Objective To investigate the current status and awareness of pharmaceutical services in hospitals in Guizhou province and to provide a reference for exploring and carrying out pharmaceutical service fees.Methods The questionnaire was designed by the"wjx.cn"website.Three kinds of questionnaires were designed for pharmacists,doctors,nurses,and patients as the research objects,with corresponding differences in some questions,and promoted on WeChat,Dingxiangyuan,and other network platforms.Results A total of 655 questionnaires were collected,and 639 valid questionnaires were recovered,with an effective recovery rate of 97.56%.324 pharmacists(50.70%),82 doctors and nurses(12.83%),233 patients(36.46%)were surveyed.The average approval score of these three groups of respondents on pharmaceutical service fees was 4.67,4.23,and 4.22,respectively(full score:5).Conclusions Overall,pharmacists'professional services have received support from medical staff and patients.However,patients'pharmaceutical service projects currently focus on dispensing services.The recognition of pharmacists'work and the public's awareness of pharmaceutical services can be improved by enhancing the professional ability of pharmacists,strengthening publicity and guidance,and exploring"Internet+pharmaceutical services",etc.,to promote the sustainable development of pharmaceutical services.

Objective:To evaluate the clinical efficacy and safety of secukinumab in the treatment of moderate to severe the adults with plaque psoriasis.Methods:The clinical data from 183 adult patients with moderate to severe plaque psoriasis treated with secukinumab were collected.The patients received subcutaneous injections of secukinumab once a week at weeks 0,1,2,3,and 4,followed by an injection every 4 weeks,with each dose of 300 mg.The follow-up period was 52 weeks.The psoriasis area and severity index(PASI),body surface area(BSA),investigator global assessment(IGA),and dermatology life quality index(DLQI)scores of the patients with psoriasis were caculated.The clinical efficacy and safety of secukinumab in the treatment of moderate to severe plaque psoriasis were evaluated,and the influencing factors were analyzed.Results:Compared with week 0,the PASI、BSA、IGA and DLQI scores of the patients were significantly decreased at weeks 4,12,24,and 52 of secukinumab treatment(P<0.05).After treated with secukinumab,the percentages of the patients achieving PASI 75,PASI 90,and PASI 100 at week 4 were 95.6%,84.2%,and 47.5%,respectively;at week 12,they were 97.3%,95.6%,and 78.7%,respectively;at week 24,they were 97.8%,96.7%,and 84.2%,respectively;and at week 52,they were 98.4%,97.8%,and 83.6%,respectively.The percentages of the patients with BSA≤1%at weeks 4,12,24,and 52 were 80.9%,94.5%,95.6%,and 94.0%,respectively.The percentages of the patients with IGA score of 0/1 at week 4,12,24,and 52 were 86.3%,97.3%,96.7%,and 95.6%,respectively.The percentages of the patients with DLQI score of 0/1 at weeks 4,12,24,and 52 were 76.6%,89.1%,92.9%,and 91.8%,respectively.At week 4 of secukinumab treatment,there were significant differences in age,body mass index(BMI),disease duration,baseline PASI score,and history of previous biologic treatment between the patients in two groups(P<0.05).At week 24 of secukinumab treatment,there were significant differences in age and BMI between the patients in two groups(P<0.05).At week 4,BMI≥25 kg·m-2,disease duration≥10 years,baseline PASI score≥10,and a history of previous biologic treatment were risk factors affecting the recovery of the patient(P<0.05).At week 24,age≥40 years was a risk factor affecting the recovery of the patient(P<0.05).During the treatment period,44 out of 183 psoriasis patients reported 49 adverse reactions,and the adverse reaction rate was 24.0%.No serious adverse events or fatal adverse reactions occurred.The adverse reactions included upper respiratory tract infections in 23 cases,eczema-like skin lesions in 10 cases,skin fungal infections in 6 cases,urticaria in 3 cases,mild liver function abnormalities in 2 cases,folliculitis in 2 cases,conjunctivitis in 2 cases,and otitis media in 1 case.Conclusion:Secukinumab treatment for the adult patients with moderate to severe plaque psoriasis is rapid-acting and has lasting efficacy.The BMI,disease duration,baseline PASI score,history of previous biologic treatment,and age are the factors influencing the clinical efficacy of secukinumab.The overall safety is good,and secukinumab may be used as a first-line treatment option for moderate to severe plaque psoriasis.

