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Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.
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OBJECTIVE To analyze the influential factors for potentially inappropriate medication （PIM） in elderly cancer patients. METHODS The data of elderly cancer patients hospitalized in a hospital from January to December 2021 were collected. According to the Beers standard of the American Geriatrics Society in 2019 （hereinafter referred to as the “2019 version of Beers standard”） and Criteria for Potentially Inappropriate Drug Use in Chinese Elderly （2017 version） （hereinafter referred to as the “Chinese PIM standard”）， the PIM status of elderly cancer patients was retrospectively analyzed. Multivariate Logistic regression analysis was used to identify influential factors for PIM. RESULTS A total of 293 patients were included in the study. According to the 2019 version of Beers standard， 211 patients （72.01%） had PIM， of which 204 （69.62%） had PIM related to drugs， 6 （2.05%） had PIM related to diseases or symptoms， 46 （15.70%） had PIM that should be used with caution， 32 （10.92%） had PIM with drug-drug interaction that should be avoided， and 11 （3.75%） had PIM based on renal function； the top 5 drugs in the list of incidence were proton pump inhibitors， metoclopramide， the first-generation antihistamines as promethazine， analgesics as ibuprofen and megestrol. According to the Chinese PIM standard， there were 132 patients （45.05%） with PIM， of which 119 （40.61%） had PIM related to drugs， involving 25 drugs （included 7 high-risk drugs and 18 low-risk drugs）， and 24 （8.19%） with PIM in disease status； top 4 drugs in the list of incidence were promethazine， megestrol， ibuprofen and cimetidine. Multivariate Logistic regression analysis showed that compared with patients with hospital stay≤10 days， patients with hospital 20054） stay between 11 and 30 days had a higher risk of PIM [odds ratio （OR）＝8.836 8， 95% confidence interval （CI） （3.217 8， 31.940 9）， P＝0.000 1]； compared with the patients with the 65895198。E-mail：fjman@cmpt.ac.cn number of clinical disease diagnosed≤5， patients with the number of clinical disease diagnosed≥11 had a higher risk of PIM [OR＝10.930 1， 95%CI （3.000 9， 70.922 9）， P＝0.001 8]； compared with surgical treatment， patients receiving antineoplastic drugs had a higher risk of PIM [OR＝2.209 5， 95%CI （1.180 2， 4.176 9）， P＝0.013 6]. CONCLUSIONS Elderly cancer patients have multiple diseases， complicated medication， and a high incidence of PIM. The length of hospital stay （11-30 d）， the number of clinical disease diagnosed （≥11） and anti-tumor drugs are main influential factors for PIM in patients.
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【Objective】 To investigate the risk factors and predictive effectiveness of prostate imaging reporting and data system (PI-RADS) score for patients with clinically significant prostate cancer (CsPCa) whose PI-RADS score was 3, so as to provide evidence for the diagnosis and treatment. 【Methods】 The clinical and multi-parameter magnetic resonance imaging (mpMRI) data of 153 CsPCa patients treated during Jan.2017 and Dec.2021 whose PI-RADS score was 3 were retrospectively analyzed. With PI-RADS score of 3 as the independent risk factor for CsPCa, the other relevant independent risk factors in predicting CsPCa were evaluated. 【Results】 Univariate and multivariate analyses showed that prostate-specific antigen (PSA) density and apparent dispersion coefficient (ADC) were independent risk factors for the diagnosis of CsPCa (P<0.05). Analysis of receiver operating characteristic (ROC) curve showed that combined PSA density and ADC were more effective than PSA density and ADC alone (P<0.05). 【Conclusion】 The combination of PSA density and ADC can guide clinicians to identify high-risk CsPCa patients from patients with PI-RADS score of 3 points.
