OBJECTIVE:To guide the formulation of emergency management plan for pharmacy department and reduce emer-gency risk. METHODS:By the methods of risk integration,considering the frequency and severity of the hazard events,the risk integral value of emergency events was calculated and hazard level was judged. RESULTS:The top three hazard events of pharma-cy department were information system failures (75.21),fire (63.00) and cytotoxic drugs overflow (62.21). All of the above events were moderate risk. According to the results of this evaluation,pharmacy department targeted emergency drills,in order to improve the ability to cope with risks. CONCLUSIONS:In order to improve the ability of facing and dealing hazard events,disas-ter vulnerability analysis is the base of developing and exercising emergency plans.

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.

Objective:To investigate the effect of Xuefu Zhuyu Decoction on myocardial protection and the interaction between Cadherin-NrF2 pathway and ferroptosis in patients with chronic heart failure resulting from qi deficiency and blood stasis. Methods:A case-control study was conducted on 100 patients with heart failure resulting from qi deficiency and blood stasis who received treatment at The First People's Hospital of Huzhou from February 2021 to May 2022. These patients were divided into a basic western medicine group and a Xuefu Zhuyu Decoction group with 50 patients per group using the random number table method. The basic western medicine group received conventional treatment, while the Xuefu Zhuyu Decoction group received treatment with Xuefu Zhuyu Decoction in addition to conventional treatment. Both groups were treated continuously for 8 weeks. Interleukin-13, intercellular adhesion molecule-1, nitric oxide, cystatin C, thromboxane B2, soluble cluster of differentiation 40 ligand, vascular endothelial cadherin were detected before and after treatment, and soluble tyrosine kinase receptor AXL (sAXL), soluble stromal lysin-2, and ferric ion levels were determined. The mRNA expression levels of glutathione peroxidase 4 and NrF2 were detected. Syndrome scores were evaluated. Clinical efficacy was compared between the two groups. Results:After treatment, the levels of interleukin-13 [(7.63 ± 1.85) ng/L], intercellular adhesion molecule-1 [(41.71 ± 6.25) ng/L], and cystatin C [(0.61 ± 0.17) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(10.56 ± 2.13) ng/L, (50.11 ± 8.34) ng/L, (1.03 ± 0.22) ng/L, t = 7.34, 5.69, 10.68, all P < 0.05]. The levels of soluble cluster of differentiation 40 ligand [(14.61 ± 1.19) μg/L] and thromboxane B2 [(40.18 ± 7.24) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(16.03 ± 1.47) μg/L, (53.37 ± 10.16) ng/L, t = 5.30, 7.47, both P < 0.05], while the level of nitric oxide [(59.92 ± 6.16) μmol/L] in the Xuefu Zhuyu Decoction group was significantly higher than that in the basic Western medicine group [(53.17 ± 5.49) μmol/L, t = 5.78, P < 0.05]. The level of ferric ion [(0.23 ± 0.08) μg/L] in the Xuefu Zhuyu Decoction group was significantly higher than that in the basic western medicine group [(0.16 ± 0.05) μg/L, t = 5.24, P < 0.05]. The levels of vascular endothelial cadherin [(3.02 ± 0.72) ng/L], NrF2 mRNA [(2.11 ± 0.43)], and glutathione peroxidase 4 mRNA [(4.65 ± 0.74)] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(4.34 ± 1.05) ng/L, (2.93 ± 0.56), (5.16 ± 0.88), t = 7.33, 8.21, 3.13, all P < 0.05]. The levels of Galectin-3 [(62.48 ± 6.09) μg/L], soluble stromal lysin-2 [(0.98 ± 0.24) ng/L], and sAXL [(42.16 ± 7.54) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(70.96 ± 8.15) μg/L, (1.57 ± 0.46) ng/L, (56.11 ± 10.02) ng/L, t = 5.89, 8.04, 7.86, all P < 0.05]. The Xuefu Zhuyu Decoction group had lower scores for shortness of breath or wheezing [(1.06 ± 0.24) points], palpitations [(0.92 ± 0.15) points], fatigue [(0.75 ± 0.17) points], low voice [(0.68 ± 0.16) points], spontaneous sweating [(0.83 ± 0.21) points], fatigue and laziness [(0.73 ± 0.20) points], prone to fatigue [(0.66 ± 0.14) points], and dark complexion or lips [(0.61 ± 0.16) points] compared with the basic western medicine group [(1.65 ± 0.49) points, (1.15 ± 0.27) points, (1.16 ± 0.31) points, (1.12 ± 0.29) points, (1.28 ± 0.32) points, (1.28 ± 0.37) points, (1.01 ± 0.21) points, (0.96 ± 0.25) points, t = 7.64, 5.26, 8.20, 9.39, 8.31, 9.24, 9.80, 8.33, all P < 0.05]. The total response rate of the Xuefu Zhuyu Decoction group was significantly higher than that of the basic western medicine group [(96.00% (48/50) vs. 88.00% (44/50), Z = 1.91, P < 0.05). Conclusion:Treating patients with heart failure with Xuefu Zhuyu Decoction can inhibit inflammation, improve vascular endothelial cell function, regulate Cadherin-NrF2 pathways, reduce oxidative stress injury, further inhibit ferroptosis, reduce the levels of Galectin-3, soluble stromal lysin-2, and sAXL, protect myocardium, relieve clinical symptoms, and improve its efficacy.

