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Objective: To investigate the association of blood lead and blood selenium with serum high-sensitivity C-reactive protein (hs-CRP) among Chinese adults aged 19 to 79 years. Methods: The participants were enrolled from the first wave of China National Human Biomonitoring (CNHBM) conducted from 2017 to 2018. 10 153 participants aged 19 to 79 years were included in this study. Fasting blood samples were obtained from participants. Lead and selenium in whole blood and hs-CRP in serum were measured. Individuals with hs-CRP levels above 3.0 mg/L were defined as elevated hs-CRP. Generalized linear mixed models and restricted cubic spline models were used to analyze the association of blood lead and blood selenium with elevated hs-CRP. Logistic regression models were used to analyze the multiplicative scale and additive scale interaction between blood lead and blood selenium on elevated hs-CRP. Results: The age of participants was (48.91±15.38) years, of which 5 054 (61.47%) were male. 1 181 (11.29%) participants were defined as elevated hs-CRP. After multivariable adjustment, results from generalized linear models showed that compared with participants with the lowest quartile of blood lead, the OR (95%CI) of elevated hs-CRP for participants with the second, third, and highest quartiles were 1.14 (0.94-1.37), 1.25 (1.04-1.52) and 1.38 (1.13-1.68), respectively. When compared with participants with the lowest quartile of blood selenium, the OR (95%CI) of elevated hs-CRP for participants with the second, third and highest quartiles were 0.86 (0.72-1.04), 0.91 (0.76-1.11), and 0.75 (0.61-0.92), respectively. Results from the interaction analysis showed no significant interaction between lead and selenium on elevated hs-CRP. Conclusion: Blood concentration of lead was positively associated with elevated serum hs-CRP, and blood concentration of selenium was inversely related to elevated hs-CRP, while blood lead and selenium did not present interaction on elevated hs-CRP.
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Adult , Aged , Asian People , Biomarkers , C-Reactive Protein/analysis , China/epidemiology , Humans , Male , Middle Aged , Risk Factors , Selenium , Young AdultABSTRACT
Acidosis, regardless of hypoxia involvement, is recognized as a chronic and harsh tumor microenvironment (TME) that educates malignant cells to thrive and metastasize. Although overwhelming evidence supports an acidic environment as a driver or ubiquitous hallmark of cancer progression, the unrevealed core mechanisms underlying the direct effect of acidification on tumorigenesis have hindered the discovery of novel therapeutic targets and clinical therapy. Here, chemical-induced and transgenic mouse models for colon, liver and lung cancer were established, respectively. miR-7 and TGF-β2 expressions were examined in clinical tissues (n = 184). RNA-seq, miRNA-seq, proteomics, biosynthesis analyses and functional studies were performed to validate the mechanisms involved in the acidic TME-induced lung cancer metastasis. Our data show that lung cancer is sensitive to the increased acidification of TME, and acidic TME-induced lung cancer metastasis via inhibition of miR-7-5p. TGF-β2 is a direct target of miR-7-5p. The reduced expression of miR-7-5p subsequently increases the expression of TGF-β2 which enhances the metastatic potential of the lung cancer. Indeed, overexpression of miR-7-5p reduces the acidic pH-enhanced lung cancer metastasis. Furthermore, the human lung tumor samples also show a reduced miR-7-5p expression but an elevated level of activated TGF-β2; the expressions of both miR-7-5p and TGF-β2 are correlated with patients' survival. We are the first to identify the role of the miR-7/TGF-β2 axis in acidic pH-enhanced lung cancer metastasis. Our study not only delineates how acidification directly affects tumorigenesis, but also suggests miR-7 is a novel reliable biomarker for acidic TME and a novel therapeutic target for non-small cell lung cancer (NSCLC) treatment. Our study opens an avenue to explore the pH-sensitive subcellular components as novel therapeutic targets for cancer treatment.