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OBJECTIVE To establis h and validate a population pharmacokinetic model of docetaxel in malignant tumor patients. METHODS The clinical data of malignant tumor patients treated with chemotherapy regimen containing docetaxel in our hospital from June 2019 to December 2021 were retrospectively collected . According to the results of blood concentration detection ， based on the three -compartment model the nonlinear mixed effect model （NONMEM）was used ；covariates（age，weight，height， body surface area ，Karnofsky performance scale ，total protein ，albumin，total bilirubin ，aspartate aminotransferase ，alanine aminotransferase and serum creatinine ）affecting clearance （CL）were screened by “forward inclusion and backward exclusion ”； the population pharmacokinetic model of docetaxel was established . The model was tested for goodness -of-fit diagnosis and internal validation by Bootstrap . RESULTS A total of 264 measured blood concentrations of 132 patients with malignant tumors during chemotherapy were included . The covariates that had significant effect on CL of docetaxel were serum creatinine and total bilirubin （P＜0.01）. The results of Bootstrap analysis （parameter median values and 95% confidence intervals ）were close to predict results of the established model ；the final model estimated that the population typical value of docetaxel CL was 37.82 L/h. CONCLUSIONS The population pharmacokinetic model of docetaxel in malignant tumor patients is established successfully ， which can be used for the formulation and optimization of clinical individualized regimen .
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OBJECTIVE To eval uate the effectiveness ，safety and economy of deferasir ox for the treatment of iron overload in thalassemia with rapid health technology assessment ，and to provide evidence-based basis for rational clinical use. METHODS Retrieved from Chinese and English database/website as PubMed ，Embase，Cochrane Library ，NHS EED ，CADTH，CNKI and Wanfang database ，health technology assessment （HTA），systematic evaluation/meta-analysis and pharmacological studies about deferasirox versus deferoxamine/deferiprone for the treatment of iron overload in thalassemia were collected from the inception to June 2021. Based on literature screening and data extraction ，the quality of literature about HTA reports ，systematic evaluation/ Meta-analysis and pharmacoeconomic research were evaluated with HTA checklist ，A Measurement Tool to As sess Systematic Reviews，standard scale of economic evaluation report. The effectiveness and safety results were described quantitatively ，and the economic evaluation results were described qualitatively. RESULTS One HTA report ，five systematic evaluation/meta-analysis and five pharmacoeconomic studies were selected from 1 569 literature. Included HTA reports ， systematic evaluation/meta-analysis，pharmacoeconomic studies were high in quality. Most studies reported that 30 mg/（kg·d） deferasirox was E-mail：aydgs@126.com better than deferoxamine in reducing the levels of s erum ferritin and liver iron overload ；ADR induced by deferasirox were mainly gastrointestinal irritation symptoms ，skin itching ，joint pain，transaminase elevation ，etc.，which generally did not affect subsequent treatment. There was no statistical significance in severe ADR between deferoxamine group and deferasirox group [RR ＝0.96，95％CI（0.85，1.08），P＝0.52]. Compared with deferoxamine，deferasirox had higher cost-effectiveness ；but deferasirox was less likely to be cost-effective than deferiprone. CONCLUSIONS Deferasirox has good effectiveness and safety for iron overload in thalassemia ，and has good economic advantages in Britain and Iran ，compared with deferoxamine.
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Objective@#To investigate the association between body mass index ( BMI ) and mortality risk among older Chinese based on the China Health and Retirement Longitudinal Study ( CHARLS ). @*Methods@#The demographic features, BMI, prevalence of chronic diseases and mortality among the elderly at ages of 60 years and greater were captured from the CHARLS database from 2011 to 2018. A multivariable Cox proportional hazards regression model was used to examine the association between BMI and the risk of death.@*Results@#Totally 6 023 subjects were enrolled, including 3 006 men ( 50.09% ) and 3 017 women ( 49.91% ), and 68.69% of the participants ( 4 137 subjects ) were at ages of 60 to 69 years. There were 637 subjects ( 10.58% ) with underweight, 1 544 ( 25.63% ) with overweight, and 557 ( 9.25% ) with obesity. During the follow-up period ( 35 091 person-years ), 1 035 subjects died. Multivariable Cox proportional hazards regression analysis revealed an increased risk of mortality among the underweight elderly ( HR=1.496, 95%CI: 1.261-1.775 ) and a reduced risk of mortality among the obese elderly ( HR=0.671, 95%CI: 0.511-0.881 ) relative to the elderly with normal weight, after adjustment for age, gender, smoking, household registration, administration of anti-diabetic drugs, administration of anti-dyslipidemia drugs, and administration of anti-hypertensive drugs.@*Conclusion@#It is found that the risk of mortality among the Chinese elderly correlatives with BMI through the analysis of CHARLS data.
