Objective To explore the drug selection, usage, dosage and effect of clinical pharmacists in the treatment of secondary Candida bloodstream infection in patients with digestive tract perforation, and provide reference for rational clinical use of such anti-infection therapy. Methods During the treatment of Candida infection, anti-infection specialist clinical pharmacists suggested replacing fluconazole for anti-infection treatment, and adjusted the usage and dosage of caspofungin to ensure the application of full treatment course. Results The patient’s Candida bloodstream infection was effectively controlled. Conclusion Echininocandins such as caspofungin are the first choice for Candida infection. The maintenance dose should be reduced to 35 mg qd in patient with moderate liver function injury, and the anti-infection treatment should be done at least 14 days after the blood culture being negative. Clinical pharmacists participate in clinical pharmaceutical care practices such as clinical ward rounds, and actively assist doctors to develop individualized anti-infection programs, which could improve the level of clinical drug use and the clinical outcome of diseases.

Objective To investigate the therapeutic effect of axillary single-site laparoscopic mastectomy in the treatment of gynecomastia.Methods From August to October of 2023,axillary single-site laparoscopic bilateral mastectomy was conducted in 31 patients with gynaecomastia.A 2-2.5 cm incision in the axilla was made,followed by lipolysis and liposuction in the anterior and posterior glandular spaces.After scalpel dissection of the subcutaneous Cooper's ligament,laparoscopic mastectomy was completed,with placement of a drainage tube in the area of the operation.Results The axillary single-site laparoscopic bilateral mastectomy was successfully completed in all the 31 cases.The median operating time was 70(60,90)min,the intraoperative hemorrhage was(12.6±2.3)ml,the time to remove bilateral drainages was(1.5±0.2)d,and the duration of hospitalization was(3.0±0.5)d.The weight of resected mammary gland was(66.1±25.9)g on the right side and 67.7(42.0,87.0)g on the left side.The differences in postoperative chest circumference,nipple to nipple distance,bilateral sternal notch to nipple distance,nipple to midline distance,and nipple height were statistically significant when compared with the preoperative period(P<0.05).Postoperative reduction in chest circumference was(6.52±3.12)cm,the distance between nipples reduced by(2.46±1.53)cm,the right nipple height shifted upwards by 0.82(0.17,1.47)cm,and the left nipple height shifted upwards by 0.87(0.00,1.40)cm.The bilateral nipple position was symmetry postoperatively.There was no statistically significant difference in the bilateral nipple to midline distance and height difference values(P>0.05).Numbness and discomfort in the area of the right nipple and areola occurred after surgery in 1 case,and the symptoms were largely resolved 2 months after surgery.Subcutaneous hemorrhage on the left chest wall occurred postoperatively in 1 case and was resolved by placing a tube through a small incision in the areola to irrigate and drain.No postoperative complications such as hemorrhages,effusions,infections,or nipple-areola necrosis occurred in the remaining 29 cases.Patients'subjective self-assessment of cosmetic results 2 months after surgery was very satisfactory(all were 15 points).Conclusion Axillary single-site laparoscopic mastectomy is a safe and effective treatment for gynecomastia,which is of high value for promotion.

Objective To observe the effects of methylenedioxygenase(TET2)expression on the proliferation ability,apoptosis rate,cell cycle,migration,and invasion of non-small cell lung cancer cells.Methods Detect the expression of TET2 gene and protein in different non-small cell lung cancer cells through RT-PCR and Western blot.Knock down the gene expression of the highest TET2 expressing cells(shRNA1)and overexpress the gene in the most low TET2 expressing cells(OE-TET2).Detect the effect of TET2 expression on cell proliferation through CCK-8,observe the effect of TET2 expression on cell apoptosis and cell cycle through flow cytometry,and observe the effect of TET2 expression on cell migration and invasion ability through migration and invasion experiments.Results The expression levels of TET2 gene and protein in H1299 cells were the highest,while A549 cells had the lowest expression levels(P＜0.05).The proliferation ability of OE-TET2 group cells was significantly lower than that of normal A549,while the proliferation ability of shRNA1 group cells was significantly higher than that of normal H1299 cells(P＜0.05).The apoptosis rate of OE-TET2 group was significantly higher than that of normal A549 cells,while the apoptosis rate of shRNA1 group was significantly lower than that of normal H1299 cells(P＜0.05).The number of migration and invasion cells in the OE-TET2 group was significantly lower than that of normal A549 cells,while the migration and invasion cells in the shRNA1 group were significantly higher than those in normal H1299 cells(P＜0.05).Conclusion TET2 can reduce the proliferation ability,increase its apoptosis rate,and slow down its migration and invasion ability of non-small cell lung cancer cells.

