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Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical bacterial isolates from bloodstream infections in China in 2021.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2021 to December 2021. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 11 013 bacterial strains were collected from 51 hospitals, of which 2 782 (25.3%) were Gram-positive bacteria and 8 231 (74.7%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.6%), Klebsiella pneumoniae (18.9%), Staphylococcus aureus (9.8%), coagulase-negative Staphylococci (6.3%), Pseudomonas aeruginosa (3.6%), Enterococcus faecium (3.6%), Acinetobacter baumannii (2.8%), Enterococcus faecalis (2.7%), Enterobacter cloacae (2.5%) and Klebsiella spp (2.1%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 25.3% and 76.8%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci was detected; more than 95.0% of Staphylococcus aureus were sensitive to ceftobiprole. No vancomycin-resistant Enterococci strains were detected. The rates of extended spectrum B-lactamase (ESBL)-producing isolated in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 49.6%, 25.5% and 39.0%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.2% and 15.8%, respectively; 7.9% of carbapenem-resistant Klebsiella pneumoniae was resistant to ceftazidime/avibactam combination. Ceftobiprole demonstrated excellent activity against non-ESBL-producing Escherichia coli and Klebsiella pneumoniae. Aztreonam/avibactam was highly active against carbapenem-resistant Escherichia coli and Klebsiella pneumoniae. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii (5.5% and 4.5%). The prevalence of carbapenem-resistance in Pseudomonas aeruginosa was 18.9%. Conclusions:The BRICS surveillance results in 2021 shows that the main pathogens of blood stream infection in China are gram-negative bacteria, in which Escherichia coli is the most common. The MRSA incidence shows a further decreasing trend in China and the overall prevalence of vancomycin-resistant Enterococci is low. The prevalence of Carbapenem-resistant Klebsiella pneumoniae is still on a high level, but the trend is downwards.
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Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.
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Objective@#To analyze the epidemiological characteristics of rotavirus in children under 5 years old in China (excluding China Hong Kong, Macau and Taiwan data, the same below) from 2005 to 2018.@*Method@#Data on other infectious diarrhea in the country from 2005 to 2018 were downloaded from the National Notifiable Disease Report System was to build a database for report cases of rotavirus diarrhea in children under 5 years of age, and descriptive epidemiological methods were used to analyze the data.@*Result@#In 2005-2018, a total of 820 588 cases of rotavirus infection in children under 5 years old were reported nationwide, with male 500 944 cases, and with an average annual incidence of 63.7/100 000. The reported incidence showed a fluctuating upward trend increased from 8.4/100 000 to 178.1/100 000. The number of reporting provinces increased from 17 to 30. The reported incidence showed a peak of season from November to following February. The reported cases of rotavirus diarrhea in children under 5 months of age was 13.1%(107 845 cases), and the high-incidence age ranged from 6 months to 2 years old, accounting for 70.3% (576 874 cases), with a peak of 11-13 months (163 947 cases). The top three provinces (cities) reporting the incidence rate were Zhejiang (535.2/100 000), Guangdong (334.3/100 000) and Beijing (317.3/100 000), the provinces with the low reported case rates were Shanxi (0.9/100 000), Heilongjiang (1.6/100 000) and Liaoning (2.5/100 000), but there was no case reported in Tibet; The report cases of south region (745 526 cases) were 9.9 times north region (74 935 cases).The cases of rotavirus infection and other diarrhea pathogens were detected simultaneously accounted for 1.8% (15 030 cases) and mainly were positive for rotavirus and adenovirus (90.1%, 13 544 cases).@*Conclusion@#The rate of rotavirus infection in children has increased rapidly since the age of 6 months, and 84.4% of the reported cases were infants before the age of 2 years.
