OBJECTIVE:To provide reference for clinical rational drug use. METHODS:Medication error(ME)cases report-ed from outpatient department from Oct. 2014 to Sept. 2015 in our hospital were analyzed,including ME category,classification, cause and proportion of persons who triggered or detected ME. RESULTS:Among 207 reports,there was no case of category A, 199 cases of category B,8 cases of category C,no of categories D-I. Among them,162 cases occurred in the links of prescrip-tions by doctors (78.26%),45 cases (21.74%) occurred in the links of dispensing prescriptions by pharmacists,the top 3 ME were improper usage(42.59%),improper administration route(40.74%)and inappropriate solvent(5.56%);the top 3 dispensing errors were variety error(40.00%),specification error(28.89%)and number errors(24.44%). The main causes for prescription errors were incomplete information system(56.17%)and drug information missing of doctors(43.83%);the main causes for dis-pensing errors were double specifications of drugs(35.56%),similar drug name(28.89%)and staffsntired(26.67%). In terms of the persons who triggered ME,the proportions of pharmacists,nurses,patients or their families were 97.58%,1.45% and 0.97%, respectively. CONCLUSIONS:Further strengthening information system and the on-the-job training for physicians and pharmacists can reduce the ME to some extent.

Objective To assess the reliability and validity of the Pittsburgh sleep quality index (PSQI) .Methods The cross-sectional survey was conducted in the outpatient department of this hospital .544 insomnia and non-insomnia voluntary participants (18-65 years old) from July to October 2011 were assessed with PSQI and the insomnia severity index (ISI) ,which were randomly delivered to them .Results The test-retest reliability of PSQI was 0 .994 .The split-half reliability coefficient of PSQI was 0 .824 . The overall Cronbach′s alpha coefficient was 0 .845 .The confirmatory factor analysis showed that the fitting indicators for the χ2/df ,root mean square error of approximation(RMSEA) ,non-normed fit index(NNFI) ,comparative fit index(CFI) and goodness-of-fit index(GFI) were 4 .83 ,0 .09 ,0 .96 ,0 .98 and 0 .97 respectively .The correlation coefficient between the PSQI and ISI was 0 .842 . The correlations coefficients between PSQI with the questionnaire type ,interview date and interview department were -0 .046 , 0 .276 and -0 .331 .Grouping by individuals with or without insomnia ,the area under the receiver operator characteristic curve (ROC) for PSQI was 0 .944(95% CI:0 .925-0 .963) .Conclusion PSQI has good reliability and validity ,and could be used for the sleep quality comprehensive evaluation in the patients with insomnia .

The shape and structure of granules are controlled by the granulation process, which is one of the main factors to determine the nature of the solid dosage forms. In this article, three kinds of granules of a traditional Chinese medicine for improving appetite and promoting digestion, namely, Jianwei Granules, were prepared using granulation technologies as pendular granulation, high speed stirring granulation, and fluidized bed granulation and the powder properties of them were investigated. Meanwhile, synchrotron radiation X-ray computed micro tomography (SR-µCT) was applied to quantitatively determine the irregular internal structures of the granules. The three-dimensional (3D) structure models were obtained by 3D reconstruction, which were more accurately to characterize the three-dimensional structures of the particles through the quantitative data. The models were also used to quantitatively compare the structural differences of granules prepared by different granulation processes with the same formula, so as to characterize how the production process plays a role in the pharmaceutical behaviors of the granules. To focus on the irregularity of the particle structure, the box counting method was used to calculate the fractal dimensions of the granules. The results showed that the fractal dimension is more sensitive to reflect the minor differences in the structure features than the conventional parameters, and capable to specifically distinct granules in structure. It is proved that the fractal dimension could quantitatively characterize the structural information of irregular granules. It is the first time suggested by our research that the fractal dimension difference (Df,c) between two fractal dimension parameters, namely, the volume matrix fractal dimension and the surface matrix fractal dimension, is a new index to characterize granules with irregular structures and evaluate the effects of production processes on the structures of granules as a new indicator for the granulating process control and optimization.

