Objective To understand the occurrence and main characteristics of medication errors (ME) in Xiamen Maternal and Child Health Hospital.Methods All the ME reports received by the ME submission system of Xiamen Maternal and Child Health Hospital from January 1,2015 to December 31,2017 were collected,and ME characteristics such as the time of occurrence,classification,grade,drugs involved,and triggering factors were analyzed.On the basis of the 9-level grading method (grade A-Ⅰ),ME were further divided into potential errors (including potential error problems and errors that happened but the drugs were not given to patients) and out-door errors (the wrong drugs had been given to patients).Results A total of 18 944 ME reports were collected,including 12 ME that occurred before the link of prescription and did not involve patients and 18 932 ME that occurred in the link of prescription and various links after the prescription.Of the 18 932 ME,231 were out-door errors,which accounted for 1.22％ of overall ME.A total of 3 553 074 patients (number of registrations)were prescribed in the study period in the hospital and the incidences of overall ME and out-door errors were 0.53％ (18 932/3 553 074) and 0.07‰ (231/3 553 074),respectively.The highest incidences of both the potential errors and out-door errors appeared from 13:00 to 13:59 [21.87‰(1 120/51 248);0.18％(9/51 248)].The top 3 ME classes in the 18 944 ME were prescription errors (77.37％,14 657 ME),dispensing and location errors (17.35％,3 286 ME),and omission and delivering errors (2.22％,421 ME).Of the 18 944 ME,6 (0.03％),18 821 (99.35％),111 (0.59％),and 6 (0.03％) ME were grading as A,B,C,and D,respectively,while none was grading as E-Ⅰ.Personnel factor took the first place [59.65％ (11 301/18 944)] in all the triggering factors of ME,followed by environmental factor [17.71％ (3 355/18 944)].Conclusions The incidence of overall ME in Xiamen Maternal and Child Health Hospital was 0.53％ and most of the ME were not serious,which were no harm to patients.The peak time of the ME occurrence lasted from 13:00 to 13:59.Prescription error was the main type of ME and the main trigger factor was personnel factor.Results of the study could help to develop targeted precautions to reduce the occurrence of ME.

Objective To understand the occurrence and main characteristics of medication errors (ME) in Xiamen Maternal and Child Health Hospital.Methods All the ME reports received by the ME submission system of Xiamen Maternal and Child Health Hospital from January 1,2015 to December 31,2017 were collected,and ME characteristics such as the time of occurrence,classification,grade,drugs involved,and triggering factors were analyzed.On the basis of the 9-level grading method (grade A-Ⅰ),ME were further divided into potential errors (including potential error problems and errors that happened but the drugs were not given to patients) and out-door errors (the wrong drugs had been given to patients).Results A total of 18 944 ME reports were collected,including 12 ME that occurred before the link of prescription and did not involve patients and 18 932 ME that occurred in the link of prescription and various links after the prescription.Of the 18 932 ME,231 were out-door errors,which accounted for 1.22％ of overall ME.A total of 3 553 074 patients (number of registrations)were prescribed in the study period in the hospital and the incidences of overall ME and out-door errors were 0.53％ (18 932/3 553 074) and 0.07‰ (231/3 553 074),respectively.The highest incidences of both the potential errors and out-door errors appeared from 13:00 to 13:59 [21.87‰(1 120/51 248);0.18％(9/51 248)].The top 3 ME classes in the 18 944 ME were prescription errors (77.37％,14 657 ME),dispensing and location errors (17.35％,3 286 ME),and omission and delivering errors (2.22％,421 ME).Of the 18 944 ME,6 (0.03％),18 821 (99.35％),111 (0.59％),and 6 (0.03％) ME were grading as A,B,C,and D,respectively,while none was grading as E-Ⅰ.Personnel factor took the first place [59.65％ (11 301/18 944)] in all the triggering factors of ME,followed by environmental factor [17.71％ (3 355/18 944)].Conclusions The incidence of overall ME in Xiamen Maternal and Child Health Hospital was 0.53％ and most of the ME were not serious,which were no harm to patients.The peak time of the ME occurrence lasted from 13:00 to 13:59.Prescription error was the main type of ME and the main trigger factor was personnel factor.Results of the study could help to develop targeted precautions to reduce the occurrence of ME.

