Objective To explore the effects of post-discharge continuous nursing intervention on medication compliance and negative emotion of patients with acute myocardial infarction after percutaneous coronary intervention (PCI).Methods 168 patients with acute myocardial infarction were selected.All of them got emergency PCI after admitted.Then,they were simply randomized into observation group (84 cases) and control group (84 cases) using coin toss method combined with random comparison table.The observation group accepted continuous nursing intervention after discharged,including regular home visits,telephone feedback and clinical visits.The control group got a regular clinical follow-up.Their medication compliance and negative emotion were investigated after 1 month,3 months,6 months and 12 months from discharged,respectively.Results Relevant data with different periods of patients with repeated measurement data analysis of variance,discharge for 3 months,6 months and 1 year,compared with the control group,the medication compliance of the observation group increased obviously,the SAS and SDS scores decreased obviously,the differences were statistically significant (t =1.432,2.781,1.432,2.781,2.504,3.783,2.761,4.621,4.884,all P ＜ 0.05).Further analysis of the data between inter group effect,time effect,inter action effect showed that with the extension of the discharge time,the medication compliance and SAS,SDS scores of the two groups were significantly different (F =30.258,P ＜ 0.01;F =2.673,P ＜ 0.05;F =2.024,P ＜ 0.05).In hospital,there were no statistically significant differences in the quality of life of patients between the two groups(t =1.250,1.250,1.250,1.250,0.694,1.113,2.463,all P ＞ 0.05).1 year after discharge,compared with the control group,the movement and exercise,interpersonal relationships,nutrition,health responsibility,self-actualization,stress management scores in the observation group significantly increased,the differences were statistically significant (t =2.463,3.146,2.463,3.146,2.633,2.115,all P ＜ 0.05).Conclusion Continuous nursing interventions can effectively reduce acute myocardial infarction patients'anxiety and depression after PCI,improve their compliance and prevent recurrent cardiovascular events.

Objective To establish an analytical method to determine arsenic in cosmetics with graphite furnace atomic absorption spectrometry. Methods Arsenic in cosmetics was determined by graphite furnace atomic absorption spectrometry with citric acid as a matrix modifier. Results The detection limit was 0.03 ? g/ g, the related coefficient of the standard curve for the present method was 0.997-0.999, and relative standard deviation was 4.7%, rate of recovery was 92%-106%. Conclusion Graphite furnace atomic absorption spectrometry is sensitive, reliable, simple and rapid for determination of arsenic in cosmetics.

Objective To investigates the gene expression of telomerase by real-time quantitative telomeric-repeat amplification protocol assay (RTQ-TRAP) in the peripheral blood mononuclear cells (PBMC) of colorectal carcinoma patients and the relationship between the telomerase gene expression in PBMC and clinicopathological features. Methods Peripheral blood samptes were collected from 71 colorectal carcinoma patients, 20 benign colorectal disease patients and 25 normal controls. The telomerase gene expression in PBMC was measured by RTQ-TRAP, and serum CEA in colorectal carcinoma patients was measured by chemiluminescence immunoassay. Results The gene expression of telomerase in PBMC was positive in 50 out of 71 cancer patients (70. 4% ) , 1 out of benign patients (5. 0% ), respectively. The difference of the telomerase gene expression of PBMC in benign colorectal diseases and cancer patients was significant (χ2 = 24. 521, P < 0. 001 ). There was no significant association between the expression of telomerase and patient's gender, age, Dukes stage, and tumor site. The positive rate of CEA in colorectal carcinoma patients was not significantly higher than positive rate of telomerase gene expression(χ2 = 2. 286,P = 0. 125). Conclusions The RTQ-TRAP method is highly accurate and sensitive in measuring telomerase gene expression. The detection of telomerase gene expression in PBMC of colorectal carcinoma patients is a simple and useful molecular marker for the diagnosis of colorectal carcinoma.

OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.

