Objective To investigate the distribution of traditional Chinese medical syndromes and clinical characteristics of influenza in South of Five Ridges.Methods A retrospective analysis was carried out in 162 cases of influenza patients admitted from outpatient department,emergency department and inpatient department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2014 to 2016.The distribution of clinical manifestations and syndrome types of the included influenza patients was analyzed.Results The average age of the included influenza patients was 35.76 ± 11.4 years old.The clinical syndromes were mainly characterized by fever,aversion to cold and chills,fatigue and weakness.And damp-accumulation manifestations of heaviness in the body,poor appetite,dry mouth without willing to drink,nausea and vomiting were also predominant.The main syndrome types were wind-heat attacking defense phase syndrome,wind-cold fettering exterior syndrome,heat-toxin attacking lung syndrome,heat-toxin accumulating lung syndrome,and damp syndrome.Of the syndrome types,wind-heat attacking defense phase syndrome and heat-toxin attacking lung syndrome were the leading types,accounting for 77.79％ and interweaving with damp syndrome and heat-damp syndrome.Conclusion The syndromes of influenza patients in South of Five Ridges are usually complicated by damp syndrome or damp-heat syndrome,and the predominant syndrome type is wind-heat interweaved with damp syndrome,which is correlated with the climate being damp and hot in South of Five Ridges.

Objective: To analyze the clinical]features of the patient with nephrotic syndrome who developed Pneumocystis carinii pneumonia (PCP) and cytomegalovirus pneumonia (CMP) after oral administration of tacrolimus caspsules, and to discuss the correlations between immunosuppressive patient and Pneumocystis carinii (Pc) and cytomegalovirus (CMV) infection, and to provide the basis for the reasonable treatment plan in the early stage. Methods: The clinical materials of one patient with nephrotic syndrome who developed PCP and CMP after oral administration of tacrolimus capsules were collected and the clinical symptoms, past medical history and outcomes, auxiliary examination, treatment plan and prognosis were analyzed; the relevant literatures were reviewed. Results: The male 47-year-old patient was admitted to hospital because of cough for 1 month, shortness of breath for 1 week and fever for 3 d. The patient had the history of diabetes mellitus and took the medication regularly , and the level of blood sugar was well controlled. At the beginning of 2018, the patient received renal biopsy due to edema of the lower extremities and was diagnosed as stage II membranous nephropathy accompanying with mild mesangial proliferative diabetic nephropathy; the patient was orally administrated with glucocorticoid. In July 2018, the patient was diagnosed as nephrotic syndrome and stage II membranous nephropathy, and had been orally administrated with tacrolimus capsules after discharge. After admission, the patient developed acute respiratory distress syndrome rapidly; the multiple exudation and nodular foci of both lungs were found on the chest imaging, and the infectious lesions were considered. The IgM antibody and IgG antibody of CMV of the patient were both positive. The high throughput gene detection results of the infection pathogens in blood showed Pneumocystis jiroveci of Pneumocystis and human herpesvirus 5 (HHV-5). PCP complicated with CMP was diagnosed definitively. The patient was treated with sulfamethoxazole combined with ganciclovir and noninvasive ventilation. The patient was discharged after the condition was improved. Conclusion: The patient with low immunity should be alert to the mixed infection of PCP and CMP if he develops rapidly progressive hypoxemia.

Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.

Objective To explore the effects of postoperative nursing on patients′ postoperative safety and and rehabilitation process after total knee arthroplasty ( TKA ) that based on concept of fast-tract surgery (FTS).Methods Totally 200 patients who had surgery for total knee arthroplasty from January 2013 to July 2014 were randomly assigned to the routine group (n=100) and the FTS group (n=100). Patients in the routine group were received routine postoperative nursing, while patients in the FTS group received optimized postoperative nursing that based on FTS concept. The time to start eating after surgery, VAS pain score, the removal time of urethral catheter and drainage tube, the first off-bed activity time after operation,the recover speed of knee joint function and incidence of postoperative complications were compared between two groups.Results Compared with the routine group, the time to start eating after surgery in the FTS group was (4.56±0.33) h;the removal time of urethral catheter was (15.12±3.43) h; the removal time of drainage tube was (17.43±3.91) h, and they were all shorten ( t=21.82,31.60,14.99;P<0.01) . The pain score in the FTS group within 3 d after surgery was (1.39±1.12), and was lower than that in the routine group (t=10.993,P<0.01); in the FTS group, the first off-bed activity time after surgery was (16.72±2.01)h;the time of actively straight leg raising was (18.2±6.3)h;the time of actively bending knees for 90 degree was (3.5±1.7) h, and they were all markedly advanced (t=57. 23,8.885,4.545;P<0.01) . There were 6 cases of complications that caused by pain in the routine group, while there were none in the FTS group ( P<0.05) . There was no statistically significant difference in cases with other complications between two groups ( P>0. 05 ) . Conclusions Application of optimization postoperative nursing scheme for total knee arthroplasty based on FTS is safe. It can shorten the time to start eating after surgery, reduce postoperative pain levels, promote the postoperative early ambulation, and has no adverse effect on the incidence of postoperative complications.

