Discussion on the use of occupational contraindication cardiovascular disease in Technical Specifications for Occupational Health Surveillance (GBZ 188-2014) / 中华劳动卫生职业病杂志

Technical Specifications for Occupational Health Surveillance (GBZ 188-2014) has played an important role in screening occupational contraindications and preventing occupational diseases since its implementation. However, during the use of occupational health examination, we found that the use of occupational contraindication on cardiovascular disease was not "homogenized" due to the differences in the understanding of various physical examination institutions. Therefore, this paper mainly discussed the connotation and quantitative standards of organic heart disease, arrhythmia, hypertension in the occupational contraindication cardiovascular disease in the specification for "homogenization".

Evolution and Connotations of "Prohibition"， "Contraindication"， or "Use with Caution" in Chinese Materia Medica / 中国实验方剂学杂志

This study systematically combed and analyzed the use of such terms as "prohibition"， "contraindication"， and "use with caution" in ancient Chinese books on materia medica and prescriptions， Pharmacopoeia of the People's Republic of China（《中华人民共和国药典》）， and teaching materials and monographs of Chinese materia medica by means of hermeneutics， commentariology， textology， and data mining， and explored the historical evolution and conceptual connotations of "prohibition"， "contraindication"， and "use with caution" in Chinese materia medica， so as to provide reference for standardizing their understandings and clinical reasonable medication. The "prohibition"， "contraindication"， and "use with caution" of Chinese materia medica were first proposed in the period of pre-Qin and Han dynasties. "Prohibition" and "contraindication" were separately developed in the Sui， Tang， and Five dynasties and Song， Jin， and Yuan dynasties and have been widely used since the Ming and Qing dynasties. The "use with caution" becomes popular rapidly in modern times and is often present in clinical medication together with "prohibition" and "contraindication". "Prohibition" basically means strictly prohibited and "contraindication" means to avoid as much as possible. The terms "prohibition"， "contraindication"， and "use with caution" have experienced evolution from the pre-Qin period to modern times， and they are used to describe the degree of restriction on drug use（"prohibition" > " contraindication" > "use with caution"）.

Application and precautions of prone position ventilation in pediatric acute respiratory distress syndrome / 中国小儿急救医学

Prone position ventilation(PPV) is an effective treatment for moderate to severe pediatric acute respiratory distress syndrome(PARDS) and should be used in the early stage. PPV can improve oxygenation and reduce mortality.However, at present, the rate of application of PPV in moderate to severe PARDS is still low, which may be related to the insufficient understanding of its therapeutic effect and the lack of trained and skilled staff.Prone operation requires the coordinated efforts of doctors and nurses.Three to five medical personnel are required to participate in this routine operation, and the endotracheal tube and various invasive tubes must be carefully fixed.The safety of children during the prone operation should be guaranteed, and the extubation, migration or kinking of invasive pipelines must be avoided.Children receiving extracorporeal membrane oxygenation can be ventilated in prone position, but additional operators are required during prone operation.Medical staff should receive training related to the prone operation, master the contraindications of PPV, and avoid related complications.After the outbreak of COVID-19, the application of PPV has gradually increased.The key research progress of PPV in acute respiratory distress syndrome mostly comes from the adult field.More clinical studies should be carried out on the use of PPV in pediatrics in the future, so as to better treat PARDS.

Analysis on the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin / 中华劳动卫生职业病杂志