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OBJECTIVE@#To explore the influencing factors and countermeasures of infection in leukemia patients after allogeneic peripheral blood hematopoietic stem cell transplantation.@*METHODS@#A total of 126 patients with leukemia admitted in our hospital from August 2016 to March 2018 were selected. The number of infected patients after transplantation was recorded, and the causes of infection were analyzed.@*RESULTS@#Among the 126 patients, 43 were positive for infection, and the infection rate was 34.13%. A total of 89 pathogens were detected, of which bacteria accounted for 64.05%; virus accounted for 22.47%, and fungi accounted for 13.48%. The patient's age, donor type, pre-transplant infection, prophylactic use of antibiotics and aGVHD all were factors influencing the patient's infection (P＜0.05). The follow-up results showed that the incidence of infection in the intervention group significantly decreased after intervention with prevention program (P＜0.05). After reasonable nursing intervention, the incidence of infection in the intervention group after follow-up for 12 months was lower than that in the control group (P＜0.05).@*CONCLUSION@#Pre-transplant infection and prophylactic use of antibiotics are factors influencing the infection after allogeneic hematopoietic stem cell transplantation. The incidence of infection can be reduced by reasonable infection prevention.
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Humans , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Infections , Leukemia , Peripheral Blood Stem Cell TransplantationABSTRACT
To analyze the epidemiological characteristics of rotavirus in children under 5 years old in China (excluding China Hong Kong, Macau and Taiwan data, the same below) from 2005 to 2018. Data on other infectious diarrhea in the country from 2005 to 2018 were downloaded from the National Notifiable Disease Report System was to build a database for report cases of rotavirus diarrhea in children under 5 years of age, and descriptive epidemiological methods were used to analyze the data. In 2005-2018, a total of 820 588 cases of rotavirus infection in children under 5 years old were reported nationwide, with male 500 944 cases, and with an average annual incidence of 63.7/100 000. The reported incidence showed a fluctuating upward trend increased from 8.4/100 000 to 178.1/100 000. The number of reporting provinces increased from 17 to 30. The reported incidence showed a peak of season from November to following February. The reported cases of rotavirus diarrhea in children under 5 months of age was 13.1%(107 845 cases), and the high-incidence age ranged from 6 months to 2 years old, accounting for 70.3% (576 874 cases), with a peak of 11-13 months (163 947 cases). The top three provinces (cities) reporting the incidence rate were Zhejiang (535.2/100 000), Guangdong (334.3/100 000) and Beijing (317.3/100 000), the provinces with the low reported case rates were Shanxi (0.9/100 000), Heilongjiang (1.6/100 000) and Liaoning (2.5/100 000), but there was no case reported in Tibet; The report cases of south region (745 526 cases) were 9.9 times north region (74 935 cases).The cases of rotavirus infection and other diarrhea pathogens were detected simultaneously accounted for 1.8% (15 030 cases) and mainly were positive for rotavirus and adenovirus (90.1%, 13 544 cases). The rate of rotavirus infection in children has increased rapidly since the age of 6 months, and 84.4% of the reported cases were infants before the age of 2 years.
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BACKGROUND@#Minimal change nephropathy (MCD) is a common pathological type of nephrotic syndrome and is often associated with acute kidney injury (AKI). This study aimed to investigate the clinical characteristics and related factors of AKI in patients with MCD and nephrotic syndrome.@*METHODS@#Patients from Chinese People's Liberation Army General Hospital who were diagnosed with pathological renal MCD with clinical manifestations of nephrotic syndrome were included from January 1, 2013 to December 31, 2017. Patients diagnosed with membranous nephropathy (MN) by renal biopsy from January 1, 2013 to December 31, 2017 are included as a control population. We retrospectively analyzed the clinical and pathological characteristics of patients as well as the percentages and clinical characteristics of AKI in different age groups. We assessed the correlation of pathological characteristics with serum creatinine using multivariate linear regression analysis.