine curettage was performed within 1-2 days after uterine artery embolization(UAE).The digital subtraction angiography(DSA)fluoroscopy time,body surface radiation dose,blood loss during uterine curettage,time spent for uterine curettage,length of hospital stay,and postoperative follow-up results were compared between the two groups.Results Successful uterine curettage was accomplished and the uterus was retained in all the patients.In the observation group,no balloon-related complications occurred.In the control group,all the 40 patients developed different degrees of fever,pain at uterine area,and other post-embolization symptoms after UAE.In the observation group and the control group,the DSA fluoroscopy time was(9.2±1.1)seconds and(1 273.6±141.1)seconds respectively,the body surface radiation dose was(7.7±0.8)mGy and(1 503.8±101.8)mGy respectively,the differences between the two groups were statistically significant(both P＜0.05);the blood loss during uterine curettage was(30.3±14.7)mL and(27.5±13.2)mL respectively,the time spent for uterine curettage was(41.6±16.2)min and(42.8±15.0)min respectively,the differences between the two groups were not statistically significant(both P＞0.05);the length of hospital stay was(6.0±0.7)days and(7.3±0.8)days respectively,the difference between the two groups was statistically significant(P＜0.05).All patients were followed up for more than 3 months,the time of β-hCG turning to negative,time of vaginal bleeding,time of menstruation returning to normal,and patient satisfaction rate in the observation group were(21.1±2.4)days,(8.2±1.1)days,(29.5±2.2)days and 95.0%(38/40)respectively,which in the control group were(24.6±3.3)days,(13.6±2.6)days,(46.7±7.3)days and 67.5%(27/40)respectively,the differences in the above indexes between the two groups were statistically significant(all P＜0.05).Conclusion In performing uterine curettage for CSP patients,both bilateral internal iliac artery Fogarty balloon occlusion and UAE can significantly reduce the intraoperative blood loss,but bilateral internal iliac artery Fogarty balloon occlusion is superior to UAE in reducing radiation dose,in shortening the patient's hospital stay,the time of β-hCG turning to negative,the time of vaginal bleeding and the time of menstruation returning to normal,and in improving the patient satisfaction rate.

Objective To evaluate the postoperative analgesia efficacy and clinical safety of hydro-morphone patients-controlled intravenous analgesia(PCIA)in patients with scar pregnancy after auxiliary uterine artery embolization(UAE).Methods A total of 116 patients with scar pregnancy,who received auxiliary UAE at the Fuyang Municipal People's Hospital of China between January 2021 and September 2022,were enrolled in this study.According to the intravenous self-controlled analgesic drugs used after UAE,the patients were randomly and equally divided into observation group(n=58)and control group(n=58).Ten minutes before the procedure,intravenous injection of 2 mg hydromorphone(observation group)or 2 μg/kg sufentanyl(control group)was performed,and the PCIA pump was connected.In the observation group,the mixed solution of 10 mg hydromorphone+100 mg flurbiprofen axetil+100 mL saline was put in the analgesic pump,while in the control group,the mixed solution of 2 μg/kg sufentanyl+flurbiprofen axetil 100 mg+100 mL saline was put in the analgesic pump.The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h visual analogue scale(VAS)scores,the Bruggrmann comfort scale(BCS)scores,the number of pressing analgesic pump times within postoperative 48 hours,the used dosage of analgesic drugs,the adverse reactions,and the incidence of postoperative complications were recorded.Results The difference in the post-UAE 0.5-h VAS scores between the observation group and the control group was not statistically significant(P＞0.05),while the post-UAE 4-h,8-h,12-h,24-h and 48-h VAS scores in the observation group were significantly lower than those in the control group,and the differences were statistically significant(all P＜0.05).The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h BCS scores in the observation group were significantly higher than those in the control group,and the differences were statistically significant(all P＜0.05).The number of pressing analgesic pump times and the used dosage of analgesic drugs within postoperative 48 hours in the observation group were lower than those in the control group,and the differences were statistically significant(all P＜0.05).No statistically significant differences in the complications such as drowsiness,skin itching,hypoxia,or respiratory depression,etc.existed between the two groups,while the difference in the incidence of adverse reactions between the two groups was statistically significant(P＜0.05).Conclusion Hydromorphone and sufentanil PCIA can relieve the pain in scar pregnancy patients after UAE.Hydromorphone is superior to sufentanil in reducing the number of pressing analgesic pump times within postoperative 48 hours,reducing the used dosage of analgesic drugs,and decreasing the incidence of adverse reactions,therefore,hydromorphone PCIA has a certain promotion value.(J Intervent Radiol,2024,33:240-244)

