OBJECTIVE:To probe into the method suitable for centralized ARDs monitoring in hospital METHODS:Using the software made by ourselves,a retrospective analysis was carried out on the data of 462 patients who stayed in hospital from November 1999 to October 2000 and have received chlorpheniramine maleate,cyproheptadine or semprex RESULTS:42 patients suffered from ARDs induced by 9 categories,22 kinds of drug Antibiotics occupied first place among these drugs CONC_LUSION:The microcomputer drug warning system can be used to retrieve relevant information of ARDs and to prevent undetected ARDs,which will help improve the evaluation of safety of drugs

OBJECTIVE:To establish a computer monitoring system for ADRs so that a centralized supervision can be carried out in hospital.METHODS:Based on the hospital HIS system,the information of medication was retrospectively analysed and the real-time monitoring of the information was carried out.RESULTS:This system made early warning and monitoring of ADRs become easier and simpler,and provided a proper condition for large-scale ADR monitoring.CONCLUSION:The application of real-time supervision and drug safety evaluation system provides a new and timely way to guarantee the rational and safe use of drugs in clinical practice.

OBJECTIVE:To establish a way to monitor drug-induced liver damage by using hospital centralized management system for monitoring ADR.METHODS:Using self-designed computer program,the data of inpatients with abnormal ALT,AST and TBIL,admitted in the period from Dec. 2001 to Feb. 2002,were extracted from hospital HIS system of databa_se,and ADR and irrational drug-use were retrospectively analysed.RESULTS:There were 50 ADR incidents concerned with 30 kinds of drug and 11 cases receiving irrational medication concerned 10 kinds of drug.CONCLUSION:By this way,we can timely get the information of drug-induced liver damage and set up a new way for developing centralized ADR monitoring in hospital.

Objective To evaluate the curative effect of transcatheter arterial chemoembolization (TACE) combined with intensity modulated radiation therapy (IMRT) in treating advanced hepatocellular carcinoma (HCC),and to discuss the occurrence of adverse events.Methods A total of 59 patients with advanced HCC were enrolled in this study.The patients were randomly divided into TACE plus IMRT group (study group,n=30) and TACE group (control group,n=29).The early tumor response rate,progression free survival (PFS),median survival time (mST),and adverse reactions were analyzed.Results The early tumor response rate in the study group was 60.0％,which was significantly higher than 34.4％ in the control group (P=0.043).PFS of the study group was 260 days,which was remarkably higher than 195 days of the control group (P=0.006).The mST was 468 days in the study group,which was 431 days in the control group (P=0.195).In the study group,2 patients developed severe liver function damage,which was improved after active liver protection therapy for more than 20 days.Conclusion For the treatment of advanced HCC,TACE combined with IMRT can improve early tumor response rate and prolong PFS time,moreover,its adverse reactions can be well tolerated by patients.

Objective To analyze the value of 2-and 9-question patient health questionnaires (PHQ-2 and PHQ-9) for screening status of depression in cardiovascular outpatients.Methods From June 2013 to January 2014,a total of 201 outpatients from psycho-cardiological outpatients departments were consecutively enrolled into this study.All patients were asked to complete PHQ-9 and the mental psychological assessment by qualified researchers trained by psychiatry according to the composite international diagnostic interviews (CIDI),50 cases were retested to assess the retest reliability after one week.The PHQ-2 and PHQ-9 were validated with the CIDI as the reference criteria.Results According to the CIDI,42(21.3％) out of the 201 outpatients were diagnosed as depression.For PHQ-9 scale,a cutoff value of 10 presented satisfactory results with 87.1％ sensitivity,83.5％ specificity,58.7％ positive predicting value,95.6％ negative predicting value and the area under the ROC curve (AUC) was 0.877 (SE =0.032,95％ CI:0.813-0.938).The Cronbach's alpha coefficients and test-retest reliability of the PHQ-9 were 0.809 and 0.882,respectively.Compared with CIDI,the cutoff value of the PHQ-2 was 3 with 85.7％ sensitivity,69.2％ specificity,57.1％ positive predicting value,93.6％ negative predicting value,and the AUC was 0.806(SE =0.042,95％ CI:0.774-0.889).The Cronbach's alpha coefficients and testretest reliability of the PHQ-2 were 0.785 and 0.813,respectively.Conclusion The PHQ-2 and PHQ-9 are reliable and efficient instruments for screening and especially excluding depression in cardiovascular outpatients.

