ABSTRACT
OBJECTIVE To develop an individualized medication list for elderly patients by evidence-based pharmacy method， and to support clinical decisions on rational use of METHODS Firstly， drugs with risk genetic information were screened out by systematically reviewing evidence-based pharmacy information. Secondly， researchers investigated the included drugs in lists from different data E- sources. Drugs included in three or more data sources and drugs proposed by the expert committee were then included in the medication list. Thirdly， for the drugs included in two data sources， researchers designed questionnaires to investigate the necessity of drug-related gene testing. According to the scoring results of the expert questionnaire， drugs with higher scores were included in the list. Data sources included real-world data （list of high frequency medication in hospitals， high frequency medication for elderly outpatients and inpatients in National Health Care Claims Data， drugs related to frequent medication errors and so on） and evidence-based pharmacy evidence （the websites of Clinical Pharmacogenomics Implementation Consortium， Dutch Pharmacogenetics Working Group， Food and Drug Administration and so on）. RESULTS The study obtain 68 drugs with risk genetic information which were included in three data sources. Combined with 23 drugs proposed by the expert committee， a list containing 74 drugs was preliminarily formed after de-duplication. A total of 37 drugs included in two databases with risk genetic information were scored through the questionnaire survey to form a supplementary list of 26 drugs. This is the final composition of the list of 100 drugs developed in this study. Among them， there are 43 drugs for the central nervous system， 15 drugs for the cardiovascular system， 12 anti-tumor drugs and so on. Twelve drugs were included in six or more data sources， which mainly consisted of drugs for digestive system， all proton pump inhibitors. CONCLUSION In this study， a list of 100 commonly used drugs which require individualized medication for the elderly was developed by evidence-based pharmacy method. The drug list will be updated in time as available evidence changes， and can provide guidance for rational use of medicines for elderly patients.
ABSTRACT
OBJECTIVE：To investigate the occurrence of medication errors （ME）in patients with hyperuricemia/gout and its related factors ，in order to avoid and reduce the occurrence of related ADE and ensure the safety of drug use in patients. METHODS：The ME reports related to hyperuricemia/gout were collected from National Monitoring Network for Clinical Safe Drug Use during Sept. 22nd，2012 to Jul. 9th，2020，and then analyzed in terms of reporting provinces ，classification and drugs involved，error content ，initiator and error factors. RESULTS ：A total of 179 ME reports ，which met inclusion criteria ，were included from 47 hospitals in 11 provinces. The drugs involved mainly included benbromarone （36 cases，20.11％），allopurinol （31 cases，17.32％），calcium carbonate D 3（30 cases，16.76％），inverting sugar electrolyte （24 cases，13.41％）and sodium bicarbonate（22 cases，12.29％）. Grade B ME were the most frequently reported （124 cases，69.27％）；severe ME occurred in 3 cases（1.68％）. The main errors were contraindications ，accounting for 70 cases（37.43％，mainly involving calcium carbonate D 3 and inverting sugar electrolyte ）. The people who caused ME were mainly doctors ，involving 126 cases（70.39％，the main content of errors was contraindications ）. The main error factors for ME were personnel factors ，involving 120 cases（67.04％，mainly lacking of knowledge ），followed by environmental factors （33 cases，mainly equipment failure ）. CONCLUSIONS ：ME in patients with hyperuricemia/gout are mainly caused by uric acid-lowering drugs and non-uric acid-lowering drugs that cause changes in uric acid. The main error contents include contraindications ，which were mostly caused by non-uric acid-lowering drugs and doctors. The main error factors are lack of knowledge and equipment failure. It is suggested to strengthen personnel training or introduce clinical medication support decision-making system ，while pay attention to the correct use and maintenance of related equipment in the process of drug use.
ABSTRACT
Objective To investigate the significance of a comprehensive test on the semen stain in the field of forensic evidence;Methods PSA tests performed on samples obtained supernatant and sediment STR genotyping by differential lysis method;Results Through STR testing,there are inconsistencies with the PSA test results in which 13 cases of false positive and false negative in 1 case.The supernatant was detected in two cases of male component,coeducational 9 cases;Conclusion PSA test strips there are some false positive and false negative rate,test isolated by the difference lysis supernatant can not only increase the success rate of the fine on the semen stain can also as a supplement to bring more valuable information for the semen stain.
