OBJECTIVE:To guarantee the reliability of cold chain drug storage device and the quality of the drugs in the hospi-tal. METHODS:The establishment and effects of drug cold chain monitoring platform in our hospital were introduced as well as re-lated improvement and measures. RESULTS:The cold chain monitoring platform was established in our hospital through equipping with related equipment, constructing platform network, determining monitoring point, setting early warning condition, etc. All-weather and real-time monitoring of temperature and humidity were realized for different districts of the hospital and different cold chain equipments. The platform could provide the information about operating condition of equipment,and complete drug re-frigeration temperature record;equipment failure could be dissolved in time based on early warning message. Through analyzing rea-sons of early warning message,the unqualified equipment was updated in time,which further improve the system and procedure of cold chain monitoring platform. Within 2 years after the implementation of the platform,53 sets of special refrigerator for drug were updated. Monthly early warning message and the rate of refrigeration equipment early warning decreased from 6869 and 100% in Sept. 2014 at the early stage of short message warning function to 1083 and 40% in Feb. 2016,respectively. CONCLU-SIONS:The establishment of drug cold chain monitoring platform guarantees the reliability of cold drug storage condition so as to ensure the quality of drug in the hospital.

OBJECTIVE:To improve the drug turnover rate and the work efficiency of drug storehouse,and to reduce the cost of drug storage. METHODS:Based on ABC dynamic classification,original drug procurement management module in HIS was im-proved. Scientific,accurate and reasonable drug procurement plan was generated by the system automatically through setting pro-curement proportion coefficient. Drug procurement by type was achieved through adding classification scanning function,based on distribution mode and drug property classification. Related index were compared before and after improvement to evaluate the ef-fects of the improvement. RESULTS:Compared with before improvement,average monthly inventory amount of drugs in our hos-pital reduced by 6.44%,turnover rate increased by 47.13%(increasing from 4.18% to 6.15%),and the time for developing pro-curement plan decreased by 75.00%(decreasing from 8 h to 2 h). CONCLUSIONS:The improvement of drug procurement man-agement module effectively reduce drug inventory and improve turnover rate of drugs and work efficiency.

OBJECTIVE:To assess the ability of suppliers and manufacturers in dealing with drug quality problems so as to provide reference for hospital in optimizing future suppliers and manufacturers.METHODS:The drug quality registration form in drug storehouse in 2007 in our hospital was analyzed in respect of the quality of drugs which were classified into type A and type B.RESULTS:The A-type drug quality problems,i.e drug quality problems presented in the production of drugs, accounted for 28.6%,and B-type drug quality problems,i.e drug quality problems involved in circulation and use of drugs, accounted for 71.4%.CONCLUSIONS:Drug quality data analysis report can objectively reflect the overall condition of hospital drug quality and the drug quality of the suppliers,thus it can be used as reference for hospital in optimizing future drug manufacturing enterprises and suppliers.

Objective To study the chemical composition from leaves of Smallanthus sonchifolius.Methods Some chromatography methods were used in the isolation procedure,while the structures were determined on the aids of NMR and MS spectral analyses.Results A new compound,together with five known compounds,was isolated from the ethanolic extract of the leaves.The new compound is characterized as 5,8-dihydroxyl-(5H,8H)-?-ionol(Ⅰ).Other compounds are obtained for the first time from the title plant and identified as ent-kaurane-3?,16?,17-triol(Ⅱ),entkaurane-16?,17-diol-19-oic acid(Ⅲ),3,4-dihydroxybenzaldehyde(Ⅳ),1-pentacosanol(Ⅴ),and 1-octacosanol(Ⅵ),respectively.Conclusion Compounds Ⅰ-Ⅵ are isolated from the plants of genus Smallanthus for the first time.Compound Ⅰ is a ?-ionol derivate firstly isolated from genus Smallanthus.It is named as sonchifolol.