Objective To analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1), and to investigate its clinical significance in bone marrow mononuclear cells of patients with chronic myeloid leukemia chronic-phase (CML-CP) after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction was used to measure the expression level of LEF-1 gene in 38 CML-CP patients after initial diagnosis and chemotherapy and 20 persons without blood system diseases and neoplastic diseases as normal control. The difference of LEF-1 expression level between the patients and healthy control was compared, and the effect of imatinib on the main molecular response (MMR) was analyzed. Results The expression of LEF-1 mRNA in 38 newly diagnosed patients [0.00214 (0.00020 - 0.02120)] was significantly higher than that in normal controls [0.00101 (0.00009 - 0.00233)] (U= 163.0, P< 0.01). The expression of LEF-1 mRNA in MMR group [0.00107 (0.00010 - 0.00519)] was significantly lower than that in non-MMR group [0.01015 (0.00091 -0.03615)] (U= 25.0, P< 0.01). There was no significant difference in LEF-1 mRNA expression between the normal control group and the MMR group after imatinib treatment (U= 201.0, P> 0.05). The level of LEF-1 mRNA expression of non-MMR group was also higher than that of the normal control group (U= 14.0, P<0.01). The rate of acquiring MMR was significantly higher in high LEF-1 mRNA expression group [84.2 %(16/19)] than that in low expression group [47.4%(9/19)] (χ2=4.209, P<0.01). The time of acquiring MMR was significantly shorter in the high LEF-1 mRNA expression group [(10.0 ± 4.5) months] than that in the low expression group [(14.6 ± 3.8) months] (t= 2.705, P< 0.01). Conclusions LEF-1 may be involved in the occurrence and development of CML, and reflects the tumor burden. It may be one of the indicators to predict the efficacy of imatinib.

Objective To investigate the mRNA level of lymphoid enhancing factor-1 ( LEF-1) in bone marrow mononuclear cells after the initial diagnosis and chemotherapy of patients with multiple myeloma (MM) and its clinical significance. Methods The LEF-1 mRNA of target gene in 42 MM patient was detected by real-time fluorescence quantitative polymerase chain reaction (RTQ-PCR), and 20 patients without hematological disease were enrolled as the healthy controls. Results The LEF-1 mRNA median level in previously diagnosed MM patients was significantly higher than that in the healthy controls [0.01068 (0.00017 - 0.14100) vs. 0.00101 (0.00009 - 0.002326)], and the difference was statistically significant (U = 91.00, P< 0.001); The LEF-1 mRNA median level in MM patients after chemotherapy was declined compared with the patients before chemotherapy [0.00011 (0.00001 - 0.01548) vs. 0.01068 (0.00017 -0.14100)], and the difference was statistically significant (U = 343.0, P< 0.001). The LEF-1 mRNA median level of MM patients after chemotherapy in progression of disease (PD) group was higher than that in the non-PD groups [0.08386 (0.00288 - 0.14100) vs. 0.003454 (0.000156 - 0.05660)], and the difference was statistically significant (U = 343.0, P< 0.001). The overall survival (OS) rate in the high LEF-1 expression group was shorter than that in the low LEF-1 expression group for MM patients in the initial diagnosis (47.6%vs. 65.5 %, χ2 = 3.931, P= 0.0414). Conclusion LEF-1 may be involved in the occurrence and development of MM, which has a potential to become an indicator of evaluating the poor prognosis and PD of MM patients, and could be served as a novel therapy target for the treatment of MM.

