1.Analysis of prescription errors made by outpatient electronic prescription system
Zhibo CAI ; Yan LIN ; Miaolian WU
Chinese Journal of Hospital Administration 2008;24(12):852-855
Errors in prescriptions are common phenomena in prescriptions produced by clinicians. With development and application of information technology in medical fields, electronic prescription system has been regarded as the best resolution for effective prevention of errors in prescriptions. A retrospective study of the prescriptions made by the electronic prescription system of the hospital studied over one year showed that this system could reduce errors easily made in manual prescriptions significantly, but it failed to reduce the errors related to dosages. Those dosage-related errors were mainly caused by change of physician prescribing behavior and defective man-machine interaction. Electronic prescription system, though functions basically, can not avoid prescription errors effectively, which poses a potential threat to safe use of medicines in patients. It is urgent at the moment to perfect the functions of electronic prescription system, promote a friendly man-machine interaction and reduce errors made by system errors.
2.Status quo and legitimacy analysis for temporarily dispensed drugs used in hospitals
Zhibo CAI ; Yan LIN ; Yu WANG ; Bingyi SHENG
Chinese Journal of Hospital Administration 2009;25(4):266-269
Availability of appropriate drugs for children has been a bottleneck both at home and abroad for years.As a result, drugs for adults that are market available emerge a choice of convenience for children's treatment instead.For unique physiological and psychological characteristics of children, these drugs must be dispensed on individual basis before usage to children in question.Such drugs play a key role in children's treatment, and incur many problems on the other hand in their use and practice, such as drug stability, dosage accuracy, potential risks, as well as legitimacy in drug dispensing and use.A safe, reasonable and normalized use of such drugs calls for an orchestrated effort among pharmacists, trade associations and drug regulators as well.
3.Long-term effects of meniscal allograft transplantation to repair rabbit knee cartilage by different methods
Xuejin LI ; Qun LI ; Zhibo ZHANG ; Hongjian YAN
Chinese Journal of Tissue Engineering Research 2010;14(7):1170-1173
BACKGROUND: There are no ideal substitutes for meniscus. Meniscel allograft transplantation has become a feasible method to retain maniscal function following injury. Currently, the meniscus conservancy methods include fresh meniscus, low temperature preserved meniscus; freeze-dried meniscus.OBJECTIVE: To observe the long-term effects of meniscus allograft transplantation by different methods.METHODS: A total of 70 adult New Zealand rabbits were used, and 30 were selected as meniscus donors. The remaining 40 rabbits were divided into 4 groups (n=10): after meniscectomy, control group was not treated; fresh group underwent fresh meniscus allograft transplantation; low temperature group underwent low temperature preserved meniscus allograft transplantation; freeze-dried group underwent freeze-dried meniscus allograft transplantation. Of 30 donors, 10 received fresh meniscus transplantation, and the other received temperature preserved meniscus and freeze-dried meniscus transplantation 1 week after low temperature and freeze dried preservation. The rabbits were sacrificed 12 months after surgery for gross and histological observation.RESULTS AND CONCLUSION: The meniscus allografts of rabbits healed well, and no rabbits died. Gross observation showed that the appearance and elasticity of fresh meniscus group was similar to normal meniscus; tibial plateau was covered well, with no additional wearing in the cartilage of tibial plateau or condyles of femur. In low temperature and freeze-dried preservation groups,the meniscus grafts healed well, but their volume was small and the elasticity was poor; tibial plateau was only partially covered.Pathological observation suggested that fresh meniscus group had orderly arranged collage fiber and similar chondrocyte appearance, number and distribution to normal meniscus, while sparse collagen fiber end small number of meniscus grafts were observed in the other groups. Results show that meniscal allogrefting can survive, retain certain function and structure and prevent the degenerative changes of the knee joint. Moreover, fresh meniscal grafts exhibit best effects, as the grafts following low temperature or freeze-dried preservation degenerate and their volume diminish 1 year following meniscectomy.