Objective:To investigate serum vitamin A and vitamin D status in children aged 2-<7 years in 20 cities in China.Methods:A cross-sectional study was conducted. A total of 2 924 healthy children aged 2-<7 years were recruited from September 2018 to September 2019 from 20 cities in China, categorized by age groups of 2-<3 years, 3-<5 years, and 5-<7 years. The demographic and economic characteristics and health-related information of the enrolled children were investigated. Body weight and height were measured by professional staff members. The serum vitamin A and vitamin D levels were detected by high-performance liquid chromatography-tandem mass spectrometry. Chi-square test and Logistic regression were applied to analyze the association between vitamin A and vitamin D deficiency and insufficiency as well as their underlying impact factors.Results:The age of the 2 924 enrolled children was 4.33 (3.42, 5.17) years. There were 1 726 males (59.03%) and 1 198 females (40.97%). The prevalences of vitamin A and vitamin D deficiency in enrolled children were 2.19% (64/2 924) and 3.52% (103/2 924), respectively, and the insufficiency rates were 29.27% (856/2 924) and 22.20% (649/2 924), respectively. Children with both vitamin A and vitamin D deficiencies or insufficiencies were found in 10.50% (307/2 924) of cases. Both vitamin A ( χ2=7.91 and 8.06, both P=0.005) and vitamin D ( χ2=71.35 and 115.10, both P<0.001) insufficiency rates were higher in children aged 3-<5 and 5-<7 years than those in children aged 2-<3 years. Vitamin A and vitamin D supplementation in the last 3 months was a protective factor for vitamin A and D deficiency and insufficiency, respectively ( OR=0.68 and 0.22, 95% CI 0.49-0.95 and 0.13-0.40, both P<0.05). The rates of vitamin A and D insufficiency was higher in children with annual household incomes <60 000 RMB than in those with annual household incomes ≥60 000 RMB ( χ2=34.11 and 10.43, both P<0.01). Northwest and Southwest had the highest rates of vitamin A and vitamin D insufficiency in children aged 2-<7 yeas, respectively ( χ2=93.22 and 202.54, both P<0.001). Conclusions:Among 20 cities in China, children aged 2-<7 years experience high rates of vitamin A and vitamin D insufficiency, which are affected by age, family economic level, vitamin A and vitamin D supplementation, and regional economic level. The current results suggest that high level of attention should be paid to vitamin A and vitamin D nutritional status of preschool children.

Objective To analyze the infection situation of Helicobacter pylori (Hp) and its correlation with pepsinogen (PG) in the 60~80 year old population in Jianye District, Nanjing City. Methods From December 2018 to December 2020, 758 elderly people aged 60 to 80 in the community in Jianye District Nanjing City. were selected. All subjects were tested for Hp by 13C-UBT method, and clinical signs of Hp positive people aged 60 to 80 years were analyzed. Including gender, age, alcohol consumption, family history of stomach cancer, chronic gastritis, and spicy eating habits; Hp positive group was given amoxicillin capsule 1.0g/ time, twice a day, esomeprazole magnesium enteric-coated tablet 20mg/ time, twice a day, clarithromycin tablet 0.5g/ time, twice a day for 8 weeks, and Hp was detected again after the end of treatment. All levels of PGI, PGII and PGI/PGII were determined by ELISA. The serum PG level of the experimental group and the control group and the serum PG level of the Hp positive population before and after Hp eradication were compared, and the correlation between Hp infection and PG level in the elderly population was analyzed by Pearson correlation. Results A total of 161 cases (21.24%) of 758 patients with chronic gastritis had Hp infection. The proportion of Hp infection in males was significantly higher than that in females (χ²=4.128，P<0.05). The proportion of Hp infection in 70-80 years was higher than that in 60-69 years(χ²=6.771, P<0.05). The proportion of Hp infection in drinking elderly was higher than that in non-drinking elderly (χ² =8.305，P<0.05). The proportion of Hp infection in the elderly with family history of gastric cancer was higher than that in the elderly without family history of gastric cancer (χ²=6.169，P<0.05). The proportion of Hp infection in elderly patients with chronic gastritis was higher than that in patients without chronic gastritis (χ²=5.576 , P<0.05). The proportion of Hp infection in the elderly with spicy diet was higher than that in the non-spicy diet group(χ²=7.936, P<0.05). The levels of PGI and PGI/PGII in the experimental group were significantly higher than those in the control group (P<0.05). The level of PGII in experimental group was significantly lower than that in control group (P<0.05). After treatment, 76 hP-positive patients turned negative, and PGI and PGI/PGII levels after Hp eradication were significantly lower than those before Hp eradication (P<0.05). PGII after Hp eradication was significantly higher than before (P<0.05). According to Pearson correlation analysis, Hp infection in elderly population was positively correlated with PGI and PGI/PGII levels, with correlation coefficients (r1=0.408,r2=0.412,P<0.05), and negatively correlated with PGII, with correlation coefficients (r=-0.469, P<0.05). Conclusions The Hp infection rate in patients with chronic gastritis is high, mainly in elderly men in Jianye District, Nanjing City.The levels of PGI and PGII in HP-positive patients are high, and the levels of PGI/PGII are low. The serum PG level can be used to evaluate the diagnosis and treatment effect of patients with Hp infection.

