目的 分析绝经前后女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者C肽水平与代谢综合征(metabolic syndrome,MS)的关系。方法 选定本院2019年3月—2021年3月接诊的64例绝经前后T2DM患者作为试验组,以及同期门诊体检的64例健康女性作为参照组,检测并比较两组空腹C肽、餐后2 h C肽、血糖指标、血清炎症指标、血脂指标、血压指标,比较两组MS发生率,Pearson分析空腹C肽、餐后2 h C肽与血糖指标、血清炎症指标、血脂、血压的相关性。结果 试验组空腹C肽、餐后2h C肽、餐后2 h 血糖、空腹血糖、白细胞计数、TNF-α、IL-6、LDL-C、甘油三酯、总胆固醇、收缩压、舒张压均高于参照组,试验组HDL-C低于参照组,P＜0.05。试验组MS发生率(12.50%)高于参照组(1.56%),P＜0.05。空腹C肽、餐后2 h C肽与2 h PG、FPG、WBC、TNF-α、IL-6、LDL-C、TG、TC、SBP、DBP呈正相关性,与HDL-C呈负相关性,P＜0.05。结论 绝经前后T2DM患者普遍存在血脂、血压、血糖代谢紊乱及炎症反应,C肽水平增高会增加MS发生率,应当引起临床重视。

Objective To analyze the relationship between C-peptide and metabolic syndrome (MS) in premenopausal and postmenopausal women with type 2 diabetes mellitus (T2DM). Methods A total of 64 premenopausal and postmenopausal T2DM patients in our hospital from March 2019 to March 2021 were included in the experimental group, and 64 healthy women in the same period were selected as the control subjects. Fasting C-peptide, postprandial 2h C-peptide and blood glucose, serum inflammatory factors, blood lipid and blood pressure were detected and compared between the two groups. The incidence of MS was compared between the two groups. The relationship among fasting C-peptide, postprandial 2h C-peptide and blood glucose, serum inflammation, blood lipid and blood pressure were analyzed by Pearson correlation. Results Fasting C-peptide,postprandial 2h C-peptide, 2hPG, FPG, WBC, TNF-a, IL-6, LDL-C, TG, TC, SBP, DBP of the experimental group were higher than those of the control group. HDL-C of the experimental group was lower than that of the control group, P<0.05. The incidence of MS in the experimental group (12.50%) was higher than that in the control group (1.56%), P< 0.05. Fasting C-peptide and postprandial 2h C-peptide were positively correlated with 2hPG, FPG, WBC, TNF-a, IL-6, LDL-C, TG, TC, SBP and DBP, and negatively correlated with HDL-C (P<0.05). Conclusion The metabolic disorder of blood lipid, blood pressure, blood glucose and inflammatory reaction were common in T2DM patients before and after menopause. The increase of C-peptide level would increase the incidence of MS, which should be paid attention in clinic practice.

目的 分析河源市学龄前儿童发生小细胞低色素性贫血的病因。方法 对我院进行健康体检小细胞低色素性贫血儿童287例进行血常规、血清铁蛋白及地中海贫血基因检测。结果 在所研究的287 例小细胞低色素性贫血儿童病例中,分别检出 α地中海贫血 127例,β地中海贫血 48例,α/β复合地中海贫血2例;铁缺乏 83例 (合并地中海贫血20例, 缺铁性贫血45例),不明原因贫血47例。地中海贫血检出率为61.67%,铁缺乏检出率为21.95% 。结论 地中海贫血是河源市学龄前儿童发生小细胞低色素性贫血最主要的原因,其次是铁缺乏,各年龄段儿童以轻度贫血为主,6月~1岁,1~3岁为铁缺乏高发年龄。α地中海贫血基因型以--^SEA/αα最常见,β地中海贫血以βIVS-II-654/β^N最常见,小细胞低色素症在静止型最常见。

Objective To analyze the causes of microcytic hypochromic anemia in preschool children in Heyuan City. Methods A total of 287 cases with microcytic hypochromic anemia were selected in our hospital. The indexes of hematology, serum ferritin were detected and genetic testing for thalassemia was performed. Results Through genetic analysis, 127 of 287 cases of microcytic hypochromic anemia were confirmed with α-thalassaemia,48 cases with β-thalassaemia,2 cases with compound α/β-thalassaemia and 83 cases with iron deficiency (20 thalassemia cases and 45 iron deficiency anemia cases). Thalassaemia detection rate was 61.67%, iron deficiency detection rate was 21.95%. Conclusion Thalassaemia was the main reason of microcytic hypochromic anemia in preschool children in Heyuan City, followed by iron deficiency. The mild anemia was the main type among all age groups, children aged 0.5-3 had higher iron deficiency rate. The main type of α-thalassaemia was --^SEA/αα, the main type of β-thalassaemia was βIVS-II-654/β^N and the main type of microcytic hypochromic was static type.

