Analysis of the current performance of pharmacy outpatient services at grassroots medical institutions at home and abroad / 中华医院管理杂志

Pharmacy services in grassroots medical institutions provide professional pharmacy services for patients. This service not only expanded the scope of primary care delivery, but also meets the residents′need for appropriate medication. At present, the majority of grassroots medical institutions in China provide outpatient pharmacy services by means of pharmacy service alliance, and foreign grassroots medical institutions mainly provide pharmaceutical outpatient services with drug treatment management as the core for patients by granting pharmacists partial prescription rights.In recent years, pharmaceutical outpatient services in grassroots medical institutions had achieved good results in improving patient clinical outcomes, enhancing medication rationality, and enhancing patient compliance. However, there were many unresolved issues, including low public awareness, shortage of pharmaceutical talents, and imperfect guarantee systems. The author suggestted that efforts should be made to increase the publicity of pharmaceutical outpatient services, improve the training mechanism for pharmacists, strengthen cooperation between pharmacists and clinical physicians, include pharmacists in the contracted service team of family doctors, and improve various guarantee systems, in order to provide reference for promoting the sustainable development of pharmaceutical outpatient services in grassroots medical institutions in China.

Progress of Research on Gut Mycobiome and Chronic Liver Diseases / 胃肠病学

Gut mycobiome plays an important role in host’s health, and many chronic liver diseases are accompanied by gut fungi disorder. Gut mycobiome is involved in the development of liver diseases through direct colonization or indirectly through its metabolites and various regulatory factors. Regulation of intestinal fungi may provide a new strategy for the treatment of chronic liver disease. This article reviewed research methods for gut fungi and compositional changes in fungi associated with chronic liver diseases, explored the impact of gut mycobiome on liver disease pathogenesis, assessed its potential utility as therapeutic target,and objected to provide a reference for further research on liver diseases and gut mycobiome. Future researches should further explore the characteristics of intestinal fungi and their metabolites in various liver diseases so as to provide new methods for the prevention, diagnosis, and treatment of liver diseases.

The roles and challenges of primary care practitioners in prevention and control of the outbreak of coronavirus disease 2019 / 中华全科医师杂志

Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has rapidly swept across the country, posing great challenges to the public health in China. In the epidemic prevention and control, primary care practitioners play a very important role in patient triage, home-based visit, follow-up as well as screening at the checkpoints. However, due to the lack of necessary protective equipment and heavy workload, primary care practitioners are facing great challenges in containing the epidemic outbreak. Based on the relevant guidelines and practice in primary care, this article summarizes the challenges primary care practitioners encountered and coping strategies for containing the epidemic outbreak in primary care settings to provide reference for improvement of their working quality.

The roles and challenges of primary care practitioners in prevention and control of the outbreak of coronavirus disease 2019 / 中华全科医师杂志

Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has rapidly swept across the country, posing great challenges to the public health in China. In the epidemic prevention and control, primary care practitioners play a very important role in patient triage, home-based visit, follow-up as well as screening at the checkpoints. However, due to the lack of necessary protective equipment and heavy workload, primary care practitioners are facing great challenges in containing the epidemic outbreak. Based on the relevant guidelines and practice in primary care, this article summarizes the challenges primary care practitioners encountered and coping strategies for containing the epidemic outbreak in primary care settings to provide reference for improvement of their working quality.

Analysis of the difference of serum immunoglobulins, β2-microglobulin and transferrin in pre-eclampsia and pregnancies complicated with chronic kidney disease / 中华妇产科杂志

