1.Value of reflex testing in clinical practice of laboratory medicine
Xuzhen QIN ; Ye ZHAO ; Yaling DOU ; Ling QIU ; Yingchun XU
Chinese Journal of Laboratory Medicine 2021;44(3):246-249
Reflex tests are ordered when a particular test result indicates that additional testing should be performed according to the guidelines or the feedback process formulated by clinical consultation. The application scope of the reflex tests involves various subspecialties of laboratory medicine. The clinical application needs the support of qualified laboratory doctors, comprehensive information and financial system, clinical guidelines, and so on. Active application of reflex tests can promote the standardization of evidence-based medicine in clinical practice, save medical resources, and shorten the diagnosis and treatment time of patients.
2.Study on the Irrational Prescription and Medical Orders and Interventions in Our Hospital
Xiaoling SONG ; Yaling QIU ; Yanming LI ; Jinhua WEN
China Pharmacy 2015;(23):3176-3178,3179
OBJECTIVE:To promote rational drug use clinically. METHODS:Sampling rate of prescriptions in outpatient and emergency departments was no less than 1‰ of total prescriptions and no less than 100 prescriptions were reviewed every month;the sampling rate (according to the hospital records of discharge) of ward (district) doctor’s advice was no less than 1% and no less than 30 prescriptions were reviewed every month. According to drugs evaluation indicators of rational drug use,the prescrip-tions were analyzed statistically,immediate intervention and administrative intervention were adopted for irrational prescriptions and medical orders. RESULTS:The average qualified rate of outpatient prescriptions was 97.86%and 0.92%was non-standard prescrip-tions,1.20% was inappropriate prescriptions and 0.01% was extraordinary prescriptions. The non-standard prescriptions in the sec-ond half year were significantly lowered,with statistical significance(P<0.05). The inappropriate usage and dosage was not effec-tively controlled. The average qualified rate of medical orders was 96.30% and drug replacement withont any reference and incom-plete diagnosis in the second half year were significantly lowered,with statistical significance(P<0.05). The utilization rate of an-tibiotics in emergency department was 41.51%and the other indicators were basic standard. The qualified rate of Majing drugs’pre-scriptions was 81.60%and non-standard prescriptions accounted for 88.37%in the irrational prescriptions. CONCLUSIONS:Imme-diate intervention and administrative intervention have achieved some success. Immediate intervention has mainly reduced the non-standard prescriptions and administrative intervention has controlled some specific irrational prescriptions.
3.MiR-124 involves in methamphetamineaddiction in PC12 cells by inhibiting GluR2
Mingjin JIANG ; Duanwen CAO ; Jian ZHOU ; Yanni LYU ; Yaling QIU ; Jinhua WEN ; Xiaohua WEI
Chinese Pharmacological Bulletin 2017;33(7):982-986
Aim To investigate the change of miR-124 expression in methamphetamine-induced addiction in PC12 cells and the possible regulatory mechanism that it involves.Methods PC12 cells were randomly divided into 6 groups as follows: control group, methamphetamine group, agomir Negative Control group, miR-124 agomir group, agomir Negative Control+methamphetamine group and miR-124 agomir+methamphetamine group.After the treatment, the total RNA and protein were extracted in PC12 cells.The expression of miR-124 was measured by Real-time PCR and the expression of GluR2 was determined by Western blot in PC12 cells.Results Compared with those in the control group, the expression of miR-124 was remarkably decreased and the expression of GluR2 was significantly increased in the methamphetamine group in PC12 cells.Compared with those in the agomir Negative Control+methamphetamine group, the expression of miR-124 was remarkably increased and the expression of GluR2 was significantly decreased in the miR-124 agomir+methamphetamine group in PC12 cells.Conclusion MiR-124 might involve in methamphetamine-induced addiction in PC12 cells by inhibiting GluR2.
4. Evaluating the long-term prognosis of coronary artery disease patients undergoing percutaneous coronary intervention by risk stratification with ACC/AHA classification of coronary lesions
Miaohan QIU ; Weichao ZHAO ; Peng FAN ; Liya BIAN ; Jing LI ; Yi LI ; Yaling HAN
Chinese Journal of Cardiology 2020;48(2):111-117
Objective:
To evaluate the long-term prognosis of coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) by risk stratification with American College of Cardiology (ACC)/American Heart Association (AHA) classification of coronary lesions.