Objective:To investigate the clinical efficacy of Yiqi Yangyin decoction combined with metformin and irbesartan in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. Methods:A case-control study was performed to retrospectively analyze the clinical data of 92 patients with type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. These patients received treatment at the First People's Hospital of Huzhou from February 2021 to April 2023. They were divided into two groups, with 46 patients in each group, based on different treatment methods. The control group received metformin and irbesartan, while the observation group was treated with Yiqi Yangyin decoction in addition to the treatment provided to the control group. Both groups underwent treatment for 1 month. The clinical efficacy of the two groups was evaluated, and the changes in traditional Chinese medicine symptom scores, blood glucose levels, blood pressure, and the occurrence of adverse reactions were compared between the two groups before and after treatment. Results:The total response rate of the observation group was 93.48% (43/46), which was significantly higher than that of the control group [82.61% (38/46), χ2 = 5.63, P < 0.05). After treatment, the traditional Chinese medicine symptom score for the observation group was (9.43 ± 2.11) points, which was significantly lower than that of the control group [(12.11 ± 2.32) points, t = 11.34, P < 0.001]. The fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin levels in the observation group were (7.51 ± 1.34) mmol/L, (9.06 ± 2.11) mmol/L, and (6.23 ± 0.76)%, respectively, all of which were significantly lower than those in the control group [(8.75 ± 2.12) mmol/L, (11.15 ± 2.43) mmol/L, (7.11 ± 1.02)%, t = 4.13, 6.14, 4.01, all P < 0.05]. The systolic blood pressure in the observation group was (125.48 ± 8.14) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than that in the control group [(131.32 ± 9.22) mmHg, t = 6.76, P < 0.001]. The difference in the incidence of adverse reactions between the two groups was not statistically significant ( P > 0.05). Conclusion:Yiqi Yangyin decoction combined with metformin and irbesartan is highly effective in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. This combined therapy can effectively lower the traditional Chinese medicine symptom score, improve patients' blood glucose and blood pressure levels, and has a low incidence of adverse reactions.

Objective:To assess the discriminatory value of the Thyroid Follicular Tumor Ultrasound Risk Stratification System (F-TIRADS) in differentiating follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), and to compare its performance with other risk stratification systems(RSS).Methods:A retrospective analysis was conducted on 325 patients (327 thyroid nodules) diagnosed postoperatively as FTC or FTA at Affiliated Hospital of Qingdao University from January 2016 to December 2023. The cases were divided into FTC group (81 nodules) and FTA group (246 nodules). The nodules were classified based on F-TIRADS, the 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS), the 2015 American Thyroid Association guidelines (ATA guidelines), and the 2017 European Thyroid Association Thyroid Imaging Reporting and Data System (EU-TIRADS) by two ultrasound physicians. Multivariate Logistic regression analysis was used to identify independent predictors associated with FTC. Diagnostic performance of the 4 RSS was compared using postoperative pathological results as the gold standard.Results:Multivariate Logistic regression analysis showed maximum diameter, solid composition, hypoechogenicity, unclear or angular margins, marginal or ring calcifications, trabecular structure, and central blood flow were independent predictors of FTC( OR=1.914, 3.427, 9.926, 9.163, 45.918, 3.191, 8.936, respectively; all P<0.05). Within each RSS, the actual malignancy rate increased with higher risk categories, aligning closely with the recommended malignancy rates (except for ATA guidelines). The optimal cut-off values for distinguishing FTC from FTA were FTC risk 50%-90% in F-TIRADS, C-TIRADS 4B, moderately suspicious nodules in ATA guidelines, and EU-TIRADS 4, with areas under the curve of 0.916, 0.808, 0.827, and 0.836, respectively. F-TIRADS demonstrated the best overall performance (sensitivity: 82.72%, specificity: 82.93%), with significant differences compared with C-TIRADS, ATA guidelines, and EU-TIRADS (all P<0.05). Conclusions:F-TIRADS is highly effective in distinguishing FTA from FTC, outperforming C-TIRADS, ATA Guidelines, and EU-TIRADS. Clinicians should pay close attention to solid hypoechoic nodules with unclear or angular margins, marginal or ring calcifications, central blood flow, or a trabecular structure.

