Objective:To establish training system for postoperative delirium (POD) assessment and evaluate the efficacy of training for anesthesia nurses.Methods:Sixteen nurse anesthetists of both sexes in our hospital were selected and received the systemic training for POD assessment.The training system included questionnaire survey, theoretical teaching, simulated visit, clinical observation, independent evaluation, centralized question-answering, evaluation of efficacy and random inspection.The level of POD knowledge tests were performed before the training and at the end of the fourth week of independent evaluation, respectively.At week 1 and 4 of independent evaluation, the diagnostic rate of POD and sensitivity and specificity of the assessment were calculated, and Kappa consistency analysis was used to assess the consistency between anesthesia nurses and training group in diagnosis of POD.In the first week of the third month after the end of training, the evaluation results were randomly inspected, the POD diagnosis rate was calculated between the anesthesia nurses and the training group, and the consistency analysis was conducted.Results:Compared with the scores of POD knowledge questionnaire and sensitivity of the assessment of the anesthesia nurses in the first week of training, the scores were significantly increased ( P<0.05), and no significant change was found in the POD diagnosis rate in the fourth week of training ( P>0.05). Compared with the training group, the diagnosis rate of POD of anesthesia nurses was significantly decreased in the first week of training ( P<0.05), and no significant change was found at the fourth week of training ( P>0.05). In the first and fourth weeks of training, the Kappa value of anesthesia nurses and the training group was 0.676 and 0.954 ( P<0.001), respectively.In the first week of the third month after the end of training, the Kappa value between anesthesia nurses and the training group in diagnosis of POD was 0.862 ( P<0.05). Conclusion:The training system of POD assessment has been successfully established, and the standardized anesthesia nurses training of POD has been achieved with good results.

OBJECTIVE：To evaluate the efficacy and safety of atomization inhalation of polymyxin combined in the adjunctive treatment for ventilator-associated pneumonia ，and to provide evidence-based reference for clinical treatment. METHODS ： Retrieved from Cochrane Library ，Embase，PubMed，Web of Science ，CNKI，CBM，VIP and Wanfang database （from their inception to March 2021），randomized controlled trials （RCTs）about efficacy and safety of atomization inhalation of polymyxin combined with conventional treatment （trial group ） versus conventional treatment （control group ） for ventilator- associated pneumonia were collected. After data extraction and quality evaluation of included literatures met inclusion and exclusion criteria ， Meta-analysis was performed by using Rev Man 5.4 software. RESULTS ：A total of 13 clinical studies were included ，involving 2 RCTs and 11 cohort studies with a total of 1 066 patients. The results of Meta-analysis showed that clinical response rate [OR ＝ 1.53，95％CI（1.17，2.00），P＝0.002]，microbial clearance rate [OR ＝1.46，95％CI（1.11，1.91），P＝0.007] of trial group were significantly higher than those of control group ，with statistical significance. There was no statistical significance in the mortality rate [OR ＝0.88，95％CI（0.68，1.14），P＝0.32] and the incidence of renal impairment [OR ＝1.04，95％CI（0.72，1.49），P＝0.85] between 2 groups. CONCLUSIONS ：Based on current evidence ，atomization inhalation of polymyxin combined with conventional treatment can significantly improve clinical response rate and microbial clearance rate of patients with ventilator- associated pneumonia. However ， more strictly-designed ， long-term follow-up and large-scale RCTs are needed.

OBJECTIVE： To investigation occupational exposure and exposure outcome of antineoplastic in medical staff ，to provide support for their safety in Sichuan Province. METHODS：The respondents included doctors ，nurses，technicians and pharmacists from 11 related departments including tumor department ，hematology department ，PIVAS and pharmacy department in 4 third-level class A hospitals mainly in Sichuan Provincial People ’s Hospital and 6 second-level and below hospitals. Self-designed questionnaires were adopted to investigate general information of medical staff ，cognitive status to occupational exposure hazards ， occupational exposure and exposure outcome and protective behaviors and make suggestions of the investigation. RESULTS：A total of 350 questionnaires were sent out and 304 were recovered ，with effective recovery rate of 86.86％. Among 304 investigated pharmacentical staff ，involving 253 female（83.22％），51 male（16.78％），the most of persons aged 20-29 years old （43.42％）. The most of persons （66.78％）had a bachelor degree. The largest number of occupation was nurses （55.26％）；the pharmacy department had the largest number （21.71％）；working hours were mainly 8 h/day（84.21％）；working years were the most less than 5 years（39.47％）. 121 persons（39.80％）were aware of the potential hazards of occupational exposure to antineoplastic drugs，and 131 persons（43.09％）only knew a little about the Δ 项目基金：国家临床重点专科建设项目；四川省科研院所基本科 exposure hazards ；in PIVAS ，15 persons （71.43％） were 研业务项目（No.2018YSKY0017） ＊药师，硕士研究生。研究方向：临床药学。E-mail：370951417@ aware of the potential hazards of occupational exposure to qq.com antineoplastic drugs ，accounting the highest proportion among # 通信作者：主任药师，硕士生导师。研究方向：国家药物政策、药 all departments ； the proportion of technicians and other 事管理、医院药学。电话：028-87393436。E-mail：289302309@qq.com medical staff who did not know the occupational exposure 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·1009· hazard was the highest ，being 60％；the longer the total working time ，the higher the cognition degree of occupational exposure hazards （P＝0.035 8）. The most exposed antineoplastic drug was cyclophosphamide 165 persons（54.28％） and pemetrexed disodium 57 persons（18.75％）was the least. The total time of occupational exposure of medical staff in different departments was mainly short-term exposure ，among which the number of exposed persons in hematology department was the most （85.71％）. 67 persons（22.04％）reported that they had physical discomfort after excluding the influence of other physical diseases ，mainly the increase of alopecia （73.13％）；the propertion of medical staff who had physical discomfort in hematology department was the most（50.00％）；the number of nurses who had physical discomfort （31.55％）was the most. 155 persons（50.99％）could not understand the antineoplastic drug protection measures ，41 persons （13.49％） had received relevant training ，108 persons （35.53％）understood the occupational protection of antineoplastic drugs. The highest level of awareness of protective measures was found among the medical staff in PIVAS ，and only 14.29％ of the staff did not understand the protective measures. In term of occupation，the proportion of nurses who had received relevant training was the highest （19.05％）. CONCLUSIONS ：Medical staffs have a low level of knowledge about occupational exposure hazards and self-protection measures of antineoplastic drugs. The government should strengthen the construction of occupational protection regulations and standards for medical staff ；hospitals should strengthen internal management and attach great importance to the management of occupational protection in hospitals ； medical staff should increase awareness ，skills and reduce the risk of occupational exposure.