OBJECTIVE:To improve the management of automatic medicine packaging machine(ATC),so as to improve drug dispensing management. METHODS:The short-plate effect of“cask theory”was used to analyze the deficiency of ATC in soft-ware,hardware and management;pertinent improvement was conducted and its effects were evaluated. RESULTS & CONCLU-SIONS:Considering the deficiency of ATC software function,automatic form export function had been set up additionally,involv-ing form of adding and dismounting drug information,form of repeated medical order. Some improvement were carried out for fre-quent machine halt in hardware,such as adjusting the height of drug box and using spare drug groove;some carried out for incon-sistency between the accounts and drugs due to management defects,such as fixing post,improving adding drug information input. Compared with before improvement,daily times of machine halt during packaging had cut from 13.8 times to 2.3 times(decreased by 83.3%);daily total time of machine halt had shortened from 97.4 minutes to 9.6 minutes(shortened by 90.14%);the rate of packaging had increased from 14.3 packages/min to 23.33 packages/min(increased by 62.9%);the management of drug stock be-came more standard. The application of“cask theory”in the improvement of ATC can promote the quality of drug dispensing man-agement.

Objective To apply the urethral pressure profile(UPP)in patients with benign prostates hypertrophy(BPH).Methods 71 patients with BPH accepted the test of UPP.The UPP parameters were compared statistically with the ultrasonography finding.Results The maximum urethral pressure,maximum urethral closure pressure and prostatic urethral length in BPH were higher than normal(P<0.01).Conclusion The test of urethral pressure profile(UPP)is helpful for identifying the site of obstruction and degrees in BPH patients,although there are some limits.

OBJECTIVE:To shorten time consuming for dispensing mode of automatic medicine packaging machine(ATC), and improve the efficiency of ATC. METHODS:In the inpatient pharmacy of our hospital,previous dispensing mode that two ATC matched with one tablet case separately was replaced by new mode,i.e. one ATC(another ATC was on standby)matched with two tablet cases(one of them added medicine beforehand),and the information of drug-position coordinate was equipped. The time con-sumed,average daily number of packages,financial expenses and labor costs were recorded and analyzed to evaluated the effect of new mode. RESULTS & CONCLUSIONS:Compared with previous mode,new dispensing mode improve the efficiency of ATC greatly. In previous mode,two ATCs and four pharmacists work simultaneously and spend 4.5 hours for 3 850 bags of medicine, which cost 4 400 000 yuan;in new mode,only one ATC and three pharmacists work simultaneously,and spend 3.0 hours for 4 015 bags of medicine,which cost 2 350 000 yuan. Therefore,double-universal tablet cases greatly improves the efficiency of ATC and reduce the financial expenses as machine maintenance and labor cost.

Objective Understand shunde Uistrict Foshan City,Guangdong Province in the incidence of breast cancer in women.Methods The joint selectivity ductoscopy examination of the clinical breast examination screening,breast X-ray radiography examination from March 2011 to January 2013,Shunde District,FoShan City,Guangdong Provice,3 600 bladder than 40 years old woman with breast cancer screening.Results Three thousand six hundred women were found in 10 cases of breast cancer,the detection rate of 278/100 000 (10/3 600).Breast clinical examination found 1 313 cases of breast abnormalities,142 cases of breast lumps,nipple discharge line fiberoptic ductoscopy to cheek the 100 cases,X-ray radiography examination of four and more than 72 cases,accounted for a total of 45.19％ of the screening population (1 627/3 600).Conclusions Joint ductoscopy X-ray radiography examination of breast cancer screening in the normal population can help to detect early breast cancer,and to provide the basis for early clinical treatment.

Objective To assess the efficacy and the optimum dose of recombinant human ery- thropoietin(rhEpo) in the treatment of the anemia of premature.Methods 40 preterm infants with less than 35 weeks of gestational age and less than 2000gin of birth weight were randomly assigned to receive subcutaneous rhEpo 150U?kg~(-1)?t~(-1)(n=10) 250U?kg~(-1)?t~(-1)(n=15),three times weekly for 6 weeks,or no treatment(control,n=15).Results Postnatal decline of hemoglobin(Hb) and hematocrit (Hct) were lessened in the treated groups,particularly in the rhEpo 250U?kg~(-1)?t~(-1)group; and there were significant differences in each groups by analysis of variance(all P0.05).Serum iron dropped,more significantly in the treated groups than in control group (all P0.05).After treatment,serum levels of erythropoietin was higher in rhEpo 250U?kg~(-1), t~(-1) group than in both rhEpo 150U?kg~(-1)?t~(-1) and control groups (P0.05).No side effects related to rhEpo therapy were observed.Conclusious RhEpo therapy for premature infants is effective and dose-dependent.Therapy is more efficient when given in high dose.It can reduce or replace the need for blood transfusion.