目的 研讨不同促排方案在非卵巢多囊样改变高反应人群的疗效。方法 回顾分析2018年1月—2019年12月在我院进行体外受精助孕患者共711周期(含389个胚胎移植周期)。分为三组:A组:采用卵泡期长方案414周期(232个移植周期)。B组:采用黄体期长方案221周期(121个移植周期);C组:采用拮抗剂方案76周期(36个移植周期)。结果 A组的卵泡输出率(follicular output rate,FORT)最高;B组获卵数、2PN数、卵泡卵母细胞转化指数为三组中最高,但临床妊娠率、种植率最低;C组的人绒毛膜促性腺激素日促黄体生成素、每卵雌二醇水平为三组最高,但FORT、≥16 mm优势卵泡数最低。结论 在非卵巢多囊样改变高反应患者中,卵泡期长方案较黄体期长方案更利于改善妊娠结局,拮抗剂方案更经济、安全。

Objective To investigate the efficacy of different progestin-primed ovarian stimulation in non-polycystic ovarian morphology(non-PCOM) patients with high ovarian response. Methods A total of 711 cycles for in-vitro fertilization treatment(including 389 embryos transfer cycles) in our hospital from October 2018 to November 2019 were summarized in this retrospective study. All the patients were divided into three groups. In group A, 414 cycles for follicular phase gonadotropin-releasing hormone(GnRH) agonist long protocol(including 232 embryos transfer cycles)was used. In group B, 221 cycles for luteal phase GnRH agonist long protocol(including 121 embryos transfer cycles)was used. In group C, 76 cycles for GnRH antagonist protocol(including 36 embryos transfer cycles)was used. Results Follicular output rate(FORT) in group A was the highest. The number of oocytes, 2PN embryos and follicle-to-oocyte index in group B were the highest among the three groups,while the clinical pregnancy rate and implantation rate were the lowest. Luteinizing hormone on human chorionic gonadotropin injection day、estradiol level per follicle in group C were the highest,while FORT and the number of ≥16 mm dominant follicles were the lowest. Conclusion In non-PCOM patients with high ovarian response,follicular phase GnRH agonist protocol had better pregnancy outcome compared with luteal phase GnRH agonist protocol, and the GnRH antagonist protocol appeared to be more economical and safe.

目的 了解石岐区户籍居民2019年死因分布和主要死因对预期寿命的影响,为调整疾病控制战略方向提供支撑。方法 对2019年石岐区户籍居民死因数据进行基于国际通用编码ICD-10的分类,通过计算预期寿命、死亡率、去死因预期寿命变化、标准化死亡率、寿命损失率和潜在寿命损失年数对死因数据进行研究与分析。结果 石岐区户籍居民2019年粗死亡率为636.88/10万,每10万男性和女性分别平均死亡706.39人和569.86人,恶性肿瘤、心脏病、脑血管病、呼吸系统疾病和内分泌营养代谢疾病为前五位死亡原因。恶性肿瘤中肺癌、肝癌和结肠直肠肛门癌的死亡率位列前三,心脏病中缺血性心脏病死亡率最高。撇除死因的影响后,增加预期寿命的前三名分别是恶性肿瘤(4.40岁)、心脏病(2.76岁)和脑血管病(1.79岁)。2019年石岐区潜在寿命损失年数为10 001.32人年,减寿率为58.64‰,恶性肿瘤、损伤和脑血管病是潜在寿命损失年数前三位死因,减寿率分别为27.80‰、7.72‰和5.18‰。结论 恶性肿瘤、心脏病和脑血管病是石岐区户籍居民的主要死因,也是造成2019年石岐区户籍居民寿命损失的最主要疾病,并造成沉重的疾病负担,应作为今后的防控重点,政府需采用综合性的防控措施,降低慢性病的危害,保护居民健康。