@*RESULTS@#A total of 367 patients with MCD were included in the analysis, with a sex ratio of 1.46: 1 (male: female) and an age range of 6 to 77 years. Among all the patients, 109 developed AKI (29.7%), and of these patients, 85 were male (78.0%). In the 586 patients with MN, 27 (4.6%) patients developed AKI. The percentage of AKI in MCD patients was significantly higher than that in MN patients (χ2 = 41.063, P < 0.001). The percentage of AKI increased with age in the MCD patients. The percentage of AKI in patients aged 50 years or older was 52.9% (46/87), which was significantly higher than that [22.5% (63/280)] in patients under 50 years (χ2 = 6.347, P = 0.013). We observed statistically significant differences in age (43 [27, 59] years vs. 28 [20, 44] years, Z = 5.487, P < 0.001), male (78.0% vs. 51.4%, χ2 = 22.470, P < 0.001), serum albumin (19.9 ± 6.1 g/L vs. 21.5 ± 5.7 g/L, t = 2.376, P = 0.018), serum creatinine (129.5 [105.7, 171.1] μmol/L vs. 69.7 [57.7, 81.9] μmol/L, Z = 14.190, P < 0.001), serum urea (10.1 [6.2, 15.8] mmol/L vs. 4.7 [3.6, 6.4] mmol/L, Z = 10.545, P < 0.001), IgE (266.0 [86.7, 963.0] IU/ml vs. 142.0 [35.3, 516.5] IU/ml, Z = 2.742, P = 0.007), history of diabetes (6.4% vs. 1.2%, P = 0.009), and history of hypertension (23.9% vs. 5.1%, χ2 = 28.238, P < 0.001) between the AKI group and the non-AKI group. According to multivariate linear regression analysis, among the renal pathological features analyzed, renal tubular epithelial cell damage (β = 178.010, 95% CI: 147.888-208.132, P < 0.001) and renal interstitial edema (β = 28.833, 95% CI: 11.966-45.700, P = 0.001) correlated with serum creatinine values.@*CONCLUSIONS@#The percentage of AKI in MCD patients is significantly higher than that in MN patients. Patients over 50 years old are more likely to develop AKI. Renal tubular epithelial cell injury and renal interstitial edema may be the main pathological lesions that are associated with elevated serum creatinine in patients with MCD.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Acute Kidney Injury/etiology , Cross-Sectional Studies , Kidney , Nephrosis, Lipoid/complications , Nephrotic Syndrome/complications , Retrospective StudiesABSTRACT
Objective:To explore the kinematics characteristics of obstacle crossing in old people with high or low falling risks in Community. Methods:From July to September, 2016, 27 old persons in community were divided into high falling risk group (H group, n = 15) and low fall risk group (L group, n = 12) according to the performance of Timed "Up and Go" Test and Five Times Sit to Stand Test. The kinematics characteristics were analyzed with Ariel Performance Analysis System as obstacle crossing. Results:The total time of crossing and the swing time of crossing legs were longer in H group than in L group (t > 2.073, P < 0.05), and the maximum height of standardized centre of mass was less in H group than in L group (t =-2.014, P < 0.05). As the crossing leg was just above the obstacle, the angle of knee of crossing leg was more in H group than in L group (t > 2.106, P < 0.05), the velocity of hip of crossing leg was less in H group than in L group (t = -2.119, P < 0.05), and the acceleration of ankle of swinging leg was less in H group than in L group (t = -3.038, P < 0.05). Conclusion:When the old people cross the obstacle, they trend to fall if they spend more time to overcome, lower in mass centre, in less speed of crossing hip and less acceleration of swinging ankle.
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Objective:A novel four-degree-of-freedom upper limb rehabilitation robot was designed to overcome the shortcomings of the structure of the most of serial robots. Methods:The shoulder and elbow joint drive system and the information detection system were placed in the base. The synchronous belt drive system and the spiral bevel gear transmission system were designed to transmit power from the base to the shoulder and elbow joint of the arm. The cubic polynomial trajectory planning method based on the joint space was selected to accomplish the trajectory planning of the recovery movements of taking objects and drawing quadrilaterals, and the single-degree-of-freedom motion control experiment and multi-degree-of-freedom trajectory planning experiment were designed to verify the rationality and feasibility of the design. Results:Each joint of the rehabilitation robot reached the designed range of motion at the designed speed, and well completed the planned rehabilitation training movements. Conclusion:This robot can effectively reduce the volume and mass of the mechanical arm, overcome the influence of motor noise and radiation on patients' rehabilitation training, and assist patients to complete a variety of rehabilitation exercises.
