Objective:To investigate the potentially inappropriate medication(PIM)among elderly patients with chronic diseases in Shanghai communities and related influence factors.Method:Six community Health service Centers were choosen using stratified sampling. Total 968 elderly patients with chronic diseases who visited to the outpatient clinic of Shanghai Community Health Service Centers from July to August 2018 were included in the study. The PIM was investigated according to the 2015 Beers criteria. The χ 2 test and multivariate logistic regression model were used to analyze factors related to the PIM. Results:The survey showed that 317 elderly patients had PIM with 412 person-doses. In 134 person-doses, the PIM was unrelated to the disease; in 18 person-doses, PIM was caused by interaction of drug with disease/symptoms; in 259 person-doses PIM was related to the drugs that should be cautiously used for elderly; only in 1 person-dose the PIM was caused by the interaction between drugs. The drugs with the highest proportion of PIM were diuretics, benzodiazepines and aspirin. There were significant differences in age, kinds of diseases, kinds of drugs and times of visiting community health service centers between elderly patients with PIM and those without PIM (χ 2=42.28, 35.51, 46.47, 38.46; all P<0.05). The main PIM-related factors were age, kinds of diseases, kinds of drugs and times of visiting community health service centers. Conclusion:The study shows that the prevalence of PIM among elderly chronic diseases patients in Shanghai communities is relatively high, which is associated with the age, kinds of diseases, kinds of drugs and times of visiting community health service centers.

OBJECTIVE: To explore the genetic etiology of a small-for-date infant with gastrointestinal bleeding, developmental delay and thrombocytopenia (Zhu-Tokita-Takenouchi-Kim syndrome). METHODS: Clinical and laboratory examinations were carried out for the patient. Next-generation sequencing (NGS) was used to detect potential variant associated with the disease. Candidate variant was verified by Sanger sequencing of the child and her parents. RESULTS: NGS revealed that the child has carried a heterozygous c.5751_5754del variant of the SON gene, which resulted in a frameshift p.V1918Efs*87. The same variant was detected in neither parent. CONCLUSION The heterozygous variant of SON gene probably underlay the ZTTK syndrome in this child. Above finding has enriched the mutational spectrum of the SON gene and provides a basis for genetic counseling and clinical decision-making.
Child ; Family ; Female ; Genetic Testing ; Heterozygote ; Humans ; Infant ; Intellectual Disability/genetics* ; Mutation

【Objective】 To establish a three-in-one smart hospital characterized with smart service, smart medical care and smart management to improve the hospital’s ability to prevent and control and respond to coronavirus disease 2019 (COVID-19). 【Methods】 Combined with the core needs of normalized prevention and control of the epidemic, the overall structure of the smart hospital was established. Emerging technologies were used as the means to strengthen system integration and security as the basis, and the interconnection and electronic medical record project were the starting point to carry out 31 projects of information system construction and integration. 【Results】 Through the construction of smart service, a service mechanism that integrates online and offline services and covers the whole process of diagnosis and treatment has been realized. Through the construction of integrated physician workstations, smart nursing, medical quality control and other platforms with electronic medical records as the core, the clinical diagnosis and treatment capabilities have been improved. Through the improvement and optimization of the information system, the capacity of the hospital's emergency management of the epidemic has been effectively improved. 【Conclusion】 The construction of smart hospitals can provide a solid guarantee for the prevention and control of COVID-19, but it also faces many problems. The construction of smart service needs the strong support of the competent government departments, the integration of smart medical care needs to be further strengthened, and smart management needs to be further strengthened.