The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

Objective To explore the effect of high-intensity ultrasound focused ablation in the treatment of ⅡB cesarean scar Pregnancy.Methods A total of 365 patients in our hospital from January 2019 to December 2021 which were ⅡB Cesarean Scar Pregnancy were selected as the research objects.The research objects were divided into the experimental group pretreated by high-intensity ultrasound ablation(186 cases)and the control group without treatment(179 cases)to compare the levels of intraoperative blood loss,postoperative vaginal bleeding time,human chorionic gonadotropin(HCG)decline rate after the operation,success rate of operation and other indicators.Results The amount of intraoperative blood loss and postoperative vaginal bleeding time in the experimental group were less than those in the control group(P<0.05),and the decrease rate of blood HCG in the experimental group was higher than that in the control group(P<0.05).There was significant difference in the success rate of operation between the experimental group and the control group(P<0.05).There was no significant difference in menstrual volume between the experimental group and the control group(P>0.05),but the control group had prolonged menstruation,and the incidence of postoperative complications between the experimental group and the control group have no statistical significance.Conclusion High-intensity focused ultrasound ablation can effectively reduce intraoperative blood loss in patients of type ⅡB cesarean scar pregnancy,reduce the application of invasive methods such as laparoscopy,can be promoted as a pretreatment method for type ⅡB cesarean scar pregnancy.

Objective: To explore the effects of protein powder on the bioavailability of perfluoroalkyl substances (PFASs) in blood and kidneys of rats and renal function change. Methods: Twenty-four rats of the SD strain were randomly divided into the negative control group, PFASs group and protein powder group, with 8 rats (half males and half females) in each group. PFASs included 13 perfluorocarboxylic acids (PFCAs) and 8 perfluorosulfonic acids (PFSAs), and the mixture was used as a test subject for intervention. The rats in the negative control group were given deionized water at doses of 20 mL/kg·bw, in the PFASs group were given 5 mL/kg·bw of PFASs mixtures and 15 mL/kg·bw of deionized water, and in the protein powder group were given 5 mL/kg·bw of PFASs mixtures and 15 mL/kg·bw of protein powder (0.258 g/mL). After intervention for 28 successive days, body weight and kidney mass were weighed, and the kidney volume index was calculated. Serum creatinine and blood urea nitrogen were detected by an automatic biochemical analyzer. The PFCAs, PFSAs and PFASs contents were quantified in blood and kidney using ultra-high performance liquid chromatography-electrospray tandem mass spectrometry, and the bioavailability was estimated. Results: There was no significant differences in kidney mass, kidney volume index, serum creatinine and blood urea nitrogen among the negative control group, PFASs group and protein powder group (all P>0.05). The bioavailability of blood PFCAs, PFSAs and PFASs in the protein powder group was not significantly different from the PFASs group (all P>0.05). Compared with the PFASs group, the bioavailability of PFCAs, PFSAs and PFASs were significantly increased in kidneys of male rats in the protein powder group (all P<0.05), while were not significant different in those of female rats (all P>0.05). Conclusion Protein powder at the dose of this study can significantly improve the bioavailability of PFASs in kidneys of male rats, while there no obvious effects on the bioavailability of blood PFASs and renal function.

ObjectiveTo explore the possible mechanism of the Yiqi Jiedu formula （YQ） in treating ischemic stroke （IS） from the perspective of the microbial-gut-brain axis （MGBA）. MethodRats were randomly divided into five groups， with six in each group， including sham surgery group， model group， and low， medium， and high dose YQ groups （1， 5， and 25 mg·kg^-1）. Except for the sham surgery group， all other groups were established with a middle cerebral artery occlusion （MCAO） model using the thread occlusion method. The success of modeling was determined through neurobehavioral scoring， and the protective effect of YQ on IS was evaluated. Then， the changes in gut microbiota before and after MCAO modeling and YQ administration were compared using 16S rDNA sequencing technology， and the possible biological pathways related to the effect of this formula were analyzed. The expression of inflammatory factors such as interleukin-6 （IL-6）， interleukin-17A （IL-17A）， and interleukin-10 （IL-10） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the expression of tight junction proteins ZO-1 and Occludin in brain and intestinal tissue， and hematoxylin-eosin staining （HE） was used to observe pathological changes in the cerebral cortex and colon， so as to validate the possible mechanism of action. ResultYQ significantly improved the neurobehavioral score of MCAO rats （P<0.01） and played a good regulatory role in intestinal microbial disorders caused by enriched pathogens and opportunistic pathogens during the acute phase. Among them， significantly changed microorganisms include Morgentia， Escherichia Shigella， Adlercreutzia， and Androbacter. Bioinformatics analysis found that these bacteria may be related to the regulation of inflammation in the brain. Compared with the blank group， the detection of inflammatory factors in the serum of IS model rats showed an increase in inflammatory factors IL-6 and IL-17A （P<0.01） and a decrease in the content of anti-inflammatory factor IL-10 （P<0.01）. Compared with the model group， the content of inflammatory factors IL-6 and IL-17A in the serum of the treatment group decreased （P<0.05）， and that of anti-inflammatory factor IL-10 increased （P<0.01）. The expression results of barrier proteins ZO-1 and Occludin in brain and intestinal tissue showed that the expression levels of both decreased in IS model rats （P<0.05）， while the expression levels of both increased in the treatment group （P<0.05）. ConclusionAcute cerebral ischemia can lead to an imbalance of intestinal microbiota and damage to the intestinal barrier， and it can increase intestinal permeability. YQ can regulate intestinal microbiota imbalance caused by ischemia， inhibit systemic inflammatory response， and improve the disruption of the gut-blood brain barrier， preventing secondary cascade damage to brain tissue caused by inflammation. The MGBA may be an important mechanism against the IS.

