Objective: To investigate the role of clinical pharmacist in the treatment of patients with severe infections in urology department.Methods: An objective analysis of the important roles of clinical pharmacists was carried out by making and adjusting the anti-infective treatment plan of two patients in urology department.Results: During the participation in the treatment of two patients with severe infections in urology department, clinical pharmacists played important roles in the treatment of the diseases through observing the clinical symptoms,analyzing the conditions of the patients and giving the pharmaceutical opinions and suggestions, and finally the infections were controlled successfully.Conclusion: Clinical pharmacists should participate in the therapy strategy adjustment in urology department using their professional knowledge to play important roles in the management of anti-infection strategy for severe patients.

OBJECTIVE:To compare the effectiveness and safety of low-molecular-weight-heparin(LMWH)calcium and rivar-oxaban in preventing lower extremity deep venous thrombosis (DVT) in the elderly patients after surgery of replacement of frac-ture. METHODS:A total of 58 elderly patients underwent hip or artificial femoral head replacement were randomly divided into LMWH group (29 cases) and Rivaroxaban group (29 cases). All patients received basic prevention and physical prevention for DVT after surgery. Based on this,LMWH group was given Heparin calcium injection 4100 IU subcutaneously 10 h after surgery, for 10 d. Rivaroxabar group was given Rivaroxaban tablet 10 mg 10 h after surgery,once a day,for consecutive 10 d. The occur-rence of DVT and positive D-dimer were observed in 2 groups after surgery. The PT,APTT,TT,FIB and platelet counts abnormal-ity were also observed in 2 groups. RESULTS:There was no statistical significance in the incidence of DVT,the occarrence of pos-itive D-dimer,PT,APTT,TT,FIB and platelet counts abnormality 4,10 d after surgery between 2 groups(P>0.05). CONCLU-SIONS:LMWH and rivaroxaban both can be used for lower extremity DVT in the elderly patients after replacement of fracture sur-gery of and have similar therapeutic efficacy and safety.

In order to meet the need of limb rehabilitation, the control system that takes programmable logic controller (PLC) as the core was studied based on analysis of mechanical structure and working principle for the rehabilitation training device. The function and characteristics of hardware are analyzed for control system, overall hardware scheme design is completed. Then different training modes of software are developed, in which touch screen as a host computer, is responsible for human-computer interaction, control instructions transmission and information display; PLC as lower machine, receives control instructions and acquires data from sensor, controls torque and speed of the motor. Patients can choose training mode according to their specific situations. Experimental results show that control system is stable and reliable in performance.

Objective To study the impacts of alcohol dependence on the anticonvulsant effect of diazepam. Meth?ods Kunming mice (n=36) were divided into 3 groups (n=12 in each group), Alcohol Dependence Group(A group), Diaze?pam Group(D group)and Normal Saline Group(N group). A group received an intraperitoneal injection with a 0.2 mL dose of 0.8%alcohol in NS (normal saline) , while both D and N group received an injection with a 0.2 mL dose of NS without alco?hol , twice a day. Mice’s autonomic activities were monitored every day. After 7 days, the electroconvulsive experiment was performed. Both A and D group were given a weight-based dose of 0.05 mL/10 g of 0.05%diazepam via intraperitoneal injec? tion, while N group was given a 0.05 mL/10 g dose of NS. Before administration and after 15, 30, 60 min of administration, the convulsion threshold of each group was measured. Results The count of autonomic activity of mice in A group was less than that of mice in D and N group during the 2nd day to 6th day(P<0.05). On the 1st and 7th day, the difference of the count of autonomic activity of mice between A group and the other two groups was not statistically significant(P>0.05). The convulsion threshold of mice in A group was higher than that of mice in D and N group before administration(P<0.05). Af?ter administration, the convulsion threshold of mice in N group didn’t show statistically significant difference from that of mice before administration(P>0.05). After 15 min of administration, the convulsion threshold of mice in D group was high?er than that of mice in A and N group(P<0.05), while the convulsion threshold of mice in A group was higher than that of mice in N group(P<0.05). After 30 min and 60 min of administration, both the convulsion thresholds of mice in A and D group were higher than that of mice in N group(P<0.05). However, at this point, the difference of the convulsion thresholds of mice between A and D group was not statistically significant(P>0.05). Conclusion Alcohol dependence has anticon?vulsant effect. Alcohol dependence weakens the anticonvulsant effect of diazepam.