Objective To analyze the distribution characteristics of death causes and influence of major death causes on life expectancy of Shiqi district in 2019, and provide support to develop strategies for disease prevention and control. Methods The 2019 death causes of residents in Shiqi district were classified by International Classification of Diseases-10 (ICD-10). The life expectancy, mortality rate, cause eliminated life expectancy, standardized mortality rate, potential years of life lost rate (PYLLR), and potential years of life lost (PYLL) were calculated. Results The mortality of residents of Shiqi district in 2019 was 636.88/10⁵. The male mortality and female mortality were 706.39/10⁵and 569.86/10⁵, respectively. The top five causes of death in Shiqi district were malignant tumors, heart diseases, cerebrovascular diseases, respiratory diseases, and endocrine nutrition and metabolic diseases. The malignant tumors with top three death rates were lung cancer, liver cancer, and colorectal and anal cancer. The highest death rate of heart disease was ischemic heart disease. The top three causes shortening life expectancy were malignant tumors(4.40 years), heart diseases(2.76 years), and cerebrovascular diseases (1.79 years). The PYLL was 10 001.32 person-year, the PYLLR was 58.64‰ in Shiqi distric,2019. The top three causes of life loss were malignant tumors, injury and cerebrovascular diseases. The PYLLR of those three death causes were 27.80‰, 7.72‰, and 5.18‰, respectively. Conclusion Malignant tumors, heart disease and cerebrovascular diseases were the main death causes and the major diseases for life lost of residents in Shiqi district, which caused heavy disease burden and should be focused in the future. For protecting the residents from the harm due to chronic non-communicable diseases, comprehensive preventive and controling measures should be taken by government.

目的 通过生物信息学方法,分析阿司匹林抗结直肠癌的作用机制。方法 在DrugBank 5.1.5中查找阿司匹林的直接作用蛋白靶点(direct protein targets,DPTs);构建阿司匹林DPTs的蛋白质-蛋白质相互作用(protein-protein interaction,PPI)网络并分析相关信号通路;从GEO数据库中获取结直肠癌表达谱芯片数据,筛选中心度最高的20个结直肠癌差异表达基因作为Hub基因;将DPTs相互关联基因与结直肠癌Hub基因求交集,确认阿司匹林抗结直肠癌的潜在作用靶点,分析其在TCGA数据库结肠腺癌样本中的表达情况,并进行GO功能富集分析和KEGG信号通路分析。最终通过RT-PCR和WB实验验证阿司匹林抗结直肠癌的潜在靶点。结果 在DrugBank 5.1.5中确定了11个阿司匹林DPTs,KEGG信号通路分析发现其中6个DPTs(EDNRA,IKBKB,NFKB2,NFKBIA,PTGS2,TP53)与癌症的发生发展有关。将DPTs相关联基因与筛选的20个结直肠癌Hub基因求交集,发现5个基因(CDK1,AURKA,CCNB1,MAD2L1,TPX2)可能是阿司匹林抗结直肠癌的潜在作用靶点,其在TCGA数据库结肠腺癌样本中均表达上调,基因功能主要富集于细胞周期调控。RT-PCR和WB实验结果显示阿司匹林可以降低人结肠癌细胞中CDK1,AURKA,CCNB1,MAD2L1,TPX2的mRNA水平和蛋白表达。结论 CDK1,AURKA,CCNB1,MAD2L1,TPX2可能是阿司匹林抗结直肠癌的潜在靶点,其可能通过影响细胞周期调控发挥抗肿瘤作用。

Objective To analyze the mechanism of aspirin against colorectal cancer(CRC)by bioinformatic analysis. Methods DrugBank 5.1.5 was used to identify direct protein targets (DPTs) of aspirin. The protein-protein interaction (PPI) network of DPTs was constructed and involved signaling pathways were analyzed. CRC-associated gene expression datasets were downloaded from GEO database, and the top twenty differentially expressed genes with the highest degree were screened out as Hub genes. Common genes between the genes associated with the DPTs and the Hub genes of CRC were the potential targets of aspirin against CRC. The potential targets in TCGA database colon adenocarcinoma (COAD) samples were examined. GO functional enrichment analysis and KEGG signaling pathway analysis of the potential targets were performed. The potential targets of aspirin against CRC cells were verified by reverse transcription-polymerase chain reaction (RT-PCR) and western blot (WB). Results Eleven DPTs of aspirin were identified in DrugBank 5.1.5. KEGG signaling pathway showed that 6 genes (EDNRA, IKBKB, NFKB2, NFKBIA, PTGS2, TP53) were associated with the occurrence and development of CRC. By intersecting 20 Hub genes of CRC with genes associated with the DPTs of aspirin, it was found that 5 genes (CDK1, AURKA, CCNB1, MAD2L1, TPX2) might be the potential targets of aspirin against CRC. They were all up-regulated in TCGA-COAD samples, and the gene functions were mainly enriched in cell cycle regulation. The results of RT-PCR and WB showed that aspirin could down-regulate the mRNA and protein expression levels of CDK1, AURKA, CCNB1, MAD2L1 and TPX2 in human colon cancer cells respectively. Conclusion CDK1, AURKA, CCNB1, MAD2L1 and TPX2 could be potential targets of aspirin against CRC by affecting the progress of cell cycle regulation.