4.Relationship of Claudin-1 and VEGF-C protein with colorectal cancer
Yan LI ; Milu WU ; Yushuang LUO ; Zhibo LIU ; Rong CHEN
Chongqing Medicine 2016;45(7):909-911
Objective To investigate the expression of tight junction protein 1(Claudin‐1) and vascular endothelial growth factor C(VEGF‐C) in colorectal carcinoma tissues and the relationship between them .Methods Totally 50 cases of colorectal carci‐noma ,paracancerous tissues and 50 cases of normal colorectal tissues from Department of Pathology were detected by immunohisto‐chemistry SP method ,according to the patient′s age ,gender ,lymph node metastasis ,depth of invasion ,clinical stage for comprehen‐sive comparison ,and analyze the Claudin 1 and VEGF‐C protein expression in colorectal cancer tissues .Results The positive rates of Claudin‐1 ,VEGF‐C in colorectal cancer tissues was significantly higher than that in paracancerous tissue and normal colorectal tissues (χ2 =32 .270 ,P=0 .000;χ2 =41 .209 ,P=0 .000) ,the positive rate of Claudin‐1 ,VEGF‐C in paracancerous cancer tissues was significantly higher than that in normal colorectal tissues (χ2 =7 .294 ,P=0 .007 ;χ2 = 5 .741 ,P=0 .017) .The expression of colorectal carcinoma Claudin‐1 had close relationship with differentiation ,invasion degree ,TNM stage ,lymph node metastasis(P<0 .05) ,the expression of VEGF‐C had colse relatons with infiltration degress ,TNM stage ,lymph node metastasis ,tumor size(P<0 .05) .The expression of colorectal cancer Claudin‐1 ,VEGF‐C had significantly positive correlation (χ2 =10 .953 ,P= 0 .001 ,r=0 .468) .Conclusion The expression of colorectal cancer Claudin‐1 ,VEGF‐C was significantly higher than that in paracancerous tis‐sue and normal colorectal tissue ,the expression of Claudin‐1 ,VEGF‐C had a certain relationship with clinical staging .
5.Competency-oriented management:construction of multi-dimensional curriculum system for graduate students of clinical medicine
Jingzhu DONG ; Donghua ZHANG ; Ming FANG ; Yan XU ; Zhibo WANG ; Jiao XU ; Hong BO
Chinese Journal of Medical Education Research 2015;(2):127-130
Identifying the goals of outstanding doctor tralning and orienting medical students' competency, we conducted rational integration and construction of curriculum system for graduate students of clinical medicine and implemented 5 modes of module teaching including professional course, foreign language course, practical skill course, scientific research course and comprehensive ability course . According to the different characters of courses and professional development , we adopted multi-dimensional teaching methods and input the quality education throughout the whole teaching process. These efforts promoted the reform of graduate course evaluation system and provided effective security for improving teaching contents, teaching methods, teaching means and evaluating methods.
6.Characteristics and clinical value of MRI/1H-magnetic resonance spectroscopy in tumor-like inflammatory demyelinating diseases
Yan HUANG ; Xiuhua MA ; Zhibo XIAO ; Peng XUE ; Sijia ZHANG ; Yong CHEN ; Qiong ZHANG
Chinese Journal of Neurology 2014;47(10):687-690
Objective To summarize the magnetic resonance imaging/ 1 H-magnetic resonance spectroscopy (MRI/1 H-MRS) features of tumor-like inflammatory demyelinating diseases (TIDD),and investigate the clinical value of MRI/1 H-MRS.Methods MRI features of 10 cases of TIDD in brain confirmed by pathology were retrospectively analyzed and compared with pathology.Results The lesions mainly located in the white matter with mild mass effect.MRI scan all showed low T1 high T2 signal,and 7 cases showed high signal,3 cases showed slightly high or mixed signals on DWI.Enhanced MRI showed 5 cases with significant enhancement withopen loop sign,4 cases with significant patchy or nodular enhancement,1 case with mild flakes or linear enhancement.Three cases showed expanded blood vessels and plumbed to the lateral wall inside the edge of the lesions.1H-MRS performance showed 4 cases all with significantly increased Lac and Lip; 3 cases with rised glutamate and glutamine complex β,γ-Glx peaks,reduced N-acetylaspartate acid (NAA),increased Cho to varying degrees.All pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis,hypertrophy and abnormal mitotic figure.Seven cases could be seen obesity glial cells.Conclusions TIDD had its salient MRI features:lesion had obvious edema and mild mass effect,MRI enhancement showed open loop sign and small veins expansed,on perfusion-weighted imaging it showed low perfusion.1H-MRS showed β,γ-Glx peaks,Lac and Lip peaks significantly increased,NAA slightly reduced,Cho mildly elevated.Comprehensively analyzing the MRI and 1H-MRS features,combined with clinical manifestations,contribute to the diagnosis of the disease.