Objective To observe the therapeutic effect of laparoscopic sleeve gastrectomy (LSG) in treating patients with obesity and polycystic ovary syndrome (PCOS). Methods In this retrospective analysis, clinical materials of 60 patients with obesity and PCOS by LSG were analyzed, and postoperative improvements of PCOS symptoms were observed. Results A total of 60 patients had a preoperative mean body mass index (BMI) of (39.4±5.4) kg/m² and an average age of (26.3±6.1) years old, and all of them successfully completed LSG. After follow-up of 12 to 18 months, 50 cases (83.3%) had normalized menstrual cycles, with an average recovery time of (4.5 ±2.2) months after surgery, and 7 cases had natural pregnancy after surgery. Before surgery, ultrasound results in 35 patients indicated polycystic ovarian morphology (PCOM), and 29 cases (82.9%) regained normal ovarian status with an average recovery duration of (6.3±2.8) months. Complicated hyperandrogenemia was observed in 31 patients, and 29 cases (93.5%) exhibited normalization of testosterone levels within 18 months after surgery. At 18 months after surgery, the BMI was (26.47±4.70) kg/m², the average weight loss was (32.4±7.4) %. Conclusion LSG is a safe and effective treatment for obese PCOS.

Objective:To implement scoping review of the quality evaluation tool for mobile medical applications (mHealth APP) based on the perspective of health promotion, so as to provide reference for the development or introduction of tools suitable for China and provide inspiration for conducting high quality mHealth APP electronic health intervention research.Methods:Following the method of scoping review, mHealth APP quality evaluation tool development and validation articles published from January 2008 to February 2022 were systematically searched in Cochrane Library, PubMed, EMbase, Institute for Scientific Information (ISI) Web of Science, SCOPUS, CINAHL, PsyINFO, China National Knowledge Infrastructure, VIP, WanFang Data and China Biomedical Literature Database. This study extracted the basic information of the tool and used topic analysis to summarize and integrate the content of the tool items.Results:A total of 27 studies were included, involving 14 mHealth APP quality evaluation tools. The theme analysis process of evaluating the content of items generated a total of 300 primary codes, which were classified into four themes, including software attributes, medical science, behavioral science, and user experience.Conclusions:As a cross disciplinary product, the mHealth app faces multiple challenges in terms of quality. At present, the focus of existing quality evaluation tools varies, among which scientific evaluation originates from the special positioning of mHealth APP and needs to be taken seriously. Different evaluation perspectives may be potential factors that affect the quality evaluation results, and as a key link, users' needs need to be further focused and explored.

Objective : To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and the clinical prognosis of acute pancreatitis (AP) , and to provide a genetic basis for early identification of critically ill patients. Methods : A total of fourteen single nucleotide polymorphisms (SNPs) on the VDR gene were detected in 508 AP patients by using improved ligase detection reaction (imLDR) technology. Unconditional Logistic regression analysis was used to explore the association of VDR gene polymorphisms with outcome ( sepsis/severe AP/death) of AP patients after adjusting for age , sex , body mass index(BMI) , smoking and drinking status and APACHE II score under different genetic models. Results : Rs12721375 GA/AA genotype had a lower risk of sepsis than GG (P = 0. 02) and the A allele had a lower risk of sepsis than G (P = 0. 009) . Rs2853559 GA and GA/AA had higher risks of sepsis than GG (P = 0. 022 and 0. 026 respectively) . Rs11168287 AA had a higher risk of severe AP than GG and GG/GA (P = 0. 030 and 0. 022 respectively) . Rs2853559 AA genotype had a higher risk of severe AP than GG and GG/GA ( P = 0. 022 and 0. 021 respectively) . The risk of death of rs11168283 CT/TT genotype was lower than that of CC (P = 0. 046) . Conclusion VDR gene polymorphisms are related to the clinical outcome of AP patients in Chinese Han population. VDR gene is involved in the progression of AP.