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Corona virus disease 2019 （COVID-19） has led to more than 500 million cases， including 6.19 million deaths. Mutated strains of SARS-CoV-2 （alpha， beta， gamma， delta and omicron） have successively emerged. Currently the omicron variant is gradually replacing the delta variant， driving a surge of cases in most countries including China， posing a great challenge to the prevention and treatment of COVID-19. In the face of the severe pandemic situation， a large number of non-medical volunteers are fighting on the front lines of the war against the pandemic and are vulnerable to exposure due to lack of professional knowledge. This paper introduces the routine skills training of volunteers and emergency response， aiming to provide behavioral guidance for non-medical volunteers in designated isolation facilities.
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Objective: To clarify the epidemiological characteristics and spatiotemporal clustering dynamics of COVID-19 in Shanghai in 2022. Methods: The COVID-19 data presented on the official websites of Municipal Health Commissions of Shanghai during March 1, 2022 and May 31, 2022 were collected for a spatial autocorrelation analysis by GeoDa software. A logistic growth model was used to fit the epidemic situation and make a comparison with the actual infection situation. Results: Pudong district had the highest number of symptomatic and asymptomatic infectants, accounting for 29.30% and 35.58% of the total infectants. Differences in cumulative attack rates and infection rates among 16 districts (P<0.001) were significant. The rates were significantly higher in Huangpu district than in other districts. The attack rate of COVID-19 from March 1, 2022 to May 31, 2022 had a global spatial positive correlation (P<0.05). Spatial distribution of COVID-19 attack rate was different at different periods. The global autocorrelation coefficient from March 16 to March 29, April 6 to April 12 and May 18 to May 24 had no statistical significance (P>0.05). Our local autocorrelation analysis showed that 22 high-high clustering areas were detected in eight periods.The high-risk hot-spot areas have experienced a "less-more-less" change process. The growth model fitting results were consistent with the actual infection situation. Conclusion: There was a clear spatiotemporal correlation in the distribution of COVID-19 in Shanghai. The comprehensive prevention and control measures of COVID-19 epidemic in Shanghai have effectively prohibited the growth of the epidemic, not only curbing the spatially spread of high-risk epidemic areas, but also reducing the risk of transmission to other cities.
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Humans , COVID-19/epidemiology , China/epidemiology , Disease Outbreaks , Epidemics , Spatial AnalysisABSTRACT
ObjectiveTo explore whether Hei Xiaoyaosan can inhibit the inflammatory response in the hippocampi of Alzheimer's disease （AD） rats by regulating and activating the Wnt/β-catenin signaling pathway to improve the cognitive and memory dysfunction. MethodAmong the 90 male Wistar rats， 12 were randomly selected as the blank group （normal saline） and 12 as the sham operation group （normal saline）. For the remainder， amyloid β-protein42 （Aβ42） was injected in the left and right hippocampus to induce AD， and then the AD rats were randomized into model group， low-， medium-， and high-dose Hei Xiaoyaosan groups （corresponding doses of Hei Xiaoyaosan， ig）， and donepezil group （donepezil hydrochloride，ig）， with 12 in each group. The administration lasted 42 days. The pathological changes of hippocampal CA1 region was observed based on Nissl staining. The escape latency on the 1st to 5th day in Morris water maze was recorded and the spatial memory on the 6th day was tested. Enzyme-linked immunosorbent assay （ELISA） was employed to detect the expression of interleukin （IL）-6， IL-10， and tumor necrosis factor-α （TNF-α） in rat hippocampus and serum， Western blotting to examine the protein expression of glycogen synthase kinase-3β （GSK-3β）， β-catenin， and peroxisome proliferator-activated receptor gamma （PPARγ）， and real-time polymerase chain reaction （Real-time PCR） to determine the mRNA expression of rat GSK-3β， β-catenin， and PPARγ. ResultCompared with the