Objective: To investigate the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin. Methods: In June 2020, the occupational health inspection data of 16113 benzene workers in 514 enterprises with benzene hazards in 16 municipal districts in Tianjin from January to December 2019 were included in the analysis. Enterprise information included the employer's region, economic type, industry classification and enterprise scale. Occupational health inspection data for benzene workers during their on-the-job period included routine inspection indicators and benzene special inspection indicators. Multivariate unconditional logistic regression was used to analyze the relationship between personal general information, occupational history, enterprise information and suspected benzene poisoning and occupational contraindications of benzene workers. Results: There were 16073 benzene workers in the normal group and 24 in the suspected benzene poisoning group. The detection rate of suspected benzene poisoning in females was higher than that in males (χ(2)=8.26, P=0.004) . There was no significant difference in the detection rates of suspected benzene poisoning among different dimensions such as age, length of service, occupational health inspection institution location, employer location, industry classification, economic type, and enterprise scale (P>0.05) . There were 16073 benzene workers in the normal group and 16 in the benzene contraindication group. The detection rate of benzene contraindications for workers in suburban areas where occupational health inspection institutions were located was higher than that in urban areas (χ(2)=9.71, P=0.002) , and there was no significant difference in the detection rates of contraindications for benzene in other dimensions (P>0.05) . Multivariate logistic regression analysis showed that female benzene workers were more likely to detect suspected benzene poisoning (OR=3.53, 95%CI: 1.57-7.94, P=0.002) ; benzene workers who received physical examination in suburban occupational health inspection institutions (OR=5.81, 95%CI: 1.94-17.42, P=0.002) , the employer's area was in the suburbs (OR=9.68, 95%CI: 1.23-76.07, P=0.031) , and female workers (OR=3.07, 95%CI: 1.13-8.37, P=0.028) , it was easier to detect occupational contraindications. Conclusion: Female benzene workers with employers located in the suburbs have a higher risk of detecting occupational contraindications, and women are more likely to detect suspected benzene poisoning. The management of benzene operations in the production environment of enterprises in the suburbs of Tianjin and the occupational health monitoring of female workers should be strengthened.

Successful Left Atrial Appendage Closure with Watchman Device Implantation in Two Patients with Inferior Vena Cava Filters

Percutaneous procedures through femoral access in patients with inferior vena cava (IVC) filter may be at risk of complications. We evaluated the feasibility and safety of left atrial appendage closure (LAAC) through femoral access in patients previously implanted with IVC filter. We described the WatchmanTM device implantation in two patients with formal contraindication for oral anticoagulation. First patient had a GreenfieldTM filter and the second one an OpteaseTM filter, and in this patient an attempt to withdrawal the filter immediately before the LAAC procedure failed. A femoral approach was performed in both patients using a 14 Fr sheath. Before crossing IVC filters, venographies did not detect any thrombus. All steps of IVC filter crossing were performed under fluoroscopic guidance. No immediate or intrahospital complications related to the procedure occurred. Herein, we presented two cases of successful LAAC closure with Watchman device in patients with two different kinds of IVC filters.

Analysis of occupational disease, suspected occupational disease and occupational contraindication in a petrochemical enterprise / 中国职业医学

OBJECTIVE: To analyze the diagnosis of occupational disease and the detection status of suspected occupational disease and occupational contraindication in recent years in a petrochemical enterprise. METHODS: The data of new cases of occupational disease reported by a petrochemical enterprise from 2008 to 2019, the cases of suspected occupational disease and occupational contraindication from 2015 to 2019 were collected. The related data was descriptively analyzed. RESULTS: A total of 30 new cases of occupational disease were reported in this petrochemical enterprise from 2008 to 2019. Among them, there were 16 cases of occupational noise deafness, 10 cases of chronic occupational benzene poisoning, 2 cases of occupational leukemia caused by benzene, 1 case of occupational solvent gasoline poisoning and 1 case of occupational pneumoconiosis. Among the 30 cases of occupational diseases, 28 cases(93.3%) were related to benzene and noise exposure, and 19 cases(63.3%) came from the chemical and oil refining divisions. From 2015 to 2019 in this petrochemical enterprise, 24 cases of suspected occupational disease were reported, of which 17(70.8%) suspected cases were diagnosed as occupational disease, and 63 cases of occupational contraindication were reported, including 47(74.6%) cases of occupational contraindication caused by noise. CONCLUSION: Benzene and noise should be taken as the key factors of occupational hazard for prevention and control in the petrochemical enterprises, and control measures should be adopted for special operation links and job posts to control the hidden dangers of benzene and noise that exceeds the standard limits.