Objective To analyze the mutations of causal genes in 5 children with primary distal renal tubular acidosis (dRTA),and explore their association of genotype and phenotype,so as to raise the awareness of the disease.Methods The whole exome sequencing was used to identify mutations in these 5 children from 5 families.Results A total of 4 different mutations of ATP6V0A4 gene were found in 2 dRTA children,including a novel heterozygous intron mutation (c.639 + 1G＞ A),a reported heterozygous nonsense variant (c.580C ＞T,p.Arg194*) and 2 novel heterozygous duplications (c.1504dupT,p.Tyr502Leufs*22;c.2351dupT,p.Phe785Ilefs*28).Two novel heterozygous missense mutations of ATP6V 1B 1 gene (c.409C ＞ T,p.Pro 137Ser;c.904C ＞ T,p.Arg302Trp) were identified in the third child,and a heterozygous missense mutation of SLC4A1 gene (c.1765C ＞ A,p.Arg589Ser) previously reported was found in the fourth child.No mutation of the dRTA-related causal genes was found in the fifth child.Furthermore,the mutations of causal genes in each of the first three children were compound heterozygous,which were consistent with the autosomal recessive inheritance pattern,and the variant from the fourth child was de novo.Conclusions The present study has found 7 mutations,including 5 novel variants,which enriches the human gene mutation database (HGMD) and contributes to a better understanding of the disease mechanisms.

Objective:To construct an ultra-early limb movement program for elderly hip fracture surgery patients based on evidence-based practice and the Delphi method.Methods:From May to December 2023, the PIPOST Model (population, intervention, professional, outcome, setting, type of evidence) was used to develop evidence-based questions. Relevant databases were searched to obtain, summarize, and evaluate evidence related to ultra-early limb movement after hip fracture surgery in elderly patients. A draft of the movement program was created with the search timeline set until June 1, 2023. A total of 29 experts were invited to participate in two rounds of Delphi expert consultation to finalize the ultra-early limb movement program for elderly hip fracture surgery patients.Results:A total of 20 studies were included, consisting of six guidelines, four expert consensuses, three systematic reviews, and seven original research articles. The response rates for the two rounds of Delphi expert consultation were 100.00% (29/29) and 86.21% (25/29). The expert authority coefficients were 0.931 and 0.920, and the Kendall coordination coefficients were 0.205 and 0.112 (all P<0.01). The final ultra-early limb movement program for elderly hip fracture surgery patients included four modules and 39 operational items. Conclusions:This study develops an evidence-based, expert-validated ultra-early limb movement program for elderly hip fracture surgery patients, demonstrating its necessity, scientific basis, and practicality. The program provides a reference and guidance for clinical staff in facilitating ultra-early movement for hip fracture patients post-surgery.

ObjectiveTo observe the pharmacodynamic effect of propofol by target controlled infusion (TCI) in patients with different liver functions during surgery.MethodsSixty patients undergoing laparotomy under general anesthesia with endotracheal intubation in the Third Affiliated Hospital of Sun Yat-sen University between June 2013 and June 2014 were enrolled in this prospective study. Among the 60 patients, 51 were males and 9 were females with the age ranging from 18 to 70 years old and the median of 48 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into 4 groups according to the Child-Pugh liver function grading, the normal liver function group (N group,n=7), grade A group (A group, n=21), grade B group (B group,n=20) and grade C group (C group,n=12). TCI propofol were given to all patients during the operation with the target plasma concentration of 3 μg/ml. Bispectral index (BIS) and hemodynamic parameters of the 4 groups during the anesthesia induction period (within 30 min of TCI) were recorded. The percentage of patients with BIS dropped below 40 and the incidence of hemodynamic events in each group were compared. The comparison was conducted using Chi-square test or Fisher's exact test.ResultsDuring the anesthesia induction period, BIS of the 4 groups dropped with time and was stable at 20 min. The percentage of patients with BIS below 40 in N, A, B and C group was respectively 9.2%, 11.2%, 20.4% and 26.8%, C group was signiifcantly higher than N and A group (χ2=12.28, 18.81;P<0.05). During the anesthesia induction period, the incidence of hypotension in N, A, B and C group was respectively 0, 5%, 8% and 16%, C group was signiifcantly higher than N, A and B group (P<0.0001, P<0.0001,P=0.0195). The incidence of bradycardia in N, A, B and C group was respectively 15%, 5%, 3% and 0, C group was significantly lower than N, A and B group (P<0.0001,P=0.0003,P=0.0085). ConclusionsSimilar trends of change in anesthesia depth are observed in patients with different liver function when using propofol TCI, but patients with severe hepatic dysfunction may more likely to develop fulminant suppression of brain wave and hypotension.