blank group， the number of neurons in the hippocampal CA1 area of model group was significantly reduced， the arrangement was uneven， the cell body was damaged more obviously， and the Neisser body was unclear. The treatment group was significantly prolonged （P<0.01）， and the number of crossing stations was significantly reduced （P<0.01）， the levels of IL-10 in serum and hippocampus of rats in the model group were significantly decreased， while the levels of IL-6 and TNF-α were significantly increased （P<0.01）， the GSK-3β protein and mRNA in the model group were significantly increased， and the protein expressions of β-catenin and PPARγ were significantly decreased （P<0.01）， and the difference was more obvious. The number of neurons in the donepezil group was more distributed， neatly arranged， the structure was intact， and the Nissl bodies were clear and definite， the escape latency on the 3rd to 5th days in middle and high dose groups of Hei Xiaoyaosan and the donepezil group was significantly shortened （P<0.01）， the number of crossing platforms increased significantly （P<0.01）， the expression levels of IL-10 in the rat hippocampus and serum were significantly increased， while IL-6 and TNF-α were significantly decreased （P<0.01）， GSK-3β in the rat hippocampus was significantly increased. The expressions of GSK-3β protein and mRNA were significantly decreased， while the expression levels of β-catenin and PPARγ protein and mRNA were significantly increased （P<0.01）. There was no significant difference in each index between the donepezil hydrochloride group and the high-dose Hei Xiaoyaosan group. ConclusionHei Xiaoyaosan can inhibit the inflammatory response in the hippocampus of AD rats by regulating the Wnt/β-catenin signaling pathway， thereby alleviating the cognitive and memory impairment of AD rats.
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OBJECTIVE@#To investigate the significance of peripheral blood lymphocyte to monocyte ratio (LMR) and corrected levels of serum calcium (cCa) as prognostic markers for the newly diagnosed multiple myeloma (MM) patients.@*METHODS@#The clinical data of 114 newly diagnosed MM patients in the Second Affiliated Hospital of Kunming Medical University from January 2013 to March 2020 were retrospectively analyzed. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value, and the patients were divided into high LMR group and low LMR group (LMR≥3.35 and LMR < 3.35). Moreover, the patients were divided into four groups according to initial diagnosis LMR and LMR after four courses of treatment (LMR4): Group A (LMR≥3.35, LMR4≥3.35), Group B (LMR≥3.35, LMR4 < 3.35), Group C (LMR < 3.35, LMR4≥3.35), and group D (LMR < 3.35, LMR4 < 3.35). The simple prognosis model was established by combined with LMR and cCa, the patients were divided into Group a (no risk factor), group b (1 risk factor) and Group c (2 risk factors). Independent sample T-test, Pearson Chi-square test or Mann-Whitney U test were used to evaluate the differences between various parameters, and Kaplan-Meier method and Cox regression were used for survival analysis.@*RESULTS@#The median follow-up time was 13.05（0.1-72.5）months. Survival analysis showed that the patients with low LMR predicted poor prognosis, the overall survival (OS) time of the patients with low LMR was significantly shorter (17 vs 50.5 months, P=0.006) than the patients with high LMR, the difference was also significant between group A and Group D (56.5 vs 30.5 months, P=0.043). The OS of the patients was also significantly shorter in the high cCa group (≥2.75 mmol/L) compared with normal group (8.5 vs 34 months, P=0.006). Multivariate survival analysis showed that LMR < 3.35 (P=0.028) and cCa≥2.75 mmol/L (P=0.036) were the independent risk factors affecting prognosis of MM patients. The comparison of risk factors showed that the median OS of Group a, b and c was 50, 20, and 8.5 months, respectively. The prognosis of the patients without risk factors was better than that of patients with 1-2 risk factors (Group a vs Group b, P < 0.0001; Group a vs Group c, P=0.002).@*CONCLUSION@#LMR and cCa are the independent risk factors affecting the prognosis of newly diagnosed MM patients, and the development of a simple prognosis system combining them can quickly identify the prognosis of newly diagnosed MM patients.