Objective:To evaluate the effect of patent foramen ovale on the development of post-operative stroke in the patients undergoing non-cardiac surgery using a meta-analysis approach.Methods:A comprehensive search was conducted across multiple databases including PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China Biomedical Literature Database, Wanfang Data Knowledge Service Platform, and China Journal Full Text Database.The inclusion criteria encompassed studies assessing the correlation between patent foramen ovale and post-operative stroke.The primary outcome measure focused on the incidence of post-operative stroke, and secondary outcome measures comprised mortality, myocardial infarction rate, and readmission rate within 30 days after surgery. The quality of literature meeting the inclusion criteria was evaluated and data were extracted, and then meta-analysis was conducted using RevMan 5.4 software.Results:Eight retrospective cohort studies involving 21 142 237 patients were included.The results of meta-analysis showed that patent foramen ovale was associated with post-operative stroke and readmission within 30 days after surgery.There were no significant differences in all-cause mortality and myocardial infarction rates between patent foramen ovale group and mon-patent foramen ovale group ( P>0.05). Conclusions:Patent foramen ovale can increase the risk of post-operative stroke in the patients undergoing non-cardiac surgery.

Adipose progenitor cells(APCs) represent a prominent stromal cellular component of adipose tissue and are now identified as highly heterogenous populations. However, the role of APCs in regulating systemic metabolism remains unknown. Using single cell RNA-sequencing, we investigated the role of the APC subpopulations in regulating development of type 2 diabetes. CD9 + CD55 low APCs are the novel subset identified in this study, which is significantly increased in type 2 diabetic patients. Transplantation of these cells from type 2 diabetic patients into adipose tissue caused glycemic disturbance in mice. Depletion of pathogenic APCs improved obesity-related glycemic disturbance. Collectively, our data provide deeper insights into human APC functionality and highlights APCs as a potential therapeutic target to combat type 2 diabetes. This study has been published in Nature Communications, 2024, 15(1): 4827.

Objective: To describe the clinical features, causal agent and transmission mode of a fever outbreak in a school in Shanghai. Methods: Field epidemiological approaches including case definition development, searching for contacts, distribution of diseases description, environmental sampling and laboratory testing. Results: A total of 16 influenza like cases were included, all concentrated in the one class of grade two, including 15 students and 1 teacher. Among student cases, the incidence rate was 36.59% (15/41), the average age was 7.4 years, the incidence rate was 36.84%(7/19) for boys, 36.36%(8/22) for girls. The clinical course was 5-15 days, with the median of 9 days, and 18.75%(3/16) of the cases stayed studying while sick. The nasopharyngeal swab specimens in 16 cases all tested positive for influenza B, of which 11 tested positive for mycoplasma pneumoniae and 1 case also tested positive for coronavirus OC43. Body temperature, number of mononuclear cells, and treatment time of patients infected with Influenza B and mycoplasma pneumoniae were higher than those of patients infected with influenza B alone( P <0.05). The outbreak lasted for 12 days, all sick students were treated and discharged from hospital, with no severe cases or death, and the outbreak was effectively controlled. Conclusion This campus cluster outbreak caused by influenza B and mycoplasma pneumoniae. Patients with influenza B with mycoplasma pneumoniae have severe symptoms and a long course of illness, suggesting the importance of early management of the epidemic.

