OBJECTIVE:To provide reference for the medication safety in elderly patients with chronic diseases. METHODS:Elderly inpatients with chronic diseases and nursing staff in affiliated hospital of shaoyang medical college,from Mar. 2014 to May 2015 were randomly selected for a questionnaire survey to analyze the influential factors of drug safety and health education de-mand,and the difficulty sources of nursing staff in developing health education was explored. RESULTS:Totally 500 questionnaire was sent out to elderly patients with chronic diseases,500 were effectively received with effective recovery of 100%;and totally 200 were sent out to nursing staff,200 were effectively received with effective recovery of 100%. In the 500 surveyed patients, 193 had ADR,which was affected by age,educational background,monthly income,disease course,whether received health edu-cation,etc.(P<0.05),patients with older age,lower educational background and monthly income,longer disease course and no receiving health education showed higher incidence of ADR;the influential factors for health education demands included education-al background,occupational status,disease course,quality evaluation of nursing staff,etc.(P<0.05),patients with higher educa-tional background,lower disease course,higher occupational status and quality evaluation of nursing staff showed stronger health education demands. The difficulty sources of surveyed nursing staff in developing health education were busy work,being afraid of misunderstanding,embarrassing,cognitive and skill deficits. CONCLUSIONS:The drug safety of elderly patients with chronic dis-eases is related to many influential factors,as well as the health education demands. Nursing staff should continuously improve their ability and quality,combined with the above influential factors,carry out health education with physicians and pharmacists to ensure the medication safety.

Objective To investigate the effects of human umbilical mesenchymal stem cells (hUCMSCs) on Wistar rat models of stress urinary incontinence and its possible mechanism.Methods hUCMSCs cells were separated and extracted from human umbilical cord of cesarean delivery of full-term pregnancy women.The models of stress urinary incontinence (SUI) of Wistar rats were established by imitating delivery damage and ovary removing surgery,and then randomly divided into three groups:model group,transforming growth factor-β1 (TGF-β31) group,hUCMSCs group,and normal rats as normal group;and every group included ten rats.Maximal bladder capacity (MBC),leak point pressure (LPP),abdominal leak point pressure (ALPP),and sneezing experiment of rats including normal rats,model rats and model rats accepted TGF-β1 or hUCMSCs treatment were examined.When the treatment accomplished,the rats were killed and urethral sphincter were separated and examined by hematoxylin eosin (HE) staining and the proteins of troponin Ⅰ (TnI),troponin C (TnC),troponin T (TnT),tropomyosin (Tm),actin (AT),myosin heavy chain (MHC) and myosin light chain (MLC) of urethral sphincter was detected with Western blot method.Results The cells of hUCMSCs were extracted and authenticated,SUI models of Wistar rats were successfully established and authenticated.Compared to model group and TGF-β1 group,the MBC,LPP and ALPP of hUCMSCs group dramatically improved (P ＜ 0.05),while the positive rate of sneezing experiment significantly dropped (P ＜ 0.05).HE staining showed urethral sphincter became attenuation,fracture,sparse and disorder,simultaneously the proteins of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter reduced (P ＜ 0.05).While the damaged urethral sphincter basically restored the normal structure and the proteins of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter up-regulated through hUCMSCs treatment (P ＜ 0.05).Conclusions The treatment of hUCMSCs translation could observably improve the clinic symptoms of SUI Wistar rat models,and its mechanism may be related to enhancement of the protein expression of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter,and were involved in the rehabilitation and reconstruction of urethral sphincter.

Objective To explore the symptoms of anxiety,family structure,and the distribution features of family about in-patients.And to find out the influence of the family structure on in-patients' symptoms of anxiety.The results would provide evidentiary support and suggestions for in-patients to improve quality of life and for prevention and intervention of anxiety.Methods Family table was used to register the family structure which was classified as the nuclear family,stem/expended family and other classification.The anxiety of in-patients was measured by self-rating anxiety scale.Results A total of 512 cases of in-patients completed the survey,there were 483 valid questionnaires.The rate of effective questionnaire was 94.34％.In family structure of in-patients,core family accounted for 48.65％,stem/expended family was 36.85％.The sex of family structure showed significant difference,the female proportion of the nuclear family was significantly higher than male.Among all in-patients,78.05％ did not have anxiety,low-level,medium-level,and severe anxiety showed no significant differences.The effects of anxiety on family structure had significant differences.The anxiety level of stem family was relatively higher.Conclusions Economic development and the population flow due to industrialization and globalization changed family structure of our country,especially in coastal de-velopment cities with fast economic development,fast-paced and stressful work,and it may affect the influ-ence of Chinese traditional family structure on anxiety of the in-patients.

