Objective To discover the effects of the Prescription Administrative Policy in force on the quality of the prescriptions in a tertiary hospital in 2007. Methods The prescriptions of 400 cases were sampled systematically for evaluation, and 60 patients were interviewed. Results The average eligibility rate of the prescriptions was but 37. 2% in this hospital, which was mainly plagued by incompleteness, nonstandard and irrationality found in prescriptions. Implementation of the Policy contributed to a significant improvement of some indicators. For example, the eligibility rate increased by 12. 2% (P=0. 004) ,the percentage of the use of antimicrobial agents dropped significantly (P=0. 001),and the percentage of generic names used rose significantly (P = 0. 000). Conclusions The implementation of the Policy is highly positive for prescription quality.

Objective:To evaluate the clinical efficacy and safety of Infliximab (IFX) in pediatric Crohn′s disease (CD).Methods:The efficacy of IFX therapy in 30 patients suffering from active CD who were not completely improved with traditional medicine and enteral nutrition or had intolerance to the medicine in Beijing Children′s Hospital Affiliated to Capital Medical University from December 2014 to December 2019 were retrospectively analyzed.Pediatric Crohn′s Disease Activity Index (PCDAI), blood biochemistry indices, mucosal healing, nutritional status, and adverse reactions were compared and evaluated.Results:Thirty active CD cases, with 18 males and 12 females, were enrolled, and the average age was (8.63±4.76) years old.Three cases who didn′t complete 3 times of IFX injection and 1 case who lost to be followed up were excluded.A total of 26 cases of CD in active period were enrolled in this study on efficacy.The clinical remission and response rate of 26 cases were 61.5% and 84.6%, respectively, at 14-week of IFX therapy.The clinical remission and response rate of 21 cases were 71.4% and 85.7%, respectively, at 30-week.The clinical remission and response rate of 15 cases were 86.7% and 93.3%, respectively, at 54-week.At week 14 th, PCDAI score [(9.56±8.05) scores vs.(29.02±10.86) scores] decreased compared with before treatment ( t=7.339, P<0.05). The levels of erythrocyte sedimentation rate [(15.54±10.26) mm/1 h vs.(33.77±21.30) mm/1 h] and C-reactive protein [(4.79±12.94 ) mg/L vs.(16.33±23.43) mg/L] were obviously decreased, and the hemoglobin [(126.27±16.51) g/L vs.(110.58±16.45) g/L], hematocrit [(37.03±3.95)% vs.(33.52±4.32)%], and albumin levels [(42.30±3.03) g/L vs.(37.13±5.68) g/L] were remarkably increased compared with those before treatment ( t=3.932, 1.993, -3.398, -3.060, -4.009, all P<0.05). Height for age Z score and body mass index Z score were increased after IFX treatment, without statistically significant differences (all P>0.05). Conclusions:IFX therapy had good clinical efficacy in controlling inflammatorys and inducing clinical remission in pediatric CD.

Objective To investigate status of the intravenous use of antibiotics in outpatients and emergency patients of a tertiary first-class hospital, and provide a reference for developing management measures in next step. Methods By a retrospective method,all the prescriptions using antibiotics by intravenous administration in outpatients and emergency department patients from a tertiary first-class hospital in 2013 were extracted from the hospital information system. The categories of antimicrobial agents,proportion of intravenous use of antimicrobial drugs,ranking of the antibiotic consumption sum and defined daily dose,and the top 10 clinical departments or wards intravenously using antimicrobial drugs were chosen to analyze. The data in 2014 were extracted as a comparison. Results Outpatients and emergency department patients respectively used 8 categories 31 kinds and 8 categories 30 kinds of intravenous antimicrobial drugs, with high consumption of cephalosporins and restricted antimicrobials such as sodium cefoxitin.Intravenous use of antimicrobial drug prescription proportion in emergency department is higher than that in outpatient department. Conclusion After intervention in 2014, antibiotic consumption is effectively controlled as compared that in 2013. But management should be strengthened and appropriate interventions should be taken to ensure the use of intravenous antibiotics in a safe,effective and economical manner.