Objective To observe the effect of Hydroxychloroquine (HCQ) on the apoptosis of peripheral blood mononuclear cells (PBMCs) of Systemic lupus erythematosus (SLE) patients and on the level of Th17 cells and IL-17.Methods The peripheral blood of 20 incipient SLE patients in active stage were taken,and PBMC were separated for cell culture.Using HCQ and Chlorambucil (CLB) as an intervention,and after cultured for 24 h and 48 h,the apoptosis of PBMC and the level of Th17 were tested using Flow cytometry (FCM),the supernatants were collected to test for the level of cytokine IL-17 by ELISA.One-way ANOVA was used and SNK-q was used in the comparison between every two groups.Results There was significant difference in the apoptosis rate of mononuclear cells between the HCQ and CLB group at 24 h [HCQ:(10.3±0.7)％,CLB:(8.5±1.1)％] and48 h [HCQ:(13.9±0.6)％,CLB:(11.8±0.8)％] (P＜0.05).There was significant difference between HCQ [24 h:(0.81±0.13)％,48 h:(0.73±0.45)％] and CLB group [24 h:(0.78±0.26)％,48 h:(0.68±0.20)％] in Th17 percentage (P＜0.05).The levels of IL-17 in the supematants of the HCQ group [24 h:(26.3±0.97)％,48 h:(24.2±0).91)％] and CLB group [24 h:(24.6±0.7)％,48 h:(22.6±1.1)％] were significandy different between the two groups(P＜0.05).Conclusion HCQ has apoptosis-induction effect on PBMC,and it can decrease the number of Th17 and IL-17 level in the PBMCs.

Objective To investigate the effects of chronic restraint stress on learning and memory in Wistar and Sprague-Dawley (SD) rats.Methods Healthy adult male Wistar rats (n=6) and Sprague-Dawley rats (n=6) were subjected to restraint stress 10 h daily for 28 days.After that, all rats were tested for recognition memory by novel object recognition test , and spatial memory and working memory by Morris water maze test .Results After restraint for 10 h daily for 28 days, the restraint rats of the two strains demonstrated lower discrimination index (DI)than the control group, but on-ly SD rats showed significant difference ( P<0.05 ) .The restraint SD rats showed higher escape latency than the control rats, and on the 5th day the difference became significant (P<0.05), and there was no significant difference between Wistar restraint and control rats .The working memory test showed that restraint SD rats exibited longer escape latency than the control rats (P<0.05), while Wistar rats didn’t show significant difference between the two groups .Conclusions The results of this study demonstrate that the impairments of learning and memory in SD rats subjected to restraint 10 hour per day for 28 days are more serious than that in the Wistar rats .Therefore , SD rats may be a better choice as an animal model to study the effects of chronic restraint stress on learning and memory impairment .

The calcium gate encoded by CCH1 and MID1 genes is the main channel for external calcium absorption. As one of the important secondary messengers, the elevation of calcium concentration could activate some pathways to take part in various cell processes. In this study, we used CCH1 and MID1 mutant strains and also constructed their complementary strains to study the effect of drug tolerance and virulence of Candida albicans after CCH1 or MID1 deletion. By drug plate sensitivity assay and the broth microdilution method, we compared the changes between different strains. Moreover, we added calcium channel blocker and inhibitors to analyze the effect of calcium concentration on drug action. After the deletion of CCH1 or MID1 gene, the strain exhibited an obvious sensitivity to FLUC and ITRA, and the drug action was regulated by the calcium concentration. In a mouse model of intravenous infection, we found that attenuated virulence of cch1delta/delta or mid1delta/delta strain is specifically due to a loss of CCH1 or MID1 gene.
Animals ; Calcineurin ; genetics ; metabolism ; Calcium ; metabolism ; Calcium Channels ; metabolism ; Candida albicans ; drug effects ; genetics ; pathogenicity ; Candidiasis ; microbiology ; Drug Resistance, Fungal ; genetics ; Female ; Fungal Proteins ; genetics ; metabolism ; Gene Deletion ; Mice ; Mice, Inbred ICR ; Virulence

