Objective This study aims to explore the application effectiveness of the PDCA cycle method in preventing and reducing internal errors in the intravenous drug dispensing center(PIVAS).Methods Internal error data from our hospital's PIVAS in 2020 and 2021 were collected.The data from 2020 represented the pre-implementation of the PDCA cycle,while the data from 2021 represented the post-implementation period.The changes in internal errors and error rates before and after imple-mentation were compared.Results After implementing the PDCA cycle management measures,the annual error rate decreased from 0.887％o in 2020 to 0.681‰ in 2021,a decrease of 23.22％.Conclusion The PDCA cycle method can effectively reduce the occurrence of internal errors,improve work accuracy,and ensure the safety of clinical drug use in PIVAS.

Objective This study aims to explore the application effectiveness of the PDCA cycle method in preventing and reducing internal errors in the intravenous drug dispensing center(PIVAS).Methods Internal error data from our hospital's PIVAS in 2020 and 2021 were collected.The data from 2020 represented the pre-implementation of the PDCA cycle,while the data from 2021 represented the post-implementation period.The changes in internal errors and error rates before and after imple-mentation were compared.Results After implementing the PDCA cycle management measures,the annual error rate decreased from 0.887％o in 2020 to 0.681‰ in 2021,a decrease of 23.22％.Conclusion The PDCA cycle method can effectively reduce the occurrence of internal errors,improve work accuracy,and ensure the safety of clinical drug use in PIVAS.

Objective:To isolate and identify a phage that can specifically lyse Salmonella enteritidis from the environment, and provide a theoretical and research basis for its use in food safety prevention and control through the exploration of the biological characteristics of the phage and the efficacy of lysing bacteria. Methods:The double-layer agar method was applied to isolate phages, and the pH stability, thermal stability, host range, one-step growth curve of the phage were determined. The phage morphology was observed by transmission electron microscopy. Next-generation sequencing was performed for the phage genome, and the lysis efficiency was evaluated.Results:Salmonella enteritidis phage JD01 had a (58±3) nm icosahedral head, a (120±5) nm tail, a thin bottom plate of about 17 nm and 5-6 spines at the tail end. The genome of phage JD01 was composed of 44 880 bp with a GC content of 50.17%, and it contained 63 putative open reading frames without any tRNA genes. The genome comparison and phylogenetic analysis revealed that phage JD01 was a novel phage belonging to the class Caudoviricetes, the family Guernseyvirinae, and the genus Jerseyvirus, lacking virulence genes and drug resistance genes. It survived below 70℃ and pH4.0-12.0, and the lysed bacteria had genus specificity. The phage JD01 had a good bactericidal effect on Salmonella enteritidis in contaminated liquid eggs. Conclusions:Phage JD01 has strong lytic activity and a wide host range, and has great potential application in food safety and control of Salmonella enteritidis pollution, which can be considered for the development of food safety biological control agents.

Objective To investigate the effect of tiopronin on renal function during anti-tuberculosis liver protection therapy.Methods Clinical data of patients with initially treated sensitive tuberculosis treated in our hos-pital from September 2019 to September 2022 and whose anti-tuberculosis regimen was only isoniazid,rifampicin,pyrazinamide and ethambutol were retrospectively analyzed.The patients were divided into study group and control group according to whether tiopronin was used.The baseline data,blood creatinine(Scr),blood urea nitrogen(BUN),urine protein,creatinine clearance,drug combination and related adverse reactions of the two groups were compared.Results Patients obtained based on inclusion and exclusion criteria were divided into a study group(n=102)(antitubercular drugs+tiopronin)and a control group(n=105)(antitubercular drugs+glutathione).There were no statistically significant differences(P＞0.05)in ALT,AST,DBIL,and TBIL levels between the two groups before treatment,at Middle and late treatment.At the later stage of treatment,serum Scr,BUN,creatinine clearance and urinary protein showed statistical differences between the study group and the control group(P＜0.05).The abnormal rate of indicators and the incidence of adverse reactions in the study group were higher than those in the control group at the later stage of treatment(P＜0.05).Conclusion For patients undergoing tuberculosis treatment,the efficacy of tiopronin and glutathione in protecting the liver is comparable.However,in terms of renal function,long-term use of tiopronin is associated with more pronounced damage.Due to the relatively low cost of tiopronin,for families with heavy economic burdens,short-term use of the drug can ensure safety,while long-term use requires close monitoring of renal function changes and timely adjustments to medication.

