Objective:To summarize the drug repercussion data in outpatient pharmacy and analyze the reasons to provide sugges-tions for the improvement. Methods: The information was collected from the hospital information system ( HIS) during January 1, 2013 and December 31, 2015, including drug name, category, quantity, amount, reasons for drug repercussion and the other statisti-cal data. Results:During the three years, the number of prescription drugs, amount of money and varieties of drug repercussion were increased. The most common reasons for drug repercussion were the other reasons, withdrawn by doctors and the request of patients. The sum of drug repercussion was positively correlated with the drug price and the amount of drug repercussion. Conclusion:The op-tion simplicity for drug repercussion in HIS is the main reason for drug repercussion bythe other reasons. The occurrence of drug re-percussion should be intervened by such methods as gradually improving the HIS, establishing intervention measures, enhancing the professional quality of pharmacists and so on.

Acceleration ; Acyl-CoA Dehydrogenase, Long-Chain ; genetics ; Animals ; Aorta ; metabolism ; Cyclin-Dependent Kinase Inhibitor p21 ; genetics ; Gene Expression ; Heart ; Heme Oxygenase (Decyclizing) ; genetics ; Male ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To investigate the safety,efficacy and effects of emergent percutaneous coronary intervention (PCI) in patients from Second Affiliated Hospital,Medical College,Zhejiang University with cardiogenic shock (CS) complicating acute myocardial infarction (AMI).Method Twenty-seven patients with CS complicating with AMI were treated by PCI with intraaortic balloon counterpulsation (IABP) support.The change of hemodynamics before and after IABP and PCI,the characteristics of PCI,the mortality during hospitalization, the major adverse cardiac events (MACE) and left ventricular ejection fraction at 30-day follow-up were observed.Results The hemodynamics were significantly improved after IABP.No patients died during PCI.Two patients died after PCI and the total mortality was 7.4% in hospital.During the period of 30-day follow-up, one patient died of heart failure.The left ventricular ejection fraction greatly improved at 30 days after PCI. Conclusions The data suggested that the use of IABP during PCI in patients with CS complicating AMI was safe, decreased mortality and improved prognosis.

Objective To investigate the situation and change of antifungal resistance in clinical Candida and other fungal iso- lates from 5 hospitals in diverse geographic region of China.Methods Antimicrobial susceptibility testing of 8 000 fungat iso- lates collected during 2001 and 2005 were carried out with 25?g fluconazole disk and 1?g voriconazole disk using disk diffusion method as recommend by CLSI/NCCLS M44-A.Disk test plates were automatically read and results were recoded with the BIOMIC Image Analysis System.The equivalent MICs were automatically calculated by the BIOMIC System software.Results The proportion of Candida atbicans and non-Candida albicans (e.g.Candida glabrata) in the total fungal isolates did not change significantly from 2001 to 2005.The susceptibility rate of C.albicans to fluconazole and vorieonazole were stable during 2001 and 2005.However, the resistance to fluconazole and voriconazole increased variably in C.glabrata and other non-Can- dida albicans fungal isolates during the same period.Conclusions The voriconazole demonstrated higher activity against all yeast species in comparison with fluconazole.The increasing resistance to fluconazole and voriconazole in non C.albicans fungal isolates including C.glabruta suggests the importance of surveillance of fungal resistance in Candida isolates.

Objective To explore the reasons for disharmony between medical staff and medical staff because of electronic clinical ordering,to specificate electronic medical order in ward in order to create a harmonious relationship between doctors and nurses. Methods The methods of qualitative research conducted in-depth interviews of 12 medical staff, field recordings and transcripts, and the method of content analysis were used. Results Two themes were sublimated:medical staff reasons:lack of communication between the medical staff;new doctors didn't have a good command of medical norms of specialist electronic orders; on the responsibility of checking the doctor's advice problems may lead to potential adverse events occurrence. System equipment reason: the electronic doctor's advice system set up the problem; the office computer quantity is insufficient. Conclusions Nonstandard electronic medical management leads to the disharmony of health care. It is suggested to standardize the management of electronic medical advice by implementation of the responsibility to avoid medical coupling errors. The health care workers need to strengthen communication, mutual understanding and forgiveness, in order to create a harmonious medical environment.

Objective: To learn the health literacy status, trend and associated factors of Ningbo residents from 2015 to 2019, so as to provide basis for developing health policies and interventions. Methods: The monitoring data of health literacy of Ningbo residents from 2015 to 2019 was collected. The health literacy level was calculated and standardized by the population data of the sixth national census of Ningbo in 2010; five-year absolute growth and growth rate were used to reflect the changing trend. Multivariate logistic regression model was employed to analyze the influencing factors for the health literacy level. Results: The health literacy levels from 2015 to 2019 were 15.44%, 21.73%, 22.41%, 27.60% and 30.03%, with an annual increase trend ( P<0.05 ). The five-year absolute growth and growth rate were 14.59% and 94.49%. The Results of multivariate logistic regression analysis indicated that the year ( OR=1.158, 95%CI: 1.132-1.184 ), age ( 25-<35岁 years, OR=1.235, 95%CI: 1.039-1.468; 35-<45岁 years, OR=1.416, 95%CI: 1.193-1.681; 45-<55岁 years, OR=1.221, 95%CI: 1.024-1.455 ) , education level ( primary school, OR=1.790, 95%CI: 1.461-2.195; junior high school, OR=2.574, 95%CI: 2.102-3.154; high school/vocational high school/technical secondary school, OR=4.863, 95%CI: 3.943-5.998; college or above, OR=8.829, 95%CI: 7.109-10.965 ) , urban areas ( OR=0.934, 95%CI: 0.874-0.998 ) and occupation ( farmers, OR=0.692, 95%CI: 0.608-0.787; workers, OR=0.746, 95%CI: 0.664-0.837; enterprise staff, OR=0.822, 95%CI: 0.745-0.906; others, OR=1.106, 95%CI: 1.009-1.211 ) were the influencing factors for health literacy level. Conclusion The health literacy level of Ningbo residents shows an upward trend from 2015 to 2019, which are associated with age, education level, area and occupation.