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Calcium , Humans , Lymphocytes , Monocytes , Multiple Myeloma , Prognosis , Retrospective StudiesABSTRACT
At present, there have been many clinical trials and systematic reviews/Meta-analysis proving the good clinical efficacy of Shufeng Jiedu Capsules in the treatment of respiratory diseases, while comprehensive discussion is still required. This article overviews and analyzes the systematic reviews/Meta-analysis of Shufeng Jiedu Capsules to provide evidence support for clinical practice. The systematic reviews/Meta-analysis of Shufeng Jiedu Capsules were searched from CBM, Wanfang, CNKI, VIP, PubMed, EMbase and Cochrane Library. The AMSTAR 2 scale and GRADE system were respectively employed for the evaluation of methodological quality and the grading of evidence quality. Finally, 8 systematic reviews/Meta-analysis published during 2018-2021 were included for analysis. The diseases involved include acute exacerbation of chronic obstructive pulmonary disease, community-acquired pneumonia, acute tonsillitis, acute exacerbation of chronic bronchitis and acute upper respiratory tract infection. The number of included RCTs studies ranged from 8 to 25. The results showed that Shufeng Jiedu Capsules combined with western medicine routine had better therapeutic effect than the latter alone in the treatment of the above five diseases. The reported adverse reactions caused by Shufeng Jiedu Capsules were mainly gastrointestinal discomforts such as mild nausea, diarrhoea and vomiting, with low incidence and mild symptoms, which can be relieved by drug withdrawal. The methodological quality of the included studies was extremely low, and the outcome indicators were mainly of low and very low grades. The efficacy and safety of Shufeng Jiedu Capsules in the clinical treatment of diseases still need to be verified based on more high-quality studies. The relevant clinical research and systematic review/Meta-analysis should pay more attention to methodological quality and reporting standards and strengthen the scientificity of research.
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Capsules , Drugs, Chinese Herbal/therapeutic use , Systematic Reviews as Topic , Treatment OutcomeABSTRACT
OBJECTIVE To review economic studies of diabetes drugs in Chinese population systematically ，and to provide reference for promoting the development of pharmacoeconomics research in the field of diabetes and improving the research quality. METHODS Retrieving from PubMed ，Embase，SinoMed，CNKI，Wanfang data ，VIP and other databases ，the literatures on economic evaluation of diabetes drugs in Chinese population were collected ；analysis was carried out on the publication ，research content，study design of the literatures. The Consolidated Health Economic Evaluation Reporting Standards 2013（CHEERS 2013） checklist was used for quality evaluation. RESULTS A total of 380 literatures were included ，involving 348 Chinese literatures and 32 English literatures. The first paper of diabetes drugs in Chinese population was published in 2001. The most evaluated drug was metformin. Most of the studies （79.2％）were conducted by medical institutions ，73.9％ of the studies were short-term economic evaluation，and the methods were mainly cost-effectiveness analysis （61.8％），and most of the studies did not reported clear research perspectives （82.6％）. Evaluated by CHEERS 2013，the average score of included literatures was only 10.57，and 85.8％ of the literatures was of unqualified quality. The average score of Chinese literatures was 10.05，that of English literatures was 16.23，and the reporting quality of English literatures was significantly better than that of Chinese literature s（P＜0.001）. CONCLUSIONS The existing literatures on the economic evaluation of diabetes drugs in Chinese population is of low quality. There are problems such as lack of research perspectives ，single research institution/method ，and non-standard reporting. It is recommended that medical institutions ，universities/research institutions ，enterprises，government and other institutions should strengthen cooperation ，improve their research level ，pay attention to more and newer clinically effective treatment regimens ，and promote the transformation of research results into decision-making evidence.