Objective:To isolate and identify a phage that can specifically lyse Salmonella enteritidis from the environment, and provide a theoretical and research basis for its use in food safety prevention and control through the exploration of the biological characteristics of the phage and the efficacy of lysing bacteria. Methods:The double-layer agar method was applied to isolate phages, and the pH stability, thermal stability, host range, one-step growth curve of the phage were determined. The phage morphology was observed by transmission electron microscopy. Next-generation sequencing was performed for the phage genome, and the lysis efficiency was evaluated.Results:Salmonella enteritidis phage JD01 had a (58±3) nm icosahedral head, a (120±5) nm tail, a thin bottom plate of about 17 nm and 5-6 spines at the tail end. The genome of phage JD01 was composed of 44 880 bp with a GC content of 50.17%, and it contained 63 putative open reading frames without any tRNA genes. The genome comparison and phylogenetic analysis revealed that phage JD01 was a novel phage belonging to the class Caudoviricetes, the family Guernseyvirinae, and the genus Jerseyvirus, lacking virulence genes and drug resistance genes. It survived below 70℃ and pH4.0-12.0, and the lysed bacteria had genus specificity. The phage JD01 had a good bactericidal effect on Salmonella enteritidis in contaminated liquid eggs. Conclusions:Phage JD01 has strong lytic activity and a wide host range, and has great potential application in food safety and control of Salmonella enteritidis pollution, which can be considered for the development of food safety biological control agents.

Objective To investigate the effect of tiopronin on renal function during anti-tuberculosis liver protection therapy.Methods Clinical data of patients with initially treated sensitive tuberculosis treated in our hos-pital from September 2019 to September 2022 and whose anti-tuberculosis regimen was only isoniazid,rifampicin,pyrazinamide and ethambutol were retrospectively analyzed.The patients were divided into study group and control group according to whether tiopronin was used.The baseline data,blood creatinine(Scr),blood urea nitrogen(BUN),urine protein,creatinine clearance,drug combination and related adverse reactions of the two groups were compared.Results Patients obtained based on inclusion and exclusion criteria were divided into a study group(n=102)(antitubercular drugs+tiopronin)and a control group(n=105)(antitubercular drugs+glutathione).There were no statistically significant differences(P＞0.05)in ALT,AST,DBIL,and TBIL levels between the two groups before treatment,at Middle and late treatment.At the later stage of treatment,serum Scr,BUN,creatinine clearance and urinary protein showed statistical differences between the study group and the control group(P＜0.05).The abnormal rate of indicators and the incidence of adverse reactions in the study group were higher than those in the control group at the later stage of treatment(P＜0.05).Conclusion For patients undergoing tuberculosis treatment,the efficacy of tiopronin and glutathione in protecting the liver is comparable.However,in terms of renal function,long-term use of tiopronin is associated with more pronounced damage.Due to the relatively low cost of tiopronin,for families with heavy economic burdens,short-term use of the drug can ensure safety,while long-term use requires close monitoring of renal function changes and timely adjustments to medication.

Anti-virulence strategy has been considered as one of the most promising approaches to combat drug-resistant bacterial infections. Pore-forming toxins (PFTs) are the largest class of bacterial toxins, inflicting their virulence effect through creating pores on the cell membrane. However, current solutions for eliminating PFTs are mostly designed based on their molecular structure, requiring customized design for different interactions. In the present study, we employed erythroliposome (denoted as RM-PL), a biomimetic platform constructed by artificial lipid membranes and natural erythrocyte membranes, to neutralize different hemolytic PFTs regardless of their molecular structure. When tested with model PFTs, including α-hemolysin, listeriolysin O, and streptolysin O, RM-PL could completely inhibit toxin-induced hemolysis in a concentration-dependent manner. In vivo studies further confirmed that RM-PL could efficiently neutralize various toxins and save animals' lives without causing damage to organs or tissues. In addition, we explored the underlying mechanisms of this efficient detoxification ability and found that it was mainly macrophages in the spleen and the liver that took up RM-PL-absorbed toxins through a variety of endocytosis pathways and digested them in lysosomes. In summary, the biomimetic RM-PL presented a promising system for broad-spectrum and powerful toxin neutralization with a mechanism of lysosome-mediated toxin degradation.