Objective:To investigate the effect of pulsed electric field (PEF) combined with low temperature plasma (LTP) on mouse liver cancer cell.Methods:H22 mouse liver cancer cells were divided into liver cancer group, PEF treatment group, LTP treatment group, combined group A (first PEF treatment immediately after LTP treatment), combined group B (first LTP treatment immediately after PEF treatment), combined group C (same as combined group A, but 20 minutes interval) and combined group D (same as combined group B, but 20 minutes interval). Cell viability was detected by cell counting, apoptosis was detected by flow cytometry, intracellular reative oxygen species (ROS) was marked by fluorescence and counted. Twenty healthy female Kunming mouse aged 4-6 weeks without specific pathogens were subcutaneous injected with liver cancer cells, and then were randomly divided into model group, PBS control group, PEF experimental group, LTP experimental group and combined group (LTP+ PEF, no interval) ( n=4). Tumor relative volume and tumor inhibition rate were measured. Results:The survival rates were liver cancer cell group (98.3±0.9)%, PEF treatment group (66.8±4.4)%, LTP treatment group (62.1±3.9)%, combined group A (43.7±3.7)%, combined group B (31.0±1.4)%, combined group C (46.8±2.9)%, combined group D (39.0±2.3)%. Compared with liver cancer cell group, the cell survival rate of all treatment groups was decreased, and the cell survival rate of the four combined treatment group was lower than that of PEF treatment group and LTP treatment group, the differences were statistically significant (all P<0.05). The survival rate of combined B group was the lowest. The results of apoptosis detection were consistent with those of cell survival rate. Under fluorescence microscope, the ROS fluorescence of cells in the combined group B was significantly increased, and the ROS fluorescence of cells in the LTP treatment group was more than that in the PEF treatment group, and the percentage of ROS positive cells in the combined group B was higher than that in the LTP treatment group and the PEF treatment group, with statistical significance (all P<0.05). Tumor relative volume and tumor inhibition rate in the combined group were better than those in the PEF and LTP groups, and the differences were statistically significant (all P<0.05). Conclusion:LTP combined with PEF has a better killing effect on H22 cells than PEF or LTP treatment, which is expected to be a new tumor therapy.

Objective:To establish the normal reference range of neurotransmitters in Han-nationality children aged 3-12 in Hubei province.Methods:A prospective study was conducted on healthy Han-nationality children aged 3-12 who took physical examination in Wuhan Children′s Hospital, Hubei province from January to August 2021.The children were asked for their medical histories, and those with neurological diseases, psychiatric diseases, infection, trauma, and a drug history in the past 2 weeks were excluded.The plasma of 324 children (262 males, 62 females; 217 cases in the 3-7 years old, 107 cases in the 8-12 years old) and urine of 391 children (302 males, 89 females; 266 cases in the 3-7 years old, 125 cases in the 8-12 years old) were collected.They ultra performance liquid chromatography-mass spectrometry multiple techniques (UPLC-MS/MS) were used to detect 10 kinds of neurotransmitters (e.g., dopamine, epinephrine, glutamic acid, etc.) in plasma and 8 kinds of neurotransmitters (e.g., dopamine, epinephrine, 5-hydroxyindoleacetic acid, etc.) in random urine.The normal reference range of neurotransmitters in Han-nationality children aged 3-12 in Hubei province was established.The Kruskal- Wallis H test was made for statistical analysis of the differences in neurotransmitter levels among different age groups and gender groups.The neurotransmitter levels between different groups were compared by the Nemenyi test. Results:There were no significant differences in the levels of various neurotransmitters in children of different genders(all P>0.05). There were significant differences in the levels of dopamine, methoxy-norepinephrine, tryptophan and γ-aminobutyric acid in the plasma of children aged 3-7 years and 8-12 years.There were significant differences in the levels of dopamine, epinephrine, norepinephrine, methoxy-norepinephrine, high vanillic acid and 5-hydroxyindoleacetic acid in the random urine between the 3-7 years old group and the 8-12 years old group. Conclusions:The normal reference range of neurotransmitters in Han-nationality children aged 3-12 in Hubei province is established.This study provides reference for clinical practice and lays a foundation for the study of neurotransmitter-related diseases in children.

