Analysis on 17 refeeding syndrome cases based on literature review of case reports / 中华临床营养杂志

Objective:To discuss the onset and development pattern and characteristics of refeeding syndrome (RFS) induced by nutrition support and to provide reference for rational drug use in parenteral nutrition management.Methods:Case reports of RFS from CNKI, Wanfang, VIP database and Pubmed from 2000 to 2020 were retrieved. The clinical data were collected and statistically analyzed.Results:A total of 17 reports, including 17 cases, were included in the analysis. Patients were 6 males(35.29%) and 11 females (64.71%). The distribution of age was from 29 weeks in a premature neonate to 87 years old. 12 cases (70.59%) of RFS occurred within 3 days after starting the nutrition support. The most common clinical manifestation were cardiovascular system symptoms (88.23%), with dyspnea as the most reported symptom (41.17%). 15 patients (88.23%) recovered after appropriate intervention and 2 patients died(11.76%).Conclusions:Refeeding syndrome is a potentially fatal condition. The risk of RFS should be assessed before initiating nutrition support. Patients at risk of RFS must be monitored closely at the early stage of nutritional support.

Effect of meticulous management on prevention and control of healthcare-associated infection in pharmacy intravenous admixture service / 中国感染控制杂志

Objective To evaluate the application effect of meticulous management mode on prevention and control of infection related to pharmacy intravenous admixture service(PIVAS). Methods Qualified detection results of hygiene status of object surface,air culture quality,hand hygiene of medical staff in PIVAS in a hospital from Janu-ary 2014 to December 2016 were investigated,meticulous management measures were taken to intervene and analyze the detection results.Results The qualified rates of hand hygiene in 2014-2016 were 68.18%,81.82%,and 100.00% respectively,hand hygiene qualified rates in different years were statistically different(χ2=2.993,P=0.019). Qualified detection rates of surface of small objects,surface of horizontal laminar flow hoods,surface of biosafety cabinets,and air quality of dressing room Ⅰ and Ⅱ in PIVAS all increased to 100% in 2016.Conclusion Strengthening meticulous management of the internal work of PIVAS can effectively improve staff's standardized operation.

Investigation and analysis on the quality of teaching bone marrow smear / 国际检验医学杂志

Objective To Investigation the quality of marrow smear purchased by CDUTCM.Methods The quality and the typ-icality of marrow smears purchased during 2015 -2016 were collectively examined,and then decided whether these smears fit the blood cell morphology experimental teaching requirement.Results Of all the 960 marrow smears purchased these two years, 49.7% failed in smear made or stained,and 16.0% failed to meet the teaching requirements in the typicality of marrow cells.Con-clusion Teaching marrow smears,being different from clinic ones in their preparation and morphological diagnosis,must be of great quality in sustaining and of better typicality in their cell features.

Investigation and Analysis of Clinical Nurses' Satisfactory Degree to PIVAS in Our Hospital / 中国药房

OBJECTIVE:To provide reference for improving the service quality of PIVAS in our hospital. METHODS:Satis-faction questionnaire was designed by us. The survey was conducted among clinical nurses from 40 wards of our hospital about their satisfactory degree to pharmaceutical care of PIVAS and related influential factors. The survey data were analyzed statistically. RESULTS:A total of 280 questionnaires were sent out,and 271 effective questionnaires were collected with effective recovery of 96.79%. The overall satisfaction degree of nurses to PIVAS services was higher [(4.31±0.89)points]. The top 3 items were"drug admixture correction rate""infusion order rationality"and"drug packing quantitative accuracy rate rate",scored (4.57 ± 0.70), (4.56 ± 0.73) and (4.50 ± 0.76),respectively;the last 3 items of satisfaction were"timeliness of telephone answering service""timeliness of temporary medical orders'distribution"and"serviceable time for temporary medical orders'admixture",scored (3.73 ± 1.16),(3.75 ± 1.03) and (3.96 ± 1.01),respectively. The univariate analysis and multivariate analysis showed that there were statistical differences in the satisfaction score among nurses with different ages from different departments(P<0.01). The nurs-es in cardiovascular medicine department and ICU showed lowest satisfaction on service effect,and the nurses aged 20-29 years old showed highest satisfaction on service effect. There was no statistical significance in satisfactory degree among nurses with different gender,nursing ages,education background and professional titles(P>0.05). CONCLUSIONS:The overall satisfaction of clinical nurses to PIVAS service is favorable. The items of temporary medical orders-related service score the lowest,and service effect is related to nurses'departments and age. It is necessary to combine the shortage of work and the demand of clinical services to strengthen the management and promote the continuous improvement of PIVAS service quality.