Objective To compare patients'satisfaction and comfort associated with automated breast volume scanner(ABVS),handheld ultrasound(HHUS)and mammography(MMG).Methods Five hundred and twenty-eight women who performed ABVS examination and previously had undergone MMG and HHUS were enrolled.BMI,bra size,with or without lesion,lesion size,pain score of MMG,ABVS and HHUS were documented and analyzed.Results The pain score of MMG was significantly higher than that of ABVS[4.0(2.0,6.0)vs 2.0(1.0,4.0)](P <0.05).92.4% of the cases were preferred for the ABVS examination,which was higher than that for the MMG(45.5%),and was similar to HHUS(94.7%).Bra size,BMI,with or without lesion and lesion size could affect the pain degree of ABVS.Conclusions Routine use of ABVS will be well tolerated by patients than MMG.

Objective To investigate the cognition of colorectal cancer-related knowledge and influencing factors of patients with middle- and advanced-stage colorectal cancer in ethnic minority areas of Inner Mongolia. Methods According to the national population and the prevalence of colorectal cancer, 277 patients with colorectal cancer were selected by stratified and random sampling in Inner Mongolia. The patients were surveyed in Baotou, Chifeng, Bayannaoer, and other hospitals. The questionnaire included patients' basic information, cognition of colorectal cancer risk factors and screening knowledge, screening information, etc. Results Before suffering from the disease, the patients' knowledge of colorectal cancer (risk factors, early screening knowledge, treatment methods) was low. About 54.9% of patients were unaware of high risk factors for colorectal cancer, 75.8% of patients did not understand the knowledge of early screening of colorectal cancer, and 37.5% of patients did not underst and the treatment of colorectal cancer. The main influencing factors of colorectal cancer cognition were education level and occupation. Patients who work in institutions and enterprises and with higher education level had better cognition. Conclusion Patients with middle- and advanced-stage colorectal cancer in Inner Mongolia have poor knowledge and awareness of risk factors and screening of colorectal cancer before diagnosis. Education level and occupation are factors influencing colorectal cancer cognition, therefore, people with low knowledge rate of colorectal cancer and low education level as well as unemployed laid-off people should be given priority intervention.

Objective:To identify risk variables for prolonged postoperative length of stay (PPOLOS) in hip fracture patients by machine learning algorithms and construct Nomogram models.Methods:A retrospective case-control study was conducted to select 248 patients with hip fracture diagnosed and treated in Yingtan 184th Hospital from June 2019 to June 2023 by convenient sampling method. Two machine learning algorithms were used (least absolute shrinkage and selection operator, LASSO and support vector machine-Recursive Feature Elimination, SVM-RFE) to screen PPOLOS risk variables. Construct a Nomogram model to predict the risk of PPOLOS in patients with hip fracture based on intersection risk variables. The model was validated using internal data sets.Results:Among the 248 patients with hip fracture, there were 79 males and 169 females, aged (64.49 ± 8.02). The mean postoperative length of hospital stay of 248 patients was (7.98 ± 5.68) d, and the median was 7 d. LASSO algorithm identifies 7 risk variables, the SVM-RFE algorithm identified 8 risk variables. Intersectional risk variables were age, body mass index (BMI), Charlson comorbidity index (CCI), type of surgery, and central granulocytocyte ratio (NLR). Multivariate Logistic regression analysis(intersection risk variables) showed that age [ OR=1.649(1.235-2.202)], BMI [1.603(1.204-2.134)], CCI [ OR=1.670(1.236-2.258)], type of surgery [ OR=1.620(1.209-2.170), 1.699(1.243-2.321)], and NLR [ OR=3.258(2.299-4.617)] were independently associated with the risk of PPOLOS (all P<0.05). The results showed that the conformity index of the Nomogram model was 0.865 (95% CI=0.768-0.945). The area under the curve was 0.852 (95% CI=0.748-0.962). When the risk threshold was >0.08, it could provide significant clinical net benefit. The clinical impact curve showed effective identification of PPOLOS patients in high-risk groups. Conclusions:This Nomogram model can guide medical staff to make clinical diagnosis and treatment decisions as soon as possible to avoid risks, allocate medical resources rationally, and improve nursing quality.