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Objective:To analyze the compatibility rules of prescriptions containing Forsythiae Fructus based on data mining and explore the anti-inflammatory mechanism of Forsythiae Fructus based on network pharmacology，so as to provide reference for the rational clinical application of Forsythiae Fructus and the development of health foods and new Chinese medicines. Method:The prescriptions containing Forsythiae Fructus in the<italic> Dictionary of Traditional Chinese Medicine Prescriptions</italic> were collected，based on which a clinical prescription database was constructed. The Chinese herbs combined with Forsythiae Fructus and the corresponding indications were subjected to frequency statistics，association rule analysis，and complex network analysis using SPSS Statistics 26，IBM SPSS Modeler 18.0，and Gephi 9.2. The active components and targets of Forsythiae Fructus for anti-inflammation were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP），BATMAN-TCM，and SEA，and the targets related to anti-inflammation from GeneCards，Online Mendelian Inheritance in Man （OMIM），CTD，and GenCLiP3. Following the analysis of protein-protein interactions （PPI） with STRING，a PPI network was constructed. The enrichment analysis was performed using Metascape，and the active component-anti-inflammation target-signaling pathway network of Forsythiae Fructus was constructed by Cytoscape 3.8.2. Result:According to the inclusion and exclusion criteria，2 245 prescriptions containing Forsythiae Fructus were harvested，involving 512 Chinese herbs，with a total usage frequency of 27 314. The Chinese herbs that were most frequently combined with Forsythiae Fructus （>800 times） were Glycyrrhizae Radix et Rhizoma （1 483 times），Scutellariae Radix （964 times），and Angelicae Sinensis Radix （842 times）. Hence，the herbal pairs "Forsythiae Fructus-Scutellariae Radix" and "Forsythiae Fructus-Angelicae Sinensis Radix" were further explored. The prescriptions containing Forsythiae Fructus could be utilized for the treatment of 29 kinds of diseases，and three representative disease categories including "carbuncle，gangrene，sores and ulcers"，"ophthalmic diseases and syndromes" and "epidemic diseases" are selected for data mining. There were 19 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Lonicerae Japonicae Flos-Angelicae Sinensis Radix" as the core herb combination for "carbuncle，gangrene，sores and ulcers". The clustering analysis revealed one multi-herb clustering group，four herbal pairs，and single herb Lonicerae Japonicae Flos，the complex network analysis four herbal modules，and the factor analysis six common factors. There were 23 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Scutellariae Radix-Angelicae Sinensis Radix" as the core herb combination for "ophthalmic diseases and syndromes". The clustering analysis revealed two multi-herb clustering groups and four herbal pairs，the complex network analysis four herbal modules，and the factor analysis five common factors. There were 28 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Menthae Haplocalycis Herba-Lonicerae Japonicae Flos" as the core herb combination for "epidemic diseases". The clustering analysis revealed three multi-herb clustering groups，one herbal pair，and two single herbs Forsythiae Fructus and Glycyrrhizae Radix et Rhizoma，the complex network analysis four herbal modules，and the factor analysis five common factors. As demonstrated by network pharmacology-based analysis，the core anti-inflammation components of Forsythiae Fructus were quercetin，luteolin，and kaempferol，and the core targets were phosphoinositide-3-kinase regulatory subunit 1 （PIK3R1），protein kinase B 1 （Akt1），and epidermal growth factor receptor（EGFR）. The biological pathways were mainly concentrated in proteoglycans in cancer，pathways in cancer，and PI3K/Akt signaling pathway，with such functions as inhibition of transcription factors，regulation of enzyme activity，and inflammation-related gene expression involved. Conclusion:This study employed a variety of data mining techniques to objectively，intuitively，and scientifically uncover the compatibility rules of Forsythiae Fructus in the treatment of high-frequency diseases. It has been found that Forsythiae Fructus is often combined with heat-clearing herbs，tonifying herbs，exterior-releasing herbs，and blood-activating and stasis-resolving herbs for diverse diseases and syndromes. Under the premise of clearing heat and removing toxin，reinforcing healthy Qi and dredging stagnation are also emphasized. According to the degree of internal heat exuberance，the heat-clearing herbs with different merits are combined. This study has revealed the unique advantages of Forsythiae Fructus in the treatment of specific diseases and syndromes as well as its multi-component，multi-target，and multi-pathway mechanisms in anti-inflammation，breaking through the limitations in modern clinical and experimental research of Forsythiae Fructus. These findings are of great significance for guiding the rational clinical application of Forsythiae Fructus and the development of health foods and new Chinese medicines，thus better accelerating the development of Chinese medicine health industry.
