Investigation on Nutritional Status and Nutritional Intervention of Inpatients with Malignant Tumor in Our Hospital / 中国药房

OBJECTIVE:To provide reference for strengthening the rational nutritional intervention of patients with malignant tumor. METHODS:From Sept. 2016 to Oct. 2017,191 inpatients diagnosed as malignant tumor in our hospital were targeted. Nutritional support pharmacist used Nutritional Risk Screening 2002 (NRS 2002) and Patient-generated Subjective Global Assessment(PG-SGA)to conduct nutritional status assessment within 48 h of admission;at the same time,nutritional intervention for patients during hospitalization was investigated. RESULTS:Among 191 patients,NRS 2002 score ≥3 (with nutritional risk) was classified in 123 cases,and total incidence of nutritional risk was 64.40％. Totally 129 cases were classified into grade B and C(malnutrition)by PG-SGA,and total incidence of malnutrition was 67.54％. There was statistical significance in the incidence of malnutrition among patients aged below 60 years old and patients aged more than 60 years old(P<0.05). NRS 2002 and PG-SGA showed a consistency of Kappa=0.557 (P<0.001), with moderate consistency degree. Of 191 patients, only 46 received nutritional intervention(only 2 cases received total enteral nutrition),and the overall intervention rate was 24.08％. Among them, the intervention rate of patients with nutritional risk was only 34.15％(42/123), and the intervention rate of patients with malnutrition was 31.78％(41/129). CONCLUSIONS:The incidence of nutritional risk and malnutrition among patients with malignant tumors is high, especially in elderly patients. But clinical nutrition interventions are obviously inadequate and the application rate of enteral nutrition support is low. Therefore,nutritional support pharmacists are required to assist and cooperate with physicians,combined two tools as NRS 2002 and PG-SGA that can promptly and effectively screen patients who already have nutritional risk or malnutrition on admission and comprehensively evaluate their nutritional status, so as to give appropriate nutritional intervention.

Regulation of pulmonary surfactant synthesis in fetal rat type II alveolar epithelial cells by microRNA-26a.

Pulmonary surfactant, a unique developmentally regulated, phospholipid-rich lipoprotein, is synthesized by the type II epithelial cells (AECII) of the pulmonary alveolus, where it is stored in organelles termed lamellar bodies. The synthesis of pulmonary surfactant is under multifactorial control and is regulated by a number of hormones and factors, including glucocorticoids, prolactin, insulin, growth factors, estrogens, androgens, thyroid hormones, and catecholamines acting through beta-adrenergic receptors, and cAMP. While there is increasing evidence that microRNAs (miRNAs) are involved in the regulation of almost every cellular and physiological process, the potential role of miRNAs in the regulation of pulmonary surfactant synthesis remains unknown. miRNA-26a (miR-26a) has been predicted to target SMAD1, one of the bone morphogenetic protein (BMP) receptor downstream signaling proteins that plays a key role in differentiation of lung epithelial cells during lung development. In this study, we explored the regulation role of miR-26a in the synthesis of pulmonary surfactant. An adenoviral miR-26a overexpression vector was constructed and introduced into primary cultured fetal AECII. GFP fluorescence was observed to determinate the transfection efficiency and miR-26a levels were measured by RT-PCR. MTT was performed to analyze AECII viability. qRT-PCR and Western blotting were used to determine the mRNA and protein level of SMAD1 and surfactant-associated proteins. The results showed that miR-26a in fetal AECII was overexpressed after the transfection, and that the overexpression of miR-26a inhibited pulmonary surfactant synthesis in AECII. There was no significant change in cell proliferation. Our results further showed that overexpression of miR-26a reduced the SMAD1 expression both in mRNA and protein level in fetal AECII. These findings indicate that miR-26a regulates surfactant synthesis in fetal AECII through SMAD1.

Analysis of the applications of antibacterial agents to outpatients in primary hospitals in Hefei City of Anhui Province / 中国基层医药

Objective To investigate the applications of antibacterial agents to outpatients in primary hos -pitals in Hefei City of Anhui Province,and to provide reference for rational use of antibacterial agents.Methods In 2011, fourty-five primary hospitals in Hefei City were selected randomly ,including urban community health service centers (Group A) and township hospitals(Group B),and thirty or fourty outpatient prescriptions were analyzed monthly . Results In Group A, the percentage and intensity of antimicrobial usage , the proportion of the combination and injectable formulation were ( 45.36 ±20.02 )%, ( 89.73 ±25.50 ) DDDs · ( 100 cases ) -1 · d-1 , 13.34%, 23.16%,respectively,and the data in Group B were (61.36 ±17.18)%,(108.46 ±32.27)DDDs· (100 cases) -1 · d-1,29.13%,46.39%,respectively,which the former were significantly lower than the latter.Conclusion In primary hospitals,the applications of antibacterial agents to outpatiants are not rataional ,including high percentages of usage and unreasonable selection of species ,and more supervision and training need to be given to the medical staff , especially in township hospitals .

Advances on clinical application of non-absorbable antibiotic rifaximin / 中华临床感染病杂志

Rifaximin as a representative of the non-absorbable antibiotics,has special effects and wide application prospects in treatments of acute intestinal tract infections,irritable bowel syndrome,inflammatory bowel disease,diverticulosis of colon,hepatic encephalopathy and so on.This paper reviews the advances on clinical efficacy and safety of rifaximin to provide reference for clinical use.

Survey of awareness on essential drugs policy in community / 中国基层医药

Objective To evaluate the understanding and supporting degree of staff and patients in Hefei's primary medical institutions on the essential drugs policy.Methods The staff and outpatients were taken from 45 primary medical institutions in Hefei, and “ medical staff questionnaire” and “ patient questionnaire” were finished.Results Total understanding rates of medical staff and patients were 89.4％ and 59. 1％ ,respectively, total supporting rate was 90. 8％ and 93.9％, respectively. The supporting rate is affected by age, educational level, residence and other factors. Conclusion In order to meet the public demand for health and medicine, the essential drugs policy should be publicized and the elderly,urban and rural patients and the medical staff should be paid more affention.