Discussion on enrollment reform of clinical medical postgraduates / 中华医学教育探索杂志

This paper analyzes the current enrollment situation of clinical medical postgraduates, such as the gap between schools and regions, the structure of students diversification and the uneven quality, discusses the training target of clinical medical postgraduates, probes into the principles of enrollment for clinical medical postgraduates and the reexamination program which includes re qualification examination, qualification examination, physical examination, interview, written examination, clinical skills assessment, and puts forward some pertinent suggestions.

Comparative Study on Concentration Monitoring of CsA in Human Whole Blood by EMIT and HPLC / 中国药师

Objective:To compare the difference and correlation of HPLC and enzyme-multiplied immunoassay test( EMIT) for the determination of CsA in human whole blood. Methods:A total of 119 clinical samples at different concentrations of CsA were collected and respectively determined by HPLC and EMIT. The difference and correlation of the two determination methods were investigated. Results:There was significant difference in the blood concentrations of CsA determined by HPLC and EMIT(P<0. 05). CsA concen-tration determined by EMIT was 26. 2 ng·ml-1 higher than that determined by HPLC, and 95% CI was (14. 6-37. 7) ng·ml-1 . A satisfactory correlation was achieved between the two methods(r=0. 997 4). Conclusion:There is statistically significant difference in the CsA concentration in whole blood respectively determined by EMIT and HPLC. Attention should be paid to CsA monitoring by E-MIT and HPLC, and relevant adjustment should be carried out.

Analysis of blood concentration monitoring result for cyclosporin a in renal transplant recipients surviving for more than three years / 中国药学杂志

OBJECTIVE: To analyze the results of blood concentration monitoring for cyclosporin A (CsA) in renal transplant recipients who have survived for more than three years, thus to investigate the relationship between CsA dose, blood concentration interindividual variability and gender and age, and to determine the possibility of decrease CsA dose and blood concentration by new triple therapeutic protocol, and to analyses the relationship between postoperation time and ρ2 and ρ0. METHODS: The blood concentrations of CsA of 97 patients (1 780 cases) were determined by FPIA method. The relationships between time after surgery, gender, age, immunosuppressive strategy and blood concentration of CsA were analyzed. RESULTS: The blood concentration and dose of CsA decreased with time after surgery, with significant inter-individual difference. The doses for female patients were larger than those for males in the early days after surgery, and then became smaller than male in later time, with no statistical significant difference. Under similar doses, the blood concentrations of CsA in females were lower than those in males, but with no significant difference. Twentyfour months after transplantation, significant difference of blood concentration was revealed between female and male patients (P < 0.05). With increasing age, the dose and blood concentration decreased in the two groups. The dose and blood concentration of CsA in patients elder than fifty years were lower than those in patients younger than fifty years in the same period after surgery. Compared with the old triple therapeutic protocol group, the dose of CsA and blood concentration decreased in the new triple therapeutic protocol group with significant difference. The ρ2 and ρ0 decreased following the time after operation with reduction of CsA dose. CONCLUSION: Significant individual difference exists in the dose and blood concentration of CsA in patients after renal transplantation. Multianalysis of the clinical feature of patients should be performed to adjust the therapeutic protocols, thus to achieve personalized pharmacotherapy and the best treatment results.

