OBJECTIVE:To provide reference for clinical rational drug use. METHODS:The medical orders of oral tablet in the inpatients collected from our hospital in 2014,and the application of oral tablet splitting was analyzed statistically. RESULTS:There were 220 specifications in total,and 93 tablets were split for use,accounting for 42.27%. Of all split tablets,there were 52 kinds with split mark on surface,accounting for 55.91%. There were 357 602 medical orders of tablet and 15 202 of tablet split-ting,accounting for 4.25%. The top three categories in frequency of splitting were Benserazide tablets,Digoxin and Clonazepam tablet. CONCLUSIONS:To meet the demand of clinical treatment,tablet splitting has its rationality. It is necessary to enhance com-munication among pharmacists,doctors and nurses to weigh the pros and cons before treatment.

Objective To analyze the clinical effects of allogenic acellular dermal matrix (ADM) treatment for diabetic foot ulcer (DFU) with meta-analysis.Methods Databases including PubMed,Cochrance Library,Embase,and OVID EBM Reviews were searched using key words " diabetic foot,diabetic ulcer,diabetic wound,acellular dermal matrix,acellular dermal regenerative tissue matrix,acellular regenerative tissue matrix,AlloDerm,SureDerm,KaroDerm,Graftjacket,Hyalomatrix PA,and Hyalograft 3D",and Chinese Biological Abstracts,Chinese Journals Full-text Database,VIP Database,and Wanfang Database were searched using key words in Chinese version”糖尿病足,糖尿病足溃疡,异体脱细胞真皮基质,真皮基质”to obtain the published trials of allogenic ADM treatment for DFU from January 1990 to July 2015,and then meta-analysis was used to analyze the trials.The measurement indexes were wound contraction rate,wound healing rate,complete epithelization time of wound,and complication rate.Meta-analysis was conducted by RevMan 5.2 statistical software.Results A total of 5 trials involving 426 DFU patients were included,with 224 patients in group ADM who received allogenic ADM treatment and 202 patients in conventional treatment group (CT) who received conventional moist treatment.There was no statistically significant difference between group ADM and group CT in wound contraction rate,with mean difference 20.34 (with 95％ confidence interval-25.27-65.94,P =0.38).The wound healing rate of patients in group ADM was higher than that in group CT,with relative risk (RR) 1.90 (with 95％ confidence interval 1.29-2.80,P ＜0.01).There was no statistically significant difference between group ADM and group CT in complete epithelization time of wound,with mean difference 1.20 (with 95％ confidence interval-2.93-0.52,P =0.17).The complication rate of patients in group ADM was lower than that in group CT,RR =0.54 (with 95％ confidence interval 0.38-0.76,P ＜ 0.001).Publication bias might exist in wound contraction rate,wound healing rate,complete epithelization time of wound,and complication rate.Conclusions Compared with conventional moist treatment,allogenic ADM treatment can accelerate wound healing and reduce complication rate in patients with DFU.

With the aging of population, the elderly (≥65 years old) cancer patients have become one of the main populations for cancer care. For inoperable locally advanced head and neck squamous carcinomas, cisplatin-based concurrent chemoradiotherapy is the first-line choice. Several large clinical studies have shown that patients under 70 years of age can still benefit from concurrent chemoradiotherapy, while it should be cautious to apply chemotherapy to patients aged 70-80 years. For elderly patients who are intolerant to cisplatin, carboplatin or other regimens with less gastrointestinal and renal toxicity should be considered. Although anti-epidermal growth factor receptor (EGFR) monoclonal antibodies combined with radiotherapy has been proved to be more effective than radiotherapy alone in total patient population, age-subgroup analysis showed limited benefit in elderly patients. The safety of immune checkpoint inhibitors in elderly patients has been validated and those with high programmed death ligand-1 (PD-L1) expression may benefit from concurrent or neoadjuvant immunotherapy, however, high-level evidence is still lacking. For patients older than 80 years, radiotherapy alone may be superior to concurrent chemoradiotherapy, and hypofractionated radiotherapy for palliative purposes can be safely used in this population.

Radiotherapy is an essential part of comprehensive treatment, as well as a radical treatment for head and neck cancer (HNC). The COVID-19 has continued so far, imposing a great impact on cancer care. Since conventional fractionated radiotherapy (CFRT, 2 Gy/F) requires as long as more than six weeks of treatment time, a huge challenge for epidemic control is created for both hospitals and patients. Hypofractionated radiotherapy (Hypo-RT) may be more suitable than CFRT for patients during pandemic by increasing the fraction size, thus reducing fraction number and treatment duration. Early studies have explored the application of Hypo-RT in HNC in palliative setting, which partially proved its safety and effectiveness. Recently, the efforts have been made in definitive treatment using hypofractionated regimen, as well as its combination with systemic treatment and immunotherapy. Indeed, regarding the pandemic of COVID-19, Hypo-RT has been recommended by several expert consensus in the HNC. In this review, relevant research progress was summarized and clinical implication of Hypo-RT in COVID-19 pandemic era was discussed.