目的 探究硼替佐米、地塞米松联合环磷酰胺治疗骨髓瘤的疗效及对患者不良反应发生的影响。方法 研究对象为我院2016年1月—2020年12月收治的60例骨髓瘤患者,将其随机分为研究1组(n=20)、研究2组(n=20)与对照组(n=20)。对照组给予硼替佐米联合沙利度胺及地塞米松化疗,研究1组给予硼替佐米联合环磷酰胺及地塞米松化疗,研究2组给予硼替佐米联合来那度胺及地塞米松化疗。对比三组治疗效果、免疫功能变化情况、相关血清因子水平以及骨代谢因子水平变化情况。结果 对照组治疗有效率85.0%比研究1组95.0%、研究2组90.0%低(P＜0.05);三组治疗前的免疫对比无较大差异(P＞0.05),对照组经治疗后的免疫功能比研究组差(P＜0.05);三组治疗前的相关血清因子水平比较无较大差异(P＞0.05),对照组经治疗后的相关血清因子水平比研究1组、研究2组高(P＜0.05);对照组经治疗后的骨代谢因子水平变化比研究1组、研究2组差(P＜0.05)。结论 硼替佐米、地塞米松联合环磷酰胺治疗骨髓瘤效果理想,药物不良反应发生率下降,患者生活质量得到改善,可在临床推广应用。

Objective To investigate the clinical efficacy of bortezomib,dexamethasone combined with cyclophosphamide in the treatment of myeloma and the effect on the occurrence of adverse reactions in patients. Methods The subjects were 60 myeloma patients admitted to our hospital from January 2016 to December 2020, and they were randomly divided into study group 1 (n=20), study group 2 (n=20) and control group (n=20). The control group received bortezomib combined with thalidomide and dexamethasone chemotherapy, the study group 1 received bortezomib combined with cyclophosphamide and dexamethasone chemotherapy, and the study group 2 received bortezomib combined with lenalidomide and dexamethasone chemotherapy. The therapeutic efficacy, the changes of immune function,serum factors and bone metabolism factors were compared among the three groups. Results The effective rate of control group was 85.0%, which was lower than those of study group 1 and study group 2 (P＜0.05). There was no significant difference of immune function among the three groups before treatment (P＞0.05), which of the control group after treatment was worse than that of the study groups (P＜0.05). There were no significant differences in the levels of related serum factors among the three groups before treatment (P＞0.05),which in the control group after treatment was higher than those in the study group 1 and study group 2 (P＜0.05). After treatment, the changes of bone metabolic factors in control group were worse than those in study group 1 and study group 2 (P＜0.05). Conclusion Bortezomib, dexamethasone combined with cyclophosphamide in the treatment of myeloma had ideal effect, and the incidence of adverse drug reaction was reduced, the quality of life of patients was improved, which can be popularized in clinical application.

目的 探讨大黄穴位贴联合直肠指力刺激在脑卒中后便秘患者的应用效果。方法 本研究选择2019年1月—2019年12月间我院收治的脑卒中后便秘患者90例,随机分成A组(大黄穴位贴组),B组(直肠指力刺激组),C组(大黄穴位贴联合直肠指力刺激组)三组,每组30例。记录三组患者便秘治疗有效率,采用Wexner便秘评分系统评估三组患者治疗前后的便秘程度并进行自身前后对比。结果 三组干预前后Wexner评分采用自身配对非参数秩和检验,差异有统计学意义(P＜0.05)。三组干预前后差值采用Kruskal-Wallis H检验结果差异有统计学意义(H=26.211,P＜0.05),经过两两对比,差异有统计学意义(P＜0.05)。值得注意的是,干预后C组Wexner评分下降。干预后C组患者的有效率高于其他两组,有效率结果为C组(90%)＞B组(80%)＞A组(53.5%),差异有统计学意义(P＜0.05)。结论 相较于单一应用大黄穴位贴或直肠指力刺激,大黄穴位贴联合直肠指力刺激治疗效果更好,可有效降低便秘发生率,提高病人生活质量。

