Objective To discuss on the management of the medicines in ward pharmacy of primary hospitals and ex-plore effective measures to improve the quality of medicines management .Methods Based on the real situation , managing the quantity of medicines in inpatient pharmacy, including the setting of the reasonable quantity, the procedures of storing and de-livering, the quality control on the general medicines and the management of high -risk medicines, to improve the quality of management of the medicines in ward pharmacy .Conclusion The use of medicines in ward pharmacy of primary hospitals is becoming more and more standardized and rationalized by strengthening the management of the medicines in inpatient pharmacy .

Objective To analyze the serum inflammation related factors of influenza A ( induced by sub-type H1N1 virus) patients with epidemic febrile damp-heat syndrome and warm-heat syndrome. Results Fifty-six patients confirmed as influenza A ( H1N1) were differentiated into epidemic febrile damp-heat syndrome ( 36 cases) and epidemic febrile warm-heat syndrome (20 cases) . And then we observed the serum immune globulins IgM and IgG, interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-ɑ), tumor growth factor beta 1 (TGF-β1), lipolysaccharide binding protein (LBP), Toll-like receptor 4 (TLR4) and soluble CD14 (sCD14) levels of the influenza A patients. Results Insignificant differences of serum IgM, IgG, IL-8, TNF-ɑand TGF-β1 levels were shown between epidemic febrile damp-heat syndrome patients and epidemic febrile warm-heat syndrome patients (P>0.05), but the differences of LBP, TLR4 and sCD14 were significant (P<0.05) .Conclusion Influenza A (H1N1) patients with epidemic febrile damp-heat syndrome have higher serum LBP, TLR4 and sCD14 levels than patients with epidemic febrile warm-heat syndrome, indicating that inflammatory reaction is severer in influenza A (H1N1) patients with epidemic febrile damp-heat syndrome.

Objective To determine the content of protocatechuic acid in Spatholobus suberectus Dunn.Methods HPLC method was developed for the determination of protocatechuic acid in Spatholobus suberectus Dunn.The separation was performed on C18 column with acetonitrile-water-orthophosphoric acid(8 ∶92 ∶0.1) as a mobile phase with the flow rate being 1.0 mL/min.The detection wavelength was set at 260 nm.Results A satisfactory separation between protocatechuic acid and impurity was obtained.The calibration curve was linear in the range of 0.020～2.008 ug,r=0.999 9.The average recovery was 98 %,and RSD was 0.1 %(n=5).Conclusion The method is accurate and can be used for the detemrmination of protocatechuic acid in Spatholobus suberectus Dunn.

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.

Objective To analyze the risk factors of pressure sores in patients underwent fracture surgery to establish a nomogram model to predict the risk of pressure sores. Methods From June 2012 to June 2017,3 796 patients underwent fracture surgery were enrolled in this study.Their clinical data were analyzed and univariate analysis was used to determine the risk factors related to pressure sores. The significant variables were included in the multivariate Logistic regression analysis to analyze the risk factors of pressure sores. Then the R software was used to establish a predictive nomogram model. Bootstrap method was used to validate the nomogram model and ROC curve was used to explore the predictive efficacy of the model in predicting the pressure sores. Results A total of 392 cases out of 3 796 cases of fracture surgery had pressure sores.The prevalence rate was 10.33%(392/3 796).Age(OR=3.56,95% CI 1.84-5.21),obesity(OR=2.25,95% CI 1.27-3.69),malnutrition(OR=3.91,95% CI 1.90-5.87), diabetes mellitus (OR=2.73,95% CI 1.50-4.32), and surgery time over 2.5 h (OR=5.14,95% CI 2.81-7.25) were all independent risk factors for pressure sores in fracture surgery (P<0.05). The nomogram model showed a C-index of 0.749 with good discrimination and accuracy,while ROC curve showed that the area under the curve for the nomogram model predicting pressure sores was 0.727 (95% CI 0.661-0.815). Conclusions The nomogram built based on age, obesity, malnutrition, diabetes mellitus, and surgery time over 2.5 h has good discrimination and accuracy which could be helpful for screening the patients with high risk and making the interventional strategies.

