OBJECTIVE:To explore the application and feasibility of tracer methodology in the continuous improvement of high-alert medications management in the hospital,and to improve the quality of high-alert medications management and ensure the safety of clinical medication. METHODS:According to the theory and requirements of tracer methodology,a series of interven-tions were applied to the management of high-alert medications in our hospital. The comparisons on the mastery of high-alert medi-cations knowledge,review and evaluation results and the incidence of adverse events were conducted before and after applying trac-er methodology,so as to evaluate the improvement effect of tracer methodology on high-alert medications management. RESULTS:After implementing intervention measures such as the reduction of high-alert medications list and medical staff training about high-alert medications,compared to before management,medical staffs had improved the knowledge level of high-alert medica-tions (the average awareness rate increased from 69.6% to 88.5%);the review and evaluation results had been improved signifi-cantly (the proportion of the terms with qualified level evaluation results or above increased from 66.67% to 88.89%);the inci-dence of adverse events was reduced(from 0.321% to 0.139%). CONCLUSIONS:The tracer methodology has a significant effect on the management of high-alert medications in our hospital. It is feasible and can be widely used in the management of high-alert medications in the hospitals.

BACKGROUND:Stem cels can induce immune tolerance, prolong graft survival time and reduce rejection in organ transplantation, which have become a hot research. OBJECTIVE:To induce immune tolerance to alogenic kidney transplantation with amniotic fluid stem cels in recipient rats and to explore the mechanism underlying immune tolerance. METHODS: Amniotic fluid stem cels were isolated from Wistar rats. Two inbred male rat strains, Wistar rats and Sprague-Dawley rats, were selected as donors and recipients of kidney transplantation. The rat models of renal orthotopic transplantation were divided into the folowing four groups: a sham-operated group (n=10, Sprague-Dawley rats); an isograft group (n=10, Sprague-Dawley to Sprague-Dawley rats); a control group (n=10, Wistar to Sprague-Dawley rats, treated with 1 mL saline); and an experimental group (n=10, Wistar to Sprague-Dawley rats, treated with 1 mL of 3×106/L amniotic fluid stem cels). Serum levels of creatinine, urea nitrogen, interleukin-2, interferon-γ, parameters of oxidative stress were detected at 5 days after operation. Flow cytometry was employed to determine the percentage of CD4+ and CD8+ lymphocytes in the peripheral blood. Kidney transplants were observed pathologicaly. RESULTS AND CONCLUSION:Compared with the control group, the levels of creatinine, urea nitrogen, interleukin-2, interferon-γ, parameters of oxidative stress and proteinuria were lower in the experimental group (P < 0.05). Percentages of CD4+, CD8+ and CD4+/CD8+ ratio were also significantly lower in the experimental group than the control group. However, the rate of cretinemia clearance in the experimental group was significantly higher than that in the control group (P < 0.05). Furthermore, the degree of kidney injury in the experimental group was significantly lower than that in the control group. Our findings demonstrate that the amniotic fluid stem cel transplantation can induce immune tolerance, extenuate oxidative stress, attenuate pathological damage to the kidney transplant and preserve kidney function from acute rejection in rats undergoing kidney transplantation.

OBJECTIVE:To explore the efficacy and safety of probucol combined with butylphthalide in the treatment of pa-tients with acute cerebral infarction. METHODS:172 patients with acute cerebral infarction were randomly divided into observation group and control group,86 cases in each group. All patients received conventional treatment for acute cerebral infarction,includ-ing thrombolysis,anti-platelet aggregation,reducing intracranial pressure,nutritional support,intensive lipid-lowering within onset 4.5 h,timely treatment of the underlying diseases;based on it,control group received Probucol tablet,0.5 g every times,bid. Ob-servation group additionally received Butylphthalide and sodium chloride injection,100 ml every times,bid,in 9:00 and 17:00 ev-ery day,infusion within 50-90 min. Both groups lasted for 2 weeks. Lipid metabolic indexes,the changes of serum S100β,NSE and hs-CRP levels,NIHSS score,clinical efficacy before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with before treatment,triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol (LDL-C) levels in 2 groups significantly decreased,high-density lipoprotein cholesterol level significantly increased, and TG,TC and LDL-C levels in observation group decreased more significantly,the differences were statistically significant(P<0.05). Serum S100β,NSE and hs-CRP levels and NIHSS scores in 2 groups significantly decreased,and NSE level NIHSS scores and in observation group decreased more significantly,the differences were statistically significant (P<0.05). The total effective rate in observation group was 89.5%,significantly higher than control group (62.8%),the difference was statistically significant (P<0.05). There were no obvious adverse reactions during treatment,and also no obvious liver and kidney function,blood coagula-tion and ECG changes. CONCLUSIONS:Probucol combined with butylphthalide can effectively improve the lipid metabolism and decrease serum NSE level in the treatment of patients with acute cerebral infarction,and plays positive role in early recovery of neu-rological function.

Objective: To investigate the clinicopathologic characteristics and etiological factors of cervical cancer in young Uygur women in Xinjiang.Methods" We reviewed 350 cases of young Uygur females diagnosed with cervical cancer in our hospital during 1998-2007.The patients were divided into two groups according to their admission time (1998～2002 group and 2003～2007 group).Results: The incidence of cervical carcinoma among yong Uygur women was 12.9% in the 1998-2002 group and 10.3% in the 2003-2007 group.The first symptom was vaginal contactive bleeding.In both groups, most patients were peasants, but the percentages of highbrow was higher in the 2003-2007 group.Patients in the 2003～2007 group were of older age at first marriage and had lower rate of abortion.There was no significant difference in histological type between the two groups.However, patients in the 2003-2007 group presented with much earlier stage of cervical cancer and 56.9% of them were of stage Ⅱ disease, compared with 18.1% in the 1998-2002 group (P<0.05).Squamous cell carcinoma was the dominant histological type.Conclusion: The incidence of cervical carcinoma in young Uygur women tends to decrease due to screening and advocation of late marriage, less reproduction in remote rural areas of Xinjiang.