Objective To investigate the effect of dietary intake on the childbirth outcomes of pri-mipara women with full-term labor analgesia.Methods A total of 400 primipara women with full-term labor analgesia were randomly divided into observation group and control group.The observation group received intake management and individualized dietary guidance,while the control group ate and drank according to their own wishes.The childbirth quality,the incidence of vomiting,the use of oxytocin due to uterine atony,the rate of intrapartum fever,the rate of perineal incision,the rate of cesarean section,the rate of vaginal assisted delivery,and the rate of postpartum hemorrhage were compared be-tween the two groups.The duration of the first stage of labor,the duration of the second stage of labor,the duration of labor analgesia,and the amount of postpartum hemorrhage within 2 hours were also compared.Neonatal Apgar score,random blood glucose,umbilical artery blood pH value,umbilical ar-tery blood lactic acid(Lac)value,the incidence of neonatal asphyxia,the incidence of neonatal fever,and the incidence of neonatal hypoglycemia were compared between the two groups.Results The ob-servation group had lower incidences of vomiting,oxytocin use rate due to uterine atony,intrapartum fever rate,perineal incision rate,transferring cesarean section rate,and vaginal assisted delivery com-pared to the control group(P＜0.05).The observation group had lower rates of postpartum hemor-rhage,shorter duration of the first and second stages of labor,shorter duration of labor analgesia,and less postpartum hemorrhage within 2 hours compared to the control group,and the incidences of neonatal hyperglycemia and hypoglycemia in the observation group were lower than those in the control group(P＜0.05).There were no statistically significant differences in umbilical artery blood pH value,Lac value,neonatal Apgar score,random blood glucose,neonatal asphyxia rate,and neo-natal fever rate between the two groups(P＞0.05).Conclusion Intake management and individ-ualized dietary guidance during labor can reduce the incidence of uterine atony,shorten the duration of labor,decrease the incidence of dystocia,reduce postpartum hemorrhage within 2 hours and de-crease the incidence of neonatal glucose abnormality.

Objective:To identify the risk factors for intrapartum fever during labor analgesia and establish the prediction model.Methods:The medical records from pregnant women with intrapartum fever during labor analgesia were retrospectively analyzed. According to whether the highest body temperature ≥38 ℃, the parturients were divided into intrapartum fever group and non-fever group. The general data from patients, duration of hospital stay before labor, induced labor, prenatal hemoglobin concentration, body msaa index (BMI) during pregnancy, artificial rupture of membranes in the incubation period, frequency of vaginal examination and etc. were collected. The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify intrapartum fever-related risk factors, and the weighted score regression prediction model was established. Hosmer-Lemshow Test was used to assess the fit of the model, and the receiver operating characteristic curve was drawn to evaluate the model. The nomogram was drawn for visually presenting the regression model. The clinical calibration curve, decision curve analysis and clinical impact curve were drawn to assess the created prediction model. Results:There were 99 parturients developed fever during labor analgesia, with an incidence of 34.7%. The results of logistic regression analysis showed that duration of hospital stay before labor, prenatal hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination were the independent risk factors for intrapartum fever during labor analgesia. The area under the receiver operating characteristic curve was 0.943, 95% confidence interval was 0.916-0.969, the sensitivity was 86.9%, the specificity was 88.6%, and the Youden index was 0.755. The prediction model of the line chart was assessed by Hosmer-Lemshow, P=0.898. Conclusions:Duration of hospital stay before labor, hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination are independent risk factors for intrapartum fever during labor analgesia in parturients, and the risk prediction model developed can effectively predict the occurrence of intrapartum fever during labor analgesia.

Objective To investigate the effect of dietary intake on the childbirth outcomes of pri-mipara women with full-term labor analgesia.Methods A total of 400 primipara women with full-term labor analgesia were randomly divided into observation group and control group.The observation group received intake management and individualized dietary guidance,while the control group ate and drank according to their own wishes.The childbirth quality,the incidence of vomiting,the use of oxytocin due to uterine atony,the rate of intrapartum fever,the rate of perineal incision,the rate of cesarean section,the rate of vaginal assisted delivery,and the rate of postpartum hemorrhage were compared be-tween the two groups.The duration of the first stage of labor,the duration of the second stage of labor,the duration of labor analgesia,and the amount of postpartum hemorrhage within 2 hours were also compared.Neonatal Apgar score,random blood glucose,umbilical artery blood pH value,umbilical ar-tery blood lactic acid(Lac)value,the incidence of neonatal asphyxia,the incidence of neonatal fever,and the incidence of neonatal hypoglycemia were compared between the two groups.Results The ob-servation group had lower incidences of vomiting,oxytocin use rate due to uterine atony,intrapartum fever rate,perineal incision rate,transferring cesarean section rate,and vaginal assisted delivery com-pared to the control group(P＜0.05).The observation group had lower rates of postpartum hemor-rhage,shorter duration of the first and second stages of labor,shorter duration of labor analgesia,and less postpartum hemorrhage within 2 hours compared to the control group,and the incidences of neonatal hyperglycemia and hypoglycemia in the observation group were lower than those in the control group(P＜0.05).There were no statistically significant differences in umbilical artery blood pH value,Lac value,neonatal Apgar score,random blood glucose,neonatal asphyxia rate,and neo-natal fever rate between the two groups(P＞0.05).Conclusion Intake management and individ-ualized dietary guidance during labor can reduce the incidence of uterine atony,shorten the duration of labor,decrease the incidence of dystocia,reduce postpartum hemorrhage within 2 hours and de-crease the incidence of neonatal glucose abnormality.