OBJECTIVETo compare the difference of the dose distribution in clinical target volume and organ at risk (OAR) between coplanar decile field intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy (3D-CRT) for postoperative radiotherapy of cervical cancer.

METHODSTen postoperative patients with cervical cancer were selected randomly to undergo CT scan and planning target volume (PTV) and OAR contouring. 3D-CRT and coplanar decile IMRT planning was performed for each patient with a prescribed dose of 50 Gy. The homogeneity index (HI), conformity index (CI), maximum dose, minimum dose, mean dose of PTV, and irradiated volume of OARs were calculated and the results were compared.

RESULTS5-field IMRT, 7-field IMRT and 9-field IMRT plans had a significant better conformity index (CI) of PTV compared with 3D-CRT (P<0.05) . Compared with 3D-CRT plans , V30, V40, and V50 of the bladder, V50 of the small bowel, and V30, V40, and V50 of the rectum in the coplanar decile IMRT plans were all significantly reduced (P<0.05) but showed no significant differences among the IMRT plans (P>0.05).

CONCLUSIONCoplanar decile IMRT plans is superior to 3D-CRT plan in terms of the conformity index (CI) of the PTV and sparing the bladder, rectum and small bowel. Seven-field and 9-field IMRT do not warrant more benefits than 5-field IMRT, and the latter can significantly reduce the treatment time and costs.

Adult ; Female ; Humans ; Middle Aged ; Postoperative Period ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Uterine Cervical Neoplasms ; radiotherapy

Background and Purpose:Lung cancer is the most malignant tumour in the world.Its incidence is growing and NSCLC is predominent(80%) in lung cancer.Most patients with lung cancer were diagnosed in late stages.The tumour could be shrunk by neoadjuvant chemotherapy when the case with stage Ⅲ NSCLC was considered not possible for radical operated neoadjuvant chemotherapy may lead to the following,operation could be improved,micrometastasis could be annihilated and survival could be extended.Objective of this paper was to analyse the prognostic factors for survival in patients treated by surgery and chemotherapy for NSCLC.Methods:98 cases of neoadjuvant chemotherapy combined with surgery for NSCLC,stageⅠ~Ⅲ,were collected retrospectively in our hospital from 1995 to 1997.35 cases were stageⅠ.21 cases were stage Ⅱ.42 cases were stage Ⅲ.83 cases had 1 cycle of chemotherapy pre-operatively.15 cases had 2 cycles chemotherapy pre-operatively.Regimes of chemotherapy were MVP,MOP and MAP et al.Response rate(RR) of chemotherapy was:45 cases had partial response(PR) and 53 cases were stable disease(SD).Operative mode was lobectomy and pneumectomy with lymph nodes dissection.Pathologic type was squamous,adeno,adeno-squamous and others.All the patients were treated by chemotherapy for two or three cycles after surgery except for the patients in stageⅠin 1996~1997.After being followed-up for more than 5 years,data were examined using life table,KaplanMeier method,Log Rank statistic and Cox-mantel test.The possible factors affecting survival were tested with univariate and multivariate analysis.Results:The median followed-up time of 98 cases for NSCLC was 41.2 months.36 cases were alive.62 cases were dead.The 1-,3-,5-year survival rate of 98 cases for NSCLC was 88.78%、49.63% and 18.46%.The 5-year survival rates of stageⅠ、ⅡandⅢ were 33.23%、20.26% and 5.52% respectively(P=0.0002).The 5-year survival rates of N_(0)、N_(1)、N_(2) were 35.49%、19.08% and 4.90% respectively(P=0.0004).In the 98 cases of NSCLC,better prognosis was correlated with earlier stage.The prognosis was better if the period from last chemotherapy before operation to operation was no more than 1 month. The prognosis of lobectomy,lung hila activity,thorax lymph nodes negativity and squamous cancer was better.The prognosis was poorer if the tumor had invaded big vessels,viscera,chest wall,pericardium and quantity bleeding during≥400ml.The prognosis was better if the tumor was fibrotic.The prognosis of 2 cycles of chemotherapy pre-operatively might be better than 1 cycle.The prognosis of tumor necrosis was poorer and the prognosis of chemotherapy post-operatively was better.Conclusions:The main prognostic factors affecting survival in patients treated by surgery and chemotherapy for NSCLC was stage,the period from last chemotherapy before operation to operation,operation mode,lung hila activity,thorax lymph nodes,site of tumor invasion,bleeding quantity,pathologic type,tumor fibrosis and necrotis,cycles chemotherapy pro-operation and chemotherapy post-operation.