OBJECTIVE:To establish a method for the determination of related substance in posaconazole raw material.METHODS:HPLC method was adopted.The separation was performed on Zorbax Eclipse Plus C18 column with mobile phase consisted of 0.05 mol/L ammonium acetate solution (pH adjusted to 4.0 using acetic acid)-acetonitrile (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 262 ran,and the column temperature was 30 ℃.The sample size was 20 μL.RESULTS:The linear range of intermediate I was 0.05-5.0 μg/mL (r=0.999 9);the limit of quantitation was 0.05 μg/mL,the limit of detection was 0.013 μg/mL;RSDs of precision test,stability test and repeatability test were lower than 2.0％;the recoveries was 98.00％-101.69％ (RSD=1.22％,n=9).CONCLUSIONS:The method is simple,accurate and suitable for the determination of related substance in posaconazole raw material.

Objective:To understand the clinical features and risk factors of the first seizures in children with febrile seizures, to guide clinicians to take appropriate intervention measures for children with risk factors, and to reduce the incidence of febrile seizures.Methods:A total of 616 children with first-onset febrile seizures admitted in our hospital from August 2016 to August 2018 were enrolled in this study.The clinical characteristics and risk factors of first-onset seizures were retrospectively analyzed.And 601 children with fever but no seizures were randomly selected as the control group.Results:There were 616 children with febrile seizures, including 344 males and 272 females, 584 Hans and 32 Mongolian.A total of 126 cases (20.5%) were under 1 year old, 405 cases (65.8%) were 1-3 years old, and 85 cases(13.7%) were over 3 years old.The upper third of the episodes were acute upper respiratory tract infections[53.6%(330/616)], herpetic angina[25.9% (160/616)], and infant acute rash[10.5%(65/616)]. There were 570 cases(92.5%) with seizures at 38.0 ℃ and above, 16 cases(2.6%)had fever after seizures.A total of 534 cases(86.7%) had seizures within 24 hours of fever, and 608 cases(98.7%) presented with a generalized seizures.The duration of seizures was less than 5 min in 548 cases (89.0%), 5-14 min in 48 cases (7.8%), 15-29 min in 16 cases (2.6%) and more than 30 min in 4 cases (0.4%). Of the 572 patients (92.9%), only one seizure occurred in a single heat stroke.In the clinical type, simple febrile seizures accounted for 88.3%(544/616), complex febrile seizures accounted for 11.0%(68/616), and seizures persisted in 0.7%(4/616). Risk factors analysis showed that age, low sodium, low iron and low zinc, cesarean section, abnormal birth history, vaccine exposure history one week before convulsion, and family history of febrile seizures were statistically different between the febrile seizure group and the control group( P<0.05). Logistic regression analysis found that the age of first febrile seizures, low iron, cesarean section, low sodium and family history of febrile seizures were the independent risk factors for the first episode of febrile seizures ( P<0.05). Conclusion:The first episode of febrile seizures are more common in infants and young children under 3 years old.It is mainly caused by simple febrile seizures.The temperature of seizures is high and it is easy to occur within 24 hours after fever.Viral infection is the most common cause.The risk factors for the first episode of febrile seizures are episode age, low iron, cesarean section, low sodium and family history of febrile seizures.Taking appropriate interventions for risk factors can reduce the incidence of febrile seizures.