Textual Research on Ancient and Modern Literature of Classical Prescription Wandaitang / 中国实验方剂学杂志

The Wandaitang，recorded in an ancient medical book named Fu Qingzhu's Obstetrics and Gynecology，is one of the Classical Prescriptions. The detailed discussion and record on Wantaitang by later medical scholars can be also regarded as the inheritance and development of the original academic thought from Fu Qingzhu's Obstetrics and Gynecology. By referring to recent literatures，we have found that there are a few reports on Wandaitang from the perspective of ancient literature，but such reports are not systematic or comprehensive enough. Under the premise of inheriting but not rigidly adhering to the ancients，investigation and analysis would be made in this paper from the aspects of the origin，efficacy，dose conversion between ancient and modern uses，usage and dosage form，modern clinical application，contraindications and others based on ancient and modern literatures，in order to further promote the textual research work on Wandaitang and provide reference for its secondary research and development. The research results showed that the origin of Wandaitang can be traced back to the Bianzhenglu（Collecting Record of Differentiation of Symptoms and Signs），and its effect can be summarized as invigorating Qi and spleen，soothing liver-Qi stagnation，elevating yang and arresting leucorrhoea. In view of the great difference between the dose of the original prescription of Wandaitang and the recommended dose in the pharmacopoeia，the author recommended that the clinical dosage of Wandaitang should be 30 g Atractylodis Macrocephalae Rhizoma，30 g Dioscoreae Rhizoma，6 g Ginseng Radix et Rhizoma，15 g Paeoniae Radix Alba，10 g Plantaginis Semen，10 g Atractylodis Rhizoma，3 g Glycyrrhizae Radix et Rhizoma，3 g Citri Reticulatae Pericarpium，3 g Schizonepetae Spica Carbonisata，and 3 g Bupleuri Radix. The main indications included leucorrhea，vulva pruritus，diarrhea，stranguria，anorexia，eczema，vertigo and so on. This prescription should be used with caution in pregnant women or those with excessive phlegm and dampness，Qi stagnation of spleen and stomach，or deficiency of Yin-fluid and blood. The research and development of Wandaitang compound preparation can be inclined to the direction of compound granules，to give full play to its clinical value and market value. The above studies，based on the textual research of ancient and modern literatures，are of great significance for clarifying the origin and clinical application of Wandaitang，and provide a new idea and basis for the secondary development of Wandaitang.

Analysis of contraindication detection of radiation workers in a city during a five-year period / 中国辐射卫生

Objective To analysis contraindication detection of radiological workers and explore thevariation trend. Methods Occupational health examination data of radiological workers were selected from 2014 to 2018. Contraindications were identified according to the criteria, and the detection rates and trends were described in each statistical dimension. Results A total of 17197 cases were selected. Among them 74 patients were found contraindication and the detection rate is 0.43%. The major abnormalities were in thyroid gland and crystalline lens; The detection rate of female is higher than that of male (χ2 = 25.24，P < 0.01); High age andhigh working age groups showed a higherrate of contraindication detection; The abnormal rate of contraindication increased with the age; The risk of > 30 working years group is 2.541 times that of 1 ～5 working years group (95%CI: 1.32 ～4.88). The abnormal rate of thyroid grand was increased year by year, and the trend test showed statistical significance (χ2 = 3.87，P < 0.05). Conclusion Low dose ionizing radiation has a great effect on thyroid gland and crystalline lens of radiation workers, whichhigh age and high working years group should be pay attention to. The contents of occupational health monitoring should be further regulated to safeguard the health of radiation workers so that we can discover the possible health effects and take intervention earlier.

Case report on toxicity of methotrexate in tubal ectopic pregnancy

Ectopic pregnancy is defined as pregnancy outside uterine cavity. Of all ectopic pregnancy, tubal ectopic is most common. Most cases today are diagnosed early and hence timely treatment is possible. In stable patients, medical line of management with methotrexate can be used. With early diagnosis and medical line of treatment, use of injectable methotrexate is on rise. Being aware of characteristics of methotrexate like mechanism, dosage, side effects and contraindications, appropriate patient selection and watchful monitoring will help reduce methotrexate induced toxicity.

