OBJECTIVE To know about the working mode and human resource status of pharmacy intravenous admixture services （PIVAS） in national medical institutions. METHODS Through questionnaire survey， the national PIVAS was invited to fill out questionnaire and statistical analysis was performed on the effective sample data related to PIVAS working mode and human resources in the questionnaire. RESULTS In this study， 761 PIVAS from 722 medical institutions of 29 provinces were involved in the questionnaire survey， with 471 valid questionnaires for working mode and 441 valid questionnaires for human resources survey. In terms of working mode， among 471 PIVAS， 292 PIVAS （62.0%） were in pharmacist-alone mode， and 176 PIVAS （37.4%） were in pharmacist-nurse cooperative mode； there was no significant difference in the types of medical orders received by PIVAS between these two working modes except for the other medical orders （P＞0.05）. In terms of human resource setting， among 441 PIVAS， the average number of total staff of single PIVAS was 24（16，33）， including 11（6，19） pharmacists， 7（2，13） nursing staff， and 3（1，5） workers； there was a statistically significant difference in the number of personnel among three groups （P＜ 0.01）. The per capita income of PIVAS respondents in 2019 was [7.9（4.8，10.7）]×104 yuan， and in 2021 it was [8.8（5.8，11.7）]× 104 yuan， with an increase of 9.0% compared to 2019. The difference between the two groups was statistically significant （P＜ 0.01）. CONCLUSIONS Medical institutions’ PIVAS in China had not fully implemented the pharmacist-alone work model， and some medical institutions had chosen a pharmacist-nurse cooperative mode. It is suggested that relevant departments formulate corresponding qualification requirements and training standards for nursing personnel as soon as possible based on sufficient research on PIVAS’s demand for nursing professionals.

OBJECTIVE To know about the pharmacy intravenous admixture charge and operation balance of pharmacy intravenous admixture services （PIVAS） in national medical institutions. METHODS Using questionnaire survey method， the national PIVAS leaders were invited to fill in the questionnaire， investigation and statistical analysis of the drug dispensing charge standard and the income and expenditure situations of PIVAS nationwide were conducted. RESULTS A total of 761 PIVAS completed the questionnaire， among which 466 PIVAS （61.2%） had already started implementing pharmacy intravenous admixture charge， mainly in tertiary hospitals. The charge standards for chemotherapy drugs and parenteral nutrition solutions were relatively high， while the standards for packaged drugs were the lowest， with differences in charge standards among provinces（P＜0.05）. Among the 25 provinces that reported annual drug preparation fee revenue， Hubei had the highest revenue in both 2019 and 2021. In 2019， the number of PIVAS with a balance of payments was more than that of PIVAS with an imbalance of payments， but the number of PIVAS with an imbalance of payments in 2021 exceeded the number of PIVAS with a balance of payments （P＜0.05）； among them， eight provinces were unbalanced in 2019 and 2021， such as Tianjin， Chongqing， Guizhou， etc. CONCLUSIONS PIVAS charge standards of the surveyed medical institutions in all provinces are not unified. It is suggested to improve the charge standard further， formulate the charge adjustment cycle， and promote a sustainable development of PIVAS.

Objective To explore the correlations between image quality of prospective and retrospective electrocardiogram(ECG)-gated CT coronary angiogram and radiation dose in patients with different heart rates.Methods A total of 135 patients undergoing 256-slice spiral CT coronary angiography were enrolled in the study.Among them,66 cases received prospective ECG-gated scanning(prospective ECG-gated group)and further divided into two subgroups with heart rate≤80 beats/min(prospective ECG-gated+low heart rate subgroup,n=39)and>80 beats/min(prospective ECG-gated+high heart rate subgroup,n=27).The other 69 cases underwent retrospective ECG-gated scanning(retrospective ECG-gated group),including 45 cases with heart rate≤80 beats/min(retrospective ECG-gated+low heart rate subgroup)and 24 with heart rate>80 beats/min(retrospective ECG-gated+high heart rate subgroup).The baseline data,image quality[mean CT value,image noise,signal-to-noise ratio(SNR),subjective image quality score]and radiation dos[CT volume dose index(CTDIvol),dose length product(DLP),effective dose(ED)]were compared among 4 subgroups.The correlations of image quality with heart rate and radiation dose in prospective and retrospective ECG-gated groups were analyzed.Results The heart rates in prospective and retrospective ECG-gated+low heart rate subgroups were lower than those in prospective and retrospective ECG-gated+high heart rate subgroups(P<0.05).When comparing the mean CT value,image noise,SNR and subjective image quality score among 4 subgroups,no statistically significant differences were observed(P>0.05).The CTDIvol,DLP and ED in prospective ECG-gated+low heart rate subgroup were significantly lower than those in the other 3 subgroups(P<0.05),and the indicators in prospective ECG-gated+high heart rate subgroup were lower than those in retrospective ECG-gated group(including low and high heart rate subgroups)(P<0.05).Pearson correlation coefficient analysis revealed that the mean CT value,image noise,SNR,subjective image quality score had no significant correlation with heart rate,CTDIvol,DLP and ED in prospective and retrospective ECG-gated groups(P>0.05).Conclusion The subjective and objective image quality of 256-slice spiral CT coronary angiography is not correlated with radiation dose.Prospective ECG-gated scanning can reduce the radiation dose and ensure the image quality as compared with retrospective ECG-gated scanning.This holds true for eligible patients with high heart rate,and the former can effectively reduce radiation exposure.Therefore,prospective ECG-gated scanning is worthy to be promoted in clinic.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

