Objective:To simulate the spot characteristics of light emitting diode (LED) array light sources used in non-invasive phototherapy at different distances and to provide reference for the formulation of clinical non-invasive phototherapy treatment schemes.Methods:The ray tracing module in Comsol software was used to simulate the spot characteristics of LED light sources with different power and arrays at different distances, and the fitting curve was analyzed. The model was verified by the actual LED spot measurement, and the feasibility of the treatment scheme was verified by the mouse back wound model.Results:Under the irradiation of 2×2 LED light source array, with the increase of the vertical distance from the light source, the area of the effective area and the treatment area gradually increased, the power density value in the area gradually decreased, and the uniformity gradually increased. These changes showed a linear or binomial correlation with the vertical distance. The model was improved based on the actual LED light spot, and the new model consisted of an array of 18 LEDs as the light source, and the treatment area showed better uniformity and power density values. The simulated optical parameters were used to treat mice’s wounds with light, and the results showed that light treatment could promote wound healing.Conclusions:The established medical LED array light source spot characteristics simulation can provide a reference for the development of clinical non-invasive phototherapy protocols, thus helping the clinic select the appropriate LED power and array distribution according to the treatment needs and also providing a basis for the development of medical LED array light sources.

Objective:To explore the genetic causes of cerebellar hypoplasia (CH) diagnosed by prenatal ultrasound.Methods:This retrospective study involved 32 fetuses with CH diagnosed by prenatal ultrasound in Wuxi Maternal and Child Health Hospital from January 2014 to December 2022. Prenatal ultrasound findings and genetic testing results for amniotic fluid were collected and analyzed. The correlation between fetal CH and genetic abnormality was analyzed. A descriptive statistical method was used for data analysis.Results:(1) General data: The 32 mothers were (28.0±4.9) years old, ranging from 18 to 37 years old; the gestational age at amniocentesis was (24.2±4.0) weeks, ranging from 18 +3 weeks to 37 +2 weeks. Apart from one case lost to follow-up, the other 31 cases terminated the pregnancies, including 30 terminated before 28 weeks of gestation and one at 33 weeks of gestation due to unmarried status. (2) Ultrasonic features: Among the 32 cases, 30(93.8%) were complicated by intracranial or extracranial abnormalities including cardiac abnormalities (15 cases), dilated lateral ventricles (ten cases), and abnormalities in limbs (eight cases) and face (nine cases). Two CH cases (6.2%) were isolated. (3) Genetic testing: Among the 32 cases, 13 cases (40.6%) had normal results of amniotic fluid karyotype analysis and single nucleotide polymorphism (SNP) array. Among the 19 cases with abnormal amniotic fluid test results (59.4%), 16 cases have abnormal results in amniotic fluid karyotype analysis and SNP array detection [nine cases were numerical abnormalities, including five cases of trisomy-18, three of trisomy-21, and one of trisomy-13; seven cases were chromosomal structural abnormalities, including four cases of terminal deletion of chromosome 5 (Cri-du-Chat syndrome) and three cases of reciprocal translocation of chromosomes]. There was no abnormality in karyotype analysis of amniotic fluid in three cases. Still, their SNP array test results showed copy number variations (CNV) [one of 6q terminal deletion, one of 6q terminal deletion with 5p15.33 duplication, and one of 6q terminal deletion with 15q26.3 duplication; all variations were of unknown significance]. (4) Of the 19 cases with abnormal SNP array results, 17 were accompanied by abnormal intracranial/extracranial ultrasound findings. Among them, ten cases showed cardiac malformation, seven showed lateral ventricular widening, and seven showed limb abnormality. Conclusions:Numerical abnormalities, CDCS, and 6q terminal deletion are the most common genetic causes of CH diagnosed by prenatal ultrasound. Chromosome microarray analysis should be recommended for fetuses with ultrasound-diagnosed CH to evaluate fetal prognosis accurately.