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Objective:To analyze the clinical studies on sacral nerve stimulation based on PubMed database and summarize its research status and clinical characteristics. Methods:Literatures about sacral nerve stimulation were collected from PubMed database before December 31, 2019. HistCite software was used to analyze the published year, published periodicals, published country and research institutions. Pajek software principal path analysis was used to identify the evolution direction of hot topics. The spectrum of diseases, therapeutic outcomes, stimulation methods and stimulation parameters were summarized. Results:A total of 96 articles were included. The number of publications increased significantly since 2000 and reached its peak in 2014 to 2015. The literatures with most influence were published in 2000 to 2001. All the literatures published in 32 journals, the top two were Urology and Diseases of the Colon & Rectum, which published 17 and 22 articles, respectively. The literatures came from 16 countries, and the top three were the United State (17 articles), the Netherlands (13) and the United Kingdom (13). Among the 211 institutes involved, Aarhus University Hospital (Denmark, twelve articles) and St. Marks Hospital (United Kingdom, nine) were the top two. The study involved 16 diseases, mainly about fecal incontinence, urinary incontinence and urination, shifted from urinary system diseases to digestive system diseases. 91.67% of the study corroborated the benefit of sacral nerve stimulation. Implanted stimulation (77 articles) was the most used, and transdermal stimulation (10 articles) was the second. The parameters were depending on the disease and the mode of stimulation. Conclusion:Sacral nerve stimulation can effectively improve the function of pelvic floor, which may be focused for a long time. Non-implantable sacral nerve stimulation would become the new research topic.
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Objective:To obtain the temporal and spatial trends on prostate cancer mortality in China from 2004 to 2018. Methods:The data of prostate cancer mortality was collected from 605 national disease surveillance sites and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR） and age-standardized mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）， were calculated to analyze the distributions of the mortality of prostate cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The temporal trend on the CMR of prostate cancer from 2004 to 2018 increased significantly （APC=5.23%，P<0.001）， whereas the trend on the ASMR did not change （APC=0.65%，P=0.336）. The ASMR of urban areas was higher than that of rural areas（P<0.05）. The temporal trend on the ASMR of urban or rural did not change（P>0.05）. The same trend was detected for the RR value （P>0.05）. The ASMR of eastern urban areas was higher than that of the central or the western urban areas. The ASMR of eastern rural areas was higher than that of central and western areas. In the eastern areas， both the temporal trends for the ASMRs of the urban and the rural increased （The urban： APC=1.6%， P=0.015； the rural： APC=1.02%， P=0.013）. However， the RR values for the East， the Center or the West did not change. The ASMR of the people over 60 years old was higher than that of the people under 60 years old. However， the temporal trends on the ASMRs of the group under 60 years old or the group over 60 years did not change （P>0.05）. The ASMR of the people under 60 years old in 2018 was significantly lower than that in 2004（P=0.004）. Conclusion:A significant correlation exists between the death of prostate cancer and age. The mortality of prostate cancer in urban is higher than that in rural. The current screening strategy for prostate cancer has a limited impact on the prognosis of prostate cancer patients in China. Stratified refinement of prostate cancer screening strategies for people aged over 60 years in urban areas and the causal prophylaxis of prostate cancer are priorities for future prostate cancer prevention and control.
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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.