ABSTRACT
Objectives To conduct a research on the possibility and effect factors of latent fingerprints development in clothing objects after vacuum coating, and extracting fingerprints DNA and to probe in the relation among DNA template quantity and genetic loci numbers tested, and the rfu value after coating. Methods To select two groups that are free sweat hands and sweat hands and have them press their fingerprints on the cloth, after coating, and to analyze the effect of time, to quantify and test the targeted fingerprints DNA, to compare the locus numbers tested between white and black cloth. Results As the time is prolonged, the locus numbers tested decrease. The locus numbers tested on the group of sweat hands using the same method after the same placed time are lager than the free sweat hands. When the value of rfu is 600 above, the ratio of the locus numbers tested is more than 90% and the threshold of templates is 0.013ng. The locus numbers tested of white cloth is larger, comparing with black cloth when using the same method. What is more, there exists an prohibitive influence of pigments of the dyed cloth over the PCR amplification, to put it further, the loci numbers tested will be trimmed. Conclusion The technology of vacuum coating can be well used in the area of detecting fingerprint DNA.
ABSTRACT
Objective To test the technical param eters of GlobalFiler?PC R A m plification K it for its ap-plication to forensic application value and to investigate the genetic polym orphism s. Methods The valida-tion w as conducted in sensitivity, m ixed sam ples, species specificity, adaptability, survivability, consistency, peak height balance and stability. The am plification and detection of the genom ic D N A from 373 unre-lated individuals from B eijing H an nationality w ere extracted by autom ation w orkstation. Results Global-Filer?PC R A m plification K it w as adaptive to som e m ixed, degraded and inhibited sam ples. The pow er of sensitivity and adaptability and peak height balance show ed w ell. The distributions of genotype fre-quencies for 21 STR loci in the population w ere all in accordance w ith H ardy-W einberg equilibrium (P>0.05). The PIC value of the 21 STR loci w as am ong 0.536 to 0.940; the H value w as am ong 0.558 to 0.933; the D P value w as am ong 0.783 to 0.992; the PE value w as am ong 0.243 to 0.874. Conclusion GlobalFiler?PC R A m plification K it is suitable for crim inal cases and D N A database in forensic practice. A nd 21 STR loci in B eijing H an nationality have high polym orphism , w hich have ap-plication value in forensic practice and population genetics.
ABSTRACT
Objective To study the clinical features and differential diagnosis of Langerhans cell histiocytosis (LCH).Methods A case of LCH was reported and the literatures were reviewed.Results The of multisystem LCH patient,presented with a diabetes insipidus (DI) and panhypopituitarism,was 44 years old,and developed costal,tibial and femoral multiple lesions.The final diagnosis as LCH was made based on biopsy of tibia and lymph nodes.The biopsy specimen showed that the cells were infiltrated exhibiting the characteristic morphologic features of Langerhans cell (LC) with a convoluted shape,elongated nuclei exhibiting longitudinal grooves,and immunohistochemistry results revealed positive LC for the S-100,CD1a and Langerin immunostaining.Conclusions LCH may range from a solitary lytic bone lesion (for example eosinophilic granuloma) with a favorable course to a fatal disseminated leukaemia-like form.LCH typically involves the bone,lesions almost can be found in all organs.DI and CNS involvement often present as a puzzling syndrome,which renders the diagnosis problematicly,and often delays the diagnosis of LCH.The damage to the pituitary/hypothalamus axis results in life-long hormonal replacement therapy.
ABSTRACT
To ensure the consistency of genotype results for PowerPlex?21 kit and GoldeneyeTM 20A kit. Methods The STR loci were amplified in DNA samples from 205 unrelated individuals in Beijing Han population. And consistency of 19 overlap STR loci typing were observed. The genetic polymorphism of D1S1656 locus was obtained. Results All 19 overlap loci typing showed consistent. The proportion of peak height of heterozygous loci in two kits showed no statistical difference (P>0.05). The observed heterozygosis of D1S1656 was 0.878. The discrimination power was 0.949. The excluding probability of paternity of triplet was 0.751. The excluding probability of paternity of diploid was 0.506. The polymor-phism information content was 0.810. Conclusion PowerPlex?21 kit and GoldeneyeTM 20A kit present a good consistency. The primer design is reasonable. The polymorphism of D1S1656 is good. The two kits can be used for human genetic analysis, paternity test, and individual identification in forensic practice.