Objective:To investigate the predictive value of pan-immune-inflammation value (PIV) for in-hospital mortality in patients with acute ischemic stroke (AIS) admitted to intensive care unit (ICU).Methods:The clinical data of the first-ever AIS patients admitted to the ICU in the Medical Information Mart for Intensive Care (MIMIC) -Ⅳ of the United States were retrospectively included and analyzed. According to whether the patients died in the hospital, they were divided into a survival group and a death group, and the differences in baseline data between the two groups were compared. Multivariate logistic regression model was used to analyze independent influencing factors of in-hospital mortality in patients. Receiver operating characteristic curve was used to evaluate the predictive value of PIV on in-hospital mortality. Results:A total of 1 068 first-ever AIS patients admitted to the ICU were included, with a median age of 69 years. There were 543 males (50.84%), and 182 (17.05%) experienced in-hospital mortality. Multivariate logistic regression analysis showed that after adjusting for potential confounding factors, a higher PIV (>1 555.71) was an independent risk factor for in-hospital mortality in patients (odds ratio 1.924, 95% confidence interval 1.093-3.387; P=0.023). The receiver operating characteristic curve analysis showed that the area under the curve for predicting in-hospital mortality by PIV was 0.605 (95% confidence interval 0.556-0.654), with an optimal cutoff value of 1 199.93. The sensitivity and specificity for predicting in-hospital mortality were 48.9% and 70.2%, respectively. Conclusions:A higher PIV is an independent risk factor for in-hospital mortality in AIS patients admitted to ICU, which may help identify AIS patients with a higher risk of in-hospital mortality in the ICU.

Objective:To explore the predictive value of renal resistive index (RRI) joint with semiquantitative power Doppler ultrasound (PDU) score to acute kidney injury (AKI) in non-septic critically ill patients.Methods:This prospective observational study enrolled non-septic critically ill patients admitted to the Emergency Intensive Care Unit of Cangzhou Central Hospital from January 2018 to August 2019. In addition to general data, RRI and PDU scores were measured with medical ultrasonic instrument within 6 h after admission. Renal function was assessed on the 5th day in accordance with kidney disease: Improving Global Outcomes criteria. The patients who progressed to AKI stage 3 within 5 days after admission were classified into the AKI 3 group, and the rest were classified into the AKI 0-2 group. The difference of each index was compared between the two groups in non-septic critically ill patients and patients with acute heart failure (AHF). Normal distributed continuous variables were compared using independent sample t-tests, whereas Mann-Whitney U tests were used to examine the differences in variables without a normal distribution. Categorical data were compared with the Chi-square test. Receiver operator characteristic curves were plotted to examine the values of RRI, PDU score, RRI-RDU/10 (subtraction of RRI and 1/10 of PDU score), RRI/PDU (the ratio of RRI to PDU score), and RRI+PDU (the prediction probability of the combination of RRI and PDU score for AKI stage 3 obtained by logistic regression analysis) in predicting AKI 3. Delong's test was used to compare the area under the curve (AUC) between predictors. Results:A total of 110 non-septic critically ill patients (51 patients with no AKI, 21 with AKI stage 1, 11 with AKI stage 2, and 27 with AKI stage 3) were recruited. Among them, there were 63 patients with AHF (21 patients with no AKI, 15 with AKI stage 1, 7 with AKI stage 2, and 20 with AKI stage 3). Among the non-septic critically ill patients as well as its subgroup of AHF, compared with the AKI 0-2 group, acute physiology and chronic health evaluation-Ⅱ score, sequential organ failure assessment score, arterial lactate concentration, mechanical ventilation rate, proportion of vasoactive drugs, 28-day mortality, serum creatinine, RRI, RRI-RDU/10, RRI/PDU, RRI+PDU, and rate of continuous renal replacement therapy were higher in the AKI 3 group, and urine output and PDU score were lower ( all P<0.05). As for non-septic critically ill patients, RRI/PDU [AUC=0.915, 95% confidence interval ( CI): 0.846-0.959, P<0.01] and RRI+PDU (AUC=0.914, 95% CI: 0.845-0.959, P<0.01) performed best in predicting AKI 3, and the AUCs were higher than RRI (AUC=0.804, 95% CI: 0.718-0.874, P<0.01) and PDU score (AUC=0.868, 95% CI: 0.791-0.925, P<0.01). The optimal cutoff for RRI/PDU was > 0.355 (sensitivity 92.6%, specificity 81.9%, Youden index 0.745). The predictive value of RRI-RDU/10 for AKI 3 (AUC=0.899, 95% CI: 0.827-0.948, P<0.01) was also better than RRI and PDU scores, but slightly worse than RRI/PDU and RRI+PDU, with statistically difference only between RRI and RRI-RDU/10 ( P<0.05). As for patients with AHF, RRI/PDU (AUC=0.962, 95% CI: 0.880-0.994, P<0.01) and RRI+PDU (AUC=0.962, 95% CI: 0.880-0.994, P<0.01) also performed best in predicting AKI 3, and the AUCs were higher than RRI (AUC=0.845, 95% CI: 0.731-0.924, P<0.01) and PDU score (AUC=0.913, 95% CI: 0.814-0.969, P<0.01) with statistically differences (all P<0.05). The optimal cutoff for RRI/PDU was > 0.360 (sensitivity 95.0%, specificity 90.7%, Youden index 0.857). The predictive value of RRI-RDU/10 for AKI 3 (AUC=0.950, 95% CI: 0.864-0.989, P<0.01) was also better than RRI and PDU score, but slightly worse than RRI/PDU and RRI+PDU, with statistically difference only between RRI and RRI-RDU/10 ( P<0.05). Conclusions:The combination of RRI and PDU score could effectively predict AKI 3 in non-septic critically ill patients, especially in patients with AHF. The ratio of RRI to PDU score is recommended for clinical application because of its excellent predictive value for AKI and its practicability.

