Objective:To explore the efficacy of ixazomib combination treatment therapies for multiple myeloma (MM), and the influencing factors of prognosis.Methods:The clinical data of 80 MM patients admitted to Yancheng Third People's Hospital from January 2020 to January 2022 were retrospectively analyzed. All patients received 3 courses of ixazomib combination treatment therapies (28 d was 1 course). All combination treatment therapies included ID group (ixazomib + dexamethasone, 11 cases) and ID + immunomodulator group (ixazomib + dexamethasone + lenalidomide/thalidomide, 50 cases), ID + other chemotherapy drugs group (ixazzomib + dexamethasone + doxorubicin liposome/cyclophosphamide/bendamustine, 19 cases). The clinical efficacy of patients in different treatment regimens was compared, and the prognosis was followed up and recorded. The clinical characteristics between the survival and the dead patients were compared. Cox proportional risk model was used to make multivariate analysis of the overall survival of MM patients receiving ixazomib combination therapies.Results:The treatment was effective in 9 cases (81.82%) of the ID group, 32 cases (64.00%) of the ID + immunomodulator group, and 9 cases (47.37%) of the ID + other chemotherapy drugs group. There was no statistically significant difference in the effectiveness rate of 3 ixazomib combination regimens ( χ2 = 0.62, P = 0.432). All patients were followed up for 5 to 20 months, with an average follow-up time of (15±4) months. There were statistically significant differences in immunoglobulin type, Durie-Salmon stage, early treatment line and therapeutic efficacy between the survival group (49 cases) and the death group (31 cases) (all P < 0.05). Multivariate Cox regression analysis showed that the clinical effectiveness (effectiveness vs. ineffectiveness: OR = 0.242, 95% CI 0.103-0.567, P = 0.001) and the previous first-line treatment (the first-line vs. the other lines: OR = 0.577, 95% CI 0.452-0.736, P < 0.001) were independent protective factors for the overall survival of MM. Conclusions:The 3 ixazomib combination therapies have a certain efficacy in the treatment of MM; ID regimen has the best clinical efficacy and survival. The clinical effectiveness and the previous first-line treatment are independent protective factors for the survival of MM.

OBJECTIVE：To provide ideas for the development of electronic prescription （e-prescription）service mode under the background of “Internet+”. METHODS ：Retrieving official websites and related online resources of the national and provincial governments，health committees ，medical products administration ，and medical security bureaus （up to Jun. 2020），relevant policies，supporting documents and implementation status of e-prescription service mode were sorted out and analyzed ，and the suggestions were put forward. RESULTS ：Current e-prescription service modes included four modes ，such as pharmaceutical retail enterprise e-prescription service mode ，medical institution e-prescription information sharing service mode ，internet hospital e-prescription service mode ，and medical e-commerce e-prescription service mode. The pilot of e-prescription service mode of drug retail enterprises covered the widest range of provinces and cities ，but the participation of health departments and medical institutions was insufficient ，and the pattern of comprehensive power had not been formed. The medical institutions e-prescription information sharing service mode was mainly composed of three typical examples ，namely“Wuzhou mode ”，“Fuzhou mode ”and “Gansu mode ”. However ，it had not been unified in terms of technical standards ，access conditions ，exit mechanism and execution process，etc. At present ，this model was still in a small scope of exploration and pilot stage. The internet hospital e-prescription service mode was limited by the popularization of internet hospital medical insurance payment and the improvement of corresponding rules and regulations ，which was still at the stage of cautious pilot exploration. Medical e-commerce e-prescription service model was limited by the types of drugs within the legal service scope. Meanwhile ，the industry standards and regulations of e-prescription service were in the absence at present. CONCLUSIONS ：As an innovative service mode ，the e-prescription service mode meets the real needs of the pharmaceutical retail industries ，medical institutions and patients. Each pilot mode conforms to the development trend of “Internet+”and shows a strong development momentum ，but overall it is still in the early stage of active exploration. It is urgent to further explore and research around the leading departments ，stakeholders and prescription transfer procedures.