Objective To investigate the popularization of cardiopulmonary resuscitation(CPR)knowledge and science popularization needs among urban and rural residents in Tonghai County,Yuxi City,Yunnan Province,so as to explore the establishment of an efficient and appropriate science popularization model.Methods A total of 300 residents aged 15-60 years old were selected from Tonghai County,Yuxi City,Yunnan Province using stratified and simple random sampling methods.A self-designed questionnaire was used to conduct an anonymous questionnaire survey.Results Only 20.3%of Tonghai County residents master CPR skills,and 26.2%of Tonghai County residents have never heard of CPR.There is a statistically significant difference in the awareness rate of CPR between rural residents and non-rural residents(P<0.01).There are differences in residents'age and CPR awareness(P<0.01),the age and CPR are inversely proportional.The residents have a higher willingness to perform chest compressions and mouth-to-mouth resuscitation on strangers,66.2%and 68.6%respectively.63.79%of residents have never attended relevant training.But 92.76%of the people said they were willing to participate in the relevant training when they learned the training news.Conclusion Residents in Tonghai County generally lack knowledge of CPR first aid,but the demand for first aid knowledge of residential CPR is high and the attitude towards rescue is positive.It is recommended that relevant departments increase CPR science popularization and training efforts,and popularize CPR into villages.

Objective To investigate deep neuromuscular blockade(NMD)and moderate NMD on hepatic perfusion and liver function during laparoscopic hepatectomy.Methods A total of 60 patients who received laparoscopic hepatectomy in Fudan University Shanghai Cancer Center were recruited from Dec 2021 to Dec 2022.They were randomly divided into two groups:deep NMD group(D group,n=30)and moderate NMD group(M group,n=30).D group was induced by administration of rocuronium 0.9 mg/kg followed by continuous infusion to maintain intraoperative post-tetanic count(PTC)of 1-2,while M group was induced by administration of rocuronium 0.6 mg/kg followed by continuous infusion to maintain intraoperative train-of-four(TOF)of 1-2.Indocyanine green(ICG)of 0.25 mg/kg was given intravenously both after induction and after specimen excision,and retention rate at fifteen minutes(ICGR15)was recorded.In addition,intraoperative rocuronium dosage,surgical operation satisfaction score,postoperative shoulder pain,and the occurrence of vomiting on postoperative day 1(POD1)were also recorded.Results Compared with M group,the dosage of rocuronium in D group was significantly increased(P<0.01),but there was no difference of ICGR15 between the two groups(P=0.581),even other parameters of perioperative liver function.The surgical operation satisfaction score was significantly higher(P<0.05),while the postoperative shoulder pain(P=0.037,OR=1.37,95%CI:1.01-1.86)and the occurrence of vomiting on POD1(P=0.017,OR=1.64,95%CI:1.07-2.53)were significantly lower in D group than those in M group.Conclusion Compared with moderate NMB,deep NMB can significantly improve surgery condition,reduce postoperative shoulder pain and vomiting.However,there was no significant difference between them on the hepatic perfusion and perioperative liver function.

Objective To analyze the predictive value of serum levels of procalcitonin(PCT)and cytokines on the prognosis of patients with COVID-19 at admission.Methods From November 2022 to February 2023,patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled.Chemiluminescence was used to detect serum PCT levels,and flow microsphere array was used to detect serum cytokines IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,TNF-α,TNF-β,IFN-γ level.ICU admission,mechanical ventilation and in-hospital death were defined as poor prognosis.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.Results A total of 176 patients with complete data were included,including 134 in the PCT-normal group and 42 in the PCT-elevated group,with a median age of 71.50 years and 71.59%males.Patients in the PCT elevated-group had significantly higher rates of ICU admission(38.41%vs.13.11%,P<0.05),mechanical ventilation(76.92%vs.24.59%,P<0.001)and in-hospital mortality(38.46%vs.6.56%,P<0.001)were significantly higher than those in the PCT-normal group.Serum levels of cytokines IL-6(7.40 pg/mL vs.4.78 pg/mL,P = 0.033 4)and IL-8(10.97 pg/mL vs.5.92 pg/mL,P<0.001)were significantly higher in patients with poor prognosis than in those with good prognosis.The area under the curve for PCT,IL-6,and IL-8 to predict poor prognosis in COVID-19 patients was 0.687,0.660,and 0.746,respectively;sensitivity was 52.78%,55.17%,and 72.41%,respectively;and specificity was 81.58%,74.19%,and 74.19%,respectively,as calculated from the ROC curve.When PCT,IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients,the area under the curve is 0.764,the sensitivity is 70.00%,and the specificity is 80.00%.Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19.