Objective:To explore the curative effect of Penumbra retrograde semi-retrieval Solitaire stents technique in the treatment of acute basilar artery occlusion.Methods:The clinical data of 15 patients with acute basilar artery occlusion in Shengjing Hospital of China Medical University from January 2017 to December 2019 were analyzed retrospectively. All patients were treated with Penumbra retrograde semi-retrieval Solitaire stents technique. The modified thrombolysis in cerebral infarction (mTICI) was used to evaluate the therapeutic effect.Results:Fifteen patients achieved vascular recanalization of occluded basilar artery, and mTICI 2b grade was in 3 cases, 3 grade in 12 cases. One operation completed vascular recanalization in 11 cases, 2 times in 3 cases,3 times in 1 case. CT images 24 to 48 h after operative showed no intracranial hemorrhage. The National Institutes of Health stroke scale (NIHSS) score at discharge was significantly lower than that before surgery: (4.8 ± 2.1) scores vs. (16.1 ± 5.7) scores, and there was statistical difference ( P<0.01). Conclusions:Penumbra retrograde semi-retrieval Solitaire stents technique can improve the efficiency of thrombus grasping and significantly improve patient symptoms.

OBJECTIVE:To discuss the way to realizing clinical pharmacists’prescribing rights,and to provide reference for the revise of related policies and regulations. METHODS:The clinical pharmacists prescribing rights and its necessity were inter-preted. Referring to pharmacists’prescribing rights in Canadian limited prescription mode,British dispensatory mode,United States consultative prescription mode,clinical pharmacists’prescribing rights in China were expounded. RESULTS & CONCLU-SIONS:It is necessary and feasible to achieve clinical pharmacists’prescribing rights in China. Clinical pharmacists’prescribing rights can be realized and the pharmaceutical role of clinical pharmacists can be played through conducting clinical pharmacist pre-scription training,establishing chronic disease,common disease,mild disease and other disease dispensatory,gradually revising the concept of“prescription”and“prescribing rights”,promoting the legislation of pharmacists and clinical pharmacists’prescrib-ing rights,promoting the realization of the prescription right of clinical pharmacist,prompting clinical pharmacist to play the role of pharmacy.

Objective To evaluate biochemical characteristics and the trend of diabetic complications in patients with newly-diagnosed type 2 diabetes from 1994 to 2008. Methods We utilized the database of the diabetes complications assessment and analyzed the metabolic disorder and the diabetic complications in the patients with newly diagnosed diabetes. Results 2 085 cases were collected, including 1189 males and 896 females. The average age of onset of diabetes was 51.6±13.1 and 54.6±7.9 yrs respectively in 2008 and 1994. During 1994,no case was found in subjects aged 20-29 yrs and 5% of the patients were aged 30-39; but 2% of patients aged 20-29 and 16% aged 30-39 yrs were found in 2008. BMI was increased from 24.48±4.15 in 1994 to 26.03±3.63 in 2008. Percentage of patients with abnormal BMI ( ≥25 kg/m2 ), WHR [≥0.90 (male) or ≥0.85 (female)]increased significantly from 63.6%, 75.0%, and 71.4% in 1994 to 79.6%, 95.2%, and 93.8% in 2008,respectively. Both SBP and DBP were not significantly changed. The fasting blood and postprandial blood glucose,HbA1c decreased from 10.3 mmol/L, 15.2 mmol/L, 11.1% in 1994 to 9.0 mmol/L, 14.3 mmol/L, and 8.6% in 2008, respectively. The average TG level increased from 1.7 mmol/L in 1994 to 2. 1 mmol/L in 2008,however, TC and HDL level were not significantly changed. The prevalence of diabetic retinopathy decreased from 28.2% in 1994 to 3.9% in 2008. The prevalence of diabetic nephropathy increased from 17.7% in 1994 to 24.6% in 2008. The prevalence of diabetic cardiovascular disease increased from 14.3% in 1994 to 24. 1% in 2008. Compared with the patients without microvascular complications, the patients with microvascular complications had higher SBP, DBP, and HbA1c( 136/78 vs 130/77 mm Hg, 9.41% vs 9.11% ). The patients with macrovascular complications had older age, higher SBP, TC, and TG than those without macrovascular complications (53.4 vs 50.0 yrs; 132 vs 129 mm Hg ; 5.3 vs 5.1 mmol/L and 2.6 vs 2.1 mmol/L). Conclusions In the studied newly-diagnosed diabetic patients from 1994 to 2008, there were increasing incidences of obesity and hypertriglyceridemia. However, the prevalence of diabetic retinopathy decreased significantly, while that of nephropathy showed no significant change.Cardiovascular complications were markedly increased.