OBJECTIVETo observe the effect of magnesium sulfate, Nifedipine Tablet (NT) combined Salvia Injection (SI) on endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2(TXA2), prostacyclin I2(PG2), and hemorheology of preeclampsia patients.

METHODSTotally 704 preeclampsia patients were randomly assigned to the treatment group and the control group, 352 cases in each group. All patients were treated with magnesium sulfate combined NT (on the first day: slow intravenous injection of magnesium sulfate 5 g + intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg; on the second and third day, intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg), while those in the treatment group were dripped with SI additionally at 20 mL per day for 3 consecutive days. Before and after treatment plasma levels of endothelin-1 (ET-1), nitric oxide (NO), TXA2, PGi2, and hemorheology indicators [such as high blood viscosity (HBV), low blood viscosity (LBV), plasma viscosity (PV), erythrocyte rigidity index (ERI), fibrinogen (FIB)] of two groups were detected.

RESULTSCompared with the same group before treatment, serum levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the two groups after treatment (P <0. 05), but levels of NO and PG2 increased (P <0. 05). Compared with the control group in the same period, levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the treatment group after treatment (P <0. 05), but levels of NO and PGI2 increased (P <0. 05).

CONCLUSIONMagnesium sulfate, NT combined SI could effectively regulate the balance of ET-1/NO and TXA2/PGI2, and improve hemorheology of preeclampsia patients.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelin-1 ; metabolism ; Epoprostenol ; metabolism ; Female ; Hemorheology ; Humans ; Injections ; Magnesium Sulfate ; administration & dosage ; pharmacology ; therapeutic use ; Nifedipine ; administration & dosage ; pharmacology ; therapeutic use ; Nitric Oxide ; metabolism ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Salvia ; Tablets ; Thromboxane A2 ; metabolism

Alternative Splicing ; Apoptosis ; Cell Cycle ; Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Hep G2 Cells ; Humans ; Inhibitor of Growth Protein 1 ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; physiology ; Nuclear Proteins ; genetics ; metabolism ; physiology ; Plasmids ; Protein Isoforms ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Recombinant Proteins ; genetics ; metabolism ; Transfection ; Tumor Suppressor Protein p53 ; metabolism ; Tumor Suppressor Proteins ; genetics ; metabolism ; physiology ; bcl-2-Associated X Protein ; metabolism

Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; complications ; genetics ; pathology ; Male ; Thymus Gland ; abnormalities

OBJECTIVETo investigate the origin of childhood B-cell acute lymphoblastic leukemia (B-ALL) and its epitopes recognized by cytotoxic T lymphocytes (CTL) in immunoglobulin heavy chain variable region (IgHV).

METHODSSeven IgHV gene families were respectively amplified by PCR and directly sequenced in 108 childhood ALL. The amino acid sequences were deducted from sequenced nucleotides. Bioinformatics was applied to analyses of recombination patterns, somatic mutations and germline gene segments usage, and to prediction of epitopes recognized by CTL.

RESULTSIgHV gene rearrangements were identified in 66% of the cases, including 37 (52.1%) monoallelic rearrangements, 26 (36.6%) biallelic rearrangements and 8 (11.3%) oligoclonal rearrangements. Among the obtained 40 B-ALL IgHV gene sequences, 8 (20.0%) were in frame rearrangements without stop codons. V(H3) (11/40), V(H4) (11/40) and V(H1) (8/40) amounted to 75% rearranged V(H) families. V(H)(4-59) and V(H)(4-34) were the most frequently rearranged V(H)(4) family gene segments. Usage of D2 and D3 families was most prominent (35.9% and 28.2%, respectively). Increased frequency of D7-27 (15.4%) was found as compared to that of normal peripheral B lymphocytes (P = 0.02). J(H)(6) was found in 47.5% rearrangements followed by J(H)(4) (27.5%). 8/40 (20.0%) DJ(H) junctions lacked N nucleotides, which was higher than that reported for normal peripheral B lymphocytes (P = 0.02). 17.5% B-ALL IgHV contained scattered replacement mutations with replacement (R) to silent (S) substitution ratio (R/S ratio)

CONCLUSIONB-ALL originated from progenitor or precursor B lymphocytes. B-ALL IgHV genes are of germline characteristics. Potential T cell epitopes were derived from framework regions 1 and 3 of immunoglobulin heavy chain in B-ALL.

Adolescent ; Child ; Child, Preschool ; Female ; Gene Rearrangement ; Genes, Immunoglobulin ; HLA-A Antigens ; genetics ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Immunoglobulin Variable Region ; genetics ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; immunology