Brief analysis on instructions of pediatric Chinese patent medicines in National Essential Drug Catalogue / 中草药

There are only 22 varieties of pediatric drugs in National Essential Drug Catalogue (2018 Edition), including five chemicals and 17 Chinese patent medicines (13 prescriptions). Chinese patent medicines are widely used to treat pediatric diseases. The formulations of Chinese patent medicines are mostly derived from ancient classic prescriptions, based on the theory of syndrome differentiation and treatment of traditional Chinese medicine. The instruction of Chinese patent medicine as a document to guide the use of medicines, the specification and integrity of it directly affects whether Chinese patent medicine is used safely and effectively. This paper investigates the instructions of pediatric Chinese patent medicines in National Essential Drug Catalogue (2018 Edition) comparing with the relevant requirements of the United States and Japan, analyzes the toxicity and contraindication of Chinese patent medicines for pediatrics, summarizes the problems existing in these instructions, and puts forward some suggestions. The result shows that there are few kinds of proprietary Chinese patent medicines for pediatrics. There exist common shortcomings in the instructions of Chinese patent medicines for pediatrics, such as unlabeled contents, unnormalized indications, unclear usage and dosage, unknown contraindications and unclear precautions. This study provides a basis for further perfecting the instructions of Chinese patent medicines, and it is helpful to promote the safe and rational use of medicines for children.

Occupational health surveillance in Xiacheng District of Hangzhou from 2014 to 2017 / 上海预防医学

Objective To investigate the status of occupational health surveillance in Xiacheng District of Hangzhou City from 2014 to 2017, and to provide basis for occupational hygienic supervision Methods Data on occupational health surveillance in Xiacheng District from 2014 to 2017 were collected, and the trend of occupational health surveillance was analyzed.The differences of occupational health surveillance among different hazardous agents, economic types, industries and scales were compared. Results There was no significant difference in rates of pre-job and on-job occupational medical examination from 2014 to 2017, and the rate of off-job occupational medical examination showed an increasing trend.There were statistical difference in on-the-job occupational medical examination rates among empolying units of different economic types, industries and scales.There were statistical differences in the detection rates of occupational contraindication among empolying units of different economic types, hazardous agents.There was no significant difference in the detection rates of suspected occupational diseases among empolying units. Conclusion The occupational health surveillance showed a phenomenon of "emphasizing on-the-job, neglecting pre-job and off-the-job" in Xiacheng District.Supervision department should pay more attention on manufacturing, collective and private economic.It is necessary to focus on the protection of staff contacts with chemical and physical agents. It is suggested that relevant departments should strengthen the propaganda and supervision of occupational health surveillance, according to the nature, characteristics of the employing units and types of their hazardous agents.

Expert consensus on marsupialization of cystic lesions of the jaw / 口腔疾病防治

@#Marsupialization is effective in the treatment of cystic lesions of the jaw. It is a simple operation that can result in minimal trauma, the reduction of postoperative recurrence, and maximum preservation of the surrounding tissue structure and function. However, there is a certain failure rate in clinical treatment due to the improper grasp of indications and nonstandard operation. The highest failure rate reported in the literature is 32.6%. To further standardize the clinical application of marsupialization and improve the success rate of treatment, we put forward an expert consensus of marsupialization in the treatment of jaw cystic lesions by reviewing the domestic and foreign literature and summarizing the experience in marsupialization from some famous domestic experts. In this consensus, we propose three elements of marsupialization: the establishment of the opening, the maintenance of cyst plugs and regular washing. The scope of application of marsupialization includes jaw cysts and cystic ameloblastomas. It is necessary to standardize the position of the opening, the size of the opening and the manufacture of the cyst plug, and a panoramic film or cone beam computed tomography(CBCT) should be used to observe the changes in the cystic cavity before and after operation. A second-stage operation should be performed when the lesion is significantly reduced by more than 50% or at least 5 mm from important structures; furthermore, the teeth of focus should be treated according to the relationship between the lesion and tooth and the type of tooth.