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OBJECTIVE:To provide reference for improving related policy and list about medical insurance medicines in China. METHODS:The descriptive analysis method was used to compare 2017 and 2009 edition of Medicine List for National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance in respects of item,medicine classification (including classification code,grading and name),medicine types(including new type,removed type),dosage(including new dosage classification,adjusted dosage form),the limit of payment and use.The trend of its development and the existing problems were discussed. RESULTS:Compared with 2009 edition,2017 edition of medicine list added the item of"drug classification code"and removed the item of"English name". The grading of drug classification code was reduced from six grades to four grades. The code and name of four grades classification were in accordance with the first four grades classification rules of the anatomical-therapeutic-chemistry(ATC). A total of 2 535 types were included in 2017 edition,increasing by 362 types compared to 2009 edition(151 chemical medicines,211 Chinese patent medicines). 15 types of chemical medicines were removed,and 4 types were transferred to Chinese patent medicine list;11 types of Chinese patent medicines were removed,and one type was transferred to chemical medicine list. 2017 edition was actually 20 more dosage forms than 2009 edition,involving 31 types;dosage forms of 231 types were adjusted(143 chemical medicines,88 Chinese patent medicines). Chemical medicines of usage and payment restriction increased from 239 to 302,and Chinese patent medicines increased from 72 to 115,respectively. CONCLUSIONS:2017 edition of list increases the number of medicine,expands the scope of clinical medication and improves the classification structure of the list.The number of medical insurance cost control type shows a growing trend.
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OBJECTIVE:To promote the development of hospital clinical pharmacy.METHODS:The measures which promoted the development of hospital clinical pharmacy after established by Jiangsu quality control system for pharmacy management were introduced.Through collecting clinical pharmacy indexes (the number of clinical pharmacists,the range of clinical pharmacy practice,the number of clinical pharmaceutical practice,the number of therapeutic drug monitoring (TDM),the number of reported ADR,etc.) in Jiangsu Province Pharmacy Management Quality Control Network Reporting System established by Quality Control Center during Jan.2014-Dec.2016,the development of clinical pharmacy in Jiangsu hospital were analyzed.RESULTS:The measures formulated and adopted by Quality Control Center included expanding the scale of clinical pharmacists training,strengthening the training of rational use of antibiotics,formulating provincial rational drug use standard,carrying out pharmaceutical quality control circle activities,etc.The data of clinical pharmacy indexes were collected from 61 hospitals.The results showed that,compared with Jan.2014,the number of clinical pharmacists in sample hospitals increased from 4.72 to 5.86 in Dec.2016;the number of involved special departments increased slightly;clinical pharmacy practice (weekly rounds number,medication history writing,case analysis,medication guidance,drug counseling) increased significantly;the number of beds managed by clinical pharmacists reached 289 beds;the types of TDM increased from 7.38 to 7.87,the number of yearly monitoring was 1 293;the number of monthly reported ADR increased from 14.71 to 19.34,but the number of consultation,new/severe ADR decreased slightly.CONCLUSIONS:Both service ability and service level of clinical pharmacy in 61 hospitals in Jiangsu have been improved by the establishment of the provincial quality control system for pharmacy management.
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Small cell lung cancer (SCLC) is typified by early recurrence and metastasis associated with many genetic changes.The drug ROVA-T composed of the DLL3 antibody Rovalpituzumab and the cytotoxic drug Tesirine achieves the tumor-killing effect by releasing the Tesirine when bound to DLL3.Nfib promotes the SCLC metastasis by altering the structure of the chromosome.The PRAP,EZH2 and Weel inhibitors inhibit the DNA damage repair to improve the antitumor activity of chemotherapeutic drugs.Combination of Ipilimumab and Nivolumab can activate the human immune system to exert antitumor effect.