Adolescent ; Adult ; Age Factors ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Temporal Lobe ; diagnosis ; etiology ; Humans ; Infant ; Male ; Middle Aged

Objective To evaluate the mid-and long-term follow-up outcome of revascularization and stenting of nonacute intracranial vertebrobasilar artery occlusion. Methods Consecutive data of 27 patients who suffered from nonacute intracranial vertebrobasilar artery occlusion beyond 24 hours and underwent endovascular revascularization, were retrospectively collected and analyzed. Complications and recurrent ischemic events during the follow-up period were recorded. The modified Rankin scale(mRS) scores were used and compared between pre-and postoperation. Results All 27 patients except one(96.3%) obtained successful recanalization. After the procedure, 13 patients showed improvement, 11 were stable, and 3 worse. The decline of median mRS scores, which was 4(interquarter range-IR, 2-5) preoperatively and 3(IR, 1-5) on discharge. Five patients suffered from procedural complications and three of them resulted in aggravation. Nineteen patients received imaging follow-up during the median 10 months, 6 restenosis occurred and 3 of them were symptomatic. During median 55 months clinical follow-up after operation, 2 ipsilateral stroke and 2 ipsilateral transient ischemic attack occurred. The mRS scores decreased significantly in the first one year after procedure. Conclusions Revascularization and stenting of nonacute intracranial vertebrobasilar artery occlusion can prevent recurrent ipsilateral ischemic event and improve disability recovery in the first one year.

Objective:To investigate the effect of thrombus burden on the clinical outcome of endovascular recanalization in large vessel occlusive stroke.Methods:Patients with acute anterior circulation occlusion who underwent endovascular treatment within 24 hours after onset in Zhengzhou University People′s Hospital from January 2018 to December 2019 were retrospectively collected. According to the clot burden score (CBS) of DSA, total objectives were divided into CBS≥6 group (24 cases) and CBS<6 group (38 cases). Clinical data of the two groups were collected and the modified Rankin scale (mRS) was used to evaluate the clinical outcome at 90 days after surgery. Independent sample t-test, Wilcoxon rank sum test and χ 2 test were used to compare the clinical data between the two groups. Independent risk factors affecting the clinical outcome were analyzed by binary logistic regression. Results:There were no statistically significant differences in basic demographic data, stroke risk factors and other factors between the CBS≥6 group and CBS<6 group ( P>0.05).The proportion of using tirofiban after surgery in the CBS≥6 group (63.2%, 24/38) was lower than that in the CBS<6 group (87.5%, 21/24) (χ2=4.380, P=0.044). The discharge NIHSS score of the CBS≥6 group was [5.0 (3.3, 7.8) points] lower than CBS<6 group [8.5 (1.8, 14.5) points] ( Z=5.221, P=0.022). The proportion of postoperative mRS 0-2 was (91.7%, 22/24) in the CBS≥6 group higher than CBS<6 group(39.5%, 15/38) (χ2=20.486, P=0.001), there were no statistically significant differences between the two groups ( P<0.05). The results of binary logistics regression analysis showed the CBS groups (OR=0.042, 95%CI 0.007-0.244 , P=0.001) was an independent risk factor affecting good outcome. Subgroup analysis of whether tirofiban was used or not showed there was no statistically significant difference in clinical prognosis between the two groups ( P>0.05). Conclusions:The clinical outcome of CBS≥6 group is significantly better than that of CBS<6 group, and patients with small thrombus burden are more likely to get a good clinical outcome of 90 days.