Psychopharmacology in myasthenia gravis patients with focus on depression

Myasthenia gravis is an autoimmune disease with a potential to disrupt brain function and cause depression as a result of the disease itself or treatment side effect. Some biological and psychological mechanisms have been proposed for the correlations between myasthenia gravis and depression. Depression might present in patients myasthenia gravis, and it might complicate the course of the disease. Adequate treatment might not only improve the depression but might also impact the myasthenia gravis in general.

The safety and efficacy of tPA intravenous thrombolysis for treating acute ischemic stroke patients with a history of cerebral hemorrhage

Alteplase (tPA) intravenous thrombolysis is an effective treatment for acute ischemic stroke (AIS) when administered within 4.5 h of initial stroke symptoms. Here, its safety and efficacy were evaluated among AIS patients with a previous history of cerebral hemorrhage. Patients who arrived at the hospital within 4.5 h of initial stroke symptoms and who were treated with tPA intravenous thrombolysis or conventional therapies were analyzed. The 90-day modified Rankin scale (90-d mRS) was used alongside mortality and incidence of symptomatic intracerebral hemorrhage (SICH) rates to evaluate the curative effect of these therapies. Among 1,694 AIS patients, 805 patients were treated with intravenous thrombolysis, including patients with (n=793) or without (n=12) a history of cerebral hemorrhage, and the rate of incidence of SICH significantly differed between them (8.3 vs 4.3%, P=0.039). No significant difference was found in 90-d mRS measurements (41.7 vs 43.6%, P=0.530) and 90-d mortality rates (8.3 vs 6.5%, P=0.946). A total of 76 AIS patients with a history of cerebral hemorrhage received tPA thrombolytic therapy (n=12) or conventional therapy (n=64), and a significant difference was noted in the 90-d mRS scores between the two groups (41.7 vs 23.4%, P=0.029), while no significant difference was found in SICH measurements (8.3 vs 4.6%, P=0.610) and 90-d mortality rates (8.3 vs 9.4%, P=0.227). A history of cerebral hemorrhage is not an absolute contraindication for thrombolytic therapy; tPA intravenous thrombolysis does not increase SICH measurements and mortality rates in patients with a history of cerebral hemorrhage, and they may benefit from thrombolytic therapy.

A review of complications of maxillary sinus augmentation and available treatment methods

Maxillary sinus grafting is a dependable procedure that has been in use for a long time. However, clinical complications often arise. To prevent complications of maxillary sinus grafting, it is necessary to know the contra-indications, both for general implantation and for maxillary bone grafting. In addition, presence of various complications requires careful consideration of treatment method; therefore, dentists should be familiar with the treatment protocols. Complications can be divided into postoperative, immediate postoperative, and delayed postoperative complications. Particularly for the outpatient, it is necessary to quickly distinguish between treatable cases and cases for which transfer is required. The purpose of this review is to discuss the contra-indications, complications, and treatment options for complications of maxillary sinus graft.

Analysis on the relationship between Occupational Stress Factors and Psychological Stress Reaction among Petrochemical Workers / 中华劳动卫生职业病杂志