Objective To investigate the expression and prognostic value of FOXO1 gene in liver cancer tissues based on TCGA and HPA databases. Methods The RNA-seq data of FOXO1 gene in liver cancer were downloaded from TCGA. The difference of FOXO1 gene expression between tumor and adjacent tissues was obtained via R software. The correlation between FOXO1 and clinicopathological features of liver cancer patients was analyzed. Survival analysis was carried out to evaluate the prognostic significance of FOXO1 gene expression in liver cancer patients. Univariate and multivariate Cox analyses were performed to explore prognostic factors. The correlation between FOXO1 expression and TIICs in tumor microenvironment was performed by CIBERSORT. KEGG pathways enrichment analysis was performed for the potential function of FOXO1 gene in liver cancer. Results FOXO1 was downregulated in liver cancer tissues compared with normal tissues (P=1.321E-15). Survival analysis showed that high expression of FOXO1 was positively associated with favorable OS of liver cancer patients (P < 0.05). Clinical stage, T and M stages could be prognostic indicators while FOXO1 wasn't an independent prognostic factor in patients with liver cancer. In TME of liver cancer, the expression of FOXO1 was positively correlated with resting memory CD4 T cells and naive B cells while negatively related to activated memory CD4 T cells and macrophages M2. GSEA identified that FOXO1 participated in multiple cancer-related pathways. Conclusion FOXO1 is down-regulated in liver cancer tissues, and its expression level is associated with OS of patients. FOXO1 might be a biomarker related to the prognosis of liver cancer patients and is expected to be a target for diagnosis and treatment of liver cancer.

Objective To explore the effects of systematic health courses training on quality of life in elderly patients with chronic diseases. Methods Totally 126 patients with chronic diseases who came from communities of Fuzhou city were trained with systematic health courses. Patients were evaluated by Shot Form 36 Health Survey Questionnaire (SF-36) before and after the intervention.Results After intervention, the quality of life of patients was higher than that before the intervention with a significant difference ( P<0. 05 ) . Conclusions The systematic health courses training can effectively improve the quality of life in community elderly patients with chronic diseases.

China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of 20 mm². The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer (0.71±2.44 μg/L vs 0.48±2.12 μg/L, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs 44.50 μg/L). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54–0.73) and the cutoff value as 0.81 μg/L. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68–0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.
Area Under Curve ; Ascites* ; Case-Control Studies ; China ; Cohort Studies ; Collagen Type IV ; Fibrin ; Humans ; Kidney ; Liver ; Physical Examination ; Plasma* ; Prospective Studies* ; ROC Curve ; Schistosoma japonicum ; Schistosomiasis japonica* ; Schistosomiasis* ; Ultrasonography

With the continuous development of China's economy,the people expect for higher quality medical services,and medical humanistic care is increasingly emphasized.Under this background,the"Duplex Linkage Mode",which integrates medical social workers and volunteers,has emerged.This paper reviews the current state of applying the mode in China,ex-pounds its benefits,and details its application within hospital services.This application covers guidance for outpatient and emer-gency department,inpatient ward services,hospice care,and community residents volunteer services.In addition,this paper proposes suggestions on furth for optimizing recruitment and training programs,improving management systems,establishing intel-ligent management systems,and improving volunteer support mechanisms.These measures aim to promote the sustainable and healthy development of medical humanistic services and to support the implementation of the Healthy China Initiative.

Objective:To explore the relationship between red meat intake level and the incidence of stroke in Chinese adults.Methods:The baseline data were from China Chronic Disease Surveillance Project conducted in 60 surveillance sites in 11 provinces in China in 2010. A total of 27 762 subjects with complete data in baseline survey were included in the cohort follow-up from 2016 to 2017. Multivariate nutrient-density cox proportional hazards regression model was used to analyze the association between red meat intake level and the incidence of stroke. Subgroup analysis were performed based on baseline characteristics. Sensitivity analysis was performed by using standard multivariate model, energy partition model and nutrient residual model.Results:In the 26 187 subjects, 1 259 stroke cases, including 1 074 ischemic stroke cases, occurred during an average of 6.0 years of follow-up, the incidence density was 815.0/100 000 person-years for stroke and 692.0/100 000 person-years for ischemic stroke. In models using the multivariate nutrient-density model of energy adjustment, compared with quintile group, red meat intake in quintile 2 group showed no significant association with stroke [hazard ratio ( HR)=1.07, 95% CI: 0.87-1.32] and ischemic stroke ( HR=1.03, 95% CI: 0.80-1.32) and in group of quintile 3-5, the red meat intake related risk for stroke increased by 23% ( HR=1.23, 95% CI: 1.00-1.51), 27% ( HR=1.27, 95% CI: 1.03-1.58) and 32% ( HR=1.32, 95% CI: 1.06-1.64), respectively, while the risk for ischemic stroke increased by 32% ( HR=1.32, 95% CI: 1.04-1.68), 35% ( HR=1.35, 95% CI: 1.05-1.73) and 38% ( HR=1.38, 95% CI: 1.07-1.79), respectively. Subgroup analysis revealed that blood pressure had modification effect on the association between red meat intake and incidence of stroke (interaction P=0.037). The sensitivity analysis showed no changes. Conclusions:These findings suggest that higher intake of red meat is significantly associated with an increased risk for stroke and ischemic stroke. It is necessary to take red meat intake level as one of the important indicators of stroke prevention and control.