ABSTRACT OBJECTIVE：To establish the infusion sequence regulation procedure of PIVAS，and implement individual regulation. METHODS：By combining factors such as liquid volume of each batch，incompatibility between groups and specific solvents of specific drugs，intelligent prompt system and the artificial intelligent regulation system of infusion sequence were successively established to sequence the therapeutic drugs and adjuvant drugs used for the patients with different diagnoses and different purposes in different inpatient areas in a day，so as to realize intelligent control of individual infusion sequence. From Jan. to Sept. in 2017 and from Jan. to Sept. in 2019 as research stages before and after the intelligent control of individualized infusion sequence，the control effect was evaluated with the proportion of reasonable number of infusion priority cases，the proportion of appropriate number of elderly patients’batch liquid volume cases，the proportion of incompatibility cases between separate groups， the number and cost of flushing tubes as index. RESULTS：After regulating infusion sequence individually，the proportion of reasonable infusion priority rose from 5.56％ to 98.72％ ；the proportion of batch liquid quantity appropriate cases in elderly patients rose from 9.58％ to 98.10％；the proportion which separated the incompatibility between groups rose from 41.03％ to 99.12％；the number of washing tube dropped to（0.95±0.43）times/ward/d from（12.95±0.57）times/ward/d；the cost of washing tube could be saved 85 800 yuan/year. CONCLUSIONS：The implementation of individualized infusion sequence regulation promote safe and effective infusion，and provide reference for pharmacists of PIVAS in China to carry out precise pharmaceutical care.

The important functions about the applications of the telemedicine-car in "5?12" earthquake are expatiated through the actual applications of the telemedicine system in mischance cure, some improved ideas and advice about this system in the especial estate are given to take the first-hand data for the telemedicine using in the martial and the civil especial estate, the telemedicine's farther consummate and development have grand and profound significance.

Three bibenzyls 1-3 and six other compounds 4-9 were firstly isolated from Dendrobium huoshanense stems. They were identified as 3',4-dihydroxy-3,5'-dimethoxybibenzyl(1), batatasin Ⅲ(2), 3,4'-dihydroxy-5-methoxy bibenzyl(3), dihydroconiferyl dihydro-p-coumarate(4), syringaresinol(5), 3-(4-hydroxyphenyl)-propionic acid ethyl ester(6),(3-ethylphenyl)-1,2-ethanediol(7),(S)-5-hydroxy-3,4-dimethyl-5-pentylfuran-2(5H)-one(8) and loliolide(9). Anti-inflammation assay showed that bibenzyls 1-3 could significantly inhibit the production of nitric oxide(NO) and the expression of tumor necrosis factor α(TNF-α) and interleukin 1β(IL-1β) mRNA in LPS-induced RAW264.7 macrophages. Mechanism study exhibited that the phosphorylation of nuclear factor kappa B(NF-κB) p65, inhibitor of κB(IκB), extracellular regulatedprotein kinase(ERK), c-Jun N-terminalkinase(JNK), p38 and Akt of LPS-induced RAW264.7 macrophages could be remarkably reduced by 1. These results suggested that the inflammatory response of LPS-induced RAW264.7 macrophages could be significantly inhibited by 1-3. Additionally, the anti-inflammatory effect of 1 might be contributed to its ability on the regulation of NF-κB, MAPKs and Akt signaling pathways.
Anti-Inflammatory Agents ; therapeutic use ; Dendrobium ; Humans ; Inflammation ; drug therapy ; Lipopolysaccharides ; Macrophages ; NF-kappa B ; Nitric Oxide ; Nitric Oxide Synthase Type II