Objective:To assess the consistency of ultrasound and dual-energy computed tomography (DECT) in the diagnosis of gouty arthritis(GA), reasons of the differences were further analyzed.Methods:The ultrasound and DECT images of 150 knee joints from 147 patients diagnosed with gout at the Gout Specialty Clinic of Qingdao University Affiliated Hospital from February 2022 to October 2023 were retrospectively analyzed. According to anatomy, the knee joint was anatomically segmented into five regions: intra-articular, anterior, posterior, medial, and lateral.Location of monosodium urate (MSU) deposition was meticulously recorded. The Kappa consistency test was employed to assess the consistency of the two examination results in different regions of the knee joint. The McNemar chi-square test was utilized to conduct a differential analysis between DECT and ultrasound results.Results:Double contour sign(DCS) (81.2%, 92/112) was the most common intra-articular ultrasound sign in knee joints with GA. In the extra-articular region, MSU was commonly deposited in and around the popliteal tendon (ultrasound: 51.6%, 66/128; DECT: 54.7%, 70/128). Corresponding MSU deposits on DECT were found in 9 of 92 joints with DCS and in 9 of 49 joints with aggregates detected on ultrasound.In the assessment of MSU deposits, ultrasound showed an overall higher positive rate than DECT (87.3% vs. 72.3%, P=0.001), with poor consistency between the two examinations (Kappa=0.153). In distinct anatomical regions, ultrasound and DECT showed high consistency in the medial (Kappa=0.697) and lateral (Kappa=0.718) sides and the difference was not statistically significant ( P>0.05). Intra-articular (Kappa=0.289) and anterior (Kappa=0.303) regions exhibited only fair consistency, with statistically significant diagnostic differences ( P<0.05). When exclusively assessing cases with tophus, ultrasound and DECT demonstrated high consistency in the medial and lateral aspects(Kappa=0.685, 0.748) without statistical difference ( P>0.05). In the anterior region, the consistency between the two examinations was moderate (Kappa=0.256), while in the intra-articular region, the consistency of the two methods was lower (Kappa=0.147), and the differences was statistically significant ( P<0.001). Conclusions:Both ultrasound and DECT exhibit good diagnostic capabilities for gouty knee arthritis.However, the consistency between the two techniques varies in different anatomical locations. Clinical assessment should be tailored based on the specific anatomical position. DECT has an advantage in evaluating intra-articular MSU deposits, while ultrasound is more sensitive to detect early and scattered MSU deposits.

Objective To investigate the relationship between hemoglobin glycation index(HGI)and metabolic syndrome(MS)and its components.Methods A cross-sectional study was conducted to randomly select 823 patients from the First People's Hospital of Huzhou from September 2022 to September 2023.HGI is calculated based on fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)values.The patients were divided into low HGI group(HGI<-0.250%,274 cases),medium HGI group(-0.250%≤HGI≤0.214%,275 cases)and high HGI group(HGI>0.214%,274 cases)by HGI quantile method.The general data and metabolic indexes of each group were compared,and the correlation between HGI and MS and its components was analyzed by multiple Logistic regression.Results With the increase of HGI level,the prevalence rate of MS showed an upward trend(P<0.05).The prevalence rate of MS in low,medium and high HGI groups was 24.8%,42.5%and 55.5%,respectively.Multiple Logistic regression analysis showed that elevated HGI level was risk factor for MS,central obesity,hypertension,hyperglycemia,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia(P<0.05).The risk of MS,central obesity,hypertension,hyperglycemia,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia in high HGI group was 4.005 times(95%CI:2.763-5.808),3.765 times(95%CI:2.604-5.443),1.596 times(95%CI:1.089-2.337),2.655 times(95%CI:1.809-3.895),2.024 times(95%CI:1.404-2.918)and 2.247 times(95%CI:1.537-3.284)of that in low HGI group,respectively.Conclusion HGI is related to MS and its components,and HGI may be a new indicator to prevent and monitor MS.