Sample size is one of important factors determining the results of a clinical trial, and the choice of sample size estimation methods is related to the specific design of clinical trials. On clinical safety reevaluation of postmarketing Chinese medicine, we often design cohort study, case-control study, nested case-control study or hospital centralized monitoring, which need large sample sizes. In evaluating the effectiveness of postmarketing Chinese medicine widely applied in the large population, pragmatic randomized controlled trial (PRCT) is more suitable than explanatory randomized controlled trial (ERCT). ERCT is necessary to conduct confirmatory study for new indications of postmarketing Chinese medicine. According to the specific purpose, design type and evaluation index, we choose the suitable sample size estimation method, and determine the corresponding parameters. We must estimate and determine the suitable sample size according to the specific clinical evaluation design, with comprehensive consideration of the test power, research cost and practical operability.
Cohort Studies ; Drug Therapy ; standards ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; adverse effects ; standards ; therapeutic use ; Humans ; Product Surveillance, Postmarketing ; Public Health ; Randomized Controlled Trials as Topic ; Sample Size

This is a retrospective study aimed at the clinical application of 64-slice computed tomography angiography (CTA) in evaluation the lumen before and after coronary artery stent implantation. We collected the coronary artery imaging data of 46 patients undergoing 64-slice CT before coronary artery stent implantation from July 2006 through May 2007; we also collected the data of 21 patients with 34 coronary artery stents in the same period to determine the diagnostic accuracy of CTA before and after coronary artery stent implantation. The results showed that, in 46 patients, 64-slice CT enabled the visualization of the entire coronary tree with diagnostic image quality. Sensitivity, specificity, and accuracy for the detection of stenosis > or = 50% were 92.11%, 95.64% and 94.97%, respectively. In 21 patients with 34 stents implanted, 23 (67.65%) stents showed no stenosis, 8 (23.53%) stents showed low degree of restenosis, and 3 (8.83%) stents showed high degree of restenosis. In conclusion, we can accurately evaluate the degree of stenosis of lumen before and after coronary artery stent implantation with the application of 64-slice CTA.
Adult ; Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Coronary Restenosis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Stents ; Tomography, Spiral Computed ; methods

Objective To compare the perioperative complications of prophylactic use of three antiplatelet strategies in unruptured intracranial aneurysms treated by stent assisted coiling. Methods A total of 203 consecutive patients were brought into this retrospective study including the following three groups:the loading group (n=54), with a loading dose of 300 mg to 600 mg clopidogrel at 2 h to 24h before the stenting; tirofiban group (n=50), a loading dosage of tirofiban (8 μg/kg/min over 3 min) followed by a 0.1μg/kg/min maintenance dosage; dual antiplatelet group (n=99), dual oral antiplatelet drugs (clopidogrel 75 mg + aspirin 100 mg) pretreated for 3-5 days before the operation. Events of hemorrhage and thromboembolism were recorded and the complications were compared to assess the safety and efficacy of various antiplatelet strategies. Chi-square or Fisher exact tests were used for categorical variables. Results The hemorrhagic rates were 11.1% in loading group, 2.0% in dual antiplatelet group, and 0% in tirofiban group, respectively, while the thromboembolic rates were 7.4% in loading group, 4.0% in dual antiplatelet group, and 0% in tirofiban group, respectively. For total complications, significant difference (P<0.05) existed among the three groups, and the complication rate in loading group was significantly higher than that of the dual group (P=0.016) and tirofiban group (P=0.001), while there was no significant difference between tirofiban group and dual antiplatelet group(P>0.05). The hemorrhagic rate in loading group was significantly higher than that of the dual group (P=0.023) and tirofiban group (P=0.027), while there was no significant difference between tirofiban group and dual antiplatelet group (P>0.05). In subgroup analysis of the loading group, the postoperative thromboembolic rate was significantly higher in those exposed to low molecular weight heparin than those not (P=0.039) with no increase of hemorrhagic events (P>0.05). Conclusions When compared with the dual antiplatelet strategy, tirofiban strategy may be used as a new prophylactic protocol in unruptured intracranial aneurysms treated by stent assisted coiling. Those treated by low molecular weight heparin postoperatively after receiving dual antiplatelet therapy may increase the hemorrhagic risk, although there was a significant decrease in thromboembolic events postoperatively.