Background and purpose:Nab-paclitaxel (Abraxane) is an albumin-bound form of paclitaxel that utilizes the natural properties of albumin to improve paclitaxel delivery to the tumor. It has recently been approved for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within short time after adjuvant chemotherapy. The purpose of this study was to evaluate the efifcacy and safety of albumin-bound paclitaxel in patients with aggressive and refractory metastatic breast cancer (MBC).Methods:A total of 58 patients with MBC were enrolled into this study from Jul. 2009 to Jan. 2014. All patients received albumin-bound paclitaxel-based chemotherapy. The adverse reactions were evaluated every cycle, and the short-term response was evaluated every two cycles. The patients were followed-up, and the survival was analyzed.Results:58 patients with refractory MBC were evaluable for response, 67.2% of patients received multiple line (≥3 lines) chemotherapy, 32.8% of patients with first and second line of chemotherapy were involved metastasis within one year after adjuvant chemotherapy, 84.5% of patients with visceral metastasis and 93.1% with prior taxane treatment. The objective response rate (ORR) was 13.8%, and disease control rate (DCR) was 60.3%, the median progression free survival (PFS) was 4.0 months, and the overall survival (OS) was 10.1 months. For 23 patients with triple negative breast cancer, ORR was 13.0% and DCR was 56.5%, the median PFS was 4.1 months, and OS was 6.6 months. The main toxicity was myelosuppression (grades 3 and 4 neutropenia, anemia and thombocytopenia were seen in 34.5%, 12.1% and 6.9% of patients, respectively), gastrointestinal reactions, sensory neuropathy, myodynia/arthragia, fatigue, alopecia and so on.Conclusion:The albumin-bound paclitaxel-based chemotherapy can be used in aggressive and refractory MBC. It also showed antitumor activity in taxanes-resistance patients and triple negative patients with good safety and tolerance.

Objective:To detect the proportion of lymphocyte subsets in peripheral blood of the ad-vanced breast cancer patients before and after chemotherapy with docetaxel and thiotepa,as well as the association between the proportion of peripheral blood lymphocyte subsets with the response rate and prog-nosis.Methods:The proportions of lymphocyte subsets (CD3 +T cell,CD3 +/CD4 +T cell,CD3 +/CD8 +T cell,CD3 -/CD16 +56 +NK cell,CD3 +/CD16 +56 +T cell,CD19 +B cell,CD4 +/CD25 +T cell,CD8 +/CD28 -T cell,CD8 +/CD28 +T cell)in the peripheral blood of 86 patients were analyzed with flowcytometry before and after chemotherapy.The result was analyzed in combination with clinico-pathological data.Results:The proportion of regulatory T cells (Treg)after chemotherapy in the disease control patients decreased significantly compared with that of the progressive patients (P=0.034).The difference of the proportions of Treg before and after chemotherapy affected significantly the overall survi-val (OS).The OS of the patients with decreased proportion of Treg was significantly longer than that of the patients with increased proportion of Treg,which was 23.5 and 9.4 months respectively (P<0.05). Conclusion:The patients with decreased proportion of Treg after chemotherapy had higher response rate and better survival benefit.