Objective To quantitatively analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1) in bone marrow mononuclear cells of patients with acute myeloid leukemia (AML) at intermediate-risk after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to measure the expression level of LEF-1 gene in AML patients at intermediate-risk after initial diagnosis and chemotherapy, and its relationship with effectiveness and survival were analyzed. Results The LEF-1 mRNA level in preliminarily diagnosed patients with AML was significantly higher than that in control arm [0.00519 (0.00015-0.09207) vs. 0.00101 (0.00009-0.00233)], and the difference was statistically significant (u=134.50, P<0.01). The LEF-1 mRNA level in patients after chemotherapy was significantly declines as compared to that in patients before chemotherapy [0.00107 (0.00008 - 0.00744) vs. 0.00519 (0.00015 - 0.09207)], and the difference was statistically significant (u= 317.00, P< 0.01) and LEF-1 mRNA expression level before chemotherapy in complete remission (CR) patients was significantly higher than that in non-CR patients [(0.01108 (0.00164 - 0.09207) vs. 0.00110 (0.00015 - 0.00916)], and the difference was statistically significant (u=19.00, P<0.01). High LEF-1 expression predicted a significantly better overall survival in AML patients with intermediate-risk cytogenetics (χ2= 4.549, P= 0.033). Conclusions LEF-1 may be involved in the development and progression of AML at intermediate-risk patients and is closely related to tumor burden and treatment efficacy. LEF-1 may be a good predictor of better prognosis and a novel target for therapeutic effect.

Objective To analyze the serious complications of transurethral resection of the prostate (TURP).Methods A retrospective study was conducted to summarize the clinical data of 1950 patients with benign prostatic hyperplasia from January 2005 to December 2014.All patients received TURP.The mean patient Age,disease course,IPSS score,PV and Qmax of 1 950 eligible patients were 71 years (54 to 87 years),7.6 years(0.5 to 15.0 years),(65.1 ±33.4)ml,25.5 ±3.9 and (8.1 ±2.6)ml/s,respectively.Intraoperative and postoperative complications were graded according to the CLASSIC and modified Clavien classifications,respectively.Serious complications were defined as grade Ⅲ or higher.Results Among the TURP procedures,99 serious complications occurred,resulting in a serious complication rate of 5.1％,Serious intraoperative and postoperative complication rates were 1.2％ (24 cases) and 3.9％ (75 cases),respectively.Serious intraoperative complications included ureteral orifice injury (3 cases),bladder explosion (4 cases),and transurethral resection syndrome (17 cases).Serious postoperative complications included massive hemorrhage (26 cases),severe dysuria (18 cases),permanent urinary incontinence (4 cases),cardio-cerebral vascular accident (5 cases),pulmonary thrombosis (3 cases),severe infection(18 cases),and death (1 case).Conclusions Serious complications may occur at any stages during TURP.Understanding the causes and characteristics of complications,strengthening the prevention and effective treatment is the key measure to reduce the incidence rates.

Objective To quantitatively analyze the mRNA and protein expression level of a proliferation-inducing ligand (APRIL) and investigate its clinical significance in peripheral blood mononuclear cells and plasma from newly diagnosed patients with B-cell chronic lymphocytic leukemia (B-CLL).Methods The mRNA of the target gene in 32 B-CLL patients and 15 health controls was quantified with real-time fluorescence quantitative polymerase chain reaction (RFQ-PCR) and protein by enzyme-linked immunosorbent assay (ELISA).Results APRIL mRNA was assayed with RFQ-PCR,the intra-and inter-batch reproducibility showed the coefficient of variation (CV) were 1.69 ％-6.98 ％ and 6.49 ％-10.27 ％,respectively.The expressions of APRIL mRNA and protein in patients with B-CLL were significantly higher than those in control (P ＜ 0.05),and significant difference was noted among the comparable stages in the arms (P ＜ 0.05).The expression of APRIL mRNA and protein in TDI (treatment-demand-indicator) arm was significantly higher than those in non-TDI arm (P ＜ 0.05).Conclusions APRIL may be involved in the formation and development of B-CLL and be an influence factor for disease staging.Thus,APRIL may be a prognostic indicator as well as the therapy target for the disease.