Objective:To examine the association between living conditions and physical activity of older adults in Shanghai communities, and to explore the impact of living alone on different types and intensities of physical activity.Methods:Participants included randomly recruited older adults aged 60 and above in the Hongqiao, 2nd Shimen Road and Weifang communities in Shanghai.The Physical Activity Scale for the Elderly(PASE)was used to investigate the physical activity status of participants.The higher the PASE score, the higher the activity level.Results:In terms of physical activity concerning housework and labor and total PASE scores, there were statistically significant differences between those living alone and those not living alone[50.00(35.00)points vs.80.00(55.00)points, 85.80(67.23)points vs.110.80(75.18)points, Z=1.984, 2.102, P=0.047, 0.036]. After adjusting for sex, age, and body mass index, binary Logistic regression analysis showed that living alone was associated with low levels of housework physical activity( OR=2.56, 95% CI: 1.26-5.07, P=0.009). Conclusions:For older adults in Shanghai communities, living alone is associated with lower physical activity levels, especially physical activity involving housework.It is necessary to promote the physical activity level and a positive attitude toward exercise for older adults living alone to maintain a satisfactory level of physical health.

In recent years, immune checkpoint inhibitors (ICIs) have greatly improved the survival rate of non-small cell lung cancer (NSCLC) patients without driver mutation. Compared with wild-type tumors, tumors with epidermal growth factor receptor (EGFR) mutations have greater heterogeneity in immune microenvironment characteristics such as programmed cell death ligand 1 (PD-L1) and tumor mutational burden (TMB). Whether ICIs is suitable for NSCLC patients with EGFR mutation has been controversial. Clinical studies have shown that immunomonotherapy has no significant effect on patients with EGFR mutant NSCLC. ICIs combined with chemotherapy and antiangiogenic drugs show good survival benefits. This paper overviews the clinical research and related mechanism of ICIs single drug or combination therapy inadvanced NSCLC patients with EGFR mutation.
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B7-H1 Antigen/metabolism* ; Carcinoma, Non-Small-Cell Lung/pathology* ; ErbB Receptors/metabolism* ; Humans ; Immune Checkpoint Inhibitors/therapeutic use* ; Ligands ; Lung Neoplasms/pathology* ; Mutation ; Tumor Microenvironment

