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Objective:To observe the occurrence of medication deviation in elderly patients with chronic diseases, and analyze the related factors leading to its occurrence.Methods:Convenience sampling method was used to select 164 elderly patients with chronic diseases who were discharged from the hospital after treatment from April 2021 to March 2022 as the study subjects.The pharmacists reviewed the patient's discharge medication and counted the occurrence of medication deviation.The patients were divided into the occurrence group and the non-occurrence group, and the relevant data of the two groups and their attending physicians were analyzed and compared. Logistic regression analysis was used to test the influencing factors of medication deviation in elderly patients with chronic diseases. Results:Medication deviation were identified in 110 of the 164 patients, and the incidence of medication deviation was 67.1%.Compared with the non-occurrence group, the number of diseases, discharge prescriptions of patients were more, the differences were statistically significant( Z=2.552, t=3.063, both P<0.05). The age of attending physicians in the occurrence group were younger, and their working years were shorter, professional title was lower compared with those in the non-occurrence group( Z=3.754, 3.713, Z=2.016, P<0.05 for all); Logistic regression analysis showed that the number of diseases and discharge prescriptions were the risk factors for medication deviation in elderly patients with chronic diseases( OR=1.260, 1.227, both P<0.05); older age and longer working years of attending physicians were the protective factors for medication deviation( OR=0.925, 0.930, both P<0.05). Conclusions:The incidence of medication deviation in elderly patients with chronic diseases in our hospital is high.Number of chronic diseases, discharge prescriptions, younger age and relatively shorter working years of attending physicians may lead to medication deviation.
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Objective:To investigate the effect of pharmaceutical care intervention by clinical pharmacists on inhalant use in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:A total of 140 elderly patients with COPD were randomly divided into the control group( n=70, receiving conventional medicine education)and the study group(n=70, receiving the whole pharmaceutical care intervention as add-on to the treatment for control group for 6 months). The knowledge of inhalant medication, inhalant operation score, incorrect operation rate, disease symptom score and pulmonary function were compared between the two groups. Results:Compared with pretreatment, the scores of inhalant knowledge were increased significantly in both groups after treatment.While, the scores in the pharmacology, usage, precautions, and adverse reactions as well as total scores were higher in the study group than in the control group( t=5.905, 7.064, 5.356, 5.211 and 19.600, all P<0.05). The inhalant operation scores were significantly increased with time in both groups( F time=64.259, P<0.05). The increment of inhalant operation score was higher in the study group than in the control group(F time×group=5.237, P<0.05). The overall score of inhalant operation was higher in the study group than in the control group( F group=7.218, P<0.05). The incorrect operation rate was lower in the study group than in the control group(5.7% or 4/70 vs.18.6% or 13/70, χ2=5.423, P=0.020). The scores of cough, expectoration and asthma were lower in study group than in the control group( t=11.602, 9.282 and 11.225, respectively, P<0.05). The percentage of the first second force expiratory volume to the estimated value(FEV1%)and FEV 1/forced vital capacity(FVC) were higher in the study group than in the control group( t=4.049 and 3.148, all P<0.05). Conclusions:Pharmaceutical care intervention improves patients' awareness of COPD, increases the accuracy and compliance of inhalant use, thus alleviates the clinical symptoms and improves lung function.
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To analyze the differential expression of RAW264.7 macrophage-derived exosomes miRNA stimulated by free silicon dioxide (SiO2). Methods: RAW264.7 was stimulated with SiO2 (200 mg/L) for 48 h (exo_48 h group), and the supernatant was collected. The exosomes in the supernatant were extracted by ultracentrifugation. Transmission microscopy, nanoparticle tracking analysis (NTA) and Western blotting were used to identify exosomes. High-throughput sequencing was performed to compare the differential expression of exosome miRNAs between the exo_control group (RAW264.7 cultured for 48 h without SiO2) and the exo_48 h group; miRanda, TargetScan and starBase were used to predict target genes of differential miRNAs. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were performed on target genes to further analyze the biological functions of genes. Results: The transmission microscopy showed that the exosomes were lipid membrane coated vesicles, which were heterogeneously distributed, with a diameter ranging from 30 to 100 nm, and the shape was round or elliptical. The volume kurtosis was concentrated between 40 and 100 nm and the exosome marker protein TSG101 was positive. High-throughput sequencing screened 148 differentially expressed exosomal miRNAs. MiR-219c-3p, let-7d-3p, let-7a-1-3p, miR-328-3p, miR-365-3p, and miR-7219-3p were significantly up-regulated, and miR-378d and miR-5106 were significantly down-regulated compared with the control group. Target genes were mainly enriched in mTOR signaling pathway, Wnt signaling pathway, TGF-β signaling pathway, and so on. Conclusion: The exosomes secreted by SiO2-induced macrophages contain abundant miRNAs, and their expressions are significantly different. These differential miRNAs may be involved in the activation of lung fibroblasts and epithelial-mesenchymal transition.
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Animals , Mice , Cell Line , Exosomes , High-Throughput Nucleotide Sequencing , Macrophages , MicroRNAs , Silicon DioxideABSTRACT
Objective To evaluate the role of procalcitonin (PCT)in the early diagnosis for hand,foot and mouth disease (HFMD)with bacterial infection.Methods Clinical data of 234 HFMD children who were hospitalized be-tween January and July 2012 were analyzed retrospectively,according to discharge diagnosis,data were divided into simple viral infection group (n=178)and viral associated with bacterial infection group (n=56),and data of 20 healthy children were selected as the control group.Serum PCT,C-reactive protein (CRP)and peripheral white blood cell (WBC)count were compared.Results There was significant difference in the level of PCT,CRP and WBC among three groups (F=381.94,24.18,and 26.46,respectively,all P<0.05).The positive rate of PCT,CRP and WBC among three groups was significantly different(χ2=178.25,38.98,and 71.21,all P<0.05),PCT,CRP and WBC in bacterial infection group(92.86%[52/56],85.71%[48/56],and 87.50%[49/56]respectively)were significantly higher than those of simple viral infection group (3.93%[7/178],62.36%[111/178],and 30.90%[55/178]respectively)and healthy control group (5.00%[1/20],10.00%[2/20],and 5.00%[1/20]respectively).The sensitivity rate of PCT,CRP and WBC was 92.86%,85.71%,and 87.50% respectively,specificity rate was 95.00%,90.00%,and 95.00% respectively.Conclusion The level of PCT has important value for the early diagno-sis of HFMD with bacterial infection,and its accuracy rate and sensitivity are better than CRP and WBC levels.