Silver nanoparticles (AgNPs) have been widely used in industrial, household, and healthcare-related products due to their excellent antimicrobial activity. With increased exposure of AgNPs to human beings, the risk of safety has attracted much attention from the public and scientists. In review of recent studies, we discuss the potential impact of AgNPs on individuals at the cell level. In detail, we highlight the main effects mediated by AgNPs on the cell, such as cell uptake and intracellular distribution, cytotoxicity, genotoxicity, and immunological responses, as well as some of the major factors that influence these effects in vivo and in vivo, such as dose, time, size, shape, surface chemistry, and cell type. At the end, we summarize the main influences on the cell and indicate the challenges in this field, which may be helpful for assessing the risk of AgNPs in future.
Chemistry ; Family Characteristics ; Humans ; Nanoparticles* ; Risk Assessment ; Silver*

X-linked juvenile retinoschisis (XLRS) is a rare X-linked inherited retinal disorder, mainly affects bilateral retina. Patients often present with visual deterioration accompanied by a spoke-wheel pattern in the macula due to splitting of inner retinal layers and a disproportionate decline in the b-wave relative to a-wave of electroretinogram. The current therapy is mainly directed toward treatment of complications with no effective clinical management yet. In recent years, with the deepening understanding of XLRS, adeno-associated virus(AAV)-mediated gene therapy has become a potential new approach for the treatment. Two clinical trials on XLRS gene therapy are currently underway. These two clinical trials assess the ocular safety and tolerability of recombinant AAV- RS1 vector and explore its safe dose in XLRS patients. However, the recovery of retinal structure and function in XLRS patients is unsatisfactory. Following the in-depth research and progress of clinical trials, it is expected that more accurate and effective treatments for XLRS patients will be provided in the future.

Objective:To evaluate the safety of a novel nanoparticle neurotrophic factor complex for intraocular application in non-human primates.Methods:Nanoparticles incorporated with ciliary neurotrophic factor (NP-CNTFs) were produced utilizing nanotechnology.Three adult male cynomolgus macaques were included and intravitreally injected with 10 μl NP-CNTFs at a concentration of 1 μg/μl into one of the two eyes, and these three eyes were designated as the NP-CNTFs group.The contralateral eyes received the same volume of phosphate buffered saline and were designated as the control group.Before the injection and on days 3 and 7 after the injection, routine clinical examinations of the anterior segment were performed to evaluate the ocular clinical symptoms such as conjunctival congestion, anterior chamber flare and cells.The fundus condition was observed by fundus photography.The morphological structure and thickness of retinas were detected by spectral domain-optical coherence tomography (SD-OCT).The use and care of animals were in accordance with the Guide for the Care and Use of Laboratory Animals issued by the National Institutes of Health and the standards of Association for Assessment and Accreditation of Laboratory Animal Care.The study protocol complied with the ethics of laboratory animal welfare and was approved by Hubei Topgene Biotechnology Co., Ltd.(No.IACUC-2019-012).Results:The NP-CNTFs prepared in this study had a particle size of (317±3)nm, a polydispersity index of 0.042±0.015, and a zeta potential of (-38.9±0.7)mV, and exhibited relatively good stability, bioavailability, and biocompatibility.Clinical examinations revealed that the clinical manifestations of conjunctival congestion, anterior chamber flare and cells were slightly more obvious in the NP-CNTFs group at 3 days after injection compared to the control group, but basically returned to normal at 7 days after injection.The scores of anterior-segment clinical symptoms of the NP-CNTFs and control group were (2.67±0.88) and (1.00±0.58) at 3 days after injection, and (0.67±0.33) and (0.33±0.33) at 7 days after injection, respectively, with no statistical differences between them ( t=2.50, 1.00; both at P>0.05).Fundus photography showed normal fundus in both groups at 7 days after injection with no abnormal changes including vitreous opacity, vitreous hemorrhage, retinal hemorrhage or papilloedema.SD-OCT showed no significant histological changes in the retinas at 7 days after injection in both groups.The retinal nerve fiber layer thickness of the NP-CNTFs and control group were (107.67±0.88) and (111.00±3.22)μm, respectively, and the macular foveal thickness of the two groups were (255.67±2.03) and (254.67±3.84)μm, respectively, with no statistical differences between them ( t=1.43, 0.50; both at P>0.05). Conclusions:The complex NP-CNTFs shows good safety for intraocular application in cynomolgus macaques.