Objective:To investigate the relationship between the in vivo metabolic ratio (MR) of Aripiprazole (ARI) and CYP2D6 gene polymorphism in children with tic disorders (TD) and its effect on dose-exposure (DE), so as to promote precision drug use. Methods:In this study, a real-world observational study design was used to collect 81 children with TD who visited the Department of Neurology of Wuhan Children′s Hospital from January 2021 to January 2024, the concentration of the prototype drug and the main metabolite Dehydroaripiprazole (DARI), the detection data of CYP2D6 single nucleotide gene polymorphism (SNP) and clinical data were collected, and the relationship between the DARI/ARI metabolic ratio (MR) and CYP2D6 metabolic type was analyzed by the receiver operating characteristic (ROC) curve.A DE model between ARI dose and steady-state trough concentration was established by population modeling, and the effects of CYP2D6 metabolic type, MR and body weight on DE were analyzed.Goodness-of-fit diagram (GOF), visual predictive check (VPC) and prediction error analysis were used to verify the prediction performance of the DE model.Results:ROC analysis showed that there was a correlation between MR and CYP2D6 metabolic type, the MR sensitivity cut-point of CYP2D6 ultrafast metabolic (UM) patients was 0.399, and the cut-point of MR in intermediate metabolic (IM) patients was 0.252.Based on this, the patients were divided into three categories: MR TYPE Ⅰ: MR≥0.399, MR TYPE Ⅱ: 0.252

Objective:To analyze the status and influencing factors of empathy fatigue in hospice nurses based on ABC-X model (A: stressor event; B:resources available to a family; C: family sperceptions of the stressor; X: likelihood of crisis), so as to provide a reliable basis for developing comprehensive intervention strategies.Methods:A total of 325 nurses engaged in hospice care in China from April 2022 to June 2022 were selected by convenient sampling method. The influencing factors of empathy fatigue of hospice care nurses were analyzed by ABC-X model (working environment, resilience and coping style). The hospice care nurses were investigated by self-made general questionnaire, Chinese version of Empathy Fatigue Scale, Simplified Coping Style Questionnaire, Coping Style Resilience Scale and Nursing Work Environment Scale. The statistical analysis was performed by SPSS.26.0 statistical software.Results:There were 316 females and 9 males with age of (33.0 ± 7.9) years old. The total score of empathy fatigue in 325 hospice nurses was (91.16 ± 9.60) points, the scores of empathy satisfaction, ocupational burnout and secondary traumatic stress were (31.35 ± 6.01), (28.43 ± 5.86), (31.38 ± 5.76) points respectively. The scores of positive coping style, negative coping style, psychological resilience and nursing working environment were (37.46 ± 5.69), (21.28 ± 6.90), (89.84 ± 16.46), (117.13 ± 19.95) points respectively. The negative predictive factor for empathy satisfaction among nurses with the professional title of palliative care ( t=-4.22, P<0.05), and the positive predictive factors for simple coping strategies, psychological resilience, and nursing work environment ( t=4.52, 3.05, 9.03, all P<0.05), could explain 56.7% of the total variation. Psychological resilience, simplified coping strategies, nursing work environment were negative predictive factors for occupational burnout among hospice nurses ( t=-6.93, -3.54, -2.51, all P<0.05), while work nature was a positive predictive factor ( t=2.36, P<0.05), which could explain 49.4% of the total variation. Simplified coping strategies, psychological resilience, and nursing work environment were all negative predictors of secondary traumatic stress in hospice nurses ( t=-5.40, -3.25, -5.95, all P<0.05), which could explain 48.8% of the total variation. Conclusions:Based on the ABC-X model, it is found that the empathic fatigue of hospice nurses is mainly affected by the nursing work environment, mental resilience and coping styles. It is necessary for nursing managers to actively take measures to improve the working environment and coping styles of nurses, enhance their mental resilience and reduce their empathic fatigue.

Oromucosal drug delivery preparations offer advantages such as convenient administration,suitability for patients with dysphagia,rapid onset of action,and avoidance of first-pass metabolism in the liver.The 2020 edition of the Chinese Pharmacopoeia,EP11.0,BP2022,USP44-NF39,and JP18 all include relevant standards for the quality control of different oromucosal drug delivery systems.This article compares the differences in general re-quirements for oromucosal formulations among different countries and provides an overview of inspection items for marketed oral mucosal formulations and those documented in pharmacopoeias both domestically and internationally.Foreign pharmacopoeias include a wide range of oromucosal drug delivery formulations,with more refined quality control measures for systemic action.These findings can serve as a reference for the improvement and enhancement of standards for oromucosal drug delivery systems in China.