Methods:
Data used in this study derived from the I-LOVE-IT 2 trial. I-LOVE-IT 2 trial was a prospective, multicenter, randomized, assessor-blinded, noninferiority study. A total of 1 255 patients in I-LOVE-IT 2 trial with only one lesion and underwent biodegradable polymer drug-eluting stent implantation were included and grouped according to ACC/AHA classification of coronary lesions, namely type A/B1 lesion group (
5. Value of SYNTAX revascularization index on evaluating the long-term prognosis of coronary artery disease patients with biodegradable polymer drug-eluting stents implantation
Miaohan QIU ; Liya BIAN ; Chu'ai FANG ; Peng FAN ; Weichao ZHAO ; Jing LI ; Yi LI ; Yaling HAN
Chinese Journal of Cardiology 2019;47(10):790-797
Objective:
To explore the value of SYNTAX revascularization index (SRI) on evaluating the long-term prognosis of coronary artery disease (CAD) patients implanted with biodegradable polymer drug-eluting stents (BP-DES) and define the best threshold of SRI for predicting all-cause mortality in these patients.
Methods:
Data used in this study derived from the I-LOVE-IT 2 trial (evaluate safety and effectiveness of the Tivoli DES and the Firebird DES for treatment of coronary). I-LOVE-IT 2 trial was a prospective, multicenter, randomized, assessor-blinded, non-inferiority study. A total of 1 829 patients implanted with BP-DES were divided into 3 groups, namely SRI=100% group (
6.Influencing factors of weaning outcome of intensive care unit patients with planned extubation
Jiebing LIANG ; Yaling TIAN ; Ze CHEN ; Xue QIAN ; Xinying WANG ; Xiaomin CHEN ; Zhigang ZUO ; Xiujuan LIU ; Fang QIU
Chinese Critical Care Medicine 2021;33(5):563-567
Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.
7.Progress on the resistance mechanism of Enterococcus to linezolid
Yaling LOU ; Wei YU ; Zhe WU ; Yunqing QIU
Chinese Journal of Clinical Infectious Diseases 2018;11(1):66-70
Enterococcus is an opportunistic pathogen of nosocomial infection.In recent years, the resistance rate of Enterococcus to antimicrobial agents is increasing with the widespread use of antibiotics, even leading to the development of vancomycin-resistant Enterococcus(VRE).Linezolid is a synthetic oxazolidinone antibiotic, which less likely to generates the cross-resistance with other antimicrobial agents that inhibit bacterial protein synthesis,so it has been regarded as the last line of defense for VRE.However, since the linezolid has appeared on the market, the reports of linezolid-resistant Enterococcus have also emerged.This article reviews the resistance mechanisms of Enterococcus to linezolid in order to provide reference for resistance surveillance as well as the research and development of new antimicrobial agents.
8.Application of virtual simulation combined with flipped classroom in experimental teaching of the nursing care of falls in the elderly
Dan QIU ; Hong JIANG ; Yueping ZHU ; Ting TANG ; Yaling LI ; Yan FENG ; Fu DING
Chinese Journal of Medical Education Research 2023;22(12):1901-1905
Objective:To investigate the application effect of virtual simulation combined with flipped classroom in experimental teaching of the nursing care of falls in the elderly.Methods:The 497 nursing undergraduates in the class of 2019 in Chongqing Medical University were selected as subjects and were then divided into control group (two classes with 251 students) and intervention group (two classes with 246 students). The students in the control group received traditional experimental teaching, and those in the intervention group received blended experimental teaching with virtual simulation combined with flipped classroom. At the end of the course, the use of virtual simulation platform was analyzed for the students in the intervention group, and a questionnaire survey and theoretical examination were used to compare the effect of experimental teaching between the two groups. SPSS 27.0 was used for the t-test and the chi-square test. Results:The frequency of use of the virtual simulation platform was (2.65±1.38) times per person in the intervention group, with an online learning time of 54.12-147.32 minutes. The questionnaire survey showed that compared with the control group, the intervention group had significantly higher scores of the achievement of teaching objectives and teaching satisfaction ( P<0.05). Compared with the control group after teaching, the intervention group had significantly higher scores of teaching promotion in terms of stimulating learning interest, cultivating self-learning ability, developing clinical thinking ability, improving innovation, and enhancing health education ability ( P<0.05). The intervention group had a significantly higher theoretical examination score than the control group [(79.38±5.09) vs. (77.88±4.97), P<0.05]. Conclusions:In the blended experimental teaching of the nursing care of falls in the elderly, virtual simulation combined with flipped classroom can help students master related knowledge and skills and cultivate their self-learning ability, clinical thinking ability, innovation ability, and health education ability.