Pelvic inflammatory disease （PID） is an infection of women's reproductive organs， which lasts a long time and features frequent recurrence. It is mainly caused by apoptosis， low immunity， abnormal metabolism and blood rheology indexes， and bacterial imbalance. The pathological manifestations are tissue adhesion， fibrosis， and chronic inflammation， and inflammatory response occurs in the whole process of this disease. Therefore， interfering with the inflammatory response tends to be a solution. A few therapies are available in western medicine and antibiotics are commonly used. However， antibiotic resistance is still a bottleneck in the treatment and thus the symptoms of patients fail to be obviously relieved， with pelvic tissue adhesions remained. In the treatment of inflammation， traditional Chinese medicine has remarkable effect and internal-use and external-use medicines are both used， such as oral Chinese medicinal decoction， Chinese medicine enema， Chinese medicine iontophoresis， and acupuncture. They exert therapeutic effect by regulating the conduction of related signaling pathways and influencing the expression of inflammatory cytokines. At the moment， most articles focus on the efficacy of traditional Chinese medicine in the treatment of PID， and there is a lack of summary on traditional Chinese medicine regulation of relevant signaling pathways and the pathogenesis of PID. Therefore， by summarizing relevant research， this review proposed five signaling pathways related to the occurrence of this disease， namely， transforming growth factor-β/Smads protein （TGF-β/Smads） signaling pathway， Janus kinase/signal transducer and transcription activator （JAK/STAT） signaling pathway， nuclear factor-κB （NF-κB） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， and Hippo signaling pathway， and described the pathogenesis of this disease. Thereby， this study is expected to provide effective targets and ideas for the treatment of this disease.

Objective:To investigate the allocation of nursing human resources in burn centers in China.Methods:A cross-sectional survey was conducted. Using a self-designed questionnaire, a survey was carried out from January to March 2022 to investigate the January to December 2021 status of 39 burn centers in China that met the inclusion criteria based on six strategic regions and other regions, including the hospital grade and the region, the number of nurses and opening beds in the burn centers and burn intensive care units (BICUs), the age, working seniority in burn specialty, educational background, professional title, personnel employment, and turnover of nurses and training of newly recruited nurses in the burn centers.Results:This survey covered 30 provinces, municipalities, and autonomous regions in China (excluding Hong Kong Special Administrative Region, Macao Special Administrative Region, and Taiwan region of China). A total of 39 questionnaires were collected, all of which were valid. The 39 burn centers were located in 38 tertiary A hospitals and 1 tertiary B hospital, with 26 burn centers in strategic areas. The nurse/bed ratio of burn centers in the Greater Bay Area of Guangdong, Hong Kong, and Macao was the highest, while the nurse/bed ratio of burn centers in border ethnic minority area was the lowest. Except for the Chengdu-Chongqing Economic Circle, BICUs had been set up in burn centers in other regions. Among the 39 burn centers, the percentage of nurses aged 25 to 34 years was 51.21% (738/1 441), the percentage of nurses worked in burn specialty for less than 5 years was 31.16% (449/1 441), the percentage of nurses with bachelor's degree was 69.74% (1 005/1 441), and the percentage of nurses with nursing professional title was 44.14% (636/1 441), which were the highest. There were significant differences in the employment of nurses, the percentage of permanent nurses in burn centers in the collaborative development zone of Beijing-Tianjin-Hebei was 82.48% (113/137), while the percentage of permanent nurses in burn centers in important military strategic area was only 9.42% (34/361); the turnover rate of nurses was 9.03% (143/1 584), among which the turnover rate of nurses was 18.14% (80/441) in burn centers in important military strategic area. The training for newly recruited nurses in 39 burn centers was mainly based on the guidance of senior nurses and the pre-job education+specialist training.Conclusions:The burn nursing human resources in strategic areas in China are seriously insufficient and unevenly distributed, with unstable nurse team and lack of standardized specialist training. In particular, the nursing human resources in BICUs need to be equipped and supplemented urgently.

Objective To explore the potential transformation patterns and influencing factors of symp-toms and physical function in children with acute leukemia during chemotherapy.Methods A total of 109 children with acute leukemia who were treated in a children's hospital in Shanghai from March 2021 to Sep-tember 2022 were selected as the study subjects.The general information questionnaire and the Chinese ver-sion of the Patient-Reported Outcome Measurement Information System(C-C-Ped-PROMIS)were used to e-valuate the symptoms and physical function at 1-3 days before chemotherapy(T1)and 7-17 days after chemotherapy(T2).Potential transition analysis was used for data processing.Results Three similar latent class features were identified at T1 and T2:the low distress group(T1:25.7％;T2:23.8％),the moderate dis-tress group(T1:42.2％;T2:43.6％)and the high distress group(T1:32.1％;T2:32.7％).The probability of maintaining the original group in the middle distress group and the high distress group was 60.3％and 72.3％,respectively.The probability of transition from the low distress group to the medium distress group and the high distress group was 40.2％and 22.3％,respectively.The probability of transition from the middle dis-tress group to the high distress group was 37.0％.In this study,16 cases(14.7％)were transitioned from the low distress group or the middle distress group to the high distress group,and there was a statistically signifi-cant difference in the distribution of daily fatigue within seven days at T1(P＜0.05).Conclusion The symp-toms and physical function of children with acute leukemia during chemotherapy are heterogeneous.The fa-tigue assessment at baseline can provide reference information for potential state transfer.Medical staff should give accurate supportive intervention for different stages of chemotherapy.