Objective:To assess the ration of atomization inhalation medicine which was given to the patients in the perioperative period to provide possible reference for the application of medicine in operations.Method:From the clinical pharmacy workstation combined with manual retrieval method,a research was done among some patients who had once received treatments in the four surgical wards of our hospital in order to assess the related index of the ration of atomization inhalation medicine given to the patients in the perioperative period.Result:Among the 186 patients,the proportion of the used atomization inhalation medicine ration ranged from 63.79%to 100.00%.The medicines used in the largest amount were Ambroxol Hydrochloride Injection,Sodium Chloride Injection and Etimicin Sulfate for Injection.The qualified proportion of the ration of the medicine applied to patients each single time was 56.59%.The proportions of single medicine and double medicine were 31.71%and 54.15%,respectively.Conclusion:The atomization inhalation medicine applied to the patients is basically rational in our hospital,but the overdose use of medicine in a single time and the irrational combined use of different medicines still exist.The clinicians and pharmacists need a close cooperation with each other,and analyze the process comprehensively in order to improve the atomization inhalation medicine's application.

Objective To measure tricuspid annular displacement by two-dimensional speckle tracking echocardiography in pulmonary hypertension (PH) patients,and compare with the right ventricular function parameters,finally discuss the clinical application value of this technology in evaluating the right ventricular function in PH.Methods A total of 58 patients diagnosed or suspected diagnosed as PH were divided into PH group and control group according to pulmonary arterial systolic pressure measured by echocardiography.The right ventricular function parameters included:tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).The parameters of tricuspid annular displacement included:the peak systolic tricuspid annular displacement at right ventricular free wall (TMAD1),the peak systolic tricuspid annular displacement at interventricular septum (TMAD2),the peak systolic tricuspid annular displacement at midpoint of tricuspid annulus (TMADm) and the right ventricular longitudinal shortening (TMADm％).Results ① There were significant statistical differences between two groups in TAPSE,RIMP,FAC and s' (P ＜0.01),TMAD1 (P＜0.05),and TMAD2,TMADm and TMADm％ (P ＜0.01).② Area under ROC curve indicated that parameters of tricuspid annular displacement had moderate predictive value in predicting the decline of right ventricular function in PH patients (P ＜0.01).③ Setting 15.5％ as cut-off value for TMADm％ to assessment FAC＜35 ％,TAPSE＜17 mm,RIMP＞0.54 and s'＜9.5 cm/s,their sensitivities were 81.8％,84.4％,85.7％ and 72.3％ respectively,and their specificities were 72.0％,73.1％,70.3％ and 100％ respectively.Conclusions The tricuspid annular tissue displacement parameters can predict the decrease of right ventricular function in patients with PH,and provide a new diagnostic index for clinical treatment and prognosis.

Objective To analyze the research status of childhood unintentional injury and provide a foundation for the development of targeted intervention strategies. Methods Bibliometrics were used to analyze 429 literatures of childhood unintentional injury published during 2000~2011. Results The quantity of research literatures didn't form a stable growth. The object, type and location of childhood unintentional injury were non- specific. The research contents mainly involved epidemiological characteristics, affecting factors and prevention methods, but overall designs of research had flaws. Conclusion The research should be carried out targeted and systematically.

Objective To investigate the relationshipbetween glucose fluctuation and the degree of nervous dysfunction of the acute cerebral infarction in patients with type 2 diabetes mellitus.Methods 30 patients with ACI and T2DM were chosen as observation group and 30 patients with T2DM without ACI as the control group.Glucose fluctuation in all patients were monitored for 72h with the continuous glucose monitoring system(CGMS).High frequency ultrasound was used to detect the carotid intima-media thickness (IMT).The levels of blood lipids,glycosylated hemoglobin (HbA1c),homocysteinemia(Hcy) and C-reactive protein(C-RP) were detected in all the patients.The national institute of health stroke scale(NIHSS) was performed.The correlation between NIHSS and other observed factors were analyzed.Results (1)The mean amplitude of glycemic excursions (MAGE),blood glucose standard deviation(SDBG),absolute means of daily differences(MODD),the largest amplitude of glycemic excursions(LAGE),blood lipids,HbA1c,Hcy,C-RP and IMT were statistically significant different between the two groups (all P＜0.05); (2)The MAGE,SDBG,IMT,Hey,C-RP,low-density lipoprotein cholesterol-C (LDL-C),and systolic blood pressure(SBP) were correlated with the NIHSS score (all P＜0.05) ;(3)With NIHSS score as the dependent variable and the indicators above as the independent variables,the multiple stepwise regression analysis showed that the MAGE,IMT,Hcy came into the final equation.Conclusions The blood glucose fluctuation is probably the influential factor on the development of acute cerebral infarction in T2DM patients.Therapy for lowering blood glucose smoothly should be established as soon as possible to recover the nerve function after cerebral infarction and reduce the incidence of stroke recurrence.