ObjectiveNecrotizing fasciitis (NF) has a high rate of deterioration and rapid progress, and the mortality rate is still high even after receiving treatment. The study was to explore evaluation value of serum procalcitonin (PCT), C-reactive protein (CRP) and plasma albumin (ALB) and prealbumin (PA) in the prognosis of patients with perianal necrotizing fasciitis (NF).MethodsAll data and detection data of serum PCT, CRP and plasma ALB, PA at admission from 41 perianal NF patients admitted to Hefei first people's Hospital Group from May 2009 to August 2019 were retrospectively collected. The death status was statistically analyzed. The patients in this group were divided into survival group and non-survival group, and the predictive value of various indicators on the prognosis of NF was evaluated. ResultsThe ratio of male to female was 9.25∶1. There were multiple complications, and diabetes mellitus was most common (41.46%). The patients with mixed infection and negative bacterial culture accounted for 12.20% and 17.07%, respectively. There were many kinds of bacteria detected out. Klebsiella pneumoniae (20.45%), Escherichia coli (15.91%) and streptococcus (15.91%) were common. All underwent one or more surgical treatments, with mortality of 17.07%. There was no significant difference between survival group and death group in gender, complications, microbiological test results, operation status within 6h or and nutrition support (P>0.05), while there were significant differences in time from onset to admission, proportion of patients in ICU, serum PCT and CRP, plasma ALB and PA and proportion of patients undergoing vacuum sealing drainage (VSD) (P<0.05). Logistic multivariate regression analysis showed that long duration from onset to admission, staying in ICU, high serum PCT and CRP, low plasma ALB and PA, and no conducting VSD were risk factors of poor prognosis (P<0.05). Serum PCT, CRP and plasma ALB, PA predict the prognosis receiver operating characteristic(ROC) curve, the area under the curve is 0.859, 0.811, 0.802, 0.747; the area under the curve of the four indicators combined prediction is 0.926.ConclusionThere are certain features in terms of gender, complications and microorganisms in perianal NF patients. Death risk is high. In addition, serum PCT and CRP, plasma ALB and PA are also related with prognosis, which can be applied as biochemical indexes for prognosis evaluation.

Lime sulfur is a common bactericide with strong alkalinity, and is highly corrosive to humans and animals. It is rare for lime sulfur poisoning clinically. This article discusses the clinical manifestations of a patient who was poisoned by oral lime sulfur. After the poisoning, the mucosa of the lips and pharynx broke, fever, and pulmonary inflammation quickly appeared. The pulmonary CT showed slight interstitial changes in both lungs. Through high flow oxygen inhalation, fluid infusion, drainage, maintenance of water and electrolyte balance, protection of important organ functions, and other symptomatic support and treatment, as well as control of blood pressure, blood sugar, maintenance of circulatory function and other targeted measures, the patient's condition gradually improved.
Animals ; Humans ; Calcium Compounds ; Sulfides ; Poisoning

Fibronectin extra-domain B (ED-B) has been a good target in new drug development, several relevant antibody drugs are in phase Ⅱ or Ⅲ clinical trials for metastatic melanoma, soft-tissue sarcoma and so on. Some data of phase Ⅱ clinical trials shows that ED-B antibody drugs (L19-IL2 and L19-TNF α) for melanoma are significantly superior to PD-1 antibody drugs. This article describes several aspects of ED-B, such as biological characteristics, the development of targeted drugs, and the potential therapeutic applications, including modifying protein drug structure, constructing fusion protein, expanding indications, developing companion diagnostics and individual treatments. We also discuss how to promote original innovation in drug discovery, which might help to find new development focus.

AIM: To evaluate the characteristics of choriocapillary blood flow in different patients with diabetic retinopathy(DR)based on the measurement of choriocapillaris(CC)perfusion density(PFD)using ultra-high-speed swept-source optical coherence tomography angiography(SS-OCTA)METHODS: The cross-sectional observational study was conducted on 139 cases(139 eyes)who admitted to the Second People's Hospital of Hefei, including 115 DR cases(115 eyes)and 24 control cases(24 eyes). The color retinal images were graded according to the Early Treatment Diabetic Retinopathy Study(ETDRS)scale, and the DR eyes were classified into non-DR group, nonproliferative diabetic retinopathy(NPDR)group, NPDR combined with diabetic macular edema(DME)group and proliferative diabetic retinopathy(PDR)group. The ultra-high-speed SS-OCTA was used to scan a 3mm×3mm region centered on the macular central fovea, the CC perfusion area was measured by the built-in software, and PFD was calculated. Multivariable linear regressions were used to evaluate the correlation between PFD of CC and DR degree.RESULTS: The degree of DR had a correlation with blood perfusion of CC after adjusting for various confounding factors. When compared to the control group, the PFD of CC in the central fovea of the NPDR group decreased by 9.358 units(95%CI -18.484～-0.232, P=0.045)and 9.284 units in the paracentral fovea(95%CI -18.487～-0.090, P=0.048); In the NPDR combined with DME group, the central fovea CC PFD decreased by 18.173 units(95%CI -28.583～-7.762, P=0.001), while the paracentral fovea decreased by 17.032 units(95%CI -27.521～-6.544, P=0.002); In the PDR group, the central fovea CC PFD decreased by 28.309 units(95%CI -39.978～-16.640, P<0.001), while the paracentral fovea decreased by 25.841 units(95%CI -37.597～-14.085, P<0.001).CONCLUSION: The macular perfusion can be objectively quantified by the measurement of CC PFD with ultra-high-speed SS-OCTA. The CC PFD in the macular region was significantly reduced in more advanced stages of DR. Furthermore, future research should focus on longitudinal studies in the causal relationship between CC perfusion and DR progression.

