OBJECTIVE:To improve the drug comprehensive management level of peacekeeping medical team,achieve dynam-ic management of drug information and network. METHODS:The design and development of drug management system of peace-keeping medical team were introduced in terms of overall system architecture,technical routes,system function design,etc.,and the application effect was evaluated. RESULTS:The system was designed by referencing military hospital No.1 drug management system,adopting C/S two-tier architecture,which included system settings,drug dictionary management,inventory management and other 8 modules and numbers of sub-modules. It achieved drug getting out and entering warehouse,supplying maintenance man-agement,prescription dispensing,drug withdrawal and inquiries,expendable drug monitoring,rotation transfer export data,the whole English electronic medical instruments generation,data query statistics,timely query of drugs and disease diagnosis knowl-edge base and other functions. The application of system standardized drug management and significantly improved working efficien-cy of physicians and pharmacists. CONCLUSIONS:The application of the system promotes the transform of drug management from extensive management model to elaborating management model,and the data is safe and easy to operate.

Objective To investigate the myocardial injury in patients with dengue fever. Methods Three hundred and ninety-eight patients with dengue fever were included in the study. Blood myocardial enzyme spectrum and electrocardiography were examined in all patients. Results Abnormal myocardial enzyme spectrum was detected in 40 patients ( 10. 1% ), including the elevation of blood CK-MB, CK, LDH, α-HBDH and AST levels and increased cTnT levels were also detected in 5 patients. In these 40 patients, 34 showed abnormal electrocardiogram. Sinus bradycardia was the most common complication, other complications including ST or T wave changes. Some patients had more than two kinds of electrocardiogram abnormalities. Conclusion Dengue vires infection may induce myocardial injury, which suggests that examinations for myocardial enzyme spectrum and electrocardiography are necessary.

Objective To identify the pathogens that cause hand, foot and mouth disease (HFMD) in adults and analyze the nucleotide sequences characteristics of enterovirus 71 (EV71). Methods The reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the enterovirus from the samples of four adult HFMD patients. The 227 bp amplified segments of EVT1 were then sequenced and compared with the sequences of previously isolated EVT1 strains available from GenBank by homogeneity and phylogenetic tree analyses. Results All the results of RT-PCR with enterovirus universal primers and EVT1 specific primers were positive. The EV71 sequences analysis showed that the four new sequences (named as GZ19610, GZ99310, GZ99355 and GZ46477) shared 96.0% to 99.1% nucleotide identify themselves and shared 96.9% to 100.0% homology with the strain Fuyang/17.08/3 isolated in 2008 from Fuyang, Anhui Province. Phylogenetic tree analysis showed that the genotype of the four new sequences was all subtype C4, they were the same sub-genotype as those strains isolated from Chinese mainland and Chinese Taiwan in 2004, and the genetic distance between them was most closely. Conclusions EV71 can cause adult HFMD. Compared with the nucleotide sequences of EV71 strains that isolated now and formerly in China, there is no large variation of the EV71 sequences isolated from four adult HFMD patients in Guangzhou this time. The adult HFMD patients should be isolated for treatment to avoid them transmitting the virus and causing disease spreading.

Objective To investigate the dynamic changes of dengue viral loads and IgM antibody in patients with dengue fever ( DF) and to analyze their relationships with disease severity. Methods A to-tal of 1 508 serum samples were collected from 1 140 hospitalized patients including 1 050 mild cases and 90 severe cases within 10 days after the onset of DF in Guangzhou in 2014. The viral loads were determined by using fluorescence quantitative RT-PCR. ELISA was performed to measure the dengue virus ( DENV)-spe-cific IgM antibody. Results In general, the DENV viral loads in patients declined gradually from 108 copies/ml on day 1 to 103 copies/ml on day 10 after the onset of DF. The viral loads in severe cases were significantly higher than those in mild cases on days 5 to 7 (P<0. 05). The positive rates of DENV RNA in serum samples also decreased with the disease progression from 100% on day 1 to 40% on day 10. Com-pared with the mild cases, the patients with severe DF showed higher positive rates of DENV RNA on day 6 and day 8 (P<0. 05). The DENV-specific IgM antibody could be detected on day 2 and the secretion of IgM antibody increased gradually with the disease progression. The levels of IgM antibody in mild cases were sig-nificantly higher than those in severe cases (P<0. 001). The positive rates of IgM antibody in patients in-creased form 8% on day 2 to 95% on day 6. Higher positive rates of IgM antibody were detected in mild ca-ses on days 5 and 6 as compared with those in patients with severe DF (P<0. 05). Conclusion High viral load and low level of IgM antibody during the fastigium of DF were closely associated with the disease severity.