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OBJECTIVE:To describe the effect of Jiangsu Pharmaceutical Management Quality Control Center(JPMQCC)on promoting the rational use of antibacterial agents in hospitals. METHODS:Measures in promoting the rational use of antibacterial agents taken by JPMQCC were introduced. Effect of quality control center on promoting the rational use of antibacterial agents was analyzed by collecting data(such as antibacterial prescription proportion,inpatients'use rate of antibacterial agents)about the clini-cal use of antibacterial agents during Jan. 2014-Jan. 2017 in"Jiangsu Pharmaceutical Management Quality Control Network Report-ing System"established by JPMQCC. RESULTS:Measures implemented and developed by quality center included strictly imple-menting classification management and filing system of antibacterial agents,and carrying out basic information survey for applying antibacterial agents,etc. Applying data of antibacterial agents in totally 65 hospitals were collected. Analysis results showed,com-pared with Jan. 2014,antibacterial prescription proportion for outpatient of sample hospitals in Jan. 2017 was decreased from 18.37% to 14.63%,and antibacterial prescription proportion for emergency was increased from 34.94% to 37.92%. Inpatients'use rate of antibacterial agents was decreased from 56.11%to 51.28%,and its intensity was decreased from 49.74 to 44.13. The preven-tive use rate for thyroid,breast and hernia surgery was decreased from 35.27% to 8.88%,and in interventional surgery diagnosis, it was decreased from 12.55% to 2.46%. Pathogenic detection rate of inpatients was increased from 48.44% to 54.60%. CONCLU-SIONS:The quality control management in JPMQCC for more than 3 years has promoted the rational use of antibacterial agents of 65 hospitals in Jiangsu province.
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AIM To establish HPLC fingerprints of Zhihuang Tongfeng Decoction (Phellodendri chinensis Cortex,Anemarrhenae Rhizoma,Plantaginis Semen,etc.) and to determine the contents of four constituents.METHODS The analysis of aqueous extract of this drug was performed on a 30 ℃ thermostatic Wondasil C18 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.5％ acetic acid in a gradient elution manner,and the detection wavelength was set at 245 nm.RESULTS There were sixteen common peaks in the HPLC fingerprints of ten batches of samples with the similarities of more than 0.9.Berberine hydrochloride,mangiferin,geniposidic acid and salvianolic acid B showed good linear relationships within the ranges of 0.636 2-3.575 μg (R2 =0.9999),0.338-1.425 μg (R2 =0.9990),0.6452-2.7188 μg (R2 =1) and0.938 8-5.275 μg (R2 =0.999 3),whose average recoveries were 100.56％,98.35％,100.25％ and 102.11％ with the RSDs of 2.41％,1.17％,1.24％ and 2.02％,respectively.CONCLUSION This accurate,reliable and specific method can be used for the quality control of Zhihuang Tongfeng Decoction.
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Objective:To improve the safety, rationality and efficacy of medication for cancer patients accompanied with malignant neuropathic pain by the participation of clinical pharmacists in the therapy. Methods:Clinical pharmacists participated in the therapy for one neurilemmoma cancer patient with malignant neuropathic pain, and provided a rational and individualized therapeutic regimen according to the drug experience of clinical pharmacists as well as the relevant medical guides and literatures. Results: According to the nature and degree of pain, clinical pharmacists adjusted the type and dosage of opioids and non opioid drugs. The pain was well controlled with pain score at 1-2 points. Besides, the adverse effects were alleviated to ensure the sustained drug treatment. Conclu-sion:The participation of clinical pharmacists in therapeutic practice can improve the normalization of pharmacotherapy for neurilem-moma cancer patients with malignant neuropathic pain, which also can provide ideas and methods for treating the similar patients.
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AIM To establish HPLC fingerprints of Zhihuang Tongfeng Decoction (Phellodendri chinensis Cortex,Anemarrhenae Rhizoma,Plantaginis Semen,etc.) and to determine the contents of four constituents.METHODS The analysis of aqueous extract of this drug was performed on a 30 ℃ thermostatic Wondasil C18 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.5％ acetic acid in a gradient elution manner,and the detection wavelength was set at 245 nm.RESULTS There were sixteen common peaks in the HPLC fingerprints of ten batches of samples with the similarities of more than 0.9.Berberine hydrochloride,mangiferin,geniposidic acid and salvianolic acid B showed good linear relationships within the ranges of 0.636 2-3.575 μg (R2 =0.9999),0.338-1.425 μg (R2 =0.9990),0.6452-2.7188 μg (R2 =1) and0.938 8-5.275 μg (R2 =0.999 3),whose average recoveries were 100.56％,98.35％,100.25％ and 102.11％ with the RSDs of 2.41％,1.17％,1.24％ and 2.02％,respectively.CONCLUSION This accurate,reliable and specific method can be used for the quality control of Zhihuang Tongfeng Decoction.