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Bleeding caused by ionizing radiation involves many factors, the mechanism is complicated and the management is difficult. Bleeding is recognized as one of the main causes of death after ionizing radiation. In this paper, we summarize the pathophysiological mechanisms of ionizing radiation bleeding syndrome (IRBS) from the aspects of platelet abnormality, coagulation disorder and vascular damage. Besides, we expound the clinical characteristics of IRBS in terms of the degree, time and site of the bleeding. Combined with experimental results, we put forward ideas and possible approaches for the treatment of IRBS, and the key factor is to promote the recovery of megakaryocytes and rapid platelet production after radiation exposure.
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BACKGROUND@#Acute cerebral infarction is a form of Trousseau syndrome (TS), but is relatively rare and often overlooked by clinicians. The aim of this study was to investigate the clinical, laboratory and imaging features of acute cerebral infarction in non-small cell lung cancer (NSCLC) patients with TS.@*METHODS@#Clinical data, laboratory examination and imaging data of 25 NSCLC patients with TS presented with acute cerebral infarction were collected retrospectively for analysis.@*RESULTS@#Of the 25 patients, 18 males and 7 females, aged 39-78 years old, including 22 cases of adenocarcinoma, 2 cases of squamous cell carcinoma, and 1 case of large cell carcinoma; all patients had clinical symptoms and signs of acute cerebral infarction; plasma D-dimer was significantly increased, and prothrombin time and activated partial thromboplastin time were shortened to varying degrees; all patients showed acute multiple cerebral infarction foci involving multiple intracranial arterial blood supply areas on plain head magnetic resonance imaging (MRI) [diffusion-weighted imaging (DWI) sequence], the blood supply vessel lumen corresponding to the infarction foci did not show moderate to severe stenosis on the head MR angiography (MRA).@*CONCLUSIONS@#NSCLC with multiple acute cerebral infarctions is a rare manifestation of TS, which is characterized by multiple acute cerebral infarctions involving multiple arterial blood supply areas with significant hypercoagulability. Improving the early understanding of this disease can provide some help for clinical diagnosis and treatment.
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Nowadays, ionizing radiation has become one of the risk factors for human healthy. Exploring effective protective strategies are important topics in radiological medicine. Timely using of the radiation protection agents are the most direct and effective medical protective strategy for reducing the damage of ionizing radiation to normal tissues of the body. A large number of new radiation protective agents based on mechanisms such as scavenging of free radicals, promoting DNA damage repair, inducing hypoxia of irradiated tissues and blocking bystander effect have been developed gradually. This review summarizes a variety of radiation protective agents, and their potential molecular biological mechanisms reported in recent years, to provide theoretical reference for exploring novel medical protective agents of ionizing radiation.
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Objective@#To analyze the clinical value of capsule endoscopy (CE) in small intestinal diseases and to explore the correlation between the diagnosis and clinical characteristics.@*Methods@#From June 2016 to April 2019, a total of 194 patients receiving CE were enrolled in the Department of Gastroenterology, Shanxi People′s Hospital, including 68 patients with obscure gastrointestinal bleeding, 104 with chronic abdominal pain and 22 with diarrhea.@*Results@#The detection rate of small intestinal lesions by CE was 53.6%(104/194), of which gastrointestinal bleeding was 66.2% (45/68), chronic abdominal pain was 53.8%(56/104), and diarrhea was 13.6%(3/22). The first three positive diagnostic criteria of CE for gastrointestinal bleeding were non-specific inflammation, small intestinal ulcer and vascular malformation. CE findings in patients with abdominal pain were non-specific inflammation, small intestinal ulcer and Crohn′s disease; while the major endoscopic presentations in patients with diarrhea were small intestinal ulcer and non-specific inflammation. Logistic regression analysis suggested that the clinical manifestations and gender were correlated with positive diagnosis by CE (P<0.05), and the positive diagnostic rate of CE in female patients was significantly lower than that in male patients [31.6%(25/79) vs. 51.3%(59/115), P<0.05]. The diagnostic rates of CE in patients with gastrointestinal bleeding and chronic abdominal pain were similar [55.9%(38/68) vs. 41.4%(43/104)], which was significantly higher than those with diarrhea [9.1%(2/22), P<0.05].@*Conclusions@#Capsule endoscopy has a high detection rate for small intestinal diseases, which could be the first choice in patients with unexplained gastrointestinal bleeding. Male patients and gastrointestinal bleeding are predictors of positive findings by CE.