OBJECTIVE：To provide reference for chronic disease man agement service develophed in social pharmacy. METHODS：Questionnaire about the Status Quo of Chronic Disease Management and Service in Social Pharmacy of Chengdu was designed，using the quota sampling method ，social pharmacies in five main urban areas of Chengdu were selected from May to July，2018 to conduct a questionnaire survey （one questionnaire by each social pharmacy ） on the basic situation of social pharmacies，the development of chronic disease management services ，the cognition of chronic disease management services ，and the challenges faced by chronic disease management services ，and suggestions were proposed. RESULTS & CONCLUSIONS ：A total of 272 questionnaires were sent out ，and 252 valid questionnaire were actually collected （effective recovery rate of 92.65％）. Totally 189 sample pharmacies （75.00％） had carried out chronic disease management services ，of which 112 （59.26％） pharmacies had been launched for 1-3 years；87（46.03％）had set up service areas ；68（35.98％）had full-time staff ，and 54 （28.57％）had part-time staff ，most of which were licensed pharmactists. 116（61.37％）had trained related staff for 1-2 times per year. 176（93.12％）pharmacies could provide services such as basic indicator testing （176，93.12％），establishing health records （142，75.13.％），and rational medication guidance for patients （163，86.24％）. According to the survey ，the substantial benefits of chronic disease management services included changing the health status of patients （163，86.24％），improving patients ’trust in the pharmacy and staff （141，74.60％），improving patients ’quality of life （129，68.25％），etc. More than 50％ of pharmacies faced the challenges of limited number of licensed pharmacists （102，53.97％），difficulty in establishing professional teams （112， 59.26％），and lack of trust in services （101，53.44％）. The current chronic disease management service of social pharmacy in Chengdu is in the initial stage of active exploration ，which can bring many benefits to patients and pharmacies ，and is conducive to the promotion of medical and health policies ，but there are some weak links at the same time. It is suggested that relevant government departments should strengthen the support ofpolicies and regulations ， and social pharmacies constantly 85501387。 E-mail：2191043137@qq.com improve professional level and rely on the advantages of “Internet + ”to meet the diverse needs of the public for pharmaceutical care ，and publicity efforts are intensified to · enhance the awareness and participation of patients with chronic diseases.

Objective: To evaluate the efficacy and side effects of priming regimen with pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in the treatment of initial treatment elderly patients with acute myeloid leukemia (AML). Methods: Thirty-five elderly patients with early-stage AML (non-M₃) who received pre-excitation chemotherapy in Yancheng Third People's Hospital from February 2015 to January 2019 were retrospectively analyzed. According to the different granulocyte colony-stimulating factor (G-CSF) in the chemotherapy regimen, 15 cases were in PEG-rhG-CSF group, 6 mg PEG-rhG-CSF was used alone on day 0 by subcutaneous injection; 20 cases were in recombinant human granulocyte colony-stimulating factor (rhG-CSF) group, 200 μg/m² rhG-CSF was used per day from day 0 to day 13 by subcutaneous injection, rhG-CSF was suspended or continued according to the number of white blood cells. In addition, both groups were given priming regimen with cytarabine and arubicin, or cytarabine and harringtonine. The efficacy and adverse reactions of the two groups were compared. Results: In the PEG-rhG-CSF group, there were 5 cases of complete remission, 6 cases of partial remission, 4 cases of non-remission, and 11 cases were effective. In the rhG-CSF group, there were 8 cases of complete remission, 7 cases of partial remission, 5 cases of non-remission, and 15 cases were effective. There was no significant difference in the efficacy between the two groups (χ ²= 0.012, P= 0.911). In terms of adverse reactions, the incidence of infectious fever, bone pain, duration of neutropenia, and duration of thrombocytopenia were not statistically significant (all P > 0.05). Conclusions In the pre-excitation chemotherapy for AML, the clinical efficacy and adverse effects of PEG-rhG-CSF are similar to rhG-CSF. However, the use of PEG-rhG-CSF can simplify the operation and reduce the pain and risk of local infection during chemotherapy.

