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OBJECTIVE：To evaluate the current situation and implementation effect of the pilot project of electronic prescription and remote pharmaceutical care in social pharmacy from the perspective of consumers ，and to provide reference for improving and optimizating the electronic prescription and remote pharmaceutical care in social pharmacy. METHODS ：Totally 264 consumers in 6 counties and 36 drugstores of Chengdu were randomly selected for the questionnaire survey. Descriptive statistics were conducted by using SPSS 23.0 software. Compare the distribution and differences of various. The influential factors in consumer satisfaction based on χ2 test and ordinal multiple Logistic regression analysis. Consumers were randomly selected for semi-structured interviews. Text analysis was conducted by Nvivo 12.0 software to refine the problem of this service . RESULTS ：A total of 271 questionnaires were distributed to consumers in various districts of Chengdu ，and 264 valid questionnaires were collected，with an effective recovery rate of 97.4％. Among 264 respondents，178（67.9％）knew about electronic prescription and remote pharmaceutical care ；197（74.6％）received electronic prescription and remote pharmaceutical care service in pharmacies ； 202（76.5％）said they needed this service ，and 63（23.9％）expressed that they would like to pay for it. Of the 197 respondents who had received the service ，163（82.2％）were satisfied or very satisfied with the service ，and only one （0.5％）was dissatisfied with the service. Waiting time ，satisfaction of drug demand ，staff attitude ，service platform configuration ，the qualifications of tele-practice pharmacists and service quality were the main influential factors of satisfaction ；while the service also suffered from difficulties in electronic prescription circulation ，inadequate service monitoring measures ，insufficient certification of physicians and pharmacists，cultural lag ，and irregular service processes. CONCLUSIONS ：Electronic prescription and remote pharmaceutical care service in social pharmacy is inadequate in terms of technical level ，institutional design and social acceptance. It is recommended that relevant departments implement incentive policies ，optimize technology ；follow up supporting policies in time ，strengthen supervision；and increase social publicity and supervision ，so as to promote the continuous improvement and long-term development of electronic prescription and remote pharmaceutical care in social pharmacy.
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Objective Using olfactory task functional magnetic resonance imaging (fMRI) to investigate the difference in brain olfactory activation between patients with subjective cognitive decline and normal elderly subjects, and to explore the objective image markers for early identification and evaluation the progression from SCD to Alzheimer′s disease (AD). Methods Twenty patients with SCD (SCD group) and twenty matched normal elderly subjects (NC group) were recruited from the community from March 2017 to December 2018. A full neuropsychological scale tests battery, olfactory behavioral tests and olfactory task?fMRI were performed. The differences between olfactory behavior, neuropsychological scales, and task?fMRI brain activation between the two groups were tested. Further, brain regions, which had significantly different activations under task?fMRI, were used as seeds for resting state functional connectivity (FC) analysis. Finally, the correlations between brain activation and olfactory behavior along with clinical neuropsychological scale tests were examined. Results The results of this study showed SCD had a significant decrease in olfactory behavior (olfactory recognition ability) compared with NC (t=-3.042, P<0.01), and there was no statistically significant difference in olfactory threshold. Significant declines were also observed in the SCD self?rating scale (t=6.973, P<0.01), the immediate (t=-4.623, P<0.01) and delayed (t=-2.746, P<0.01) testing of Philadelphia word learning, while the remaining neuropsychological scales were normal. In the olfactory task?fMRI, activation of bilateral primary olfactory cortical regions was significantly reduced in SCD patients, including bilateral entorhinal cortex, amygdala, piriform cortex, anterior olfactory nucleus, and head of the hippocampus. The resting state functional connectivity with the primary olfactory cortex (POC) as the seed showed that the functional connectivity between the olfactory system and the default model network (DMN) of SCD patients was significantly weakened (AlphaSim correction with voxel level P<0.01 and cluster level P<0.05). The Beta value of the left POC was significantly positively correlated with the olfactory threshold and Montreal cognitive assessment (MoCA) (r=0.329, P=0.041; r=0.317, P=0.046). Partial correlation analysis indicated that there was a significantly positive correlation between the FC of the left POC with the right/left inferior frontal gyrus, the left frontal middle gyrus and the right inferior parietal, and the score of immediate Philadelphia word learning test(r=0.411, P=0.008; r=0.400, P=0.011; r=0.329, P=0.003; r=0.454, P=0.003). The FC between the left POC and the right inferior temporal gyrus was negatively correlated with the score of trail making test (TMT) B, and the FC between the left POC and the right inferior was negatively correlated with score of language fluency test (r=-0.317, P=0.047; r=-0.333, P=0.036). The FC between the right POC and the left inferior parietal was positively correlated with the score of immediate Philadelphia word learning (r=0.315, P=0.048), while the FC between right POC and left middle occipital gyrus was negatively corrected with Language Fluency Test (r=-0.403, P=0.01). Conclusion Olfactory function has been impaired in SCD patients with normal standard cognition and phychiatric rating scales, and the changes in the activation of the primary olfactory cortex, such as the entorhinal cortex, may be an early neural circuit damage biomarker for objective evaluation of SCD.