Objective To investigate the association between SLC10A1 gene mutations in c.800G>A mutation and c.356 +1098C >T mutation, and the susceptibility to HBV infection by mother-to-child transmission ( MTCT) .Methods Totally 306 individuals born to HBeAg-positive mothers with high load HBV and without receiving nucleotide analogues treatment, including 247 HBV-infected cases and 59 non-HBV-infected ones were enrolled from Southwest Hospital during May 2011 and July 2015.Blood samples were collected from all the subjects, then genomic DNA was extracted and c.800G>A mutation and c.356+1098C>T mutation of SLC10A1 were genotyped .Chi-square test (Pearsonχ2or continuity correctionχ2) was performed to identify the difference in genotypes between two groups.Results Among vaccinated individuals (55 HBV infected and 56 not infected), the frequency of genotype GA of c.800G>A mutation in non-infected ones was 14.3%(8/56), there was a tendency of increasing compared with HBV infected ones (5.5%, 3/55), but the difference was not statistically significant (χ2 =2.424, P =0.119). Similarly, the frequencies of genotypes CC, CT and TT of the c.356+1098C>T mutation in HBV infected ones were 20.0%(11/55), 47.3%(26/55) and 32.7%(18/55), while those in non-infected ones were 12.5% (7/56), 69.6% (39/56) and 17.9% (10/56), and the difference was not of statistical significance (χ2 =5.766, P=0.056).In all subjects (vaccinated and non-vaccinated), the frequency of genotype GA of c.800G>A mutation in non-HBV infected group had an increasing tendency compared with HBV-infected offspring (13.6% vs.6.9%), but the difference was not statistically significant (χ2 =2.010, P=0.156);the frequencies of genotype CC, CT and TT of c.356+1098C>T mutation in HBV infected patients were 20.2%(50/247), 49.8%(123/247) and 30.0%(74/247), while those in non-HBV-infected group were 11.9%(7/59), 69.5%(41/59) and 18.6%(11/59), and the difference was statistically significant (χ2 =7.436, P =0.024 ) .Within the HBV infected group, the frequencies of genotype GA of c.800G>A mutation were 5.5%(3/55) in vaccinated individuals and 7.3%(14/192) in non-vaccinated individuals, and the difference was not of statistical significance (χ2 =0.030, P=0.863);Similarly, the frequencies of genotype CC, CT and TT of c.356 +1098C >T mutation in vaccinated individuals were 20.0%(11/55), 47.3%(26/55) and 32.7%(18/55), while those in non-vaccinated individuals were 20.3%(39/192), 50.5%(97/192) and 29.2%(56/192), and the difference was not of statistical significance (χ2 =0.274, P=0.872).Conclusion c.356+1098C>T mutation in SLC10A1 may be associated with susceptibility to HBV infection of child born in HBeAg positive pregnant women infected with high load HBV.

Objective To improve the application management efficiency of NSFC and provide reference for the administration of peer hospitals.Methods Using the theory of PDCA cycle manages application work of NSFC and using fishbone diagram to analyses the affecting factors of NSFC management.Countermeasures were developed and implemented based on such analysis.Results The administration work of NSFC is continuingly improved under the guidance of PDCA cycle theory.Conclusions From the long term development of NSFC application management,the method of PDCA cycle theory is an ideal model

ObjectiveTo investigate the clinical characteristic and long-term prognosis risk factor of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF). MethodsThe clinical data of 1116 HBV-ACLF patients who were hospitalized in Southwest Hospital of Third Military Medical University from January 2010 to January 2015 were analyzed retrospectively. The risk factors for 1-year survival time and prognosis were observed, and the Cox regression model was used to determine the independent risk factors for the prognosis of these patients. The t-test or t′-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. ResultsA total of 562 patients died within the 1-year follow-up period, and the fatality rate was 50.4%. The comparison between the survival group and the death group showed that age, alanine aminotransferase, total bilirubin, urea nitrogen, serum creatinine, international normalized ratio, serum Na+, white blood cell (WBC), percentage of neutrophils, platelet (PLT), HBV DNA load, Model for End-Stage Liver Disease (MELD) score, ascites, spontaneous bacterial peritonitis, gastrointestinal bleeding, pulmonary infection, sepsis, electrolyte disturbance, hepatic encephalopathy, and acute kidney injury (AKI) were the risk factors for death within 1 year (all P＜0.05). The Cox regression analysis showed that age, WBC, MELD score, hepatic encephalopathy, electrolyte disturbance, AKI, and PLT were the independent risk factors for the 1-year fatality in HBV-ACLF patients (all P＜005). ConclusionOur findings show that HBV-ACLF has a high fatality rate and is often accompanied by serious complications. The major risk factors affecting the 1-year fatality in HBV-ACLF patients are age, WBC, MELD score, hepatic encephalopathy, electrolyte disturbance, AKI, and PLT.