Wechat has been widely used in nursing clinical clerkship teaching now. The application of Wechat in nursing clinical teaching mainly takes the form of Wechat group chat, Wechat public signal platform, Wechat friendship circle, online test and so on. Among them, Wechat group chat and Wechat public signal platform are used widely. Wechat enriches the teaching way, and improve the effectiveness of teaching, moreover, it facilitates the relationship between teachers and students. However, there are the ongoing challenges such as lacking of supervision and protection of intellectual property rights.

Postprandial hypotension is an abnormal regulation of blood pressure, which is common in the elderly. Due to insidious symptoms, postprandial hypotension is easily neglected by patients and medical staff in clinical practice, but it has a high degree of harm. There are many factors related to the occurrence of postprandial hypotension, including demographic factors, disease-related factors, lifestyle factors, postprandial postural factors and so on. Among demographic factors, age is positively associated with the occurrence of postprandial hypotension. Among disease-related factors, the existence of some basic diseases such as hypertension and diabetes, and the use of most kinds of anti-hypertensive drugs can increase the risk of postprandial hypotension. Among lifestyle factors, smoking is a risk factor for postprandial hypotension: while reducing the intake of staple foods, drinking large amounts of water or drinking green tea before meals may reduce the risk of postprandial hypotension. By taking different postures after meals, postural factors affect the rate of gastrointestinal emptying and then affect the occurrence of postprandial hypotension. Among the above factors, it is feasible to prevent postprandial hypotension by changing postprandial posture.

Objective To explore the influence of long-term low-dose ionizing radiation on 8-hydroxy-2-deoxyguanosine(8-OHdG) level in the serum of radiation workers in hospitals.Methods 307 age-and sex-matched hospital radiation workers were recruited by stratified random sampling method.After deleting the subjects without dosage information,230 individuals were divided into four groups according to their job title [including diagnostic radiology (n =75),radiotherapy (n =60),nuclear medicine (n =41) and interventional radiology (n =54)].Serum 8-OHdG level was measured by ELISA assay.Results According to the statistical analysis,there was significant difference in the serum 8-OHdG level among four groups (F =9.071,P ＜ 0.05),and the content of serum 8-OHdG was significantly higher in the interventional radiology group than that in the groups of diagnostic radiology,radiotherapy and nuclear medicine (t =-4.473,-3.011,-2.189,P ＜ 0.05).There were significant differences in serum 8-OHdG level among different dose groups and working period groups(F =7.659,3.058,P ＜ 0.05).The serum 8-OHdG levels significantly increased along with exposure dose and working period (r =0.300,0.142,P ＜ 0.05).Conclusions Serum 8-OHdG may be a potential biomarker of oxidative DNA damage in radiation workers exposed to low-dose ionizing radiation.

Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

With the development of clinical related disciplines, the update and establishment of relevant standards/guidelines at home and abroad, GBZ 185-2006 Diagnostic Criteria for Occupational Medicamentose-like Dermatitis due to Trichloroethylene (hereinafter referred to as “GBZ 185-2006”) was unable to meet clinical needs. Therefore, the GBZ 185-2006 was revised based on the principles of evidence-based medicine, in accordance with relevant laws/regulations and relevant standards/guidelines in combination with review of research data on occupational medicamentose-like dermatitis due to trichloroethylene (OMDT) home and abroad, and the development of clinical practice and clinical related disciplines. The main modifications include: adding terms and definitions of OMDT, modifying the description of clinical manifestations of the diagnostic principles, adjusting the description of latency, deleting the diagnostic requirement of the incidence probability, adding the specific allergen patch test as the etiological diagnostic index, standardizing the application scope, operating procedure and precautions of the specific allergen patch test. In addition, the relevant content of “Basic Characteristics and Clinical Types of Skin Damage of Medicamentose-like Dermatitis due to Trichloroethylene” in Appendix A is improved, the treatment principles are revised, and the content of new progress in treatment, artificial liver application, are added. The revised GBZ 185-2024 Diagnostic Standard for Occupational Medicamentose-like Dermatitis due to Trichloroethylene is more scientific and practical, and can provide technical basis for the standardized diagnosis and treatment of OMDT in medical and health institutions.