Objective To standardize the management of clinical trials in our hospital,reduce the incidence of protocol deviations,and provide a reference for improving the quality of clinical trials.Methods The healthcare failure mode and effect analysis(HFMEA)method was used to determine the potential failure modes of the current protocol deviation.The frequency,severity and detectability of failure modes were quantified and evaluated.The risk priority number(RPN)was calculated and the corresponding improvement measures were proposed.The RPN values before and after the implementation of HFMEA were statistically analyzed to evaluate the improvement effect.Results After the implementation of HFMEA activities,the RPN values of 14 potential failure modes decreased significantly(P<0.05);The risk level of 12 potential failure modes decreased.The HFMEA team members'ability in finding and solving problems,communication and cooperation were significantly improved.Conclusions The implementation of HFMEA activities contributes to the management of protocol deviation in clinical trials,can effectively reduce the occurrence of protocol deviation,and provides experience for improving the quality of drug clinical trials.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Humans ; Bipolar Disorder ; Schizophrenia ; Depression ; Electroencephalography

Ankle Injuries ; Fractures, Compression ; Humans ; Knee Injuries

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

Objective:To explore the diagnostic application and characteristics of contrast-enhanced ultrasound in exertional rhabdomyolysis (ERM).Methods:Three cases of ERM patients admitted to Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital in August 2019 were selected and clinical data of the patients were collected including medical history, serum muscle enzyme, electromyography, magnetic resonance imaging (MRI) and dynamic contrast-enhanced ultrasound of the thigh muscles within one week after onset.Results:All three patients had muscle soreness and dark urine after exercise and their serum muscle enzyme level exceeded five times of normal value which could be definitely diagnosed as ERM. Skeletal muscle MRI showed equal or slightly longer T 1, longer fat-suppressed T 2 weighted fluid attenuated inversion recovery images, and high diffusion weighted imaging signal. In this group, one case of femur muscle MRI showed adductor longus and semitendinosus myopathy, other two cases showed quadriceps. All cases′ MRI score was grade one. Echogenic enhancement can be seen in normal ultrasound of diseased skeletal muscle. Contrast-enhanced ultrasound showed a dynamic strengthening process in which the central area was firstly strengthened, then strengthened in peripheral area. Dynamic contrast-enhanced ultrasound showed characteristic changes in ERM with early and obvious enhancement in the central area and uneven enhancement in the central area. Conclusions:Dynamic contrast-enhanced ultrasonography of ERM lesions has its characteristic changes. The enhancement of the central area of the lesion appeared early and obvious while the surrounding area appeared late and weak, showing the characteristic of "water ripple" concentric circle reinforcement. This enhancement characteristic suggested that ERM skeletal muscle was unevenly damaged and the central area was more obvious.

OBJECTIVE： To standardize the management of temporary drug purchase， and to provide reference for drug selection in Hospital Pharmaceutical Administration and Drug Treatment Committee （Pharmaceutical Association）. METHODS： Clinical pharmacists set up drug quantitative scoring table according to the 10 attributes of drugs as effectiveness， safety， economy， etc. 15 temporary purchased drugs submitted by departments in Oct. 2018 were graded according to the rules of the scoring table， and the evaluation results were fed back to Pharmaceutical Association. A retrospective evaluation of 20 temporary purchased drugs which were discussed at the Pharmaceutical Association from Jul. to Sept. 2018 was made according to previous approval model without using drug quantitative scoring table. The effect of pre-intervention was evaluated after using drug quantitative scoring table. RESULTS： Among 15 temporary purchased drugs， 2 of them scored below 60， and the unqualified rate was 13.3％. It suggested that 2 drugs could not be discussed at the meeting. Among 20 temporary purchased drugs that have been discussed at the meeting， 9 of them scored below 60， with the unqualified rate of 45.0％， suggesting that 9 drugs may have wasted the workload of the Pharmaceutical Association. CONCLUSIONS： Drug quantitative scoring table can play a pre-intervention role in the scoring of temporary purchased drugs to a certain extent. At the same time， the table can also be used as a relevant reference for hospital drug evaluation. It is helpful to optimize hospital drug use list and improve the level of rational drug use in clinic.

Rabdosia (Bl.) Hassk is a medicinal plant rich in enantiomers such as 15α-acetoxyl-6, 11α-epoxy-6α-hydroxy-20-oxo-6, 7-seco-ent-kaur-16-en-1, 7-olide and 15α-dihydroxy-6β-methoxy-6, 7-seco-6, 20-epoxy-1, 7-olide-ent-kaur-16-ene. It has high medicinal value and huge market potential, but the yield from wild Rabdosia (Bl.) Hassk species cannot meet the needs of marketization. Carrying out pollution-free cultivation of Rabdosia rubescens (Hemsl.) Hara and Rabdosia serra (Maxim.) Hara has become the most direct and effective measure to solve this problem in order to ensure the sustainable use of the resources of Rabdosia. This paper summarized a set of non- pollution cultivation system of R. rubescens and R. serra to achieve the"safe, effective, stable and controllable"target.