Objective:To identify new host substrate of SseK3 and study its biological function.Methods:A yeast two hybrid system (Y2H) was used to identify the potential binding proteins of SseK3 from the Hela cDNA library; the arginine N-acetylglucosamine (Arg-GlcNAc) modification of the substrate protein by SseK3 was detected by co-expression in 293T cells and in vitro activity test; the modification sites of the substrate protein by SseK3 were detected by point mutation; the effect of Arg-GlcNAc modification of the substrate protein on its interaction protein binding ability was detected by immunoprecipitation test. Results:Results of Y2H and gene sequencing showed that Snapin was a new substrate of SseK3. Snapin could be Arg-GlcNAc-modified by SseK3 in vivo and in vitro; the modification sites of Snapin were arginine 119 and arginine 120; Arg-GlcNAc-modified Snapin inhibited its binding with SNAP25. Conclusions:Snapin, a new host substrate protein of SseK3, was successfully screened in this study. The Arg-GlcNAc modification of Snapin by SseK3 was studied, and the effect of this modification on Snapin function was preliminarily studied, which provided theoretical basis for further understanding the function of Arg-GlcNAc modification of bacteria and the mechanism of action in the process of pathogen infection.

Objective To explore the fluctuation characteristics of long-term doctor's order workload in pharmacy intravenous admixture services (PIVAS) and build a daily workload fluctuation prediction model and provide reference for the adjustment of PIVAS work mode. Methods Daily workload data of long-term doctor’s orders from PIVAS in the East Campus of Zhongshan Hospital affiliated to Fudan University from July 2020 to June 2021 were selected , and the time series analysis method was used to analyze the workload fluctuation characteristics and a prediction model was established. The accuracy of the model was verified by fitting parameters and prediction results. Results The fluctuation of PIVAS long-term doctor's daily workload data had the characteristics of periodicity, short-term slow rise and irregular variation. The Winters multiplier model was used to fit the series with R² = 0.777, the significance value of Ljung-Box statistic value (P value) was 0.060, and the mean absolute error percentage between the fitted and actual values was 4.45%, indicating that the model fitting accuracy was high. The average relative deviation between the predicted and actual results was 3.81%, indicating that the model prediction was effective. Conclusion The model constructed in this study could be used for the analysis and prediction of long-term doctor's orders workload of PIVAS. However, because the workload of doctor's orders has fluctuations such as periodicity and irregular changes, it is necessary to adjust the working model according to the fluctuation characteristics of the workload and the prediction results to ensure the efficient operation of PIVAS.

Objective To investigate the infection of Chlamydia pneumoniae and mycoplasma pneumoniae in adults and their association with atherosclerosis,and to provide theoretical guidance for the prevention of such diseases. Methods A case-control study was used to collect 362 patients who were diagnosed with atherosclerosis from January 2019 to December 2021 in Department of Sichuan Bazhong Central Hospital, and 370 cases who were admitted to the hospital during the same period of physical examination without any cardiovascular disease were selected as the control group, and whole blood samples of the two groups of study subjects were collected, and the infection of Chlamydia pneumoniae and mycoplasma pneumoniae was detected by PCR. Results The infection rate of Chlamydia pneumoniae was 35.49%, the infection rate of mycoplasma was 40.37%, and the co-infection rate was 11.37%；The infection rate of Chlamydia pneumoniae in the control group was 12.04%, the infection rate of mycoplasma was 15.83%, and the coinfection rate was 3.14%, and the difference between the two groups was statistically significant ( χ²=10.926, P=0.023). The effects of mycoplasma, chlamydia, and co-infection on atherosclerotic patients have sex differences, mainly manifested as higher infection rates in men; In addition, the effects of mycoplasma, chlamydia, and co-infection on atherosclerosis patients varied by age, mainly in the 55-70 years age group (P<0.05). Multivariate logistic regression results showed that Chlamydia pneumoniae infection was a risk factor for atherosclerosis (OR=1.303, 95%CI: 1.043-1.677) in the whole population, and chlamydia pneumoniae (OR=1.472, 95% CI: 1.037-1.556), mycoplasma (OR=2.003, 95%CI: 1.637-3.842) and co-infection in men (OR=1.937, 95%CI: 1.380-2.184) were risk factors for atherosclerosis, while co-infection in women (OR=1.699, 95%CI: 1.263-1.765) was a risk factor for atherosclerosis. Conclusion Chlamydia pneumoniae and mycoplasma infection are risk factors for atherosclerosis, and their impact on male groups is greater, and more attention needs to be paid to them.