Objective:To investigate the clinical features, treatments and prognoses of children with antibody-mediated central nervous system (CNS) autoimmune diseases.Methods:Two hundred and seven children with antibody-mediated CNS autoimmune diseases confirmed by anti-neuronal antibody detection in blood and/or cerebrospinal fluid in Department of Neurology, Children's Hospital of Hunan Province from June 2014 to May 2022 were enrolled. Their clinical features, laboratory and imaging data, treatment regimens and prognoses were retrospectively analyzed.Results:Of the 207 children, 117 were positive for anti- N-methyl- D-aspartate receptor (NMDAR) antibodies, 63 for anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, 32 for anti-glial fibrillary acidic protein (GFAP) antibodies, 6 for anti-contactin-associated protein-like 2 (CNTNAP2) antibodies, 3 for anti-aquaporin 4 (AQP4) antibodies, 2 for anti-gamma-aminobutyric acid type B receptor (GABABR) antibodies, and 1 for anti-anti-leucine-rich glioma-inactivated 1 (LGI1) antibodies. Acute disseminated encephalomyelitis (ADEM) was the most common clinical phenotype among the children, followed by optic neuritis (ON). Behavioral abnormalities, seizures, and involuntary movements were the most common clinical presentations of anti-NMDAR encephalitis for these children, while fever, headache, and disturbance of consciousness or vision were the most common symptoms for children with MOG antibody disease or autoimmune GFAP astrocytopathy. The coexistence of multiple anti-neural antibodies was detected in 17 patients, among which 10 had coexistent anti-NMDAR and anti-MOG antibodies (including 1 with anti-GFAP antibody), 3 had coexistent anti-NMDAR and anti-GFAP antibodies, 3 had coexistent anti-MOG and anti-GFAP antibodies, 2 had coexistent anti-NMDAR and anti-CASPR2 antibodies, and 1 had coexistent anti-GABABR and anti-CASPR2 antibodies. In our cohort, of the 202 children examined for cerebrospinal fluid, 154 had cerebrospinal fluid leukocytosis and 27 had elevated protein. Of the 203 children had electroencephalography, 179 was abnormal; abnormal EEG was mainly manifested as focal or global slow waves, and epileptic discharge in some children; 205 patients received immunotherapy. All survivors were followed up for at least 6 months; 164 recovered completely, 40 had varied sequelae, and 3 died; 28 had one or more relapses. Conclusion:Antibody-mediated CNS autoimmune diseases occur in children at all ages; most such pediatric patients have good response to immunotherapy, enjoying low mortality rate; however, some survivors have relapsing risk.

Objective:To report 2 young infants of sodium channel related epilepsy with SCN2A gene mutation, and to discuss the clinical characteristics of the disease and the efficacy and safety of lacosamide combined with the literature.Methods:Corresponding information of 2 children hospitalized in the Department of Neurology of Hunan Children′s Hospital in July 2021 and October 2021 was collected, including the symptoms, comprehensive physical examination, blood, cerebrospinal fluid, imaging, electrophysiological examination, diagnosis and treatment process, response to treatment and other clinical data, as well as the sequencing results of the whole exome of the children. The efficacy and safety of lacosamide were analyzed, and the related literatures of the Biomedical Literature Database, Wanfang Data Knowledge Service Platform and Chinese Knowledge Infrastructure Database were searched and reviewed.Results:Both of the 2 cases were girl. Their onset age was within 3 months. The initial symptoms were frequent convulsions and backward development. There was no structural abnormality in the head image. The convulsions could not be controlled according to conventional multidrug treatment. The seizures were quickly controlled with lacosamide. Now they have been followed up for 6 months. No obvious adverse reactions were found. Case 1 gene test results showed the SCN2A gene (chr2:166152333-166246334) heterozygous deletion, SCN1A gene (chr2:166847754-16693013) heterozygous deletion, the deletion size being about 5.72 Mb. Case 2 gene test results showed new missense mutation of SCN2A (c.1285G>A, p.Glu429Lys). There were dozens of seizures every day. They were treated with valproic acid, oxcarbazepine and levetiracetam successively. The seizures could not be controlled. Three focal seizures originated in the left temporal region were detected by electroencephalogram. There was no recurrence on the third day after adding lacosamide, and there was no attack after 5 months of follow-up. No obvious adverse reactions were found during follow-up.Conclusions:Sodium channel related epileptic encephalopathy often starts early, has frequent seizures, and can be accompanied by backward psychomotor development at the same time. The slow sodium channel blocker lacosamide has good efficacy and safety in the treatment of sodium channel-related epilepsy with SCN2A gene mutation or combined SCN1A gene mutation.