Objective To explore the MRI features of acute optic neuritis with positive aquaporin?4 (AQP4) antibodies and myelin oligodendrocyte glycoprotein (MOG) antibodies during the first attack. Methods Eighty five patients (105 affected nerves) with first?episode AQP4?seropositive optic neuritis (AQP4?ON; n=58; 64 affected nerves) and MOG?seropositive optic neuritis (MOG?ON; n=27; 41 affected nerves) diagnosed by our hospital Neuro?ophthalmology Department between April 2014 and December 2017 were retrospectively analyzed. Double seronegative patients or double seropositive patients were not included. All patients underwent orbital conventional MRI; 29 patients also underwent RESOLVE?DWI and 55 underwent brain T2 fluid?attenuated inversion recovery (T2FLAIR). Theclinical features (age, gender, disease duration) and MRI features (T2WI, bilateral involvement, the degree and extent of enhancement, the extent of involvement, the affected segment and ADC values of nerve; demyelinating lesions of brain) were analyzed by 2 doctors. The qualitative parameters were compared with χ2 test or Fisher exact test and the quantitative parameters were compared with two independent sample t test (normal distribution) or the Mann?Whitney U test (skewed distribution). The Kappa test was used to test the consistency of the qualitative characteristics of the images evaluated by the 2 doctors. The interclass correlation coefficient (ICC) was used to test the consistency of the ADC obtained by the 2 doctors. Results There were no significant differences in the distributions of age and disease duration between 2 groups (t=1.911, Z=-1.054, P>0.05). AQP4?ON had a higher female proportion (χ2=13.911, P<0.05) and showed mainly unilateral involvement. MOG?ON more commonly showed bilateral involvement (χ2=17.640, P<0.05), but there were no significant differences in the demyelinating lesions of brain (χ2=0.000)and the presence/absence of optic tract involvement (both P>0.05). There was a higher probability of optic nerve swelling, long segmental lesions and optic nerve head involvement in MOG?ON(χ2=16.845, 13.525, 13.264, P<0.05). Moreover, the rate of obvious enhancement and the involvement of optic chiasm was higher in AQP4?ON(χ2=7.152, 5.088, P<0.05). RESOLVE?DWI showed the ADC values of the AQP4?ON were significantly lower than those of MOG?ON (t=-3.300, P<0.05). The qualitative features of image evaluated by the 2 doctors were consistent well (Kappa=0.712-0.932, P<0.001).The ADC values obtained by the 2 doctors were consistent well (ICC=0.942, P<0.001).Conclusions For the first?episode acute optic neuritis, AQP4?ON hasobvious female predilection and the trend of unilateral involvement and obvious enhancement, while MOG?ON isoften involved bilaterally with longitudinally extensive lesions. The ADC values of the AQP4?ON are significantly lower than those of MOG?ON and AQP4?ON are more vulnerable to involve the optic chiasm. Conventional MRI and RESOLVE?DWI are helpful for differentiating AQP4?ON from MOG?ON during the early stage of the disease course.

OBJECTIVE To screen the quality biomarkers of Gnaphalium affine with anti-chronic obstructive pulmonary disease （COPD） effect and determine their contents. METHODS The effective components and targets of “G. affine” with anti- COPD effect were predicted by using network pharmacology as a search criterion. HPLC fingerprints for 10 batches of G. affine were established by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）； common peak identification and similarity evaluation were conducted； cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed to screen differential components as quality maker that affected the quality of G. affine using variable importance projection （VIP）＞1 as the standard. The same HPLC method was adopted to determine the contents of the differential components in 10 batches of samples. RESULTS A total of 10 flavonoids （such as quercetin， luteolin， and chlorogenic acid） and organic acid components， were identified through network pharmacology search， with 91 targets closely related to anti-COPD. A total of 9 common peaks were identified in 10 batches of samples， with similarity greater than 0.90. Among them， the differential components included chlorogenic acid， caffeic acid， 1，3-O- dicaffeoylquinic acid and apigenin 7-O-β-D-glucopyranoside； S3， S4， S6， S7 and S10 were clustered into one category， S2， S5， S8 and S9 clustered into one category， and S1 clustered into one category. The contents of chlorogenic acid， caffeic acid， 1，3-O- dicaffeoylquinic acid， and apigenin 7-O-β-D-glucopyranoside in 10 batches of G. affine ranged 0.070-7.653， 0.010-0.097， 0.001- 0.036， 0.508-6.627 mg/g， respectively. CONCLUSIONS Chlorogenic acid， caffeic acid， 1，3-O-dicaffeoylquinic acid， apigenin 7- O-β-D-glucopyranoside can serve as the potential quality marker for the anti-COPD effect of G. affine， with the highest content of chlorogenic acid in G. affine produced in Ji’an， Jiangxi province， and the highest content of caffeic acid in G. affine produced in Ji’an， Jiangxi province and Sanming， Fujian province. The contents of the last two components are highest in G. affine produced in Chaoshan， Guangdong province.