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OBJECTIVE:To know the status quo of clinical pharmacy in main hospitals of Jiangsu province primarily,and to provide reference for promoting the construction of clinical pharmacist system and playing active role of clinical pharmacists on rational drug use and pharmaceustical care.METHODS:A mailed questionnaire investigation was conducted among 28 committee members (coming from 28 hospitals) of the Clinical Pharmacy Branch of the Medical Association in Jiangsu Province regarding the status quo of the clinical pharmacy practice,and the correlated data and results were summarized to statistical analysis.RESULTS:A total of 28 questionnaires were distributed and 28 valid questionnaires were collected,with recovery rate of 100％.Among 28 hospitals,there were 25 general hospitals and 26 third grade class A hospitals.There were 312 full-time and part-time clinical pharmacists;there were 7.32 full-time clinical pharmacists and 3.82 part-time clinical pharmacists in each visited hospital;the proportion of full-time clinical pharmacists with master's degree and intermediate title was significantly higher than that of part-time clinical pharmacists (P＜0.05).There were 144 full-time clinical pharmacists who had been trained to obtain clinical pharmacists qualifications (70.24％).In 13 hospitals with the qualification of clinical pharmacist training base of National Health and Family Planning Commission (NHFPC),the average number of teachers was 3.77;in 5 hospitals with the qualification of provincial clinical pharmacist training base,the average number of teachers was 5.80;in a hospital with the qualification of clinical pharmacist training base of NHFPC,the number of teachers was 5.The surveyed hospital had the highest proportion of clinical pharmacy related work to participate in daily physician rounds,doctor's advice and prescription review,special review of antibiotics,drug record writing,pharmaceutical information service,outpatient drug consultation and ADR monitoring,all being 100％.Expert consultation clinic occupied the lowest proportion of clinical pharmacy work (10.71％).Setting up pharmacy for operation and anaesthesia department (28.57％),community pharmaceutical care (57.14％),pharmacogenomic testing (46.43％) and participating in the management of drug clinical trials (53.57％) occupied the lower proportion of clinical pharmacy related work.The proportion of clinical pharmacy work in training base hospital was higher than that non-training base hospital.Compared to surveyed hospitals,there was statistical significance in the proportion of special review for antineoplastic drugs,hormone drugs and blood products,expert consultation,setting up pharmacy for operation and anaesthesia department,community pharmaceutical care,pharmacogenomic testing and participating in the management of drug clinical trials in provincial clinical pharmacist training base (P＜0.05).There was statistical significance in the number of specialist consultation,case analysis,inpatient injection medical orders,check pharmacy intravenous admixture medical orders and checked outpatient prescriptions,varieties and number of monitored therapeutic drugs as well as case number of pharmacogenomic testing (P＜0.05).CONCLUSIONS:It is suggested to strengthen the construction of clinical pharmacist team in third grade class A hospital in Jiangsu province,accelerate the transition of part-time clinical pharmacists,at the same time,further improve the development of clinical pharmacy related work.
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OBJECTIVE:To achieve the drug intelligent supervision in transportation within hospital and storage process,and promote quality safety of drugs. METHODS:The function and operation of Radio frequency identification(RFID)medicine logis-tic box was introduced,its application in one year in inpatient pharmacy of our hospital since Sept. 2013 was summarized,and its application effect and deficiency were analyzed. RESULTS:RFID medicine logistic box showed heat preservation and locking func-tions,which can be used for the cold-chain medicine and lock packing transportation for the ward. It can achieve information bind-ing after connecting with corresponding platform,record real-time record temperature,logistic box opening and closing information and data,as well as a variety of ways to alarm by SMS and mail,etc. However,failed login server and unpacking caused by unsta-ble wireless signals were found when applying the box,also drug damage and other defects were caused by unreasonable box struc-ture. And the daily average incidence dropped from the initial period (Nov. 2013) 11.9 times (cases) to the late period (Sept. 2014) 3.3 times (cases) after continuous improvement. CONCLUSIONS:Applying of medicine logistic box can strengthen cold-chain transport integrity and regulatory information in our hospital,ensure the safety of drug transport and query traceability of information.