Objective: To analyze the effect of breakfast nutrition quality on the satiety among young white-collar workers. Methods: A total of 278 subjects were recruited from two cities, Shenyang and Chongqing, in June 2015. The inclusion criteria: white-collar workers aged 25-45 years involved mainly in office work, who did not experience major changes, and individuals who should follow the study protocol and sign the informed consent form. The study employed a three-phase crossover design trial. Each participant received nutritional-adequate breakfast, nutritional-inadequate breakfast, and no breakfast treatment on the basis of assignment to one of three sequences. The breakfast time was once a week and then changed, all participants underwent the tests for three successive weeks. At last, we compared the effect of participants to consume different nutritional quality on satiety sense and hunger sense. Results: A total of 232 participants completed three successive breakfast intervention studies, the age of participants was (35.2 ± 7.9) years, comprised of 48.7% male (n=113). The numbers of participants of aged 25-35 year-old and aged 36-45 were 118 and 114, respectively. Satiety scores of nutrition-adequate breakfast group, nutrition-inadequate breakfast group and no breakfast group were 63.5±14.7, 53.1±10.2 and 36.4±7.2, respectively (P<0.05). In nutrition-inadequate breakfast group and no breakfast group, male subjects scored significantly higher than female subjects (50.9±10.5 vs 46.6±9.4, 35.2±8.3 vs 31.8±5.4) (P<0.05). And, participants aged 25-35 year-old. got satiety score significantly higher than aged 36-45 (51.3±11.0 vs 45.6±12.1, 34.1±6.8 vs 32.5±7.9), the difference was statistically significant (P<0.05). The scores of hunger in the group of nutrition-adequate breakfast, nutrition-inadequate breakfast and no breakfast were 26.3 ± 8.0, 35.1 ± 11.2 and 57.3 ± 17.0, respectively (P<0.05). Conclusion The nutrition quality of breakfast affects the satiety of young white-collar workers. The better the nutrition quality of breakfast is, the higher the satiety score and the lower the hunger score become. Compared with women and participants aged 36-45 year-old, men and those aged 25-35 year-old get satiety sense more easily.

Objective To construct the stably over-expressing hB7-H3 gene human pancreatic cancer cell line PANC1,and provide tools for further investigating the function of hB7-H3.Methods hB7-H3 gene fragment was inserted into lentiviral plasmid GV287 carrying GFP to construct recombinant hB7-H3-GV287 plasmid vector.293T cells were transfected,and the GFP expression was evaluated under fluorescence microscopy.Western Blot wasused to detect the expression of hB7-H3 protein.Lentiviral vectors were packaged and the titer was determined.The recombinant hB7-H3 expressed lentivirus was used to infect PANC1 cell.Flow cytometry was applied to detecte the percentage of GFP and hB7-H3 positive cells.Real-time PCR and Western Blot was used to verify the mRNA and protein expression of hB7-H3.Self-cyclizing GV287 plasmid served as negative control (NC).Results PCR amplified fragment of recombinant plasmid was around 1 368 bp,and no amplified production of NC plasmid was observed.The DNA sequencing of recombinant plasmid was completely consistent with the designed fragment,indicating that hB7 H3-GV287 plasmid was successfully constructed.293T cells transfected with recombinant plasmid expressed hB7-H3 protein,while those cells transfected with NC plasmid did not express hB7-H3 protein.The virus titer of lentiviral packaged recombinant hB7-H3 plasmid was 2 × 108 TU/ml.The percentage of hB7-H3 positive cells,hB7-H3 mRNA and protein expression in PANC1 cells infected with cells infected with hB7-H3 lentivirus was 94.3％,5.09 ± 0.24 and 2.85 ± 0.27,respectively,which was obviously higher than 18.5％,1.28 ± 0.53 and 0.44 ± 0.69 in cells infected with NC lentivirus,and the differences were statistically significant (P value ＜0.01).Conclusions A human pancreatic cancer cell line PANC1 stably over-expressing hB7-H3 was successfully constructed.