Objective:To translate Career Success in Nursing Scale (CSNS) into Chinese and evaluate the reliability and validity of it.Methods:According to the translation principle of Brislin questionnaire, the English version of CSNS was translated, back-translated and culturally adjusted to determine the simplified Chinese version of CSNS items and form the Chinese version of CSNS. A total of 1 489 nurses from China-Japan Friendship Hospital were selected as the research objects from May to June 2021. The general information questionnaire and simplified Chinese version of CSNS were used to investigate them. Internal consistency and split-half reliability coefficient were used to evaluate the reliability of the scale. Pearson correlation analysis was used to analyze the correlation between each dimension and the relationship between each dimension and the total scale. A total of 1 489 questionnaires were collected and 1 434 valid questionnaires were collected, with an effective recovery rate of 96.3%.Results:The Chinese version of CSNS included 4 dimensions, such as "desired career development" "providing quality care" "effective self-regulation" and "fit between human and organization" , with a total of 39 items. The expert content validity was 0.984. The results of exploratory factor analysis showed that the cumulative variance contribution rate of the four common factors was 74.71%. The Cronbach's α coefficient of the total scale was 0.985 and the Cronbach's α coefficient of each dimension was 0.955-0.979. The split-half reliability of the total scale was 0.986 and the split-half reliability of each dimension was 0.957-0.979. The test-retest reliability of the scale was 0.966.Conclusions:The Chinese version of CSNS scale has good reliability and validity, which can be used to evaluate the psychological characteristics of nurses' career success.

Objective To study the coagulation function of premature infants at birth and the associated risk factors.Method From January 2014 to January 2018,a prospective study was conducted on preterm infants born in obstetrics department of our hospital.According to the gestational age,these infants are assigned into early preterm group,moderate preterm group and late preterm group.The prothrombin time (PT),activated partial thromboplastin time (APTF),fibrinogen (FIB) and thrombin time (TT) were measured using automatic coagulation analyzer.The possible risk factors affecting the coagulation function in each group were analyzed.Result A total of 795 preterm infants were studied including 93 in the early preterm group,151 in the moderate preterm group and 551 in the late preterm group.In the early preterm group,infants with premature rupture of membranes (PROM) had increased FIB,shortened TT,and infants with severe asphyxia had prolonged PT,and the differences were statistically significant (P ＜ 0.05).In the moderate preterm group,infants with PROM had significantly prolonged APTT (P ＜ 0.05).In the late preterm group,PT and TT were prolonged and FIB was decreased in male infants.Infants with PROM have increased FIB;PT was prolonged among infants with severe asphyxia (P ＜ 0.05).Multivariate linear regression analysis showed that neonatal asphyxia,weight and gender were the main factors affecting PT (P ＜ 0.05),gestational age was the main risk factor affecting APTT (P ＜ 0.05),PROM,gestational age,weight and gender were the main factors affecting FIB (P ＜ 0.05),and neonatal asphyxia was the main factor affecting TT (P ＜ 0.05).Conclusion The coagulation function of premature infants is affected by many factors including gender,gestational age,weight,asphyxia,PROM,and maternal complications.Coagulation function should be monitored in preterm infants with severe asphyxia.