Objective To study the clinical features and differential diagnosis of hairy-cell leukemia variant (HCL-V).Methods A case with HCL-V was reported and the literatures were reviewed.Results The patient had splenomegaly for twenty years and a history of recurrent pulmonary infection.His blood routine test showed a high white blood cell count and abnormal high proportion of lymphocytes.Peripheral smear and bone marrow smear both showed significantly higher proportion of lymphocytes,part of which had soma jagged,prominent nucleoli and villous/hairy cytoplasmic projections.His hairy leukemic cells expressed CD1 1c,CD19,CD20,CD22,and had variable expression of FMC-7,CD103 and lambda,but not CD5,CD23 and CD25.Transmission electron microscope showed many monocytes with villous exist in peripheral blood.Conclusions HCL-V is a rare and an indolent form of a small,mature,B-cell leukemia,based on the clinical,peripheral smear,bone marrow smear,flow cytometric analysis and transmission electron microscopy features,a diagnosis of HCL-V is confirmed.The differential diagnosis should always include splenic marginal zone B-cell lymphoma and HCL-C,because they have different clinical and biological features.

Objective To investigate the clinical application value of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney.Methods Fifty-four cases of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney were reviewed,including 9 cases with nonfunctioning tuberculosis pyonephrosis,18 cases with infection nonfunctioning pyonephrosis and 27 cases of nonfunctioning hydronephrosis.Fifty-four cases were received retroperitoneal laparoscopic nephrectomy,tuberculous and infection pyonephrosis underwent laparoscopic resection surrounding adipose capsule,nonfunctioning hydronephrosis underwent laparoscopic resection by pumping water to increase the peritoneal space.Results The operation of 54 cases were perfomed successfully.None of the patient required conversion to open surgery.During the surgery,1 case showed mild extravasation of cheese-like pus induced by laceration of the kidney capsule;2 cases had injuried on the peritoneum.The mean operation time was 125 (95-230) min,the mean blood loss was 84 (50-420) ml.All patients showed primary healing of the wound,the patients were discharged from the hospital in 6 to 11 d (mean 7.5 d).After followed up for 5-27 months,none of them had long-term complication.Conclusions Retroperitoneal laparscopic nephrectomy for nonfunctioning kidney has advantages of minimal invasion,less blood loss and quicker recovery,so it is a fairly safe and effective procedure for nonfunctioning kidney.

Objective To investigate the effects of arsenic trioxide plus thalidomide on immune function of patients with myelodysplastic syndrome (MDS).Methods Fifty-seven MDS patients (Low risk,medium risk and high risk) and 30 healthy volunteers were selected as our subjects.Thirty-four cases with medium risk Ⅱ and high risk MDS patients were randomly divided into A and B groups.Seventeen MDS patients in A group were treated with arsenic trioxide plus thalidomide,and 17 MDS patients in B group were treated with low-dose cytarabine.Lymphocyte subsets in peripheral blood were examined by flow cytometry (FCM).The adverse effect of arsenic trioxide and thalidomide were recorded.Results Compared with control group,the number of T lymphocytes(CD3 +),B lymphocytes (CD3-CD19 +) and NK cell (CD3-(CD16 CD56) +) of patients with MDS were significantly lower,and the differences were statistically significant (t =2.157,2.349,2.958 ; P ＜ 0.05 or P ＜ 0.01).The helper CD3 + CD4 + T cell (Th) ratio decreased in MDS patients than that of control group (t =2.412,P ＜ 0.05).The inhibition CD3 + CD8 + T cells (Ts) ratio increased (t =2.749,P ＜ 0.01).Th/Ts ratio inversion was seen in MDS patients.As the progression of MDS increase,Ts cell expression gradually increased and NK cells ratio gradually decreased.However,there was no significant difference among three groups.Th cells and B lymphocytes in the risk group were lower than that in the low risk group,and the difference was statistically significant (F =4.896 and 4.516,P ＜0.05),but there was no significant difference in the terms of the number of T lymphocytes,Th cell,ratio of Th/Ts and B lymphocytes among MDS groups.Number of T lymphocytes,B lymphocytes and NK cell count in group A after treatment were increased than that before treatment (t =2.435,2.468,2.653,P ＜ 0.05).In group A,2 cases were complete remission,4 cases with partial remission,and 5 cases with hematologic improvement.The total effective rate was 64.71％ (11/17),and curative effect is obviously better than that of B group (x2 =4.253,P ＜ 0.05).Meanwhile adverse effect was mild.Conclusion The cellular and humoral immune function decreased in MDS patients.The treatment of arsenic trioxide plus thalidomide on MDS is proved safety and efficacy,which might work by improving immune function of MDS patients.