Objective To analyze the characteristics of laboratory test resuits of dengue fever(DF)patients in Guangzhou area.Methods Routine tests were performed in the patients admission to hospital. Serology examination was performed in the patients in acute phase or recovery phase.The clinieal symptoms and teatures were analyzed and positive numbers and positivity ratios were calculated.Results The clinical symptoms of the dengue fever were typieal,with the features of fever,headache,myalgia and rash.The leukopenia rate was 76.0%,and the thromboeytopenia rate was 62.6%.The levels of ALT increased in 56.7%patients,and the levels of AST increased in 84.0%patients.Hypopotassemia was found in 46.1%patients.Dengue virus antibody IgM(DF-IgM)was detected positive from the first day to the 16th day of the onset,and the positive rate was 85.9% on the 8th day.Virus loads were positive by fluorescence real-time PCR in seven acute serum samples(within 3 days of the onset)of 51 cases whose DE-IgM were negative all the time, and the results was 105 -106 copies/ml(＜103 copies/ml means negative).Conclusions Clinical manifestations of this DF epidemic were typical including fever,headache,myalgia and skin rash.Most of the patients had decreased leukocyte and thrombocyte obviously.Liver damage was common but kidney damage was seldom.Halt of the patients got hypopotassemia.DF-IgM appeared in very early and persisted for a long time.The detection of DF-IgM within 7 days of the onset was helpful for diagnosis as early as possible.Viral load detected by real-time PCR could be another indicator of early pathogen diagnosis which provides complementation for antibody detection.

Objective To explore the relationship between serum homocysteine (Hcy) level before coronary angiography(CAG) and contrast induced nephropathy (CIN) after CAG.Methods We included 2264 cases of suspected coronary heart disease from May 2013 to May 2016 and all patients received CAG examination.According to whether CIN has developed or not after CAG, the patients were divided into the non-CIN group (n=2162) and the CIN group (n=102).We analyzed and compared the clinical baseline data, serum Hcy and creatinine (Cr) levels and the estimated glomerular filtration rate between the 2 groups eGFR.Results Patients in the non-CIN group were younger and with less comorbidities of diabetes and chronic kidney disease (all P<0.05).The volume of contrast media consumed in the non-CIN group was less than the CIN group [(122±21)ml vs.(147±24)ml, P=0.012).Hcy level in the non-CIN group (12.81±6.71) μmol/L was lower than that in the CIN group (21.74±11.9)μmol/L before CAG (P<0.05).No significant differences in serum Cr level and eGFR before CAG (P>0.05).At 72 hours after CAG, Cr level of the non-CIN group (69.34±19.54 μmol/L) was lower than that of the CIN group (87.34±21.38) μmol/L (P<0.05).eGFR was higher in the non-CIN group (79.34±19.54)ml/min than that in the CIN group (67.34±21.38)ml/min (P<0.05).Linear regression analysis showed that Hcy level before CAG were positively correlated with Cr level after CAG (r=0.547,P<0.01) and negatively correlated with eGFR after CAG (r=-0.271,P<0.01).Conclusions Hcy level before CAG can be used as one of an effective parameter to predict CIN.

Objective To investigate the epidemiological, clinical and pathogenic characteristics and prognosis of the first imported case of Chikungunya fever in China in 2008. Methods Epidemiological and clinical data of this mate adult patient were analyzed retrospectively. Chikungunya virus (CHIKV)-IgM was detected using enzyme linked immunosorbent assay (ELISA) and colloidal gold immunoassay. CHIKV-RNA was detected using real-time fluorescent polymerase chain reaction (RT-PCR). Results This patient had onset of fever on March 2 in 2008 and lasted for 5 days. In addition, he felt joint and muscle pains, headache and found generalized engorged maculopapule. The laboratory tests showed leukopenia and thrombocytopenia. CHIKV-IgM was detected positive at day 9 after the onset and CHIKV-RNA was all positive at day 3, 5, 7, 9 after the onset. A 575 bp fragment of RT-PCR product was sequenced and detected the nucleotide homology was 99% compared with CHIKV sequences in GenBank. The patient recovered with symptomatic supportive treatment.Conclusion This imported case of Chikungunya virus infection is reported for the first time in China.It shows similar clinical manifestations with dengue fever.