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Objective:To summarize the clinical characteristics and experiences in the diagnosis and treatment of congenital tuberculosis.Methods:This study involved four infants with congenital tuberculosis diagnosed in Guangdong Women and Children Hospital from January 2010 to January 2020. Moreover, publications of 52 congenital tuberculosis cases from Chinese hospitals between January 1994 and January 2019 were retrieved from Wanfang Database, China National Knowledge Infrastructure and PubMed. Clinical data of all patients were retrospectively analyzed.Results:All four cases we reported here were preterm infants with the onset of the disease at 14-30 d after birth and received anti-tuberculosis treatment. The interval between disease onset and diagnosis was 1-34 d. One baby was cured, one was improved, while the other two died. The median age at the onset of the disease in these 56 cases (including the four we reported and 52 from literature) was 14.5 d (7.0-20.7 d) and the median interval between the onset and diagnosis was 10.5 d (7.5~22.0 d). Forty-eight (88.9%) out of the 54 mothers were suffered from active tuberculosis during the perinatal period, including 16 diagnosed before delivery. The main clinical symptoms in these neonates were fever (82.1%, 46/56), respiratory distress (69.6%, 39/56), drowsiness and/or irritation (57.1%, 32/56), cyanosis (53.6%, 30/56), feeding difficulties (53.6%, 30/56), hepatomegaly (48.2%, 27/56) and splenomegaly (41.1%, 23/56). The positive rates of acid-fast staining, culture and polymerase chain reaction detection of Mycobacterium tuberculosis in sputum smears or gastric juice were all less than 33.3%, and the positive rate of spot test for Mycobacterium tuberculosis infection was 7/12. Chest X-ray showed miliary nodules and diffused nodules-patchy in 37.0% (20/54) and 25.9% (14/54) of the patients, respectively. Abdominal ultrasonography found 52.4% (11/21) with hepatomegaly and/or splenomegaly and 47.6% (10/21) with multiple low-density nodules in liver and spleen. The misdiagnosis rate was 28.6% (16/56). The overall mortality rate was 51.8% (29/56). However, the figure was 28.9% (11/38) in infants with anti-tuberculosis treatment and 18/18 in those without. Conclusions:Nonspecific clinical manifestations of congenital tuberculosis, together with low detection rate through laboratory tests, may lead to a higher rate of misdiagnosis and mortality. Therefore, a comprehensive assessment of the mothers of infants with suspected congenital tuberculosis is necessitated. Diagnosis and effective anti-tuberculosis treatment as early as possible are essential to improve the prognosis.
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Objective:To analyze the clinical value of capsule endoscopy (CE) in small intestinal diseases and to explore the correlation between the diagnosis and clinical characteristics.Methods:From June 2016 to April 2019, a total of 194 patients receiving CE were enrolled in the Department of Gastroenterology, Shanxi People′s Hospital, including 68 patients with obscure gastrointestinal bleeding, 104 with chronic abdominal pain and 22 with diarrhea.Results:The detection rate of small intestinal lesions by CE was 53.6%(104/194), of which gastrointestinal bleeding was 66.2% (45/68), chronic abdominal pain was 53.8%(56/104), and diarrhea was 13.6%(3/22). The first three positive diagnostic criteria of CE for gastrointestinal bleeding were non-specific inflammation, small intestinal ulcer and vascular malformation. CE findings in patients with abdominal pain were non-specific inflammation, small intestinal ulcer and Crohn′s disease; while the major endoscopic presentations in patients with diarrhea were small intestinal ulcer and non-specific inflammation. Logistic regression analysis suggested that the clinical manifestations and gender were correlated with positive diagnosis by CE ( P<0.05), and the positive diagnostic rate of CE in female patients was significantly lower than that in male patients [31.6%(25/79) vs. 51.3%(59/115), P<0.05]. The diagnostic rates of CE in patients with gastrointestinal bleeding and chronic abdominal pain were similar [55.9%(38/68) vs. 41.4%(43/104)], which was significantly higher than those with diarrhea [9.1%(2/22), P<0.05]. Conclusions:Capsule endoscopy has a high detection rate for small intestinal diseases, which could be the first choice in patients with unexplained gastrointestinal bleeding. Male patients and gastrointestinal bleeding are predictors of positive findings by CE.