Objective The aim of this study was to investigate mutations of 41 STR loci. Methods 4546 bloodstain samples were typed from 1932 father–mother–child trios by using AGCU_21+1, AGCU_EX22 and GlobalFiler_ExpressTM amplification Kit. Calculate the mutation rates of STR loci. Results 154 mutations were identified at 32 of the 41 loci. The average mutation rate was 1.0×10-3per locus(95%CI: 0.8~1.1×10-3), and the mutations of SE33 was highest. 152(98.7%) mutation events were one-step mutation, 2(1.3%) events were two-steps. The mutation events occurred in 150 father–mother–child triplets. The mutations in 146(97.3%) triplets occurred at single locus, 8 mutations were observed at two loci in 4(2.7%) triplets simultaneously. 104 paternal and 22 maternal mutations could be determined under 79212 paternal and maternal allelictransfers. The ratio of paternal versus maternal mutations was 4.7:1, and 28 unassigned mutations were observed. Conclusion STR mutation are common in paternity testing, and we should pay more attention to it.

Objective: This study aimed to investigate the impact of molecular classification and PTEN, KRAS and PIK3CA gene mutation on the outcome of fertility-preserving treatment in the patients with endometrioid endometrial cancer (EEC) and endometrial atypical hyperplasia (EAH). Methods: This is a single-center retrospective study. A total of 135 patients with EEC and EAH receiving fertility-preserving treatment and molecular classification were reviewed. The distribution of the four types of molecular classification was described. The impact of non-specific molecular profile (NSMP), mismatch repair-deficiency (MMRd), and PTEN, KRAS and PIK3CA gene mutation on the outcome of fertility-preserving treatment was analyzed. Results: Of the patients analyzed, 86.7% (117/136) were classified as having NSMP; 14 (10.4%), MMRd; 1 (0.7%), POLEmut EAH; and 3 (2.2%), p53abn EEC. The patients having NSMP and MMRd achieved similar 16-, 32-, and 48-week complete response rates. The patients harboring tier I and tier II PTEN mutations (PTENmut-Clin) achieved lower cumulative 32-week CR rates than those with PTEN-others (without PTENmut-Clin) (22/47, 46.8% vs. 50/74, 67.6%; p=0.023; odds ratio=0.422; 95% confidence interval [CI]=0.199–0.896). Insulin-resistance (hazard ratio [HR]=0.435; 95% CI=0.269–0.702; p=0.001) and PTENmut-Clin (HR=0.535; 95% CI=0.324–0.885; p=0.015) were independent negative predictors for lower 32-week CR rates. Conclusion PTENmut-Clin is an independent risk factor for unfavorable fertility-preserving treatment outcomes in the patients with EEC and EAH. The patients with MMRd receiving fertility-preserving treatment achieved outcomes similar to those of the patients with NSMP. The molecular profiles might guide fertility-preserving treatment in the prognosis and clinical decisions.

Objective To provide the basic data for forensic application by analyzing the genotypes absence at DYS448 locus. Method 5487 bloodstain samples from unrelated male individuals of Chinese Han population were obtained. 4479 samples was co-amplified using Y-filerTM and AGCU Y-24 kits. 1008 samples was co-amplified using Yfiler PlusTM and AGCU Y-24 kits .Probability of genotype absence was calculated. Results 35 samples of 35 haplotypes among 5487 non-related individuals were found to have DYS448 genotypes absence ,while 2 individuals displayed additional alleles at else locus. Conclusion The probability of DYS448 genotype absence was 0.637%, forensic scientists should pay more attention in practical cases and YSTR database.