Objective To explore the effect of rhubarb acupoint application combined with rectal finger force stimulation in patients with constipation after stroke. Methods In this study, 90 patients with post-stroke constipation admitted to our hospital from January 2019 to December 2019 were randomly divided into group A (rhubarb acupoint application group), group B (rectal finger force stimulation group) and group C (rhubarb acupoint application combined with rectal finger force stimulation group), 30 cases in each group. The effective rates of constipation treatment in the three groups were recorded, and the Wexner constipation scoring system was used to evaluate the degree of constipation before and after treatment among three groups. Results The Wexner scores of the three groups before and after treatment were analyzed by self-paired non-parametric rank sum test, and the differences were statistically significant (all P<0.05). The difference among the three groups before and after treatment using Kruskal-Wallis H test was statistically significant (H=26.211, P<0.05), and after pairwise comparison, the differences were statistically significant (P<0.05). It was worth noting that the Wexner score of group C dropped significantly after treatment. The effective rate of treatment in group C was significantly higher that those in the other two groups. The result showed effective rate of group C (90%)＞ group B (80%)＞group A (53.5%), the difference was statistically significant (P<0.05). Conclusion Compared with the single treatment of rhubarb acupoint application or rectal finger force stimulation, the combined treatment had better efficacy, which reduced incidence of constipation and improved the quality of life of patients.

目的 探讨“分-全带教”在提高门诊实习生处方审核能力的应用效果。方法 对2016届实习生进行“分-全带教”,在实习初期、后期组织实习生对100张门诊处方进行处方审核,登记审核结果。结果 实施“分-全带教”后,处方成功审核例数实习初期的163例(27.17%)提高到后期的487例(81.17%)。结论 应用“分-全带教”模式,有利于门诊实习生掌握处方审核技巧,在提高实习生处方审核能力中有良好应用前景。

Objective To make a discussion of the application result of point-all teaching model in improvement of prescription review ability of interns at outpatient service process. Methods To implement point-all teaching model on interns enrolled in 2016. To ask them to review 100 outpatient prescription at the beginning and ending of the internship respectively and record the results of their review. Results After the implementation of point-all teaching model, the correct review of the prescription has been improved from 163 (27.17%) at the beginning to 487 (81.17%) at the ending. Conclusion The point-all teaching model is conducive for interns at outpatient department to master the technique for review, so it is promising in the improving the prescription review ability of interns.

目的 探讨婴儿过敏性直肠结肠炎的临床特点及肠镜、肠黏膜病理特点。方法 回顾性分析2016年1月—2018年12月我院收治的110例婴儿过敏性直肠结肠炎的临床资料及其结肠镜、肠黏膜病理结果、食物过敏原特异度IgG、血常规、粪常规、血清总IgE检测及治疗情况。结果 110例过敏性直肠结肠炎中男67例,女43例,< 6月龄98例;单纯母乳喂养26例,单纯牛奶喂养19例,混合喂养65例;临床表现均有腹泻,大部分患儿伴有血便(93例),部分患儿伴湿疹(23例)、排便哭闹(67例)、夜眠不安稳(61例)、呕吐(8例)、营养不良(6例);血嗜酸性粒细胞升高63例;血清总IgE升高21例;食物过敏原特异度IgG检测结果,牛奶103例,鸡蛋62例;内镜下病变均累及降结肠、乙状结肠、直肠,累及横结肠76例、升结肠47例、回盲部18例;最常表现为疱疹样改变(106例)、糜烂(97例)、溃疡(13例),组织病理学表现为肠黏膜嗜酸性粒细胞浸润91例,隐窝炎、隐窝增生21例,淋巴滤泡形成18例、浅表溃疡形成4例;18例经母亲规避饮食后好转,8例经先换用氨基酸奶粉喂养1周、再逐渐引入母乳后好转;19例换用深度水解或氨基酸奶粉喂养后好转;65例经换用深度水解或氨基酸配方奶粉喂养、同时母亲规避饮食后好转。结论 婴儿过敏性直肠结肠炎缺乏特异度表现,多数临床经过良好,仅少数并发营养不良;牛奶是最主要的过敏原;腹泻、便血病史、血嗜酸细胞升高、肠镜疱疹样改变、肠黏膜嗜酸细胞浸润,提示过敏性直肠结肠炎可能性大;母亲规避饮食或换用氨基酸或深度水解奶粉治疗有效,也是确诊的标准。