The efficacy of open-wedge high tibial osteotomy for varus knee / 中华外科杂志

<p><b>OBJECTIVE</b>To introduce the biplanar opening high tibial osteotomy with rigid fixation for adult varus knee.</p><p><b>METHODS</b>Twelve patients with varus knee and degeneration of medial compartment received the biplanar opening high tibial osteotomy between June 2001 and July 2008. The pre-operative deformity was about 11.5 degrees without osteoarthritis changes in other compartments. The average range of motion was more than 90 degrees . One of the patients had ruptures of LCL and ACL, who received osteotomy after reconstruction of the ligaments. The main symptom before the operation was pain in medial compartment. The range of motion, Lysholm score and subjective satisfactory examinations were assessed before and after the osteotomy.</p><p><b>RESULTS</b>All of the osteotomy sites were healed at twelve to sixteen weeks after operation. No complications such as plate broken or injury of nerve or blood vessel had occurred. The mean correct angle was 9.5 degrees . No degenerative changes had developed in other compartments of the knee. The mechanical axis of the lower extremities was maintained during the follow-up. The overall satisfactory rate was 83.3%. Statistically significant changes exist in the Lysholm score and varus degree.</p><p><b>CONCLUSION</b>The open-wedge high tibial osteotomy is suitable for the symptomatic genu varum in younger patients with good short-term and mid-term results.</p>

Repair full-thickness meniscal defects with injectable tissue engineering technique / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effectiveness of injectable tissue engineering to repair full-thickness meniscal defects.</p><p><b>METHODS</b>From June 2008 to February 2009 full-thickness of meniscal defects were created in the anterior corner of goats, which with no blood supply, in a diameter of 2 mm. Then bone marrow stem cells (BMSCs) was mixed with injectable calcium alginate gel to fill the defects. Other groups include the calcium alginate gel and empty group were served as control groups. At different time points, the animals were sacrificed and macroscopy, microscopy determination, electroscopy and MRI detection were performed to assess the outcomes of repairing.</p><p><b>RESULTS</b>The meniscal defects had been filled thoroughly in 16 weeks after operation with white, tough and elastic repair tissue similar to normal meniscal fibrocartilage in the tissue engineering groups. The repair tissue was mainly fibrochondrocytes in line with the calcium alginate fiber. Thick matrix secreted by the cells crammed the space between fibers. The view under electroscopy demonstrated that the microstructure of the repair tissue was normal and cells were in a fibrocartilage phenotype.</p><p><b>CONCLUSION</b>The full-thickness meniscal defects in regions without blood supply can be reconstructed effectively with injectable tissue engineering.</p>

Uninduced adipose-derived stem cells repair the defect of full-thickness hyaline cartilage / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To testify the effect of the stem cells derived from the widely distributed fat tissue on repairing full-thickness hyaline cartilage defects.</p><p><b>METHODS</b>Adipose-derived stem cells (ADSCs) were derived from adipose tissue and cultured in vitro. Twenty-seven New Zealand white rabbits were divided into three groups randomly. The cultured ADSCs mixed with calcium alginate gel were used to fill the full-thickness hyaline cartilage defects created at the patellafemoral joint, and the defects repaired with gel or without treatment served as control groups. After 4, 8 and 12 weeks, the reconstructed tissue was evaluated macroscopically and microscopically. Histological analysis and qualitative scoring were also performed to detect the outcome.</p><p><b>RESULTS</b>Full thickness hyaline cartilage defects were repaired completely with ADSCs-derived tissue. The result was better in ADSCs group than the control ones. The microstructure of reconstructed tissue with ADSCs was similar to that of hyaline cartilage and contained more cells and regular matrix fibers, being better than other groups. Plenty of collagen fibers around cells could be seen under transmission electron microscopy. Statistical analysis revealed a significant difference in comparison with other groups at each time point (t equal to 4.360, P less than 0.01).</p><p><b>CONCLUSION</b>These results indicate that stem cells derived from mature adipose without induction possess the ability to repair cartilage defects.</p>