Objective:To explore the predictive value of Red Blood Cell Distribution Width (RDW) in predicting the prognosis of patients with Extracorporeal Membrane Oxygenation (ECMO).Methods:The clinical data of patients undergoing ECMO admitted to Intensive Care Unit of Sichuan Provincial People’s Hospital from January 2015 to January 2020 were retrospectively analyzed. Patients were divided into the survival group and death group according to the prognosis during ICU hospitalization. The patients' basic data , acute physiology and chronic health score system Ⅱ (APACHE Ⅱ), RDW and activated partial thromboplastin time (APTT) at 72 hours after treatment with ECMO were compared between the two groups. Univariate and Logistic regression multivariate analyses were used to analyze the prognostic factors of patients with ECMO, predictive models and death warning scores were established. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of RDW and death warning scores for the prognosis of patients with ECMO.Results:A total of 71 patients with ECMO who met the inclusion criteria were included, including 38 patients in the death group and 33 patients in the survival group. The age, APACHE-Ⅱscore, 72 h RDW and 72 h APTT in the death group were higher than those in the survival group. Respectively, the hospitalization time of ICU in the death group was significantly lower than that in the survival group ( P< 0.05). Logistic regression analysis showed that APACHE-Ⅱscore ( OR=1.117, P=0.047)、72 h RDW( OR=1.102, P=0.029) and 72 h APTT ( OR=1.049, P=0.029) were independent risk factors for death in patients with ECMO. ROC curve analysis showed that the area under ROC curve (AUC) of the APACHE-Ⅱ, score 、72 h RDW and 72 h APTT were 0.691, 0.691 and 0.632( P<0.05), Respectively, the combined AUC was 0.764, the sensitivity was 0.526, and the specificity was 0.909. The death warning score of patients with ECMO was established according to the Predictive model , which is less than 2 points with low risk of death and more than 2 points with high risk of death. The area under the ROC curve of death warning score is 0.8, the sensitivity is 0.607 and the specificity is 0.923. Conclusions:The RDW at 72 hours after treatment with ECMO has a good value in predicting the prognosis of patients with ECMO. Besides, a greater predictive value for the prognosis of patients with ECMO by combining 72 hours RDW, 72 hours APTT with APACHE-Ⅱscore than that of any separate indicator.

Objective:To summarize the clinical characteristics and influencing factors on clinical outcome of patients receiving extracorporeal cardiopulmonary resuscitation (ECPR).Methods:A total of 78 patients receiving ECPR admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial People’s Hospital) from March 2015 to December 2020 were retrospectively enrolled. Patients were divided into the survival group and death group according to clinical outcome. Their baseline data, CPR associated parameters, and pre-ECPR laboratory tests were compared between the two groups.Results:Of the 78 included patients, 51 patients were male and 27 female. Twenty-three patients finally survived, including 10 males and 13 females. There were no significant differences in age, body mass index and underlying diseases (hypertension, diabetes and coronary heart disease) between the two groups (all P > 0.05). The proportion of male patients in the survival group was lower than that in the death group ( P=0.017). Meanwhile Survival After Veno-Arterial ECMO (SAVE) score was significantly higher in the survival group than that in the death group[ (-1.57±4.15) vs. (-9.36±5.36), P<0.001]. The proportion of by-stander CPR in the survival group was higher than that in the death group ( P=0.014). The pre-ECPR serum AST, ALT, and Cr levels in the survival group were significantly lower than those in the death group (all P<0.05). Logistic regression analysis showed that by-stander CPR ( OR=0.114, 95% CI: 0.015~0.867, P=0.036) and SAVE score ( OR=0.625, 95% CI: 0.479~0.815, P=0.001) were independent risk factors predicting ICU death in patients receiving ECPR. Conclusions:ECPR is an efficient tool to improve clinical outcomes of patients with cardiac arrest. By-stander CPR and SAVE score are independent risk factors predicting ICU death in patients receiving ECPR.