Objective@#Analyze the detection rates of occupational contraindication and suspected occupational disease from the employee exposure to noise and describe the distribution characteristics.@*Methods@#According to the Technical Specifications for Occupational Health Surveillance (GBZ 188-2014) 、Diagnosis of Occupational Noise-induced Deafness (GBZ 49-2014) and Guideline of Identification of Contraindication to Job Placement (GBZ/T 260-2014) , calculate and analyze the occupational contraindication and suspected occupational disease detection rates of 149 271 workers from January 1st to December 31st in 2015 who were exposed to noise. Analyze the detection rates distribution characteristics between different gender, age, seniority, industry and enterprise scale.@*Results@#The detection rates of occupational contraindication is 2.08%. The suspected occupational disease detection rates of absences workers (2.13%) is higher than during (2.03%) . The occupational contraindication detection rates of< age 20 (2.64%) , 41~50 years old (2.48%) and<1 working years (5.35%) , are higher than others. The detection rates of suspected occupational disease increases with the growth of ages and working years. The occupational contraindication detection rates of scientific research and technology services industry (10.46%) is the highest. The suspected occupational disease detection rates of transportation warehousing and postal services (5.88%) is the highest. The occupational contraindication detection rates of medium-sized enterprise (2.27%) is the highest, meanwhile, the microenterprise’s (1.60%) is the lowest. The suspected occupational disease detection rates of large-scale enterprise (3.21%) is the highest, meanwhile, the microenterprise’s (1.33%) is the lowest.@*Conclusion@#Enterprise should insist on regular occupational health examination, strengthen screening of occupational contraindication in new workers, especially pre-job workers and detect the occupational disease patients early. Focus on non-traditional noise industries above mentioned, improve intensity of noise hazards prevention and control. The detection rates of occupational contraindication and suspected occupational disease can be used as a reference standard for the quality control of occupational examination and report of medical institutions.

Analysis on Pregnancy Contraindication in Package Inserts of Chinese Patent Medicine in Our Hospital / 中国中医药信息杂志

Objective To provide references for rational use of Chinese patent medicine (CPM). Methods The package inserts of 143 CPM which were prescribed in our hospital were set as subjects, and the contents were analyzed according to pregnancy contraindication stated in Chinese Pharmacopoeia (2015 edition). Results Among the 143 CPM, there were 74 CPM which had the contraindication labels. Only 17 CPM contained prohibited compositions and 33 CPM contained caution compositions. There were 21 CPM which had no prohibited compositions and 3 CPM had prescription confidentiality. But the contraindication labels of only 25 CPM matched with their compositions. The rest did not match with their compositions. Conclusion Some package inserts of CPM about pregnancy contraindication exist content missing and description irregularities. The drug regulatory departments should further strength the supervision and management, and improve the quality of package inserts.

Amenazas a la seguridad de la paciente por la conducción del parto con oxitocina. Experiencia en un hospital público de Lima, Perú / Threats to the safety of the patient due to the delivery management with oxytocin. Experience in a public hospital in Lima, Peru

Resumen OBJETIVO Identificar las amenazas a la seguridad de la paciente en la práctica de la conducción del trabajo de parto con oxitocina y las repercusiones maternas y perinatales en un hospital público de tercer nivel de Lima, Perú. MATERIALES Y MÉTODOS Estudio cuantitativo, descriptivo, retrospectivo y transversal efectuado en pacientes embarazadas atendidas en un hospital público, de tercer nivel, de Lima, Perú, a quienes se indicó conducción del parto con oxitocina. Los datos se tabularon en Excel y SPSS v21. El análisis univariado incluyó frecuencia y porcentaje para las variables cualitativas; se emplearon medidas de tendencia central, dispersión y desviación estándar para variables cuantitativas. RESULTADOS Se revisaron 112 historias clínicas de pacientes sin alteraciones en el trabajo de parto a quienes se indicó conducción con oxitocina (29.5%; n = 33). La principal vía de término fue el parto vaginal (73.2%; n = 82) y del grupo con cesárea el motivo más común fue la desproporción céfalo pélvica (56.7%; n = 17). Se observaron complicaciones obstétricas en 25% (n = 28), de este grupo la principal fue la hemorragia posparto (46.4%; n = 13). El peso de los recién nacidos fue 3401 ± 394 gramos, 93.7 y 96.4% obtuvieron un Apgar entre 10 a 7 al primero y quinto minutos, respectivamente. CONCLUSIONES Las amenazas identificadas a la seguridad de la paciente fueron: conducción del parto con oxitocina en quienes no tenían alteraciones en el trabajo de parto y en quienes tuvieron desproporción céfalo-pélvica, a pesar de que es una contraindicación para el procedimiento.

