Objective To analyze the prevalence status,influencing factors,and differences among different school age groups of myopia in children and adolescents in Ningxia Hui Autonomous Region.Methods From September to De-cember 2019,inYinchuan,Wuzhong,Shizuishan,Guyuan and Zhongwei of Ningxia,8 primary schools,6 junior high schools,6 senior high schools and 4 universities were randomly selected by stratified cluster random sampling.Five classes were se-lected from each grade of primary school,and four classes were selected from each grade of junior high school to university.All students in the selected classes were included in the study.A total of 14 211 students were selected for questionnaire sur-vey,physical examination and visual acuity measurement.The influencing factors of myopia in children of different grades were analyzed using the least absolute shrinkage and selection operator(LASSO)and logistic regression,and the model with the smallest Bayesian information criterion(BIC)was selected as the optimal model.Results The detection rate of myopia in children and adolescents in Ningxia Hui Autonomous Region was 70.3％.The detection rate of myopia in girls was higher than that in boys,and that in cities was higher than that in towns,with statistically significant differences(both P＜0.001).Compared with primary school students,the detection rate of myopia in junior high school students,senior high school students and college students gradually increased,and that in the college students was the highest,with statistically signifi-cant differences among different grades(all P＜0.001).The LASSO-logistic regression analysis of the influencing factors of myopia showed that urban and rural areas,gender,age,whether or not to wear glasses at present,the number of daily break exercises,whether or not to actively participate in physical activities,and whether or not to maintain regular exercises in the past 6 months were the influencing factors of myopia in primary school students(all P＜0.05).Gender and whether or not to wear glasses at present were the influencing factors of myopia in junior high school students and senior high school students(all P＜0.05).Whether or not to wear glasses at present was the influencing factor of myopia in college students(P＜0.05).Conclusion The detection rate of myopia in children and adolescents in Ningxia Hui Autonomous Region is high,and there are significant differences in the influencing factors of myopia among different age groups of children and adolescents.Wear-ing glasses is a protective factor to control myopia.Targeted health education on vision should be provided based on the aca-demic stage of children and adolescents to enhance their awareness of health care and improve their visual health.

OBJECTIVE To provide a reference for continuing education and training of clinical pharmacists. METHODS The revision of the syllabus and the improvement of training methods of practical skills training class for clinical pharmacists in the neurology department held by Xuanwu Hospital of Capital Medical University from 2007 to 2022 was sorted to summarize its advantages and characteristics. RESULTS Training programs were developed to benefit clinical pharmacists at different levels， and the training contents were adjusted according to the training programs and the needs of trainees. Teachers with teaching experience were selected to participate in the teaching. Theory teaching was combined with practice teaching in the teaching process， and case teaching and question-based teaching methods were adopted to benefit both senior clinical pharmacists and new clinical pharmacists. In addition， the influence of the training class was expanded through online teaching， so that doctors and pharmacists could communicate and learn together on the platform of the training class. For example， when designing the training program， we replaced one common neurological disease every two years， and carried rollover study on its new progress and new ideas； clinical pharmacist skill course was reduced， drug history writing， information retrieval and test index interpretation were compressed into clinical pharmacy skill course. CONCLUSIONS The continuing education platform is established for clinical pharmacists； new knowledge and concepts that clinical pharmacists of this specialty need to be familiar with are compiled into the teaching syllabus， and the experts who are familiar with the training of clinical pharmacists are selected to explain to the students so that the students could follow the platform to constantly update their knowledge and improve the ability of clinical pharmacists to participate in the clinic work.