Objective To detect and analyze the haemagglutinin (HA) gene of the first influenza A-H1N1 viral strain isolated in Guangdong Province during an influenza A pandemic in 2009.Methods A-H1N1 virus strain was isolated from the throat swab of the first patient diagnosed with A-H1N1 virus infection in Guangdong Province in 2009. Viral nucleonic acid was extracted from supernatant of cell culture and amplified using reverse transcriptase-polymerase chain reaction (RT-PCR) with HA gene-specific primers. The product was cloned, sequenced, and the homology was analyzed. Results A 1710 bp HA gene of the first influenza A-H1N1 viral strain in Guangdong Province in 2009 was acquired, which was named as A/GuangzhouSB/01/2009 (H1N1) HA with GenBank access No. GQ268003. The homology of the studied HA gene and the 277 influenza A (H1N1) isolates reported in the epidemic areas was 99.0%-99.8%, and as high as 99.8% when compared with the isolates reported in the United States where the patient had traveled. When the studied HA gene was compared with 25 isolates of Chinese seasonal A-H1N1 virus, the homology was 72.3%-85.6%. Conclusions The homology of the first isolated A-H1N1 viral strain in Guangdong Province in 2009 and epidemic influenza A-H1N1 virus is high, while it is low compared with Chinese seasonal A-H1N1 virus.

Objective Exploring clinical prediction value of the ischemia modified albumin (IMA) for acute coronary syndrome (ACS) patients after the percutaneous coronary intervention (PCI).Methods A total of 109 cases of the PCI postoperative patients of ACS at the Panggang General Hospital from January 2010 to July 2012 were included.IMA was determined within 6 hours after admission,and standardized treatment after PCI.After a 6-month follow-up,they were divided into the event group and non-event group according to cardiovascular events occurrence.Results 101 cases were followed-up,including 26 cases of cardiovascular events (25.74％) and 75 cases of no cardiovascular events (74.26％).The left ventricular ejection fraction of the event group [(45 ± 7)％] was significantly lower than the non-event group [(52 ± 10) ％] (t =1.894,P ＜ 0.05).Serum IMA of the event group[(105.51 ± 13.26) U/ml]was significantly higher than the non-event group [(85.18 ± 11.36) U/ml] (t =7.3518,P ＜0.01).After controlling other cardiovascular risk factors,IMA was still independent risk factors for cardiovascular events (OR =1.69,95％ CI: 1.18 ～ 2.13,P =0.01).Conclusions IMA have very good clinical prediction value of cardiovascular events occurrence for ACS after PCI.

Objective: To analyze the clinical features of death cases of dengue fever and the causes of their deaths. Methods: The clinical data and death reports of nine death cases of dengue fever in Guangdong Province from June 23, 2014 to September 10, 2019 were retrospectively analyzed. All of nine cases were positive for serum dengue virus RNA as confirmed by reverse transcription polymerase chain reaction, and some of the virus strains were serotyped. Results: The median age of the nine patients was 57.5 (range: 18-80) years. Among them, six patients were females; eight patients were local cases and one was imported case; all of nine cases occurred in September and October. The median time from onset to visit hospital and diagnosis was three and four days, respectively. Three of the nine patients had underlying diseases. All of nine cases had fever, including three with double-peak fever. Eight of the cases had three or more severe dengue fever warning indexes before admission. Three cases had severe bleeding upon admission, one case had shock, and six cases had organ failure. Three cases underwent invasive examination, including arterial puncture catheterization, endoscopic titanium clip hemostasis, and percutaneous transluminal coronary angiography. Two cases developed malignant arrhythmia and one had massive hemorrhage of subcutaneous soft tissue after operation. The death cases included four cases of cardiogenic shock and fatal arrhythmia, three cases of encephalitis and encephalopathy, one case of refractory shock, and one case of acute liver failure. Among the six cases that underwent serological typing, four were identified as dengue virus type 1 (DEN-1) and two were DEN-2. Conclusions Severe organ failure is the major cause of dengue fever-related death, especially fulminant myocarditis, and DEN-1 is most common. Early diagnosis and treatment, and avoidance of invasive procedures can effectively reduce the mortality rate of the severe dengue fever patients.