Objective To observe and analyze the difference of serum immunoglobulin IgA, IgG, IgM, β2-microglobulin and transferrin in pre-eclampsia (PE) and pregnancies complicated with chronic kidney disease.Methods Totally 46(40.0%)pregnancies with PE(PE group),36(31.3%)pregnancies with chronic kidney disease(chronic kidney disease group)and 33(28.7%)normal pregnancies with normal blood pressure and proteinuria without any complication(control group)delivered in Renji Hospital were recruicted in this study from February 2017 to July 2017.Serum IgA,IgG,IgM,β2-microglobulin and transferrin levels were detected. Correlation tests were conducted between these indicators and blood pressure, 24 hours proteinuria value and delivery weeks. Results (1) Comparison of general situation of pregnancies in the 3 groups:there were no significant difference in the age and child bearing history between the 3 groups(all P>0.05),while there was a significant difference in the blood pressure and deliver week(all P<0.01).There was no significant difference in 24 hours proteinuria values between PE group and chronic kidney disease group (Z=-0.187, P=0.852). (2) Comparison of serum immunoglobulin, β2-microglobulin and transferrin levels in pregnant women with three groups: serum IgA level in chronic kidney disease group was significantly higher than those in PE and control groups[(2.4±0.9)vs(1.8±0.9)vs(1.6±0.6)g/L;F=9.959,P<0.01].The serum IgG and IgM values had no significant difference between the 3 groups(all P>0.05).Serum β2-microglobulin in chronic kidney disease group was significantly higher than those in PE and control groups[(4.0±2.6)vs(2.7±0.7)vs(2.0±0.5)mg/L;F=15.892,P<0.01].Serum transferrin in chronic kidney disease group was significantly lower than those in PE and control groups[(3.0±0.8)vs(3.7±1.1)vs(3.6±0.6) g/L; F=6.284, P<0.01]. (3) The correlation between serum immunoglobulin, β2-microglobulin, transferrin and blood pressure, proteinuria value and delivery weeks in PE group: the blood pressure level was not correlated with serum IgA,β2-microglobulin and transferrin values in PE group(all P>0.05).So,24 hours proteinuria value was positively correlated with β2-microglobulin (r=0.557, P<0.01), which was negatively correlated with transferrin (r=-0.442, P<0.01) and was not correlated with IgA(r=0.089, P=0.556). There was a negative correlation between delivery weeks and β2-microglobulin(r=-0.328,P=0.026),and positive correlation with transferrin (r=0.315, P=0.035) and no correlation with IgA (r=-0.169, P=0.260). (4) The correlation between serum immunoglobulin, β2-microglobulin, transferrin and blood pressure, proteinuria value and delivery weeks in chronic kidney disease group:the blood pressure level was positively correlated with β2-microglobulin(systolic pressure: r=0.598,P<0.01;diastolic pressure:r=0.557,P<0.01),which was not correlated with IgA and transferrin in chronic kidney disease group (all P>0.05). So,24 hours proteinuria value was positively correlated with β2-microglobulin and IgA(r=0.568,r=0.330,both P<0.05), and not correlated with transferrin (r=0.255, P=0.133). Delivery weeks had a negative correlation with β2-microglobulin(r=-0.574,P<0.01),while it had a positive correlation with transferrin(r=0.369,P=0.027). No correlation was found between delivery weeks and IgA values (r=-0.257, P=0.131). Conclusion The serum levels of IgA,β2-microglobulin and transferrin in PE and pregnancies with chronic kidney disease are significantly different,which may provide clinical value for the diagnosis of PE and pregnancies with chronic kidney disease in future.

In situ secondary spleen pedicle amputation in laparoscopic splenectomy vs open splenectomy for traumatic spleen rupture / 中华普通外科杂志

Objective To compare clinical efficacy between the situ secondary spleen pedicle amputation in laparoscopic splenectomy and open splenectomy for traumatic spleen rupture.Methods From January 2013 to June 2015 a total of 70 patients with splenic rupture undergoing splenectomy were devided into laparoscopic surgery (35 cases) and open surgery (35 cases) group.Clinical data included total intraoperative blood loss,the time spent on splenic artery ligation,total operation time,postoperative drainage volume,postoperative hemoglobin,platelet and albumin levels,time of anal exsufflation,hospital stay and postoperative complications.Results The average operation time in the OS group was shorter than that in LS group (P ＜ 0.05).However,LS group was better than the OS group in splenic artery ligation time,postoperative drainage volume,anus aerofluxus time,postoperative platelet count,postoperative albumin recovery,hospital stay and postoperative complications (all P ＜ 0.05).Conclusions The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture has the advantages of a rapid recovery and a low postoperative complication.