ABSTRACT
BACKGROUND:With the increase of aging degree, chronic wounds are increasing. There is few method to cure chronic wounds at present, and vacuum sealing drainage has been applied to the clinic. OBJECTIVE:To investigate the effect of vacuum sealing drainage on the expression of nerve growth factor and the change of microvascular number in the human chronic wounds, and to study the mechanism of accelerating chronic wound healing. METHODS:Ten patients with chronic wounds were included in this study, including one case of soft tissue defect of chest, one case of osteomyelitis with bone exposure, one case of large area skin defect after amputation stump, two cases of wound infection after skin avulsion injury, two cases of shinbone osteomyelitis, and three cases of postoperative wound infection. The skin around the wounds and granulation tissue within the wounds were col ected before vacuum sealing drainage treatment and at 7, 14 days after vacuum sealing drainage treatment. The nerve growth factor expressions and the microvascular number in the wounds were measured by the immunohistochemical technology. The wound healing was also observed. RESULTS AND CONCLUSION:The nerve growth factor expressions in fibroblasts and vascular endothelial cel s at 7 and 14 days after vacuum sealing drainage treatment were significantly higher than that before treatment (P<0.001). The microvascular number was also increased after vacuum sealing drainage treatment compared with pre-treatment (P<0.05-0.01). The vacuum sealing drainage treatment reduced necrotic tissue and purulent secretion within the wounds, as wel as swel ing around the wounds. Simultaneously, granulation tissue gradual y became fine granules, bright red, and bleeding easily, thus it is suitable for promoting wound healing.
ABSTRACT
Objective The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. Methods Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. Results The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102±26),(64±15),(33±8)and(32±6)N, respectively. Conclusion The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.
ABSTRACT
Objective To investigate the clinical characteristics,diagnosis and treatment of vaginal intraepithelial neoplasia(VAIN).Methods A retrospective study was made of 6 patients with VAIN.who were hospitalized at Peking Union Medical College Hospital from 1980 to 2006.Results Five cases had a history of hysterectomy,two of whom were because of cervical intraepithelial neoplasia(CIN)or invasive cervical cancer.Four cases had the infection of high-risk oncogenic human papillomaviruses detected with hybrid capture Ⅱ(HC-Ⅱ),the other two had no record.In all patients the VAIN lesions were within the upper one third of the vagina.They were all diagnosed by colposcopic examination and directed biopsy after the abnormal cytology by thinprep cytology test(TCT).Six cases of VAIN Ⅱ-Ⅲ were treated by excisional surgery.One case had residual lesion and had another surgery 3 months after the first one.Two patients obtained remission at one-year follow-up,three had abnormal cytology by TCT 6 months after surgery,and one had abnormal cytology by TCT at six-month follow-up but normal at one-year follow-up.Conclusions A history of CIN is the main risk factor for VAIN,so routine vaginal cytology is needed for the patients after hysterectomy due to CIN.Cytology,colposcopic examination and directed biopsy are the mainstays of VAIN diagnosis.Excisional surgery is recommended for the patients with VAIN Ⅱ-Ⅲ.Long term follow-up is necessary after treatment.
ABSTRACT
OBJECTIVE: To probe into the medication status of the elder patients in community so as to provide reference for pharmacists to promote rational medication for the elderly people in community. METHODS: The medication status of 484 cases in the community was investigated through questionnaire and interview. RESULTS: The principal diseases affecting the health of the elder people included hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease. The average number of drugs they used totaled 2.92 kinds; the higher the educational background, the higher proportion of the elder people who read drug package instruction but the lower ratio of medication compliance. The elder people commonly had poor knowledge about the drugs and adverse drug reactions(91.74% and 60.74%);21.11% responded that they had ever received medication guidance from pharmacists, only 3.10% responded that they had once consulted pharmacists about medication problems. CONCLUSION: The medication of the elder people in community is characterized by multiple drug varieties, poor ADR knowledge and lower cognition on pharmacists. It is urgent to improve the pharmaceutical care ability of medical institution and enhance the social influence of pharmacists.
ABSTRACT
Objective To study the DNA extraction and its typing in cigarette butts. Method Chelex 100 extraction method was used to extract DNA of 170 cigarette butts, STR loci were typed after PCR amplification by Profiler Plus kit. Results 21 cigarette butts from one volunteer have no results, the others were all obtained typing results. The samples which were added a little tobacco have no results. Sometimes DNA in sponge contacted with mouth was typed. The small fragment loci were typed in cigarette butts which had been reserved for six months. Conclusion Cigarette butt can be typed by DNA analysis, which is useful in forensic identification.