OBJECTIVE：To construct the evaluation system for TCM pharmaceutical care quality in public hospitals of Jilin province，and to provide reference for improving the quality of TCM pharmaceutical care in public hospitals. METHODS ：On Nov. 2020，20 relevant personnel and 10 experts in the field of TCM in Jilin province were selected by theoretical sampling method and objective sampling method ，respectively；grounded theory and Delphi method were adopted to sort out and score the evaluation system of TCM pharmaceutical care quality in public hospitals. Analytic hierarchy process （AHP）was used to determine the weight of each index. RESULTS ：In the two rounds of evaluation ，experts’enthusiasm，authority and opinion coordination were relatively high. Finally ，the evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin Province was constructed ， consisting of 5 criterion layer indexes and 27 field layer indexes. The weights of the five criterion layer indexes from high to low are 0.290 for TCM pharmaceutical care management ，0.283 for TCM pharmaceutical care equipment ，0.163 for TCM prescription rationality，0.150 for TCM quality management ，0.144 for TCM pharmaceutical care ability. CONCLUSIONS ：The evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin province established in this study is scientific and applicable ， and provides a basis for improving the quality of TCM pharmaceutical care in public hospitals. Public hospitals can set up priority improvement dimensions according to the results of the quality evaluation system ，and focus the limited human and material resources on priority improvement indexes.