Objective: To analyze the clinical manifestations, diagnosis, treatment and prognosis of intestinal lymphangiectasia (IL) in children in order to improve the skills of diagnosis and treatment of IL. Method: Clinical manifestations, laboratory findings, gastroscopic findings, histopathological examinations and lymphatic radionuclide imaging assessments were analyzed retrospectively among 47 IL patients who were hospitalized in the Gastroenterology Department of Beijing Children's Hospital Affiliated to Capital Medical University from June 2007 to December 2015. All patients were followed up by telephone. According to the various causes, the patients were divided into the primary intestinal lymphangiectasia (PIL) group and secondary IL group, and their clinical manifestations were compared by t test, Rank sum test or Chi-square test. Result: In 47 IL patients, there were 38 children (81%) younger than 3 years old. There were 43 PIL patients (91%) and 4 secondary IL patients (9%). Between PIL and secondary IL, there were statistical differences in serum albumin (t=-3.950, P<0.005) , globulin(t=-2.850, P=0.007), age of onset(U=27.000, P=0.024), age at diagnosis(U=29.000, P=0.030) and course of disease(U=26.500, P=0.023), whereas there were no statistical differences in lymphocyte count, IgG, lymphatic radionuclide imaging, histopathology and gender(all P>0.05). Edema (44 cases, 94%), diarrhea (42 cases, 89%), accompanied with infection (35 cases, 74%) and ascites (30 cases, 64%) were the main clinical manifestations. In 47 IL patients, 45 patients were done gastroscopy and histopathological examinations, and there were 31 patients' histopathological examinations(69%) were positive. Forty patients were done lymphatic radionuclide imaging, and there was evidence of protein losing from gut via lymphatic radionuclide imaging in 39 patients(98%). Among 47 patients, 35 patients (74%) were followed up, 32 patients had good prognosis, 2 patient failed to show evidence of improvement, 1 patient died and no patient experienced a relapse till the end of the follow-up. In 35 patients, 28 patients were treated with medium chain triglycerides (MCT) dietary therapy, 26 patients showed improvement in symptoms, and 2 patients had no improvement. Among 35 patients with follow-up, there were 6 patients received surgical treatment, and their symptoms were improved. Conclusion PIL are the majority of IL in children younger than 3 years old. The main clinical manifestations are edema, diarrhea, accompanied with infection and ascites. For the patients without the evidence of lymphangiectasia from duodenum histopathological examination, further consideration of lymphatic radionuclide imaging, clinical manifestations, and laboratory studies are needed to make a final diagnosis. MCT dietary therapy is the cornerstone of IL medical management.