OBJECTIVE:To investigate related factors for valproic acid-induced fibrinogenopenia in epilepsy patients. METHODS:A retrospective survey was conducted to collect the epilepsy patients treated with routine dose of valproic acid regularly more than one week in Epilepsy Diagnosis and Treatment Center of Xuanwu Hospital,Capital Medical University during Jan. 1st,2017 to Mar. 1st,2017. The general situation,drug use (dosage of valproic acid,dosage form of valproic acid,drug combination),liver function,blood routine indexes and coagulation indexes,etc. were collected. Univariate and binary Logistic regression analysis were used to analyze the relationship of above factors with fibrinogenopenia. ROC curve was used to screen and predict the cut-off points when sensitivity and specificity of fibrinogenopenia were good. RESULTS:A total of 59 valid cases were collected,including 40 male(67.8％)and 19 female(32.2％);35 patients(59.3％)were under 14 years of age,and 24 patients (40.7％)over 14 years of age,with average age of(17.2±15.7). Of these,24 had fibrinogenopenia(40.7％). Univariate analysis showed that fibrinogenopenia was negatively correlated with age(P=0.042),but was positively correlated with dosage of valproic acid(P=0.003);fibrinogenopenia was not correlated with gender(P=0.679),dosage form of valproic acid(P=0.790)or drug combination (P=0.502). Binary Logistic regression analysis showed that dosage of valproic acid and neutrophil percentage, erythrocyte count and platelet count of patients were related risk factors of fibrinogenopenia;odds ratios of related risk factors were 1.101,0.925,0.132,0.976. ROC curve showed that the area under the ROC curve which was correlated with dosage of valproic acid was 0.766,sensitivity and specificity were 98.5％ and 54.3％;the cut-off dosage was 13.3117 mg/kg. CONCLUSIONS:The greater the dosage of valproic acid and the younger the age,the greater the possibility of the fibrinogenopenia. For patients with long-term use of valproic acid,even if the normal dosage are used,it is necessary to monitor fibrinogen changes regularly,for whom the dosage are greater than 13.3117 mg/kg,the frequency of fibrinogen monitoring should be increased.

Clinical pharmacists joined the team for treating a cerebral hemorrhage patient with hypertension. Medications were as-sessed by learning guidelines and consulting the related literature reports,and the regimen was adjusted according to the condition of the disease and drug characteristics during the whole process of pharmaceutical care. As a result, the clinical medication became more rea-sonable. The patient's blood pressure was controlled within the target range timely, and the vital signs were sufficiently stable so that the patient could be transferred to a general ward for the further treatment.

Objective To investigate the value of third generation dual-source CT in early differential diagnosis of intracranial hemorrhage and iodinated contrast medium after endovascular treatment of acute ischemic stroke (AIS).Methods Totally 78 patients with AIS underwent endovascular treatment were prospectively enrolled.Dual-energy CT (DECT) examination (80 kV/Sn150 kV) of the head was performed after treatment with a third generation dual-source CT scanner.Iodine overlay maps and virtual non-contrast images were post-processed.Taking conventional brain CT images obtained 24 48 h after AIS attack as references,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of DECT for identifying hemorrhage were computed respectively.Results Totally 31 patients with 53 foci of intracranial hyper-attenuation were finally enrolled.Among 53 foci,26 were correctly diagnosed as hemorrhage by DECT,23 were correctly diagnosed as iodinated contrast medium,while 1 calcification was misdiagnosed as hemorrhage combined with iodinated contrast medium,3 were misdiagnosed as contrast medium which showed delayed hemorrhagic transformation.The sensitivity,specificity and accuracy of DECT was 89.66％ (26/29),95.83％ (23/24) and 92.45％ (49/53),PPV and NPV was 96.30％ (26/27) and 88.46％ (23/26),respectively.Conclusion The third generation dual-source CT is available in early and accurate diagnosis of hemorrhagic transformation after endovascular treatment of AIS,which can help clinicians to adjust the subsequent treatment strategies in time.

Objective: To investigate the rational use of antibiotics in the elderly patients with cerebral infarction complicated with pulmonary infection.Methods: A retrospective investigation was used to analyze the drug resistance of 86 cases of elderly patients with cerebral infarction complicated with pulmonary infection.The data were collected from the consultation records of clinical pharmacists in Xuanwu hospital from February 2013 to November 2015.Results: The pathogenic bacteria mainly distributed to Acinetobacter baumannii and Pseudomonas aeruginosa, and the drug resistance rate was 48.89%.After the consultation, the rate of combination therapy increased from 20.23% to 61.63%.After using sensitive antibiotics, such as cefperazone-sulbactam,piperacillin-sulbactar and amikacin, the infectious indices recovered significantly (P＜0.05).The case proportion with BUN/SrCr＞20 in 27 cases complicated with impaired renal function was 62.9%, and although the patients didn''t use antibiotics with reduced doses, the indices of infection and renal function improved in a certain degree (P＜0.05).The case proportion with ALB and PAB decreasing was 53.49%, and after the consultation, all the infectious indices decreased and protein levels increased (P＜0.05).Conclusion: More attention should be paid to the elderly patients with cerebral infarction complicated with pulmonary infection, and sensitive antibiotics with single or combination drug therapy should be used according to the distribution of resistant bacteria.For the renal failure patients, the kind of renal failure should be clear, and then the appropriate dosage of antibiotics should be adjusted.For the patients with malnutrition, adequate protein intake contributes to the recovery of infection.The clinical symptoms and laboratory indices should be integrated to effectively develop rational treatment for the elderly patients with cerebral infarction complicated with pulmonary infection.