Objective To compare the efficacy, safety, and survivability of TCbHP versus AC-THP in the neoadjuvant therapy of HER2-positive breast cancer in real-world. Methods Clinical data of patients with HER2 positive breast cancer, who have received TCbHP or AC-THP as neoadjuvant therapy and completed surgery in 11 third-class hospitals in various cities of Hebei Province, were retrospectively collected.The total pathological complete remission (tpCR) rate, the incidence of grade 3 or higher adverse reactions and the completion rate of the given approaches were compared. Results A total of 110 cases were collected, including 78 cases in the TCbHP group and 32 cases in the AC-THP group.The tpCR rate of the TCbHP group was higher than that of the AC-THP group, but the difference was not statistically significant (64.10% vs. 56.25%, P=0.441).No significant difference was found in the breast pathologic complete response (bpCR) and axillary pathologic complete response (apCR) rates between the TCbHP group and the AC-THP group (70.51% vs. 56.25%, P=0.150;78.21% vs. 84.38%, P=0.462).Exploratory analysis revealed that the tpCR rate of the TCbHP group was significantly higher than that of the AC-THP group in patients with HR-positive breast cancer (51.11% vs. 22.22%, P=0.036).As for the patients with HR-negative breast cancer, the tpCR rate of the AC-THP group tended to be higher than that of the TCbHP group (100% vs. 81.82%, P=0.088).The incidence of grade 3 or higher adverse reactions in the TCbHP group was slightly higher than that in the AC-THP group (12.82% vs. 9.38%, P=0.753).No deaths occurred in the whole group.Moreover, no significant difference was observed in the completion rate of the given approaches between the TCbHP group and the AC-THP group (92.31% vs. 90.63%, P=0.718). Conclusion In real-world clinical practice, the neoadjuvant therapy of TCbHP and AC-THP are effective, safe, and well tolerated among patients with HER2-positive breast cancer.The tpCR rate between the two approaches was not significantly different.The AC-THP regimen could also be considered as one of the optimal regimens for HER2-positive breast cancer in neoadjuvant therapy.

Objectives:To investigate the safety and efficacy of concomitant mitral valvuloplasty(MVP)and implantation of domestic third-generation magnetically levitated Corheart 6 left ventricular assist device(LVAD). Methods:Clinical data of 13 end-stage heart failure patients who underwent Corheart 6 LVAD implantation and MVP at Central China Fuwai Hospital of Zhengzhou University from October 2021 to March 2023 were retrospectively analyzed.Mortality and complication events during hospitalization and at follow-up were collected,and changes in myocardial injury biomarkers,renal function,hemodynamics,and echocardiographic indices were observed. Results:There were no perioperative deaths and no MVP-related complications in these patients.During a mean follow-up of(14.2±5.6)months,2 patients died due to COVID-19 pneumonia and cardiac arrest respectively,11 cases(84.6%)survived.There were no recurrences of moderate-to-severe mitral regurgitation in the survived patients.Compared with preoperative value,higher cardiac output,lower central venous pressure,pulmonary artery systolic pressure(PASP),and mean pulmonary artery pressure(PAMP)were evidenced at 24 h and 72 h postoperatively,estimated glomerular filtration rate was also reduced at 1 week post operation(all P<0.010).High-sensitive troponin T level was significantly increased at 1 week post operation and then reduced at 1 month post operation,but still not returned to pre-operative level([125.5±281.9]pg/ml at baseline,[1 295.6±654.6]pg/ml at 1 week post operation and[278.0±300.5]pg/ml at 1 month post operation).Echocardiography showed that compared with preoperative period,the left ventricular ejection fraction tended to be higher at 1 and 6 months postoperatively(both P>0.017),whereas left ventricular end-diastolic dimension,PASP,and PAMP were significantly reduced(all P<0.010). Conclusions:Domestic third-generation magnetically levitated Corheart 6 LVAD implantation with concomitant MVP is safe and feasible,there is no recurrence of moderate-to-severe mitral regurgitation,a significant reduction in pulmonary artery pressure,and significant hemodynamic improvement in early to mid-term postoperatively are observed in survived patients.