Objective To investigate the expression and clinical significance of Rho GDP dissociation inhibitor 2 (Rho-GDI2) in pancreatic cancer.Methods Immunohistochemistry and RT-PCR were used to evaluate the expression of Rho-GDI2 in 60 pairs of pancreatic cancer tissues and adjacent pancreatic tissues,and its correlation with clinicopathological parameter of pancreatic cancer was also analyzed.Results The expressions of Rho-GDI2 mRNA were 0.661 ± 0.021 and 0.199 ± 0.023 in pancreatic cancer tissues and adjacent pancreatic tissues,and the positive rate of Rho-GDI2 protein expression were 73.3％ (44/60) and 41.7％ (25/60),the positive rate of Rho-GDI2 expression in pancreatic cancer tissues was higher than that of adjacent normal tissues,and the difference between the two groups was statistically significant (P ＜ 0.01).The expression of Rho-GDI2 was strongly correlated with tumor size,differentiation,staging,lymph node metastasis,vascular invasion (P＜0.05),but it was not associated with gender,age,tumor location (P ＞0.05).Conclusions Rho-GDI2 expression is up-regulated in pancreatic cancer,and is strongly correlated with the malignant biological behavior of pancreatic cancer.

BACKGROUND:Early clinical application of non-biological materials (bone cement) for treatment of hip joint is ineffective, due to the large fixed range, long fixation time, as wel as aging and rupture of bone cement interface causing complications such as prosthetic loosening. Thus, postoperative range of motion of the hip joint can be affected to some degree.
OBJECTIVE:To investigate the methods and progress of biological and non-biological materials for total hip replacement and to assess the features and clinical application of different hip prostheses.
METHODS:A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles related to biological materials and tissue-engineered hip joint using the keywords of“carpal bone, fracture ununited”in the title and abstract. The keywords were limited to Chinese and English.
RESULTS AND CONCLUSION:Biological materials for internal fixation have good wear resistance, corrosion resistance and biocompatibility. Currently, the combination of metal joint head and polyethylene acetabulum with ultrahigh molecular weight is the most commonly used in hip replacement. However, the metal joint head exhibits an elastic modulus far from the human skeleton, resulting in stress shielding effects which are easy to cause prosthetic loosening and instability. Bio-inert ceramics has high in vivo stability and good mechanical strength;and bioactive ceramics has bone conduction characteristics and performance of the living bone integration. Composite prosthesis, because of adjustable elastic modulus and sufficient mechanical strength, shows the mechanical properties close to the human bone and has been gradual y noticed. However, there is a lack of ideal prostheses with good biocompatibility and biomechanics. Therefore, hip design and manufacturing processes should be improved to elevate wear resistance and mechanical properties, to enhance the binding between prosthesis and the host bone, and to reduce stress shielding in order to improve the biocompatibility of the implant with the host, and extend the prosthetic life.

Objective To investigate the roles of aberrant expression of c-myc,c-myb,and c-erbB-2 in the development of breast cancer and its clinical significance.Methods Immunohistochimical technique (S-P method)was used to detect the expression of c-myb,c-myc and c-erbB-2 protein in 150 cases of breast cancer and 30 cases of benign proliferative lesions.heir relation to clinical pathological parameters were analyzed.Results The protein expression levels of c-myc,c-myb,and c-erbB-2 in breast cancer were higher than those in benign proliferative lesions and the difference was significant(all P ＜0.05).Expression of c-myc protein had obvious relationship to histological grade,lymph nodes metastasis and pathological types(all P ＜ 0.05).Expression of c-myb protein related significantly to histological grade (P ＜ 0.05).c-erbB-2 was associated with the tumor size,grading,PR expression (all P ＜ 0.05).The association among the three kinds of genetic proteins was observed.Conclusion Expressions of oncogenes c-myc,c-myb,and c-erbB-2 proteins are higher in breast cancer and lower in benign proliferative lesions.The difference is significant.They are related to the grading and some other prognostic factors such as tumor size,pathologic types,PR expression and lymph node metastasis.The results suggest that these oncogenes are activated in the development of breast cancer and provoke cancerous cells multiplication.Expressions of oncogenes c-myc,c-myb and c-erbB-2 mightbe considered to be the prognostic indicators of breast cancer.

Objective To explore the characteristics of gait of old hemiplegic patients. Methods 22 old hemiplegic patients were investigated with Motion Analysis. Results The bilateral support phase increased, especially for the affected lateral. The swing phase decreased, as well as the frequency, step length, stride length and walking speed. Their heads flexed forward, but trunks remained upright. The motion of range of shoulder and elbow decreased in the affected lateral (P<0.05), and the angle of flexion and adduction in the affected shoulder and flexion in elbow increases (P<0.05). The motion of range of the affected hip, knee and ankle decreased (P<0.05). Conclusion The walking ability impaired in the old hemiplegic patients, with upper limbs spasticity, vision compensation, etc.