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Objective To observe the clinical efficacy of acupuncture-moxibustion plus tuina in treating neurosensory tinnitus and hearing loss.Method Eighty-six patients with neurosensory tinnitus and hearing loss were randomized into a treatment group of 56 cases and a control group of 30 cases. The treatment group was intervened by warm needling plus tuina, while the control group was treated with conventional medications. The clinical efficacies were compared between the two groups.Result The total effective rate was 87.5% in the treatment group versus 63.3% in the control group, and the between-group difference was statistically significant (P5 years (P<0.01). In the treatment group, the total effective rate was 93.8% in those due to liver fire, 94.1% in those due to phlegm heat stagnation, 83.3% in those due to spleen-stomach deficiency, and 72.7% in those due to kidney essence insufficiency. The total effective rates of the liver fire and phlegm heat stagnation types were significantly different from the rate of the kidney essence insufficiency type (P<0.05).Conclusion Acupuncture-moxibustion plus tuina is an effective approach in treating tinnitus and hearing loss.
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Objective To document the etiologies of seizures in children admitted to the pediatric observation unit of an inen r city hospital in Chian .Me thods A ot tal of 975 children ( aged 1 month to 18 years old) admitted to the pediatric observation unit of Guangzhou Women adn Children′s Medical Center between October,2013 and October,2014 with seizures were evaluated restrospectively.Results A total of 975 patients were included in this study.The causes of seizures were febrile seizures ( 588 cases,60.3%) , epilepsy( 163 cases, 16.7%) , and benign inaf ntile convulsions associated with mild gasrt oenteritis ( 111 cases,11.4%) .The main causes of seizures for children less than one year old were febrile seizures ( 75 cases,34.1%) and epilepsy(75 cases,34.1%),following by the intracranial infection(22 cases,10.0%). Febrile seizures also predominated the causes of seizures among children between one and six years old(487 cases, 70.3%),whereas benign infantile convulsions associated with mild gastroenteritis accounting for 14.0%(97 cases) of all causes.Meanwhile, the leading causes of seizures for children of six years or older were febrile seizures(26 cases,41.9%) and epilepsy(20 cases,32.3%).Conclusion Febrile seizures is the leading cause of seizures among children.Contrast to previous studies,the proportions of epilepsy and benign infantile convulsions associated with mild gastroenteritis are increasing,while the proportion of intracranial infection is reducing.Rapid assessment and accurately identifying the etiology play an important role in the management of seizures.
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Objective Through death analysis of critically ill children with interhospital transportation,to explore the cause of death and its influencing factors.Methods We collected the data of death cases within 24 hours who were one-way transported from primary hospital to the emergency department of Guangzhou Women and Children's Medical Center between July 2012 and May 2014.We analyzed the diseases type,physiopathologic status,and the treating measures in the process of transportation.Results There were total 1 122 cases,34 children died,the mortality was 3.0％,7 cases died before admission,27 cases died within 24 hours after admission.The first three types of diseases were respiratory system diseases(8/34,23.5％),nervous system diseases (7/34,20.6％) and accidental injury (6/34,17.6％).The physiopathologic status were analyzed according to physiological status and laboratory data at admission.Most of the children had a variety of physiopathologic status.Electrolyte disturbances were found in 22 cases(81.5 ％),metabolic acidosis and respiratory failure in 19 cases (70.4％).Most cases had intravenous channel (33/34,97 ％),intravenous infusion (32/34,94.1％)and electrocardiogram monitoring (30/34,88.2％),none of the cases received vasoactive agents in transportation.Conclusion Insufficient disease evaluation before the transportation of critically ill children,inadequate monitoring and treating measures on the way are important factors causing the death of children.