Objective:To determine the effects of early enteral nutrition (EEN) on the short-term prognosis of patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:61 patients admitted to the Coronary Care Unit (CCU) of Henan Provincial Peoples' Hospital from February 2022 to March 2023 to receive VA-ECMO treatment were selected as the study objects according a retrospective survey. The patients were divided into an achievement group ( n=34) and a non-achievement group ( n=27) based on whether the feeding amount reached 70% or over of the target calories (25kcal/kg.d) on the 7th day of ECMO treatment. The general characteristics, disease information, complications, and prognosis between the two groups after ICU admission were recorded and compared. A multivariable Cox proportional hazards model was used to evaluate the impact of various factors on clinical outcomes. Kaplan-Meier analysis was used to draw survival curves for the two groups, and the predictive value of the ratio of actual EN intake to target energy was calculated by plotting the ROC curve. Results:A total of 61 patients were included, with an overall in-hospital mortality rate of 50.82% (31/61), with 32.35% (11/34) in the achievement group, and 70.37% (19/27) in the non-achievement group. Cox regression analysis revealed that the occurrence of hypoxic-ischemic encephalopathy (HR=0.341, 95% CI:0.119-0.975), ECOM weaning failure ( HR=0.269, 95% CI:0.111-0.651), and achieving EN targets on the 7th day of VA-ECMO treatment ( HR=10.891, 95% CI:1.178-100.718) were independent factors for patient mortality during hospitalization. The ROC curve for the percentage of EN achievement on the 7th day of VA-ECMO treatment and in-hospital mortality showed an area under the curve of 0.755, with a cutoff value of 0.73. Conclusion:The presence of ischemic hypoxic encephalopathy, ECOM weaning failure, and whether achieving EN targets or not is closely related to the prognosis of VA-ECMO patients. Patients who achieving EN targets of over 73% had the lowest in-hospital mortality rate. Therefore, more attention should be paid to the energy intake of VA-ECMO patients to reduce their risk of mortality.

Objective To evaluate the predicting value of circulating miRNAs for sepsis secondary to pneumonia in elderly patients.Methods From April 2016 to January 2017,44 cases with sepsis secondary to pneumonia,52 elderly patients with pneumonia and 21 healthy older adults as control were involved in this study.The expression levels of MiRNA-150 5p,miRNA-25-3p,miRNA-122 5p and miRNA-223-3p in plasma were evaluated by fluorescence quantitative PCR.The demographic characteristics,sequential organ failure assessment (SOFA)scores,prognosis and days stayed in ICU were recorded.The area under the receiver operating charaeteristic(ROC)curve was used to calculated the specificity and sensitivity of miRNA in identifying sepsis-associated pneumonia.Results There were significantly differences among levels of circulating miRNA-223-3p in pneumonia,sepsis and healthy control groups(F =36.441,P =0.000),△CT values were 2.39 ± 1.36,1.44± 1.43,and 4.58 ± 0.91,respectively.The relative expression levels of miRNA-223-3p in the three groups were significantly different (P =0.000),which were 0.189 (0.107,0.367),0.361 (0.221,0.735),and 0.044 (0.022,0.061),respectively.The AUC of miRNA-223-3p for predicting sepsis from pneumonia was 0.964(95 ％CI =0.925 1.000).At a cutoff value of 2.759,miRNA-223-3p yielded a sensitivity of 82.9％ and a specificity of 100.0％.Conclusions MiRNA-223-3p expression is up-regulated in patients with sepsis secondary to pneumonia compared to that of patients with pneumonia,and it could be used to predict sepsis associated pneumonia.