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of gastrointestinal neurilemmoma.Methods:A descriptive study was conducted to retrospectively analyze the clinical manifestations, endoscopic findings, pathological features, treatment methods and prognosis of patients with gastrointestinal neurilemmima diagnosed from May 2017 to November 2020 in the Second Affiliated Hospital of Xi'an Jiaotong UniversityResults:A total of 19 patients were collected, ranging in age from 45.0 to 70.0 years old, of whom 68.4% (13/19) were female. The clinical symptoms are non-specific, and some patients are asymptomatic (15.8%(3/19)) and may present with abdominal pain (57.9%(11/19)), nausea (31.6%(6/19)), abdominal distension (21.1%(4/19)) and decreased appetite (21.1%(4/19)), and a few with gastrointestinal bleeding (5.3%(1/19)). Tumors were most frequently found in the gastric body (42.1%(8/19)), followed by the duodenum (15.8%(3/19)). Endoscopic submucosal mass is easy to be misdiagnosed as stromal tumor. The pathological type showed shuttle cell tumor, immunohistochemical staining showed positive S100 and Vim, most Ki-67 staining proliferation rate was <5% (57.9%(11/19)), and a small part was ≥10% (10.5%(2/19)). Treatment was either endoscopic or surgical. No tendency to recur and metastasize was found in any of the neurilemmimas.Conclusion:Gastrointestinal neurilemmoma is a very rare submucosal tumor of the digestive tract, most of which are benign and rare in malignancy, and postoperative pathology is the gold standard for its diagnosis. Gastrointestinal neurilemmoma is common in middle-aged female, with diverse and non-specific clinical symptoms, difficult to differentiate from submucosal tumors such as stromal tumors, and its tendency to malignant transformation increases with tumor enlargement. Endoscopic resection is recommended for tumors with tumor diameter <3 cm without serosal invasion, with little trauma and no recurrence.

OBJECTIVE To assess changes in the demographic characteristics of patients with otitis media with effusion during the COVID-19 epidemic.METHODS This retrospective study analyzed cases of otitis media with effusion in the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital.The cases were divided into two groups:a pre-Covid-19 group(from December 1,2018,to January 31,2019),and a Covid-19 group(from December 1,2022,to January 31,2023).Patient demographics including age,sex,ear side and audiology results were collected.Additionally,age composition ratio,sex composition ratio,disease-side ratio,and audiological results were analyzed.RESULTS A total of 1 872 patients were included in the pre-COVID group,with an average age of(30.45±23.17)years(949 males and 923 females).Among them,910 were children and 962 were adults.The Covid-19 group included 1 194 patients,with an average age of(48.31±18.92)years(623 males and 571 females).Among them,95 were children and 1 099 were adults.Statistical analysis of the data revealed that the overall age distribution of the disease was different between the two groups(Z=-20.820,P＜0.001).There was a significant difference in the composition ratio of children to adults(χ2=546.838,P＜0.001),with a significant decrease and increase in the prevalence rate of otitis media with effusion in children and adults,respectively,in the COVID-19 group.Compared to the pre-COVID-19 group,the proportion of cases in the age group of 7-18 years was significantly reduced in the children's group(Z=-5.641,P＜0.001),and the proportion of prevalence increased significantly in the adult group aged 46-75 years(Z=-3.134,P=0.002).Additionally,there was a significant increase in the number of male patients in the Covid-19 group(χ2=5.15,P=0.023)when compared to the pre-COVID-19 group.CONCLUSION Compared to the pre-Covid-19 period,a significant change in the age distribution of otitis media with effusion was observed during the COVID-19 epidemic,with a significant decrease in the proportion of children and a signification increase in the proportion of adults.