In the past 20 years, with the development of molecular biology, the treatment of non-small cell lung cancer (NSCLC) has been developing. Targeted therapy has improved the survival period of patients with positive mutation of tumor driver gene. More and more targets have been found gradually. Drugs targeting different driving genes have brought the treatment of NSCLC into a promising target era. Among the many driving genes of NSCLC, the fusion of transfection proto oncogene (RET) is the addition of the epidermal growth factor receptor (EGFR), analytic lymphama kinase (ALK) and c-ros oncogene 1-receptor tyrosine kinase (ROS1) are emerging targets. Targeted drugs for RET gene fusion have been constantly updated. Recently, new high selective RET inhibitors blu-667 and loxo-292 have made important breakthroughs. This paper will review the review of the fusion mutation of RET gene in NSCLC, the detection methods, clinicopathological characteristics, targeted treatment and the research progress after drug resistance.
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Objective:To study the efficacy of astragalus polysaccharides combined with cisplatin in the treatment of malignant peritoneal effusion caused by ovarian cancer and its effect on drug resistance genes.Methods:Patients with malignant peritoneal effusion caused by ovarian cancer from January 2015 to December 2018 in Guangrao Country Hospital of Traditional Chinese Medicine were selected as the study subjects. They were divided into astragalus polysaccharide combined with cisplatin treatment group and cisplatin treatment group according to the odd and even number of hospital number, with 60 patients in each group. The patients in cisplatin treatment group were given peritoneal perfusion with cisplatin 75 mg/m 2 and 0.9% sodium chloride injection 50 ml, and the drainage tube were clamped once every 3 d. Treatment continued for 21 d. The patients in astragalus polysaccharide combined with cisplatin treatment group were treated with astragalus polysaccharide 250 ml intravenous drip once a day on the basis of cisplatin treatment group, and treatment continued for 21 d. The peritoneal effusion was pumped by drainage tube and was detected after treatment. The differences in adverse reactions, ascites recurrence time and median survival time were compared between two groups. Changes in inflammatory factors and T lymphocytes before and after treatment were detected and compared. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to detect resistance genes in peritoneal effusions including glutathione S-transferase π (GST-π), P-glycoprotein (P-gp) and multidrug resistance gene 1 (MDR1) mRNA and protein expression. Results:The incidence of gastrointestinal symptoms, Ⅲ-Ⅳ class myelosuppression and Ⅲ-Ⅳ class hepatorenal damage in the astragalus polysaccharide combined with cisplatin treatment group were significantly lower than those in the cisplatin treatment group [38.3%(23/60) vs. 66.7%(40/60), 6.7%(4/60) vs. 33.3%(20/60), 13.3%(8/60) vs. 45.0%(27/60)], while the ascites recurrence time and median survival time were significantly higher than those in the cisplatin treatment group [(6.3 ± 1.7) months vs. (5.5 ± 1.1) months, (15.2 ± 2.4) months vs. (11.7 ± 1.6) months], and there were significant differences ( P<0.05). There were no statistical differences in tumor necrosis factor (TNF)-α, interleukin(IL)-2, IL-6 between two groups before treatment ( P>0.05), after treatment in astragalus polysaccharide combined with cisplatin treatment group, the levels of TNF-α and IL-6 were lower [(21.8 ± 3.5) ng/L vs. (27.5 ± 4.1) ng/L, (17.2 ± 2.2) ng/L vs. (21.9 ± 2.7) ng/L] and the level of IL-2 was higher [(15.5 ± 1.6)ng/L vs. (12.7 ± 1.1) ng/L], and there were significant differences ( P<0.05). There was no statistical differences in CD 3+, CD 4+ and CD 8+ between two groups before treatment ( P>0.05), after treatment in astragalus polysaccharide combined with cisplatin treatment group, the levels of CD 3+, CD 4+ and CD 8+ were higher [(55.3 ± 3.9)% vs. (48.9 ± 3.2)%, (33.2 ± 3.4)% vs. (30.4 ± 2.2)%, (21.4 ± 3.1)% vs. (17.6 ± 1.9)%], and there were significant differences ( P<0.05). After treatment, the levels of GST-π, P-gp and MDR1 gene mRNA and protein expressions in astragalus polysaccharide combined with cisplatin treatment group were significantly lower than those in the cisplatin treatment group, and there were significant differences ( P<0.05). Conclusions:Astragalus polysaccharide can improve immune function and reduce drug resistance gene expression in patients with malignant peritoneal effusion caused by ovarian cancer, which can significantly improve the efficacy of cisplatin in the treatment of malignant peritoneal effusion caused by ovarian cancer and reduce adverse reactions.

"Liquid biopsy" have been intensively studied in recent decades. The exosomes carry their maternal partial functional proteins and genes. As a form of intercellular vesicular transport, exosome-mediated intercellular communication participates in a variety of physiological and pathological processes. The information transmission mediated by exosomes is associated with pathophysiological status and plays an important role in the pathogenesis of cancer. Their detection may be beneficial for the diagnosis and treatment of tumor. This article reviews advances in knowledge on the exosome properties, the effect of exosomes on malignant tumorigenesis, and their clinical application. The data will provide a reference for clinical practitioners.

Objective: To evaluate the clinical therapeutic efficacy and safety of red-blue light irradiation combined with Xihuang Capsules in the treatment of moderate to severe acne vulgaris.Methods:Eighty patients with moderate to severe acne vulgaris were randomly divided into Xihuang Capsules group (control group)and red-blue light irradiation combined with Xihuang Capsules group (observation group).The patients in observation group were treated with red-blue light irradiation (20 min biw,4 weeks)combined with Xihuang Capsules (1.5 g bid,4 weeks),while the patients in control group took only Xihuang Capsules orally (1.5 g bid,4 weeks),The changes of skin lesions and adverse reactions were observed and the curative efficacies were compared at 2 or 4 weeks after treatment.Results:After 2-week-treatment,the total effective rate in observation group was 67.5% while the total effective rate in control group was 52.5%,there was no statistically significant difference between two groups (P >0.05).The regression number of inflammatory and non-inflammatory skin lesions in observation group was significantly higher than that in control group (P <0.05).After 4-week-treatment,the total effective rate in observation group was significantly higher than that in control group (85.0% vs 65.0% ),and the difference was statistically significant (P < 0.05);the regression number of inflammatory and non-inflammatory skin lesions in observation group was significantly higher than that in control group (P <0.05).During the treatment,there were no severe adverse reactions in two groups.Mild headache and nausea occurred in observation group after red-blue light irradiation,but the above symptoms disappeared after reducing the irradiation dose.Conclusion:Red-blue light irradiation combined with Xihuang Capsules in the treatment of moderate to severe acne is proved to be a significantly effective and safe method,and it is worth to be promoted in clinic.