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Objective To investigate the characteristics of the microbiota of colonic lavage fluid from patients with diarrhoea-predominant irritable bowel syndrome (D-IBS).Methods From August 2014 to March 2015,at the Department of Gastroenterology Shanxi Provincial People's Hospital,39 patients with D-IBS were enrolled and during the same period 39 patients with self-reported symptoms such as occasional abdominal discomfort or abdominal pain but were excluded from the diagnosis of irritable bowel syndrome (IBS) were selected as control group.The colonic mucosal tissues and colonic lavage fluid of two groups of patients were collected.DNA was extracted from tissues and colonic fluid.Ten dominant bacteria,including Bacteriodes prevotella,Bacteroidetes,Clostridium,Bifidobacterium,Dialister pneumosintes,Enteropathogenic Escherichia coli,Faecalibacterium prausnitzii,Firmicutes,Lactobacillus and Salmonella,were analyzed by real-time fluorescence quantitative polymerase chain reacticn (RT-PCR).T test and Spearman correlation analysis were performed for statistical analysis.Results The numbers of Bacteriodes prevotella in colonic lavage fluid and the descending colon mucosal tissues of patients in D-IBS group were 3.096 ± 1.462 and 4.278 ± 0.290,respectively,which were lower than those of control group (4.842 ± 1.032 and 5.341 ± 0.433,respectively),and the differences were statistically significant (t =6.093 and 12.657,both P ＜ 0.01).Correspondingly,the numbers of Bacteroidetes were 3.259 ± 0.607 and 3.698 ± 0.554,respectively,which were lower than those of control group (4.085 ± 0.504 and 4.339 ± 0.263,respectively),and the differences were statistically significant (t =6.538 and 6.528,both P ＜ 0.01).The numbers of Clostridium were 5.254 ± 0.522 and 4.471 ± 0.690,which were lower than those of control group (5.949 ± 0.505 and 4.950 ± 0.604,respectively),and the differences were statistically significant (t =5.976,P ＜ 0.0l;t =3.262,P =0.002).The number of Faecalibacterium prausnitzii from colonic lavage fluid of patients in D-IBS group was 2.238 ± 1.845,which was lower than that of control group (3.222 ± 1.450),and the difference was statistically significant (t =2.619,P =0.011).The Firmicutes (r =0.678,P =0.012),Lactobacillus (r =0.358,P =0.034),Bifidobacterium (r =0.418,P =0.042) and Faecalibacterium prausnitzii (r =0.568,P =0.022) from colonic mucosal tissues were all positively correlated with those from colonic lavage fluid.However,Salmonella (r =-0.638,P =0.012) and Enteropathogenic Escherichia coli (r =-0.343,P =0.025) were negatively correlated with those from mucosal tissues.Conclusions An imbalance of the microbiota in colonic lavage fluid is found in D-IBS patients.The numbers of Bacteriodes prevotella,Bacteroidetes,Clostridium and Faecalibacterium prausnitzii significantly decrease.
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Radiation Medicine is a required subject for the students in the military medical univer-sity at present. However, some of those students are short of a deep understanding of the importance of this curriculum, which results in the changes of their learning attitudes, the lack of the proper attention on this subject, as well as the poor teaching results because of the out-dated teaching contents, the lack of the clini-cal cases, and the compression of this course, etc. Notably, the impact of the nuclear threat on the world is deepening, and the use of nuclear energy in all fields is increasing. Therefore, it is quite necessary to carry out the medical rescue after suffering from the sudden nuclear accident or nuclear threat, especially to cope with the radiation injuries well in the future battlefield by learning this course well. Based on the new trend of the nuclear threats, the nuclear accidents and the nuclear terrorism at present, we discussed how to im-prove the enthusiasm of the students in learning this course, and to enhance their learning effect.
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Massive open online course (MOOC) is an emerging online course model for the public. It is large-scale, open, interactive, etc. Therefore, MOOC has been developing rapidly at home and abroad in recent years. The advanced education philosophy of MOOC has also brought many inspirations to the teaching reform mode of Radiation Medicine. Under the background of the current military reform, the building of the online teaching platform on the basis of MOOC may realize the substantive reform of Radi-ation Medicine teaching, which can improve the comprehensive quality of the teachers and students, and cultivate more excellent military medical talents.
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The intestinal permeability is crucial for human health,and the changes of intestinal permeability may cause variety of diseases,which is widely concerned.This article reviews the latest research progress in the relationship between intestinal permeability and diseases,the main influencing factors of intestinal permeability and its common testing methods,which may provide new ideas for the clinical treatment of related diseases.