Objective:To discuss the methods and effects of clinical pharmacists in the Chinese and western medicine pharmaceu-tical care for one myelitis patient infected by brucellosis. Methods:Taking one myelitis patient infected by brucellosis as the example, clinical pharmacists provided Chinese and western medicine pharmaceutical care through making individualized drug regimen, perform-ing drug education and so on. Results:Clinical pharmacists participated in the therapeutic process actively, and performed Chinese and western medicine pharmaceutical care. As a result, the body temperature, look,tongue coating and excrement of the patient were obvi-ously improved. Conclusion:Performing Chinese and western medicine pharmaceutical care in clinics is very important for safety and effectiveness of drugs and improvement of drug use level.

Objective:To explore the methods and ideas for developing pharmaceutical care in clinical practice. Methods: The pharmaceutical care performed by clinical pharmacists and the therapeutic scheme assisted by clinical pharmacists for one patient with adult purulent meningitis were analyzed retrospectively. Results and Conclusion:Through selection of anti-infective agents, treatment of adverse drug reactions and assessment of patients’ economic capacity,clinical pharmacists help provide reasonable medication to im-prove therapeutic efficacy, safety and economy.

OBJECTIVE:To investigate the methods and breakthrough point of clinical pharmacist participating in the consulta-tion for Acinetobacter baumannii infection cases,in order to improve the level of clinical rational drug use. METHODS:The con-sultation records of 39 A. baumannii infection cases in neurology department of our hospital during 2013-2014 were analyzed retro-spectively. The patients’general condition,site of infection,bacterial culture and drug sensitivity test were analyzed statistically as well as drug regimen before and after consultation,disease condition,lab indexes and nutritional status. RESULTS:A. baumannii were found in sputum culture of all patients,among which there were 11 cases of multiple resistant bacteria(28.2%),13 cases of pan resistant bacteria (33.3%),8 cases of drug resistant A. baumannii (20.5%) and 7 cases of non-multiple resistant bacteria (17.9%). The most widely used drug was minocycline (average dose of 0.2 g/d),followed by cefoperazone-sulbactam (average dose of 9 g/d),ceftazidime (average dose of 6 g/d), etimicin (average dose of 0.27 g/d),amikacin (average dose of 0.4 g/d). The antibacterial daily doses were higher than before. 3 patients were recommended to use fosfomycin. Before consultation,2 pa-tients didn’t received antibiotics (5.1%),and there were 13 cases of single drug (33.4%),22 cases of two-drug combination (56.4%)and 2 cases of three-drug combination(5.1%). After consultation,none of patients didn’t received antibiotics(0),and there were 7 cases of single drug (17.9%),26 cases of two-drug combination (66.7%) and 6 cases of three-drug combination (15.4%). After the consultation,body temperature,symptom and infection indexes of patients got better. Clinical pharmacists ad-justed nutrition program of 12 patients (30.8%) and expecterant program of 9 patients (23.1%). Compared with before consulta-tion,oubumin level of 11 patients (28.2%) and prealbumin level of 20 patients (51.3%) were all increased. CONCLUSIONS:Clinical pharmacist should formulate reasonable therapeutic regimen and reduce irrational drug use according to infection and physi-cal condition. They should provide anti-infective regimen,at the same time,pay attention to the adjustment of expectorant regimen and nutrition support program.

Objective:To improve the training quality of neurology clinical pharmacist. Methods:The experience during the training of neurology clinical pharmacists in recent ten years was summarized. Results:The students were taught in groups according to their majors and promoted in stages according to the teaching plans. Besides,various teaching methods were carried out timely. After tutored by the methods mentioned above,the students could quickly raise their working ability to play good roles of clinical pharmacist and work independently with more confidence. Conclusion:The training quality of neurology clinical pharmacists has been effectively improved by teaching in groups,promoting in stages and providing various teaching methods timely.