Intervention in Antimicrobial Agent Use for Hospitalized Patients / 中华医院感染学杂志

OBJECTIVE To enhance the rational usage of antimicrobial agents in hospitalized patients by comprehensive interventional measures in clinics.METHODS The selected indictors recommended by WHO were applied to evaluate the use of antimicrobial agents in hospitalized patients.The hospital information was gained from hospital administration section.The prescription and treatment data were collected from the discharged patients′ medical history.Intervention was involved in managerial and educational strategies.RESULTS After intervention,the average number of antimicrobial agents prescribed per inpatient fell from 2.13 to 1.97.The average cost of antimicrobial agents prescribed per inpatient fell from 1765.23 yuan to 1136.18 yuan(P

Experimental research on human insulin-like growth factor I gene transfect the cultured bone marrow mesenchymal stem cells / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effectiveness of human insulin-like growth factor I (hIGF-I) gene transferred into the cultured goat bone marrow mesenchymal stem cells with liposome, and find a new method of cell-mediated gene therapy.</p><p><b>METHODS</b>Bone marrow was extracted from adult goats and cultured in vitro by monolayer. Then the recombinant eukaryotic expression plasmid pIRES2-EGFP-hIGF was transfected into cells by FuGene 6. After transfection, the marker gene coding enhanced green fluorescent protein (EGFP) was observed at different time points. The hIGF concentration in the supernatant fluids was measured by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry stain of hIGF was performed to detect the target protein. Besides, reverse transcription polymerase chain reaction and flow cytometry were also adopted in order to find out the changes of cells after transfection.</p><p><b>RESULTS</b>Bone marrow stem cells were all in the long shuttle-like shape and adhered to the disk. The expression of EGFP was first found at 4 h after transfection. The amount and intensity of EGFP increased gradually during the period of detection and got to the peak degree at 72 h, after that decreased slowly. EGFP was also seen in the second generation cells, but the intensity was relatively faint. The IGF-I concentration secreted into the supernatant was in accordance with the EGFP observed with the peak concentration at 34.75 ng/ml. The outcome of RT-PCR and immunohistochemistry was positive. The morphology of many stem cells was changed into triangular or irregular forms under the circumstance of the secreted hIGF-I. Percentage of stem cells in the S stage increased after transfection.</p><p><b>CONCLUSION</b>The hIGF-I gene can be transfected efficiently and safely into BMSCs by FuGene 6, and the hIGF-I protein can be secreted into the supernatant in a relatively high level during a long period, therefore accelerate the proliferation and differentiation of the transfected cells.</p>

Sorafenib plus Capecitabine for Patients with Advanced Hepatocellular Carcinoma / 中国药房

OBJECTIVE: To evaluate the efficacy and toxicity of sorafenib plus Capecitabine in patients with advanced hepatocellular carcinoma (HCC). METHODS: 20 patients (treatment group) were assigned to take sorafenib 200 mg bid for 3 consecutive weeks plus capecitabine 1 500 mg? m-2?d-1 for l4 days followed by 7 days discontinuation in 3-week treatment cycle. 22 patients in the control group only received Capecitabine 1 500 mg?m-2?d-1 for l4 days followed by 7 days discontinuation in a 3-week treatment cycle. Tumor response was assessed after 2-cycle treatment using modified WHO criteria. RESULTS: In the treatment group and the control group: the median survival times were 10.9 months and 7.2 months, respectively; the median time for tumor progression was 6.8 months and 4.3 months, respectively; the overall response rates were 20.0% and 9.1% respectively; the clinical benefit rates were 70.0% and 40.9%; the ?-foetoprotein (AFP) reduction rates were 65.5% and 39.0%, respectively. The toxicities were not significant between the two groups. CONCLUSION: Sorafenib plus Capecitabine is safe and effective for advanced hepatocellular carcinoma patients.