Integrating with current situation of medical and health informatization in our country, by means of a careful study of CDA R2.0 international standards and specifications concerned, this paper summarizes the methods about how to exchange and share informations in regional Electronic Patient Records in foreign countries. It has designed the schema of the first page of EPR, implemented formatted output of a sample based on CDA R2.0 and thus validated the feasibility and effectiveness of its applications in the future of China.
China ; Medical Records Systems, Computerized ; standards

Objective: To explore the effects of ulinastatin combined with intravenous pump injection of furosemide on myocardial enzymes, renal function and adverse reactions in patients with acute renal failure(ARF) after cardiopulmonary resuscitation(CPR). Methods: From January 2016 to May 2018, 117 patients with ARF after successful CPR in the Second People's Hospital of Hefei were divided into observation group(n=59) and control group(n=58) using simple random method.The control group received routine treatment, while the observation group added ulinastatin combined with intravenous pump infusion of furosemide.Myocardial enzymology, renal function, metabolism, inflammatory index, adverse reaction and survival rate were compared. Results: Three and 7 days after treatment, the hydroxybutyrate dehydrogenase(HDBH), isoenzymes of creatine kinase isoenzyme(CK-MB) and mitochondrial aspartate aminotransferase isoenzyme(m-AST) were decreased in the two groups, and compared with the control group, which of the observation group were lower [HDBH: (231.42±31.15)U/L vs.(268.59±34.87)U/L; F=12.01, P=0.00; CK-MB: (32.38±4.15)ng/mL vs.(37.57±3.96)ng/mL; F=15.12, P=0.00; m-AST: (25.18±4.24)U/L vs.(33.92±5.60)U/L; F=12.36, P=0.00]. After treatment, the blood urea nitrogen(BUN), 24h urine protein quantity and creatinine(Cr) in the two groups increased firstly and then decreased, and compared with the control group, those of the observation group were lower[BUN: (7.02±1.66)mmol/L vs.(8.47±1.38)mmol/L; F=11.24, P=0.00; Cr: (82.69±9.87)μmol/L vs.(90.18±10.37)μmol/L; F=10.39, P=0.00; 24h urine protein quantity: (15.43±2.17)mg vs.(18.62±3.14)mg; F=11.06, P=0.00]. Three and 7 days after treatment, the levels of blood lactic acid(Lac), hypersensitive C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) were decreased in the two groups, and compared with the control group, those of the observation group were lower [Lac: (1.18±0.27)mmol/L vs.(2.17±0.34)mmol/L, F=16.29, P=0.00; hs-CRP: (4.89±0.81)mg/L vs.(6.17±1.10)mg/L, F=13.41, P=0.00; TNF-α: (72.18±7.62)ng/L vs.(83.16±7.79)ng/L, F=11.39, P=0.00]. The incidence rates of adverse reactions in the observation group and the control group were 5.09% and 1.72%, respectively, the difference was statistically significant(χ²=0.24, P=0.62). The survival rates in the observation group and the control group were 50 cases (84.75%) and 39 cases (67.24%) respectively, the difference was statistically significant(χ²=4.92, P=0.02). Conclusion Intravenous pump injection of furosemide combined with ulinastatin can protect the heart and kidney, and improve the survival rate of patients with ARF after CPR and it is worthy of popularizing.

AIM: To study the single nucleotide polymorphisms(SNPs)of Macrophage Scavenger Receptor 1(MSR1)gene in xanthelasma palpebrarum patients.

METHODS: We drew peripheral venous blood from 20 xanthelasma palpebrarum patients and 20 healthy participants. We detected the SNPs of MSR1 gene with Sanger sequencing, examined serum lipids and α-lipoprotein of the patients, and scanned carotid arteries of the patients with color ultrasound. After that, we kept on observation of the participants.

RESULTS: There was no significant difference in the SNPs of MSR1 genotype between xanthelasma palpebrarum patients and healthy participants. However, in some patients with carotid atherosclerosis and hyperlipidemia, there were homozygous mutations at S2-SNP1, S5-SNP2 and S5-SNP4 in the exon region of MSR1 gene, which were related to atherosclerosis.

CONCLUSION: Xanthelasma palpebrarum is related to SNPs of MSR1 in atherosclerosis.