Objective:To construct an anticipatory grief intervention scheme for family caregivers of advanced cancer patients based on narrative theory, and to provide reference for anticipatory grief nursing intervention.Methods:From October 2022 to May 2023, through literature research, semi-structured interview and brainstorming method, the first draft of nursing intervention plan was constructed, the Delphi method was used to conduct 2 rounds of correspondence consultation with 15 experts, and the indicators at all levels were modified according to the opinions of experts, and the final draft of intervention plan was formed.Results:The experts were all female, aged (49.67 ± 5.83) years old. The authority coefficient of the two rounds of experts was 0.87. The Kendall coordination coefficients of the first, second, and third level indicators after the first round of expert inquiry were 0.195, 0.113, and 0.093, respectively. The Kendall coordination coefficients of the first, second, and third level indicators after the second round of expert inquiry were 0.200, 0.119, and 0.101, respectively. The differences were statistically significant ( χ2 values were 8.76-107.21, all P<0.05).Finally, a nursing intervention plan based on narrative theory was formed, which included 4 primary indicators, 19 secondary indicators and 72 tertiary indicators. Conclusions:The anticipatory grief intervention scheme for family caregivers of advanced cancer patients is scientific, practical and feasible, and can be used for psychological nursing of family caregivers.

Tripterygium glycosides tablet(TGT),the classical commercial drug of Tripterygium wilfordii Hook.F.has been effectively used in the treatment of rheumatoid arthritis,nephrotic syndrome,leprosy,Behcet's syndrome,leprosy reaction and autoimmune hepatitis.However,due to its narrow and limited treatment window,TGT-induced organ toxicity(among which liver injury accounts for about 40％of clinical reports)has gained increasing attention.The present study aimed to clarify the cellular and molecular events underlying TGT-induced acute liver injury using single-cell RNA sequencing(scRNA-seq)technology.The TGT-induced acute liver injury mouse model was constructed through short-term TGT exposure and further verified by hematoxylin-eosin staining and liver function-related serum indicators,including alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and total bilirubin.Using the mouse model,we identified 15 specific subtypes of cells in the liver tissue,including endothelial cells,hepatocytes,cholangiocytes,and hepatic stellate cells.Further analysis indicated that TGT caused a significant inflammatory response in liver endothelial cells at different spatial locations;led to marked inflammatory response,apoptosis and fatty acid metabolism dysfunction in hepatocytes;activated he-patic stellate cells;brought about the activation,inflammation,and phagocytosis of liver capsular macrophages cells;resulted in immune dysfunction of liver lymphocytes;disturbed the intercellular crosstalk in liver microenvironment by regulating various signaling pathways.Thus,these findings elaborate the mechanism underlying TGT-induced acute liver injury,provide new insights into the safe and rational applications in the clinic,and complement the identification of new biomarkers and ther-apeutic targets for liver protection.

【Objective】 To explore the feasibility and accuracy of neutrophil-to-lymphocyte ratio (NLR) in the prediction of testicular torsion (TT) in children with acute scrotal pain. 【Methods】 A retrospective case-control study was performed on 158 pediatric patients with ultrasound suspicion of TT who underwent surgical testicular examination during Jan.2017 and Jan.2024.The patients were divided into TT group and non-TT group.Clinical data and laboratory data at admission were analyzed.Sensitivity and specificity of NLR to TT were determined with the area under the curve (AUC) represented on the receiver operating characteristic (ROC) curves. 【Results】 There were with no statistically significant differences in clinical data between the two groups (P>0.05).The NLR was significantly higher in the TT group than in the non-TT group [ (4.82±2.37) vs.(2.85±0.75), P<0.05] .The optimal cut-off value of TT predicted by NLR was 2.07, the AUC was 0.809 (95%CI:0.709-0.909), and the sensitivity and specificity were 97.9% and 93.3%, respectively, which were significantly higher than other factors. 【Conclusion】 For suspicious ultrasound diagnosis of pediatric acute scrotal pain cases, NLR can be used to predict the possibility of TT and may help to evaluate the urgent surgical treatment in these patients.