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OBJECTIVE:To provide reference for rational application of tigecyclinet and alert to the occurrence of severe ADR.METHODS:Fifity patients receiving tigecycline in a level 3 general hospital during 2013-2015 were analyzed retrospectively to observe the change of symptom,sign and lab indexes after using Tigecyclinet injfection.Possible ADR of tigecycline,processing and outcomes were summarized.RESULTS:Among 50 patients,there were 24 cases of ADR,including 10 cases of inducing or aggravating blood coagulation abnormality (41.67％),9 cases of liver function injury (37.50％),4 cases of vomiting and other gastrointestinal discomfort (16.67％),1 case of red erythra with itching (4.17％).ADR of digestive system were mild and recovered after symptomatic treatment as inhibiting acid,antiemetic.Severe ADR as Liver function injury could not be recovered after symptomatic treatment as protecting liver,reducing enzyme.Nine cases of liver function injury mainly manifested as the elevation of TBIL,DBIL,ALP,LDH;8 of which suffered from liver function injury before medication and the symptom was aggravated after medication;liver function injury appeared in 3 cases on 10th day after medication and in 2 cases on 9th day after medication.Ten cases suffered from coagulation function disorder before medication and the symptom was aggravated after medication,which mainly manifested as the prolongation of APTT and TT and the elevation of INR,PT,D-dimer,etc.The coagulation function disorder was aggravated abnormally on 2nd-22th day after using tigecycline,mainly appearing on 2nd-5th day (70.00％).CONCLUSIONS:Great importance should be attached to severe ADR as coagulation function disorder,liver function injury when using tigecycline,in order to ensure the safety of drug use.
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Objective To study the safety and efficacy of continuous intravenous infusion of fentanyl in laser photocoagulation of retinopathy of prematurity (ROP).Methods From March,2014 to January,2015,ROP infants hospitalized for laser photocoagulation in Guangdong Women and Children hospital were randomly (using envelope method)assigned into the fentanyl groupand the control group.In the fentanyl group,the patients were given fentanyl combined with topical anesthesia,while onlytropical anesthesiain the control group.Premature infant pain profile (PIPP)scores,heart rate,mean artery pressure and complications within 3 days after operation were recorded. The concentration of epinephrine, norepinephrine and cortisol in the blood were measured before and after the operation.Student′s t test,non-parameter rank and chi-square test were used to compare the differences between the two groups.Results A total of 82 infants were enrolled in the study,42 in the fentanyl group and 40 in the control group.In the fentanyl group,11 .9% infants had maximum PIPP score ≥6 and 70.0% in the control group,the difference was statistically significant (P <0.05).In the fentanyl group,the PIPP score at the beginning of operation, the maximum PIPP score during operation and the PIPP score at the end of operation were 2.0,3.0and 1 .5, respectively.In the control group,these scoreswere 8.0,8.0and 8.0 respectively.The differences were statistically significant (P <0.05 ).No significant differences existed between the concentration of epinephrine,norepinephrine and cortisol before and after operationin the fentanyl group.However,these concentrations were elevated after the operation than before the operation in the control group (P <0.05).The incidence of complications within three days after operation was 19.0% in the fentanyl group and 40.0% in the control group,and the difference was statistically significant (P <0.05 ).Conclusion Comparing with topical anesthesia,fentanyl combined with topical anesthesia has lower pain scores,less stress responses and fewer complications during ROP laser photocoagulation.Fentanyl combined with topical anesthesia is a safe and effective analgesic method during ROP laser photocoagulation.
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Objective:To explore the main points of pharmaceutical care performed by clinical pharmacists for patients with sick sinus syndrome ( SSS) and essential thrombocythemia ( ET) . Methods:Clinical pharmacists participated in the whole process of drug treatment for a case of SSS and ET,and focused on the rational use of hydroxyurea ( Hu) and aspirin, the intervention in the medication and the positive follow-up. Results:Serious ADR such as bone marrow suppression was avoided by pharmaceutical care, and bleeding increase including pocket hematoma during the operation didn’ t come up. Conclusion: Timely medical intervention, pharmaceutical care for the key drugs and strengthened follow-up are the breakthrough points for pharmaceutical service of clinical pharmacists.