Standardized specialist training is key to postgraduate medical education. China is introducing the specialist training programs, yet without covering specialist training in obstetrics and gynecology(O&G). Shanghai took the lead in 2003 to pilot O&G specialists training programs within the region. This study introduced the specialist training programs in O&G in the US, and compared them with those in Shanghai, and recommending on launching O&G specialist training nationwide based on China′s specifics.

Objective To monitor the clinical distribution of Gram-positive pathogen infection and drug-resistance situation in hospitalized children with lower respiratory tract, and guide rational application of antibiotics. Methods The isolated cultures results and drug sensitivity test result of 1 219 sputum specimens in hospitalized children with lower respiratory tract were studied. Results The 1 249 strains were isolated from 1 219 sputum specimen samples. Among which, Gram-positive pathogen was 318 strains, accounting for 25.46% (318/1 249). In 318 strains Gram-positive pathogens, staphylococcus aureus was 127 strains (39.94% ), streptococcus pneumoniae was 92 strains (28.93% ), staphylococcus epidermidis was 76 strains (23.90%), and enterococcus was 23 strains (7.23%). Then, different strains of pathogens showed totally disparate drug-resistance situations, especially towards penicillin, and the drug resistant rate was highest (89.62% , 285/318), while the drug resistant rates were also high among erythromycin, cefazolin, oxacillin, azithromycin and clindamycin: 66.67% (212/318), 52.52% (167/318), 49.06% (156/318), 49.06% (156/318) and 43.08% (137/318); meanwhile, the isolated Gram-positive pathogens showed no drug-resistance to vancomycin and linezolid. Conclusions Only using antibiotics rationally according to pathogen identification and drug sensitivity test result, can effectively control the pathogen infections.

Objective To understand the molecular epidemiology characteristics and its drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in the urban area of Jilin and to provide important basis for guiding the clinical medication and prevention of the MRSA infection. Methods One hundred and three strains of MRSA from July 2013 to July 2014 in the urban area of Jilin were selected. The polymerase chain reaction (PCR) technology and multiple polymerase chain reaction were used to detect mecA gene and Staphylococcus chromosomal cassette mec typing (SCCmec) genotype of MRSA. The drug sensitivity test for 13 kinds of clinical common antibacterial drugs were detected by using the K-B method. And the source of the strains were analyzed. Results The results of SCCmec genotype of MRSA showed that SCCmecⅢtype were 62 strains, accounting for 60.2%;SCCmecⅡtype were 39 strains, accounting for 37.9%; failing to parting were 2 strains,accounting for 1.9%. Drug susceptibility test results showed that all of 103 MRSA strains were resistant to cefoxitin, cefazolin, penicillin and benzene, and drug resistance rate was 100.0%. The resistant rate to erythromycin, levofloxacin, ciprofloxacin, tetracycline, gentamicin and rifampin were 96.1%, 93.2%, 95.1%, 91.3%, 90.3%and 55.3%receptively;the resistant rate to sulfamethoxazolewas was only 1.9%;and the resistant strains to vancomycin and teicoplanin were not detected. The top three department of the distribution of the strains source were department of neurosurgery (31.1%), ICU (19.4%) and burn plastic surgery (17.5%). Conclusions The SCCmecⅢtype is the main MRSA epidemic strains, and SCCmec type II is a minor epidemic strainin the urban area of Jilin. The antibiotic resistance of MRSA is a serious problem with multiple drug resistance, but MRSA is sensitive to vancomycin and teicoplanin.