7.Biological characteristics of human umbilical cord mesenchymal stem cells following cryopreservation
Youwei WANG ; Zhibo HAN ; Shulin YAN ; Aibin MAO ; Bin WANG ; Ding WANG ; Ke CHEN ; Zhongchao HAN
Chinese Journal of Tissue Engineering Research 2010;14(10):1729-1733
BACKGROUND:An effective freezing-thawing technique is crucial for the clinical application of human umbilical cord mesenchymal stem cells(UC-MSCs).OBJECTIVE:To investigate biological characteristics of UC-MSCs after cryopreservation.METHODS:UC-MSCs were isolated from human umbilical cord and frozen in liquid nitrogen.The survival rate and the suppressive effect of γ-interferon(IFN-γ)of cryopreserved-thawed and fresh human UC-MSCs were compared.Furthermore,the multiple potentials and phenotype of UC-MSCs were estimated after cryopreservation.RESULTS AND CONCLUSION:There was no significant difference between cryopreserved-thawed and fresh human UC-MSCs on the survival rate and the suppressive effect of IFN-γ of peripheral blood mononuclear cells(PBMCs).After cryopreservation,human UC-MSCs had the potential differentiation and the phenotype of mesenchymal stem cells.
8.The Expression of Speckle-type POZ protein-like(SPOPL)in Brain Glioma
Bin XU ; Nu ZHANG ; Yuanjun HU ; Yibing YANG ; Sheng YAN ; Jinlong LIU ; Zhibo XIA
Chinese Journal of Nervous and Mental Diseases 2016;42(8):469-472
Objective To explore the expression of Speckle-type POZ protein-like(SPOPL)in human glioma tis?sues and its relationship with clinical pathological parameters and prognosis. Methods Immunohistochemical and west?ern blotting method were used to detect SPOPL expression in glioma tissues and tumor peripheral tissues in 68 cases of glioma patients including 32 cases of low grade gliomas (WHO I- II), and 36 cases of high grade gliomas (WHO III-IV). T test,χ2 test, Kaplan-Meier method and the Cox regression model were used to analyze the relationship between the expression and clinical indicators. Results The expression of SPOPL was significantly lower in gliomas than in tumor pe?ripheral tissues (t=-8.754, P<0.05), the expression of SPOPL was lower in high pathological grade tissues than in low grade of glioma tissues (t=-13.552, P<0.05). SPOPL expression was associated with pathological grade ( χ2=4.023, P<0.05). Cox regression model showed that the tumor pathological grade and different SPOPL protein expression were inde?pendent risk factors for the prognosis of patients with glioma. Conclusions SPOPL may be a biomarkers of human brain gliomas and can help to evaluate the prognosis of brain glioma.
9.Treatment values of precise target delineation of chest MRI for lung cancer
Zhenying YI ; Zhiqiao XU ; Ning LI ; Ling GAO ; Yan ZHANG ; Yongwei TIAN ; Zhibo SONG
The Journal of Practical Medicine 2016;32(18):2959-2962
Objective To investigate the treatment values of precise target delineation of chest MRI for lung cancer Methods From August 2011 to February 2015 , 45 non-small cell lung cancer patients were given chest CT scans and MRI scans before radiotherapy , and then active target tumor delineation , then related influencing factors were analyzed. Results All patients completed CT scans and MRI positioning. For patients that it was difficult to identify lung tissue lesions caused by lung cancer through CT , their MRI imaging showed high signal and the boundaries between the tumor and surrounding normal tissue became relatively clear. Meanwhile , 20 patients of borders were diagnosed by CT , while 25 by MRI; 36 patients with lymph node metastasis were diagnosed by CT while 40 by MRI. The difference was statistically significant (P<0.05). Univariate logistic regression analysis showed that pathological type and atelectasis were the influence factors for CT and MRI tumor target delineation differences (P<0.05), and multivariate logistic regression analysis showed the atelectasis was the main factor (P<0.05). Conclusion Compared with CT, breast MRI can precisely delineate target to improve the accuracy of target localization before radiotherapy. It can help determine lymph node metastasis and avoid the impact of atelectasis then ensure the accuracy of radiotherapy.