Objective To evaluate the current situation of rational drug use in medical facilities at all levels in Sichuan province by means of empirical research via WHO /INRUD selected drug use indicators SDUIs .Methods Six sample cities in Sichuan Province was extracted ,in which 1 to 3 tertiary hospitals ,1 to 3 secondary hospitals ,5 community health service cen-ters and 5 township hospitals were selected .Prescription indicators were indicated by collecting outpatient prescriptions from sample medical facilities which contained 30 prescriptions per month of every January ,April ,July and October from January 2012 to April 2015 .Results The average number of drugs was 3 .02 per prescription .The percentage of drug generic name used in prescription drugs was 90 .33％ .The percentage of antimicrobial use was 40 .09％ .The percentage of injections used was 14 .46％ .The percentage of essential drugs used among prescription drugs was 83 .27％ .The percentage of essential drugs used was 93 .05％ .Average fee amount all prescriptions was 66 .04 yuan .Conclusion Some of the indicators was of good ra-tionality ,but there were still some unreasonable phenomena .

Objective To evaluate the clinical effect of Decitabine as the basis of the chemotherapy regimen on the treatment of elderly patients with acute myeloid leukemia( AML)?Methods The clinical data of elderly patients with AML admitted to the Third People ’ s Hospital of Yancheng from January 2013 to November 2015 were retrospective analyzed?The patients were divided into Decitabine group ( cases ) and the traditional group(19 cases) according to whether or not useed Decitabine,then evaluated the efficacy?Results The overall response rate( ORR) was 70?0% in 10 patients received decitabine,47?4% in 9 patents of the traditional group, and the difference was significant( P=0?03)?At the same time,the median survival time of the two groups was 44?87 months and 13?40 months respectively,the difference was statistically significant between the two groups (P=0?04)?There was no significant difference in the incidence of adverse reactions between the two groups ( granulocyte reduction, PLT reduction, fatigue, cardiovascular events, and respiratory tract infections ) ( P>0?05)?Conclusion The effect of Decitabine as the basis of the chemotherapy regimen on the treatment of AML is better,can prolong the survival time.

OBJECTIVE:To explore the assessment indicators of the accessibility of essential medicines to comprehensively evaluate the accessibility of essential medicinesand its coverage of medicine supply security and service quality and the improve-ment of the implementation of the new Healthcare reform. METHODS:Retrieved from Chinese and English Literature and the World Health Organization(WHO),theoretical analysis was conducted for the covering the core elements of essential medicines to explore construction ideas and content of essential medicines evaluation index system with international suitability,index appropri-ateness and operability. RESULTS&CONCLUSIONS:A series of medicine policy evaluation guide established by WHO is current-ly the main basis of the accessibility of essential medicines evaluation around the world,however,there are certain limitations for these indicators.According to the concept put forward by WHO and the related organizations,the core elements of the accessibility of essential medicines include:availability,affordability,supply system,sustainable financing,medicine quality and appropriate use.