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Objective To study high-quality and high efficient meshing methods for skeleton. Methods Based on characteristics of bone structure, the mesh generation technology of computational fluid dynamics (CFD) was applied in mesh generation for bone biomechanics. Hexahedron elements and tetrahedron elements were used to simulate cortical bone and cancellous bone, respectively. Results By using CFD mesh generation technology, high-quality hexahedral elements could be obtained, the structure characteristics of skeleton could be preferably simulated, and computer automatic meshing could be implemented. The amount of time for meshing bones by the new method was only about 1/5 of that by the traditional method, and the calculation results obtained from the finite element model were basically consistent with the results from the cadaver experiment. Conclusions The CFD mesh generation technology can be applied in the field of bone biomechanics, which provides an effective approach to reconstruct complex human skeleton.
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Objective RNPC1 may act as an oncogene or suppressor gene in human tumors and its role in human renal cell carcinoma (RCC) remains unclear.The objective of this study was to investigate the role of RNPC1 in the development of RCC.Methods Over-expression of RNPC1 gene group (RNPC1 group) and short hairpin RNA interfering RNPC1 gene expression (shRNPC1 group) were respectively built in RCC CAKI-1 and CAKI-2.The blank control group (NC group) and negative control group (SCR group) were built as well.The qRT-PCR and western blot (WB) were used to detect the expression levels of RNPC1 mRNA and RNPC1 protein in RCC cells.Lentivirus infection was applied to establish stable expressed RCC cell lines of RNPC1 over-expression and interference.Detection was made on mRNA and protein expression levels in RNPC1 stable RCC cell lines.The effects of RNPC1 on cell proliferation, colony formation assay, migration, and invasion were detected by CCK-8 cell differentiation test, clone test, scratch test, and migration and invasion test.WB was applied to detect the change of protein expression in the EMT path of RNPC1 stable RCC cell lines and explore the molecular mechanism of RNPC1 effect on the biological function of RCC cells.Results The expression levels of RNPC1 mRNA and protein were found lower in shRNPC1 group than those in SCR group, while the expression levels of RNPC1 mRNA and protein in SCR group were higher than those NC group (P<0.05).The capability of proliferation in shRNPC1 group was stronger than that in SCR group, while the capability of proliferation in shRNPC1 group was weaker than that in NC group (P<0.05).The capabilities of cell migration and invasion were stronger in shRNPC1 group than those in SCR group, while the capabilities of cell migration and invasion in RNPC1 group were weaker than those in NC group (P<0.05).RNPC1 could inhibit the proliferation capability of RCC cells and might up-regulate the protein expression of E-cadherin and down-regulate the protein expression of β-catenin and vimentin, thus inhibiting EMT path and the capabilities of migration and invasion off RCC cells (P<0.05).Conclusion RNPC1 acts as a tumor suppressor in RCC and has the potential for the prediction of RCC prognosis.
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Objective:To improve the safety, rationality and efficacy of medication for cancer patients accompanied with malignant neuropathic pain by the participation of clinical pharmacists in the therapy. Methods:Clinical pharmacists participated in the therapy for one neurilemmoma cancer patient with malignant neuropathic pain, and provided a rational and individualized therapeutic regimen according to the drug experience of clinical pharmacists as well as the relevant medical guides and literatures. Results: According to the nature and degree of pain, clinical pharmacists adjusted the type and dosage of opioids and non opioid drugs. The pain was well controlled with pain score at 1-2 points. Besides, the adverse effects were alleviated to ensure the sustained drug treatment. Conclu-sion:The participation of clinical pharmacists in therapeutic practice can improve the normalization of pharmacotherapy for neurilem-moma cancer patients with malignant neuropathic pain, which also can provide ideas and methods for treating the similar patients.