10.Effects of compression treatment on occurrence of venous thromboembolism after tension-free inguinal hernia repair
Ting ZHANG ; Wenbo ZHENG ; Zhibo YAN ; Minggang WANG ; Yuchen LIU ; Mingwei ZHONG ; Guangyong ZHANG
Chinese Journal of Digestive Surgery 2021;20(7):790-798
Objective:To investigate the effects of compression treatment on occurrence of venous thromboembolism (VTE) after tension-free inguinal hernia repair.Methods:The retrospective cohort study was conducted. The clinical data of 13 263 patients with inguinal hernia who were admitted to 58 medical centers from January to December in 2017 were collected, including 1 668 in Beijing Chaoyang Hospital of Capital Medical University, 782 in East Hospital Affiliated to Tongji University, 558 in Huadong Hospital of Fudan University, 525 in Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, 488 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 382 in Tianjin People's Hospital, 378 in Peking University Third Hospital, 364 in Beijing Hospital, 356 in Shengjing Hospital of China Medical University, 348 in Huashan Hospital of Fudan University, 348 in Sichuan Provincial People's Hospital, 328 in Affiliated Hospital of Zunyi Medical University, 304 in Beijing Luhe Hospital of Capital Medical University, 296 in People's Hospital of Changshou District in Chongqing, 290 in Anhui Provincial Hospital, 281 in the First Affiliated Hospital of Dalian Medical University, 281 in Xinjiang Uygur Autonomous People's Hospital, 247 in Qilu Hospital of Shandong University, 220 in Wuhan NO.1 Hospital, 214 in the First Hospital of China Medical University, 213 in West China Hospital of Sichuan University, 206 in the Second Affiliated Hospital of Chongqing Medical University, 202 in Taiyuan Central Hospital of Shanxi Medical University, 197 in the First Affiliated Hospital of Wenzhou University, 191 in Zhongda Hospital of Southeast University, 190 in Tianjin Medical University General Hospital, 189 in Xuzhou Central Hospital, 188 in the First Affiliated Hospital of Harbin Medical University, 187 in the Second Hospital Affiliated to Naval Medical University, 175 in Chengdu Fifth People's Hospital, 173 in Tianjin Nankai Hospital, 172 in the Fourth Affiliated Hospital of China Medical University, 172 in Zhangjiakou First Hospital, 161 in Henan Provincial People's Hospital, 153 in the First Affiliated Hospital of Xi'an Jiaotong University, 149 in Shandong Provincial Hospital, 142 in the Second Hospital of Shandong University, 137 in the First Affiliated Hospital of Hunan University of Medicine, 136 in the Fourth Hospital of Harbin Medical University, 127 in Pingjiang District of the First Affiliated Hospital of Soochow University, 102 in the Central Hospital of Wuhan, 100 in the First Affiliated Hospital of Soochow University, 98 in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, 97 in the First Affiliated Hospital of Chongqing Medical University, 96 in Xijing Hospital Affiliated to Air Force Medical University, 90 in the Fourth Medical Center of Chinese PLA General Hospital, 81 in Hunan Provincial Hospital of Traditional Medicine, 80 in the First Hospital of Tsinghua University, 80 in Xinhua Hospital of Hubei Province, 61 in the First Affiliated Hospital of Zhengzhou University, 57 in Peking University International Hospital, 50 in Peking University First Hospital, 39 in Zhongnan Hospital of Wuhan University, 38 in Jilin Yan'an Hospital, 37 in China-Japan Union Hospital of Jilin University, 20 in Taikang Xianlin Drum Hospital, 16 in Chinese PLA General Hospital, 3 in the First Affiliated Hospital of Fujian Medical University. There were 11 852 males and 1 411 females, aged from 18 to 102 years, with a median age of 64 years. Of 13 263 patients, 9 995 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 3 268 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) compression treatment of patients in the compression group; (2) occurrence of VTE after tension-free inguinal hernia repair in the two groups; (3) analysis of influencing factors for VTE after tension-free inguinal hernia repair. Follow-up using telephone interview was performed to detect history of patient's thrombosis, medical history of patient's family and the incidence of postoperative VTE up to February 2018. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) Compression treatment of patients in the compression group: of the 9 995 patients in the compression group, 6 086 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 1 881 underwent compression treatment with trusses, 745 underwent compression treatment with girdles, 675 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag, and 608 underwent compression treatment with elastic underwear. (2) Occurrence of VTE after tension-free inguinal hernia repair in the two groups: patients of the two groups after matching were followed up. Occurrence of VTE after matching were 15 and 1 in the compression group and non-compression group, respectively, showing no significant difference between the two groups ( χ2=2.010, P>0.05). (3) Analysis of influencing factors for VTE after tension-free inguinal hernia repair: results of univariate analysis showed that cases with varix of lower limb, cases with oral contracep-tives or hormone replacement therapy history, cases with VTE history, clinical classification, clinical typing, surgical method, cases with anticoagulant drugs history, cases undergoing oral antiplatelet drugs, cases undergoing postoperative VTE prevention with medication were related factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=13.98, 37.71, 19.21, 4.43, 4.21, 0.07, 0.08, 0.10, 31.04, 95% confidence interval: 3.15?62.11, 8.35?170.24, 6.15?60.00, 1.43?13.76, 1.20?14.82, 0.01?0.49, 0.02?0.27, 0.04?0.29, 8.53?112.93, P<0.05). Results of multivariate analysis showed that cases with VTE history and surgical method were independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=7.78, 11.19, 95% confidence interval: 2.06?29.42, 1.45?86.55, P<0.05). Conclusion:Cases with VTE history and surgical method are independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair.