OBJECTIVE:To provide reference for reducing and avoiding medication errors of high-alert drugs in outpatient de-partment. METHODS:The medication errors of high-alert drugs in outpatient prescriptions were collected from our hospital during 2013-2014,and then analyzed retrospectively in terms of the type and degree of medication error,caused factors of medication er-rors,etc. RESULTS:670 997 prescriptions were checked in two years,and 501 medication errors were found,including 26 medi-cation errors of high-alert medication. There were 7 incorrect route of administration of insulin,1 repeated medication and 1 incor-rect dose of oral hypoglycemic agents,6 repeated administration of opioid drugs and non steroidal anti-inflammatory drugs,2 indi-cation error of paracetamol and codeine phosphate,1 specification and 1 indication error of glucose injection,2 route of administra-tion error of lidocaine,2 administration frequency errors of methotrexate,2 dose error of digoxin and 1 dose error of warfarin;18 doctors'prescribing errors were found by pharmacists'prescription audit,accounting for 69.2%;8 doctors'prescribing errors were not found by pharmacists'prescription audit,accounting for 30.8%. CONCLUSIONS:Medication errors of high-alert drugs occur mainly in the prescription segment,and the main reason is that the electronic prescription system lack of compulsory strategy and policy constraints. Improvement of safety administration of high-alert drugs need to find the error link and adopt targeted medi-cation safety practices.

OBJECTIVE:To systematically evaluate the efficacy and safety of prostaglandin E1 combined with hydration for the prevention of contrast-induced nephropathy(CIN)and provide evidence-based reference for the clinical treatment. METHODS:The PubMed,Medline (Ovid),EMbase (Ovid),Cochrane Library,VIP,CJFD and WanFang database were retrieved to collect the randomized controlled trails(RCT)of prostaglandin E1 combined with hydration for the prevention of CIN. After information collec-tion and methodology quality evaluation,the Meta-analysis was performed using Rev Man 5.3 software. RESULTS:12 RCTs involv-ing 1 732 patients were included. The results of Meta-analysis showed that the incidence of CIN in test group was significantly low-er than control group[RR=0.40,95%CI(0.30,0.53),P<0.001],the incidence of phlebitis was higher than control group [RR=10.18,95%CI(1.37,75.67),P=0.02] and there was no significant difference in the need rate of renal replacement between test group and control group[RR=0.44,95%CI(0.12,1.61),P=0.21]. CONCLUSIONS:Intravenous prostaglandin E1 combined with hydration can effectively reduce the incidence of CIN. Occurance of phlebitis should be paid attention to. Due to the limited quality and sample of included studies,it remains to be further verified by high-quality and large-sample RCT.

Aim To explore the mechanism of E.coli heat-labile enterotoxin B subunit(LTB)as adjuvant by analysis of cellular proteins interacting with LTB. Methods Whole cell proteins were purified from RAW 264.7 cell after treated with LTB or NaCl 12 h, respectively.The cellular proteins were interacted with LTB and the interacting proteins were purified by pull-down assay and identified by mass spectrography.The LTB interaction proteins were conformed with Western blot and immunofluorescence assay.Results 25 LTB interaction proteins were found,and their interaction network was mapped;four proteins (Jup,Dsp,Ddx5 and Vimentin)were indicated to be related with LTB adjuvant activity;immunofluorescence assay indicated that GM130 interacted with LTB,however,Vimentin had no interaction with LTB in vivo.After treated by LTB,the expression of β-actin was upregulated obvi-ously in RAW 264.7 cell,whereras,Hspd1 did not show any change.Conclusions LTB exerts adjuvant activity through binding to GM1 of immune cells,cau-sing endocytosis and transporting to the Golgi apparatus by vesicles.Then LTB might bind to Jup and affect TCF/LEF activity,regulating the expression of Bcl 2, IL-6,and Runx3.The result is promoted T cell and B cell proliferation,differentiation and activation by se-cretion of cytokines and immunoglobulins.

OBJECTIVE:To provide reference for clinical desicion,drug use and ADR avoidance. METHODS:Clinical pharmacists participated in the consultations and therapy plan about a patient with hiatal hernia complicating with venous catheter- related infections. Clinical pharmacists suggested pulling out peripherally inserted central catheter(PICC)and placing a catheter again. Anti-infective therapy plan had been adjusted:vancomycin 0.5 g/time,ivgtt,q12 h;fluconazole 0.2 g,ivgtt,qd(0.4 g,ivgtt,qd on the first day),cefoperazone/sulbactam 2 g,ivgtt,q8h. Vancomycin and fluconazole were additionally used for anti- infective therapy. RESULTS:Doctors adopted the suggestions of clinical pharmacist,and pulled out PICC;and then the infection of the patient was controlled effectively. Finally,the infection had been cured. CONCLUSIONS:The participation of clinical pharmacists in the consultation contributes to rational drug use,and assists doctors to make the right clinical decisions and avoid adverse drug events.

Objective To develop a sandplay analysis evaluation matrix for children with tic disor?ders. Methods 113 children were chosen as the study subjects . Based on the grounded theory,the open coding,correlated coding and core coding were carried out on coding elements for sandplay process to gain the third?level,second?level and first?level evaluation codes. The reliability and validity of the codes were tested.Results The sandplay analysis evaluation matrix for children with tic disorders was established inclu?ding 48 third?level,17 second?level and 3 first?level evaluation codes. The codes were proved to be reliable and valid through the comparison and conditional coding with query. Conclusion The sandplay analysis e?valuation matrix for children with tic disorders,which is established based on the grounded theory,is reliable and operable. It can be used as a tool to assess the psychological or behavioral problems of children with tic disorders dynamically.

OBJECTIVE: To analyze the role and significance of pepsin and pepsinogen in the pathogenesis of OME in children. METHOD: Pediatric patients with otitis media aged 2-8 years who enrolled in our department of the hospital from May of 2012 to December of 2012 were set as experimental group (38 cases, 48 ears) which should be underwent tympanic membrane puncture/tube insertion. Meanwhile, pediatric patients waiting for cochlear implant without otitis media (10 ears), were set as control group. Middle ear lavage fluid and plasma samples from the two groups were collected and detected using enzyme-linked immune method for pepsin and pepsinogen. RESULT: The concentrations of pepsin and pepsinogen in the middle ear lavage fluid of OME group [(48.8 ± 415.99) ng/ml and 676.32 ± 336.71)ng/ml] were significantly higher than those in the control group [(8.20 ± 4.59)ng/ml and (77.27 ± 50.33) ng/ml] (P < 0.01). Meanwhile, the concentration of pepsinogen in the middle ear lavage of OME patients was significantly higher than that of plasma (P < 0.01). The concentration of pepsin in the middle ear lavage fluid from the dry ear subgroup was lower than those in the serum ear and mucous ear subgroups (P < 0.01), but there was no significant difference about concentrations of pepsinogen among the dry ear, serum ear and mucous ear subgroups (P > 0.05). CONCLUSION Pepsin and pepsinogen in the middle ear cavity of OME patients maybe originated from laryngopharyngeal reflux (LPR), indicating that LPR is associated with the pathogenesis of OME in children.
Child ; Child, Preschool ; Ear, Middle ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Humans ; Laryngopharyngeal Reflux ; physiopathology ; Otitis Media with Effusion ; metabolism ; Pepsin A ; metabolism ; Pepsinogen A ; metabolism ; Tympanic Membrane ; surgery

Objective To understand the epidemiological characteristics of syphilis in Songjiang District of Shanghai from 2007 to 2017, and provide evidence for further improvement in the prevention and control measures. Methods Descriptive analysis was performed on the syphilis case data in Songjiang District from 2007 to 2017. Results In 2007-2017, a total of 8 546 cases of syphilis were reported in Songjiang District, with an average annual incidence of 48.23/100 000.The overall incidence showed a U-shaped upward trend, with the highest incidence in 2016 (68.17/100 000);the average annual incidence decreased by 6.13/100 000 from 2007 to 2010, whereas increased by 5.64/100 000 from 2011 to 2017.Syphilis was characterized as follows:1) The epidemic was dominated by the cases with local household registration, latent syphilis (51.84%), reported in June-September, aged 20-59 years (81.24%).The cases in the age group over 60 years showed a significant upward trend.2) In the local syphilis cases, there were more men than women, and the sex ratio was 1.3 : 1 (especially the sex ratio in the stage 1 and stage 2 syphilis was 1.73 : 1).In the foreign cases from other provinces, there were less men than women, and the sex ratio was 0.6 : 1. 3) In the primary syphilis cases, there were more men (35.50%) than women (20.98%), while more female cases in the latent syphilis and secondary syphilis cases.Local primary and secondary cases were mainly in the age group of 30 to 59 years (59.06%).The cases from other provinces were mainly 20 to 49 years old (85.24%). Conclusion The incidence of syphilis in Songjiang District is increasing.As primary syphilis are more likely to be male and young adults, we should strength the surveillance, establish standardized diagnosis and treatment of syphilis, advocate sexually transmitted diseases prevention and treatment and safe sexual behavior, and also promote active screening in women and the elderly for further control of syphilis.

OBJECTIVE: To analyze the therapeutic effect of proton pump inhibitor(PPI) on alleviation of hoarseness symptoms in patients with laryngopharyngeal reflux(LPR). METHOD: The LPR outpatients in ENT department of our hospital(60 cases)complained of hoarseness were enrolled in the study from August of 2013 to October of 2014. All of them were randomly divided into group A and B. The individuals in group A (30 cases) taked golden voice capsule to treat for 3 months, while the individuals in group B (30 cases) taked golden voice capsule and omeprazole to treat for 3 months. The data about reflux symptom index (RSI), reflux finding score (RFS) and voice handicap index (VHI)from the first month to the third month after treatment were recorded and compared group A with group B. RESULT: The scores of RSI and RFS in patients (60 cases) before treatment were significantly correlated with their VHI (r=0. 823, P<0. 01; r=0. 873, P<0. 01). The score changes of RSI and VHI from the first to the third month after treatment in group B were significantly higher than those in group A (P<0. 01). Meanwhile, the score changes of RFS from the third month after treatment in group B were significantly higher than those in group A (t=8. 307, P<. 01), but the differences were not significant for RFS from the first to the second month after treatment between group A and group B(t=1. 128, P>0. 05; t=0. 376, P> 0. 05). CONCLUSION PPI therapy could significantly alleviate the hoarseness symptom in LPR patients.
Hoarseness ; drug therapy ; Humans ; Laryngopharyngeal Reflux ; drug therapy ; Proton Pump Inhibitors ; therapeutic use

Traditional T vector cloning method requires onerous procedures for identifying recombinant, and directional cloning was impossible. In order to overcome these problems, we have devised a directional T vector pETG based on pET-23a(+). For gene cloning, 7 bp partial LacO sequence was introduced into DNA fragment to reconstitute a full length LacO with Bfu I digested T vector. After transformation, blue colonies were selected on LB plate supplemented with X-gal. Restriction enzyme digestion and PCR identification showed that all blue colonies contained the directionally inserted recombinants and the recombinant efficiency was nearly 100%. We have successfully cloned 103 genes from human liver cDNA; in the study complicated procedures for screening of recombinant were not required. Eight pETG clones were picked for protein expression, and all the clones successfully produced corresponding proteins. We demonstrated that the directional T vector was successfully constructed, and it was very suitable for gene cloning and expression.
Cloning, Molecular ; methods ; DNA, Complementary ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Gene Expression ; genetics ; Genetic Vectors ; genetics ; Humans ; Liver ; chemistry ; Polymerase Chain Reaction ; methods ; Recombinant Proteins ; biosynthesis ; genetics

Objective:To establish a predictive model of moderate to severe pain in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE).Methods:264 patients with HCC who underwent TACE operation in Southern Medical University from January 2017 to April 2018 were selected as the modeling set. The pain was assessed by numeric rating scales. The patients were divided into pain group ( n=96) and non-pain group ( n=168) according to whether moderate to severe pain occurred within 24 hours after the operation. Binary Logistic regression analysis were performed for variables that were statistically significant in the univariate analyses. The predictive nomogram was constructed and the internal validation was performed. In addition, 87 patients with HCC who underwent TACE operation from January 2020 to June 2020 were selected as the validation set for external validation. Results:In the modeling set, 96 patients (36.36%) had moderate to severe pain within 24 hours after TACE operation in 264 patients with HCC, and the dosage of morphine intramuscularly injected within 24 hours was 1015 mg, with an average of 10.57 mg per patient. Multivariate Logistic regression analysis showed that preoperative pain, the distance between the tumor and capsule ≤2 cm, high prothrombin activity, dosage of lipiodol>10 ml, and several thromboembolic tumors were independent risk factors for moderate to severe pain after TACE ( P<0.05). Age>50 was the protective factor of moderate to severe pain after TACE ( P<0.05). The area under ROC curve was 0.799 (95% CI: 0.745-0.853) in the modeling set. The area under Roc curve for internal validation and external validation were 0.780 and 0.788, respectively. The calibration curves showed satisfactory agreements between the model predicted probability and the actually observed probability. Conclusion:The predictive model of moderate to severe pain after TACE was established in this study has good differentiation and accuracy, it has certain guiding significance for predicting the high-risk group of moderate to severe pain after TACE operation and formulating the targeted prevention strategy.