Objective:To evaluate serum complement C1q tumor necrosis factor related proteins-3 (CTRP-3) and D-dimer (D-D) in predicting hyperacute transformation after thrombolysis in patients with cerebral infarction, and their correlation with brain injury.Methods:One hundred and sixty patients with cerebral infarction admitted in our hospital from August 2016 to August 2019 were enrolled in the study. The hyperacute transformation occurred in 29 cases after intravenous thrombolysis (occurrence group) and did not occur in 131 cases (non-occurrence group). The serum CTRP-3, D-D levels and other factors that may cause hyperacute transformation were compared between the occurrence group and the non-occurrence group. Logistic regression analysis was used to analyze the risk factors of cerebral hemorrhage. The predictive values of serum CTRP-3 and D-D for hyperacute transformation in patients with cerebral infarction were analyzed with receiver operating characteristic (ROC)curve. The correlation between serum CTRP-3, D-D and brain injury was analyzed by Pearson correlation coefficient method.Results:The National Institute of Health stroke scale (NIHSS) score [(18.6±2.2) points vs. (14.0±2.1) points, t=10.62, P<0.01], proportion of infarct diameter >5 cm [69.0%(20/29) vs. 39.7%(52/131), χ 2=8.22, P<0.01], trial fibrillation rate[72.4%(21/29) vs. 44.3%(59/131), χ 2=7.52, P<0.01], and serum D-D levels [(3.02±0.31) mg/L vs. (2.24±0.23) mg/L, t=15.44, P<0.01] of the occurrence group were significantly higher than those of the non-occurrence group; while the serum CTRP-3 levels were lower than those of the non-occurrence group [(251.3±26.9) μg/L vs. (285.7±29.2) μg/L, t=5.82, P<0.01], the onset-to-needle time (OTN) was longer than that of the non-onset group [(4.61±0.43) h vs. (2.96±0.52) h, t=15.91, P<0.01]. Logistic regression analysis showed that pre-thrombosis NIHSS ( OR=1.69, 95 %CI: 1.02-2.15, P<0.01), proportion of infarct diamete r>5 cm ( OR=3.73, 95 %CI: 1.96-5.10, P=0.001), atrial fibrillation ( OR=2.14, 95 %CI: 1.25-2.96, P<0.01), OTN ( OR=3.44, 95 %CI: 1.85-5.02, P<0.01), serum DD ( OR=2.37, 95 %CI: 1.56-3.30, P<0.01) and serum CTRP-3 ( OR=2.9 d, 95 %CI: 1.91-4.25, P<0.01) were risk factors for hyperacute transformation in patients with cerebral infarction. ROC results showed that the area under the curve (AUC) of CTRP-3 and D-D for predicting hyperacute transformation in patients with cerebral infarction were 0.723 and 0.796, respectively; and the AUC of the combination of two indicators was 0.823. The anterior cerebral infarction occurred in 28 cases, the posterior cerebral infarction occured in 132 cases. The NIHSS score were(18.7±2.1)points and (14.0±1.9)points,respectively,and the modified Rankin Scale(mRS) score were(3.8±0.5)points and(3.2±0.6) points. Pearson correlation analysis showed that the serum CTRP-3 was negatively correlated with the NIHSS score of brain damage in patients with anterior circulation cerebral infarction ( r=-0.72, P<0.01), and the correlation was less strong with the NIHSS score in patients with posterior circulation cerebral infarction ( r=-0.35, P<0.01). The serum D-D was strongly positively correlated with NIHSS score of brain damage in patients with anterior circulation cerebral infarction ( r=0.88, P<0.01), and it was less strong with NIHSS score in patients with posterior circulation cerebral infarction ( r=0.24, P<0.01). The serum CTRP-3 was strongly positively correlated with brain injury mRS score ( r=0.80, P<0.01), and serum D-D was strongly negatively correlated with brain injury mRS score ( r=-0.76, P<0.01). Conclusion:The combined detection of serum CTRP-3 and D-D has a high predictive value for the occurrence of cerebral hemorrhage in hyperacute transformation after thrombolysis in patients with cerebral infarction, and two indicators have a certain correlation with brain injury of patients.

Purpose/Significance Based on big data,a cardiovascular and cerebrovascular electronic medical record(EMR)analy-sis platform is developed.By utilizing imaging data analysis techniques and clinical document analysis techniques,the platform provides patients with precise diagnosis,treatment plans,scientific administration,prognosis prediction,smart health education prescriptions and other precise services.Method/Process The medical ontology,knowledge rules and knowledge graph for cardiovascular and cerebrovas-cular diseases are developed and constructed by using Protégé.On the basis of constructing a knowledge graph,a knowledge base for clinical diagnosis,treatment,pathological analysis and prognosis judgment of cardiovascular and cerebrovascular diseases is formed.A EMR analysis platform for cardiovascular and cerebrovascular diseases is designed based on the knowledge base.Result/Conclusion The designed cardiovascular and cerebrovascular EMR analysis platform is conducive to providing personalized diagnosis and treatment plans for different populations,and providing patients with various precise diagnosis and treatment services.

Objective To compare and explore the differences between the eight batches of drugs in the centralized procurement list and the 2018 edition of the national essential medicine list,and to provide reference for updating and improving the national essential medicine list and the national centralized procurement list of drugs.Methods The category,generic name variety,specification,and other information of drugs included in the centralized drug procurement were collected and compared with the 2018 edition of the national essential medicine list,and the reasons for differences were analyzed.Results A proportion of 39%of centralized procurement drugs were listed in national essential medicines.Forty pharmacological classifications were not involved in the drugs of centralized procurement.Only anticoagulant and thrombolytic drugs with dual attributes accounted for a smaller variety proportion than the specification proportion.Conclusion There are some differences between the centralized procurement list and the 2018 edition of the national essential medicine list,which have some rationality,but also some problems to be solved.