OBJECTIVE： To investigate the effects of new mode of medical orders evaluation according to disease classification. METHODS： Totally 16 kinds of common diseases were selected from each department of our hospital. Each 10 electronic medical records of each disease were randomly selected from 160 patients in the hospital information system from Jan. 1 to Dec. 31， 2016. The rationality of 10 720 medical orders were evaluated retrospectively during hospitalization. Statistical analysis was made on the relevant indicators such as unsuitable usage and dosage， the proportion of auxiliary drugs and unsuitable indications in medical orders of irrational drug use， and a new mode of prescription comment was established according to the classification of diseases. 9 862 medical orders of same disease types were collected after the implementation （from Apr.-May， 2017） of new mode and intervene to evaluate the irrational rate of them so as to evaluate the effects of new mode. RESULTS： In the samples in 2016， a total of 751 medical orders of irrational drug use were evaluated， the most of them were unsuitable usage and dosage （414 items， 55.12％）， especially in the intracerebral hemorrhage diseases （69 items， 16.67％）； under this kind of disease， most of irrational drug use was excessive dosage of single dosing （31 items， 44.92％）. The top three disease types in the list of the ratio of adjuvant drug cost in total drug cost were surgery for renal tumors （39.43％）， acute cerebral infarction （non-surgery） （37.03％） and intervertebral disc herniation surgery （35.26％）. 70 medical orders of irrational drug use were unsuitable indications （9.32％）. After the application of evaluation mode according to classification of disease types and intervene， the irrational rate of medical orders decreased from 7.00％ （751/10 720） before evaluation to 2.95％ （291/9 862）after evaluation， decreasing by 57.86％. CONCLUSIONS： The application of evaluation mode according to classification of disease types can achieve good results in controlling the irrational rate of medical orders and contribute to rational drug use in clinic.

OBJECTIVE: To evaluate the application of three-in-one intelligent screening in outpatient pre-inspection in children's hospital. METHODS: We randomly enrolled 100 children pre-screened by traditional method in the outpatient department of Children's Hospital of Zhejiang University from February 6th to 16th, 2020, and another 100 children by the intelligent three-in-one mode from February 17th to 27th, 2020. The traditional triage was conducted by nurses based on face-to-face, one-by-one interview of the epidemiological history and consultation department, and the temperature was measured before manual triage. The intelligent three-in-one model combined online rapid pre-inspection and triage, on-site manual confirmation, as well as synchronized online health education system. For on-line registered patients, the system automatically sent the COVID-19 epidemiological pre-screening triage questionnaire one hour before the appointment, requiring parents to complete and submit online before arriving at the hospital. The on-site registered patients were controlled at 100 m away from the hospital entrance. The nurses guided the parents to scan the QR code and fill in the COVID-19 epidemiological pre-examination triage questionnaire. At the entrance of the hospital, the nurse checked the guidance sheet and took the temperature again. The children with red guidance sheet were checked again and confirmed by pre-examination nurses, and accompanied to the isolation clinic through COVID-19 patients-only entrance. The children with yellow guidance sheet were guided to fever clinic. The children with green guidance sheet could go with their parents to the designated area, and then went to the corresponding consultation area. Health education was carried out throughout the treatment, and the system automatically posted the corresponding outpatient instructions and education courses. Parents would read the courses on their mobile phones and counsel online. The time of pre-examination and the coincidence rate of triage were compared between the two groups. RESULTS: The three-in-one intelligent pre-inspection mode took an average of (25.6±8.0) s for each child, which was significantly shorter than the traditional pre-inspection mode (74.8±36.4) s ( CONCLUSIONS The three-in-one intelligent pre-inspection model can effectively shorten the patient pre-check time, with similar triage coincidence rate to traditional model.
Adult ; Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections/diagnosis* ; Humans ; Internet ; Outpatient Clinics, Hospital ; Pandemics ; Pneumonia, Viral/diagnosis* ; SARS-CoV-2 ; Surveys and Questionnaires ; Time ; Triage/standards*