OBJECTIVE:To provide reference for further comprehensive evaluation of the improvement of the accessibility of family medicines after the implementation of the new health care reform. METHODS:Sampled as 180 households from 2 urban ar-eas,2 counties and 2 rural areas in Chengdu,a questionnaire survey was adopted based on the WHO’s manual for the Household Survey to Measure Access and Use of Medicines to investigate the situation of drug use,storage and accessibility,and the results were statistically analyzed. RESULTS:Totally 180 questionnaires were sent out,179 were effectively received with effective recov-ery of 99.44%. In the terms of medicines taken for the acute illness,there were more than 60% rural households obtained drugs from the public health care facilities,while more than 60% counties households purchased drugs in public medical and health insti-tutions;in the terms of medicines taken for the chronic illness,the proportion of households reporting a chronic illness who did not take any medicines was low(3.80%);in terms of medicines storage,the proportion of households without reserve drugs was low (13.41%). In terms of drug accessibility,the proportions of respondents who agreed that the location and opening hours of their public healthcare facility were convenient were high;there was no situation for“patients did not take prescribed drugs because med-icines were not available at the healthcare facility and drug store”,while more than 95% respondents who agreed that drugs were available at their public health care facilities and drug stores;the essential medicines in the household use of chronic drugs in Chengdu accounted more than 60%;more than 85% can afford the drug costs,while the proportion of the monthly costs for acute illness and chronic illness in the total month costs was low;the health insurance coverage reached 90% in the survey households, but the proportions of households which could reimburse acute,chronic illness drug cost were lower(14.13% and 12.66%). CON-CLUSIONS:At present,the level of drug accessibility in Chengdu is high;the implementation of National Essential Medicines System has a positive effect on reducing the economic burden of chronic disease family. But there are shortcomings in the Medicare reimbursement levels and antibiotics use,it is suggested to take effective measures to solve it,such as exploring the stable and ef-fective medical insurance fund raising channels,improving the compensation level and the level of insurance reimbursement,formu-late and implement the corresponding antibacterial drugs supervision system and regulate the rational use of antibiotics in residents.

Objective To study of zoledronic acid in the treatment of multiple myeloma bone dis-ease clinical effect and detection of serum macrophage inflammatory protein (MIP)changes of primary mye-loma (mm)in patients with serum macrophage inflammatory protein levels and multiple myeloma bone dis-ease curative effect.Methods 48 cases of multiple myeloma bone disease patients were treated with VTD regimen chemotherapy were randomly and equally divided into two groups,one group (group A)chemother-apy intermission applied zoledronic acid 4 mg per month 1 time,treatment 2 course of treatment,observa-tion of curative effect and adverse reaction,another group (B group)declined to azole phosphonic acid treatment.Results Group of pain Solution of 16 cases were markedly effective,effective in 4 cases,4 ca-ses were ineffective,efficiency 83.3%.B group bone pain relieved markedly effective in 12 cases,effective in 4 cases,8 cases were ineffective,have efficiency 66.7%.A compared to the B,the curative effect was obvious (P <0.05).By enzyme linked immunosorbent assay for the detection of the patients with a,levels of peripheral serum MIP-1a and MIP-1 beta B two groups before and after treatment.Conclusions zole-dronic acid in the treatment of multiple myeloma bone disease effectively,can significantly improve the qual-ity of life in patients with MM patients serum MIP-1a and MIP-1 beta level and multiple myeloma tumor bone disease curative effect is negative correlation,used for evaluating the effect The reference index.

OBJECTIVE: To provide suggestion for the construction of teaching staff and the improvement of the discipline of Pharmacy Administration(Ph.A).METHODS: The basic information was collected by searching official website and the websites of universities and colleges etc,and a questionnaire survey was conducted among pharmacy univeristies or colleges by means of telephone interview or on-the-spot interview etc.RESULTS: A total of 108 pharmacy univeristies or colleges sent back the effective questionnaires.There were a total of 276 Ph.A teachers,including 142 male and 134 female;145 were full-time Ph.A and 131 were part-time teachers.There were only part-time teachers in 63 universities / colleges,of whom,91 were from other teaching or research department of the discipline of pharmacy,24 from party or government administration of school,9 from hospitals,4 from pharmaceutical manufacturing enterprises,and 3 from drug administration department.CONCLUSION: The resources of Ph.A teachers are various,and the access qualification is quite low.It isadvisable to strengthen the building of Ph.A faculty and improve the whole level of Ph.A teachers.