Abstract OBJECTIVE Identify the threats to the safety of the patient in the practice of conducting labor with oxytocin and maternal and perinatal outcomes in a public tertiary hospital in Lima, during 2016. MATERIALS AND METHODS Quantitative, descriptive, retrospective and cross-sectional. A total 112 pregnants' medical histories were review who underwent augmentation of labour with oxytocin. Inclusion criteria's: term gestation, hospitalization with a 4 cm dilatation, fetuses in cephalic presentation. Exclusion criteria's: patients with previous or intercurrent pathologies to pregnancy. RESULT The augmentation with oxytocin made in pregnant women without alterations in labor (29.5%; n = 33). The main type childbirth was vaginal delivery (73.2%; n = 82) and of the group that underwent cesarean section, the most usual reason was cephalopelvic disproportion (56.7%; n = 17). Obstetric complications were observed (25%; n = 28), of this group the main was postpartum hemorrhage (46.4%; n = 13). The weight of the newborns oscillated between 3401 ± 394 g, 93.7% and 96.4% obtained an Apgar 10 to 7 at the 1st and 5th minute respectively. CONCLUSIONS The threats to the safety of the patient identified were the practice of augmentation of labor with oxytocin in pregnant women without alterations in labor and in pregnant women with cephalopelvic disproportion, although it is a contraindication to the procedure.

Investigation and Analysis of Pregnancy Contraindication in Package Inserts of 210 Kinds of Chinese Pat-ent Medicines / 中国药房

OBJECTIVE:To provide reference for drug consultation of Chinese patent medicine(CPM)in pregnancy. METH-ODS:Package inserts of CPM in our hospital during Jan.-Jun. 2016 were collected. Referring to the prohibited,contraindicated and caution materials and decoction pieces in Chinese Pharmacopoeia(part 1,2015 edition),based onnoteitem in Chinese Pharma-copoeia and Clinical Application Guidelines(2010 edition),problems existing in pregnancy contraindication labeling of package in-serts were compared and analyzed. RESULTS:There were 99 kinds of prohibited,contraindicated and caution materials and decoc-tion pieces in Chinese Pharmacopoeia. There were 210 package inserts of CPM except for the special medicine for children,in which 32 contained prohibited materials,61 contained caution materials,only 21 were in line with the contained materials. Among the package inserts of 93 CPM containing prohibited or caution materials,27 were included in Chinese Pharmacopoeia,13 in Clini-cal Application Guidelines only,17 in both,but only 6 had the same contraindication labeling. Among the package inserts of 32 CPM containing prohibited materials,6 were explicitly labeled prohibited,17 labeled contraindicated or caution,and 9 labeled none. Among the package inserts of 61 CPM containing caution materials,29 were labeled prohibited or contraindicated,15 la-beled caution,and 17 labeled none. Among the package inserts of 117 CPM containing no prohibited,contraindicated or caution materials,8 were labeled contraindicated in pregnancy,and 18 labeled prohibited in pregnancy. CONCLUSIONS:The pregnancy contraindications of most CPM are not normative,showing poor consistency with Chinese Pharmacopoeia or Clinical Application Guidelines. Except for providing drug consultation by complying with Chinese Pharmacopoeia,Clinical Application Guidelines and package insert,pharmacists can judge the CPM without labeled pregnancy contraindication by analyzing its classification of con-tained materials. Using TCM does not indicate safety drug use,in addition,some CPM contain western medicine ingredients. There-fore,pharmacists should conduct medication education for patients who used CPM in pregnancy. Considering the new and severe adverse reactions of TCM injections are more,its adverse reactions exist unpredictability,so that pregnant patients should be sug-gested to avoid using TCM injections by pharmacists.

Application of prone position in acute respiratory distress syndrome of pediatrics / 中华实用儿科临床杂志

Acute respiratory distress syndrome (ARDS) is a common critical disease in department of pediatrics.Mechanical ventilation is one of the effective means for the treatment of ARDS.In the past,in order to comfort and care for patients,the supine or semi supine position were used often.Recently,many studies have showed that prone position could change the respiratory mechanics and reduce intrathoracic pressure,avoiding lung injury caused by over stretch and hyperinflation,which is significant in improving ARDS gas exchange.