OBJECTIVE： To provide reference for improving emergency capacity of the hospital pharmacy department in response to the novel coronavirus pneumonia （COVID-19） epidemic. METHODS ：According to the related regulations and requirements of Law of the People ’s Republic of China on the Prevention and Control of Infectious Diseases ，combined with the situation of COVID- 19 epidemic prevention and control ，and management experience of relevant hospitals ，on the basis of in-depth analysis of drug supply and quality assurance ，drug dispensing management ，provision of clinical pharmaceutical services and other related material support of hospital pharmacy department，integrated emergency management model was constructed for COVID- 19 epidemic prevention and control ，and the precautions and response measures of each link were sorted out. RESULTS ：Integruted emergency management mode for COVID-19 epidemic prevention and control in hospital pharmacy department included but was not limited to human resource management，drug and disinfection products supply management （mainly including key treatment drugs and disinfection product list formulation，control，inventory increase ，etc.）；drug dispensing management （mainly including prescription ，pharmacy window ， planning quantitative reserve ， drug return ， etc.）；clinical pharmaceutical care management （mainly including providing pharmaceutical information support ，online pharmaceutical service ，monitoring drug safety ，etc.）；personnel protection and disinfection （mainly including personnel protection ，environment and window ，equipment and container ，paper prescription disinfection，etc.）；special management of donated drugs ；prevention and control knowledge training ；pharmaceutical education and scientific research management ，etc. CONCLUSIONS ：The integrated emergency management model for epidemic prevention and control is helpful for hospital pharmacy to manage public health emergencies. During the outbreak of COVID- 19，hospital pharmacy department should start integrated emergency management mode for epidemic prevention and control ，strengthen the risk control of each link ，and play a good role in the key functional departments in the special period.

Objective:To explore the effect of setting up a special elderly bowel preparation nursing group to implement optimized holistic nursing on the quality of peri-enteroscopy in elderly patients.Methods:Using the convenient sampling method, a total of 128 elderly inpatients who were scheduled to undergo ordinary or painless enteroscopy in Beijing Tongren Hospital from October 2015 to July 2018 were selected. They were randomly divided into the control group ( n=57) and the observation group ( n=71) . The control group was given routine nursing, while the observation group was given optimized holistic nursing mode. The safety of intestinal preparation, intestinal cleanliness and satisfaction of patients were compared between the two groups. Results:During intestinal preparation, a total of 56 patients in the observation group and 36 patients in the control group had excellent intestinal comfort. There was a statistically significant difference in comfort between the two groups ( Z=2.31, P< 0.05) . There were 64 cases in the observation group and 36 cases in the control group with grade 1-2 intestinal cleanliness. The difference in intestinal cleanliness between the two groups was statistically significant ( Z=4.05, P< 0.01) . Conclusions:The implementation of optimized nursing mode by the elderly bowel preparation nursing group can help improve the quality of bowel preparation of hospitalized elderly inpatients.

Objective    To investigate the effect of artificial colloid on coagulation function in pediatric patients weighing less than 5 kg with congenital heart disease during cardiopulmonary bypass in congenital heart disease surgery by using artificial colloid instead of human serum albumin. Methods    A total of 65 pediatric patients with weight less than 5 kg who underwent congenital heart disease surgery in our hospital from September 2016 to December 2017 were included in the study. They were randomly divided into two groups: an artificial colloid group (the experimental group, n=33) and a human serum albumin combined artificial colloid group (the control group, n=32). Perioperative hemoglobin concentration (Hb), blood products and hemostatic drugs used, postoperative coagulation function index and pleural fluid volume 24 hours after surgery were monitored. Results    There was no significant difference in perioperative Hb and chest tube drainage between the two groups. The platelet utilization rate in the experimental group was significantly lower than that in the control group (P<0.05). No significant difference was found in the dosage of other blood products and hemostatic drugs between the two groups during the perioperative period. There was no significant difference in coagulation parameters between the two groups before and after surgery (P>0.05). Conclusion    The use of artificial colloid as colloid priming solution during cardiopulmonary bypass has no adverse effect on coagulation function in pediatric patients weighting less than 5 kg with congenital heart disease.

Chimeric antigen receptor T-cell strategy targeting CD19 (CART19) has prominent anti-tumor effect for relapsed/refractory B-cell lymphomas. CART19-associated complications have been gradually recognized, however, late-onset complications have not been extensively studied. Herein, for the first time we report a diffuse large B-cell lymphoma patient with terminal ileum involvement obtained rapid remission and developed spontaneous terminal ileal perforation 38 days following CART19 infusion. The late-onset perforation reminds us that, for the safety of CART treatment, more cautions are warranted for the management of delayed GI complications.
B-Lymphocytes* ; Humans ; Ileum ; Lymphoma, B-Cell* ; Receptors, Antigen* ; T-Lymphocytes*