Objective To explore the carrier rate of thalassemia in Laibin city,Guangxi Province,and provide a theoretical basis for the prevention and control of thalassemia.Methods From January 2020 to December 2021,88 152 patients were screened for thalassemia in the outpatient department of the Women's and Children's Hospital of 4 counties,1 city and 1 district in Laibin by blood cell detection and hemoglobin electrophoresis.The common and rare genes in initially screened positive individuals were detected by gap polymerase chain reaction(Gap-PCR)and reverse dot blot(RBD),and the results were conducted by statistical analysis.Results ① There were 22 553 positive cases in the preliminary screening and 8 327 positive cases received the diagnosis of thalassemia gene.A total of 4 944 thalassemia carriers of thalassemia genes were detected,deducing that the total thalassemia carrier rate in the population of childbearing age in this region was 15.19%,including 3 200 cases of α-thalassemia carriers(64.73%),1 424 cases of β-thalassemia carriers(28.80%),and 320 cases of were carriers α-thalassemia combined with β-thalassemia(6.47%).② There were 3 168 cases of common thalassemia(99.00%)and 32 cases of rare thalassemia(1.00%)among α-thalassemia gene carriers.A total of 13 mutant genes and 34 genotypes were detected,and genotype SEA/αα was the comes first.③ Among the β-thalassemia gene carriers,there were 1 411 cases of(99.09%)common thalassemia and 13 cases(0.91%)of rare thalassemia.A total of 19 mutant genes and 25 genotypes were detected,with CD41-42(-CTTT)being the most common.④ A total of 53 different genotypes were detected in the carriers of α-thalassemia combined with β-thalassemia,and the top genotype was--SEA/αα βCD41-42M/βN.⑤ The carrier rates of Yao and Han nationality were comparable,and the differences were not significant(χ2=0.300,P=0.584).The differences in carrying rates between Zhuang and Yao(χ2=23.66,P＜0.001),and between Zhuang and Han(χ2=116.98,P＜0.001)were significant.⑥ The carrier rate in Xiangzhou County was the highest(20.04%),while the carrier rate in Heshan City was the lowest(12.38%).⑦ The carrier rate of females was higher than that of males,and the difference was significant(χ2=182.03,P＜0.001).Conclusion The variants genotypes of thalassemia in Laibin were complex.This study was the first to investigate the carrier rate and gene mutation spectrum of thalassemia in Laibin Area,which provides valuable baseline data for genetic counseling and prenatal diagnosis.

【Objective】 To investigate the distribution of ABO and RhD blood groups among voluntary blood donors in Guangzhou, in order to ensure clinical blood safety and better serve blood donors. 【Methods】 Routine ABO and RhD blood group screening tests were carried out among voluntary blood donors from January 2021 to December 2022. The composition ratio of ABO blood group was statistically analyzed. The samples with discrepancy between forward and reverse blood grouping and negative RhD blood group samples were further verified by serological test to analyze the ABO subtypes and the reasons for missed detection. 【Results】 A total of 749 123 blood samples were screened from January 2021 to December 2022, and 513 291 samples were collected after excluding repeat blood donors, with the ABO blood groups as 208 126(40.55%) of O type, 138 859(27.05%) of A type, 130 987(25.52%) of B type and 35 319(6.88%) of AB type. The screening results showed discrepancy between forward and reverse blood grouping in 506 samples, of which 58 were with weak/non-erythrocyte reaction, 16 with erythrocyte reaction, 215 with weak/non-serum reaction, and 217 with serum reaction. Further serological test indicated that 44 samples were ABO subtypes, among which 13 were subtype A, 26 subtype B, 5 subtype AB and 3 B (A) and 14 Bombay-like blood group. The blood group with the highest missed detection rate in repeat blood donors were A3/B3 subtype (68.42%). A total of 128 unexpected antibody positive samples were detected among 513 291 samples A total of 2 277 samples were screened negative for RhD blood type, of which 2 188 were confirmed to be Rh negative (2 188/513 291, 0.43%), 89 were D variants (89/513 291, 0.02%, ) and 30 were detected with unexpected antibodies (30/2 188, 1.37%). 【Conclusion】 The ABO blood group distribution of blood donors in Guangzhou is O>A>B>AB, and the proportion of RhD negative population is 0.43%, slightly highter than 0.3%-0.4% of Han population nationwide. The ABO blood group subtype is dominated by B subtype. The detection rate and missed detection rate of A3/B3 subtypes in routine blood group tests are the highest.

BACKGROUNDAn zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.

METHODSThis prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.

RESULTSIn terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.

CONCLUSIONAZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.

Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stavudine ; administration & dosage ; adverse effects ; therapeutic use ; Zidovudine ; administration & dosage ; adverse effects ; therapeutic use