Objective To investigate the clinical features of infantile allergic proctocolitis and its endoscopic lesions and pathological features. Methods A retrospective analysis of 110 cases of infantile allergic proctocolitis admitted to our hospital from January 2016 to December 2018 and its colonoscopy and pathological results, food allergen-specific IgG, blood routine, fecal routine, serum total IgE detection and treatment. Results Among 110 patients with allergic proctocolitis, 67 were male and 43 were female, 98 were < 6 months old; 26 were breastfed exclusively, 19 were fed milk alone, and 65 were mixed feeding. The clinical manifestations were diarrhea, most of children with bloody stools (93 cases), some children with eczema (23 cases), defecation and crying (67 cases), restless sleep (61 cases), vomiting (8 cases), malnutrition (6 cases); blood eosinophils increased in 63 cases,serum total IgE increased in 21 cases. Food allergen-specific IgG test results:103 cases of milk, 62 cases of eggs. Endoscopic lesions involved the descending colon, sigmoid colon, rectum, 76 cases of transverse colon, 47 cases of ascending colon and 18 cases of ileocecal. Most common manifested as herpes-like changes (106 cases), erosion (97 cases), ulcers (13 cases). Histopathology showed 91 cases of intestinal mucosal eosinophil infiltration, 21 cases of cryptitis and crypt hyperplasia, 18 cases of lymphoid follicle formation and 4 cases of superficial ulcer formation. 18 cases were improved after the mother evaded diet. 8 cases were improved by feding with amino acid milk powder for one week, and then breast milk was gradually introduced; 19 cases were improved after switching to deep hydrolysis or amino acid milk powder. 65 cases were improved after switching to deep hydrolysis or amino acid milk powder and simultaneously the mother evaded diet. Conclusion Infantile allergic proctocolitis lack of insufficient specific manifestations, most of the clinical cases are good, only a few are complicated by malnutrition. Milk is the most important allergen. Diarrhea, history of blood in the stool, elevated blood eosinophils, intestinal herpes-like changes, bowel mucosal eosinophil infiltration, are suggesting a high possibility of allergic proctocolitis. Mothers avoiding diet or switching to amino acids or deep hydrolyzed milk powder treatment is also effective, and this is also the standard of diagnosis of proctocolitis.

目的 探讨PBL联合SOAP门诊药历在提高门诊药师药学服务质量的效果。方法 开展SOAP门诊药历工作,并围绕实践中的典型案例开展PBL培训,由学员发现案例中的问题进行提问、分析、讨论,培训药师给予适当指导,并及时对问题解答与讨论过程中的问题进行总结。结果 PBL联合SOAP门诊药历提高了门诊药师的处方审核与处方干预水平,促进门诊药学服务工作顺利开展。结论 PBL联合SOAP门诊药历有利于培养药师独立思考和解决具体问题的临床思维能力,让门诊药师在临床实践中逐渐成长,在医院门诊药师向临床转型的实践中有良好的应用前景。

Objective To discuss the effects over the method of combining PBL with SOAP outpatient medicine records to improve the quality of pharmaceutical service of outpatient pharmacists. Methods We put the SOAP outpatient medicine records into practice and carry out the PBL training based on the typical cases in practice. In this process, the trainees can ask questions, analyze and discuss the problems in the cases, while the trainers should give some guidance, answer the questions immediately and conclude what were discussed. Results The method of combining PBL with SOAP outpatient medicine records has improved the outpatient pharmacists' level of prescription audit and intervention, it is helping to smoothly carry out the outpatient pharmaceutical service. Conclusion Combining PBL with SOAP outpatient medicine records will be helpful for pharmacists to develop their independent clinical thinking which may solve the specific problems, making them much more expert in the clinical practice. It is promising in the practice of outpatient pharmacists transforming to be clinical ones.