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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@#To understand the attitude of college students in Zhejiang towards e cigarette and its influencing factors, so as to provide basis for making prevention and control strategies.@*Methods@#In September 2020, 10 colleges and universities in Zhejiang Province were selected to conduct an online survey by a combination of typical sampling method and convenience sampling method. A multivariable Logistic regression model was used to analyze the influencing factors.@*Results@#Among 884 subjects, 93 (10.52%) were positive about e-cigarettes, 310 (35.07%) thought e-cigarettes were harmless, 252 (28.51%) thought e-cigarettes were not addictive and 67 (7.58%) of respondents were using e-cigarettes. Multivariate Logistic regression analysis showed that gender, grade, cost of living, whether or not smoking e-cigarettes were harmful to college students attitudes towards e-cigarettes( OR =0.59, 0.47, 1.87, 0.34, 0.54, P <0.05).@*Conclusion@#College students in Zhejiang Province have a positive attitude towards electronics and are not active in avoiding the dangers of smoking. To make full use of the work of concentrated trainees in tobacco control, efforts should be made to break the positive image of e-cigarettes. Junior college students should be the prioritized population for intervention, and female students should not be neglected.
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Rickettsia felis is a Gram-negative prokaryotic organism that is obligatorically parasitic in cells. Cat fleas are the main vector of Rickettsia felis. Clinical symptoms of human infection with Rickettsia felis include fever, fatigue, headache, macular papules, and eschar. There are few reports of serious complications or deaths due to infection of Rickettsia felis. A confirmed case of severe encephalitis caused by Rickettsia felis infection was admitted to neurology department of Affiliated Hospital of Jining Medical University on January 29, 2020. After comprehensive treatment of antiviral by acyclovir, mannitol dehydration to reduce intracranial pressure, human immunoglobulin to regulateimmunity, minocycline hydrochloride capsule, levofloxacin mesylate and sodium chloride against Rickettsia felis infection, control of seizure and pulmonary infection, the patient's condition was improved and then discharged. By summarizing the experience and lessons in the treatment of this patient, we hope to remind everyone to strengthen the understanding of Rickettsia felis infection.
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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.
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To develop the environment scale of unintentional injury in the home for children aged 0-6 years living in urban area of China, and test its validity and reliability. The content of the environment scale was established through the literature review, expert consultation and pilot study. A total of 1 104 children aged 0-6 years in urban area of Changsha were enrolled in this study by using a multi-stage stratified cluster random sampling method. The questionnaire was used to collect the basic information of children, the incidence of unintentional injury and the status of home environment. The reliability of the scale was tested by using Cronbach's α coefficient and split-half reliability coefficient. The content validity and construct validity were tested by using Pearson correlation analysis and factor analysis. All children were divided into two groups according to the incidence of unintentional injury in the home and the discrimination validity of the scale was tested by using -test. The scale had 54 items in 6 dimensions. The number of eligible questionnaires was 1 074, including 554 (51.6%) from boys and 519 (48.3%) from children under 3 years old. The incidence rate of unintentional injury and in-home injury was 18.34% (197 children) and 10.71% (115 children). The internal consistency reliability (Cronbach's α) coefficient for the scale was 0.87 and the split-efficacy reliability coefficient was 0.82, both meeting the standard of reliability above 0.70. The Pearson correlation coefficient between each dimension and the whole scale ranged from 0.53 to 0.84 (all values <0.001). The common factor cumulative variance contribution rate of the scale was 58.34%. There were 54 items with factor loadings greater than 0.30. The root mean square error of approximation, comparative fit index and goodness-of-fit index were 0.07, 0.61 and 0.71, respectively. The score of scale in children with injury was significantly higher than that in children without injury (0.022). The validity and reliability of the environment scale for unintentional injury in the home for children aged 0-6 years old in the urban area of China are good.
ABSTRACT
To evaluate the drug susceptibility of multidrug-resistant bacteria in elderly patients(≥65 years)with bloodstream infection, and to explore the influencing factors on generation of multidrug-resistant bacteria, so as to provide scientific basis for the early and accurate administration of antibiotics.Methods:The clinical data of the elderly patients diagnosed as bloodstream infection in Luhe Hospital from January 2016 to December 2018 was retrospective analyzed.Based on blood culture results, the isolated pathogens were divided into the multidrug-resistance group and the control group.Univariate analysis was performed by χ2 test, and the variables with statistical significance were included in the multivariate Logistic regression analysis to evaluate the influencing factors of multidrug-resistance bacteria’ infection. Results:Among 389 elderly patients with bloodstream infection, 221(56.81%)had multidrug-resistant bacteria infection.The top three bacteria detected were coagulase-negative staphylococcus(77.42%, 48/62), escherichia coli(56.80%, 71/125)and acinetobacter baumannii(55.88%, 19/34). Patients who had nosocomial acquired infections( OR=2.000, 95% CI: 1.160-3.447), used penicillins( OR=3.911, 95% CI: 1.835-8.336), used cephalosporins and quinolones within 3 months( OR=3.867, 95% CI: 1.956-7.646; OR=2.257, 95% CI: 1.087-4.688, respectively), or application of more than two antibiotics( OR=14.711, 95% CI: 1.861-116.258)had a significantly increased risk of multidrug-resistant infections. Conclusions:Taking effective preventive measures against nosocomial infections, rational use of penicillins, cephalosporins and quinolones, and careful combination use of antibiotics might be effective measures to reduce bloodstream infections caused by multidrug-resistant bacteria in the elderly.
ABSTRACT
Objective@#To develop the environment scale of unintentional injury in the home for children aged 0-6 years living in urban area of China, and test its validity and reliability.@*Methods@#The content of the environment scale was established through the literature review, expert consultation and pilot study. A total of 1 104 children aged 0-6 years in urban area of Changsha were enrolled in this study by using a multi-stage stratified cluster random sampling method. The questionnaire was used to collect the basic information of children, the incidence of unintentional injury and the status of home environment. The reliability of the scale was tested by using Cronbach′s α coefficient and split-half reliability coefficient. The content validity and construct validity were tested by using Pearson correlation analysis and factor analysis. All children were divided into two groups according to the incidence of unintentional injury in the home and the discrimination validity of the scale was tested by using t-test.@*Results@#The scale had 54 items in 6 dimensions. The number of eligible questionnaires was 1 074, including 554 (51.6%) from boys and 519 (48.3%) from children under 3 years old. The incidence rate of unintentional injury and in-home injury was 18.34% (197 children) and 10.71% (115 children). The internal consistency reliability (Cronbach′s α) coefficient for the scale was 0.87 and the split-efficacy reliability coefficient was 0.82, both meeting the standard of reliability above 0.70. The Pearson correlation coefficient between each dimension and the whole scale ranged from 0.53 to 0.84 (all P values <0.001). The common factor cumulative variance contribution rate of the scale was 58.34%. There were 54 items with factor loadings greater than 0.30. The root mean square error of approximation, comparative fit index and goodness-of-fit index were 0.07, 0.61 and 0.71, respectively. The score of scale in children with injury was significantly higher than that in children without injury (P=0.022).@*Conclusion@#The validity and reliability of the environment scale for unintentional injury in the home for children aged 0-6 years old in the urban area of China are good.
ABSTRACT
Objective:To investigate the risk factors related to hydrocephalus following traumatic brain injury in neurosurgical rehabilitation unit. Methods:From January 1st, 2016 to December 31st, 2017, 176 patients with traumatic brain injury admitting to the Department of Neurosurgery of Beijing Bo'ai Hospital were selected. They were divided into hydrocephalus group and non-hydrocephalus group according to the admitting diagnosis, and analyzed the related factors with univariate analysis and Logistic multiple regression. Results:There were 46% patients with hydrocephalus. Traumatic subarachnoid hemorrhage (OR = 4.127, 95%CI 1.742~9.776), course of disease (OR = 3.377, 95%CI 2.281~5.000) and process of operation (OR = 2.265, 95%CI 1.076~4.770) were independent risk factors to hydrocephalus. Conclusion:Hydrocephalus often emerge after traumatic brain injury in the rehabilitation period, especially for those with subarachnoid hemorrhage, course of disease over two months and surgery within 24 hours after injury.