Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Objective To investigate the risk factors of postoperative vitreous hemorrhage after minimal vitrectomy without endotamponade for proliferative diabetic retinopathy (PDR).Methods From June 2015 to June 2017,103 eyes of 103 patients with PDR diagnosed and underwent minimalvitrectomy in Henan Provincial People's Hospital were enrolled in the study.There were 58 males and 45 females,with the average age of 58.37± 10.14 years and diabetes duration of 8.7± 7.2 years.Baseline systemic parameters including sex,age,diabetes duration,hypertension,HbA1c,creatinine,whether received anticoagulants,ocular parameters including whether combined with vitreous hemorrhage,whether finished panretinal photocoagulation (PRP),whether received treatment of anti-VEGF,whether combined with iris neovascularization (NVI),lens status preoperatively,whether hypotony postoperatively and intraoperative parameters including whether disc neovascularization (NVD) bleeding,whether fibrovascular membrane (FVM) residual,laser points,whether combined with cataract phacoemulsification were identified by multivariate logistic regression analysis.Results Twenty-nine of 103 eyes (28.15％) developed PVH in 1 day to 6 months after surgery,with self absorption of 18 eyes and reoperation of 11 eyes.Univariate analysis showed there were significant differences in age (t=2.124,P=0.036),anti-VEGF(x2=7.105,P=0.008),NVD bleeding (x2=10.158,P=0.001) and FVM residual(x2=8.445,P=0.004) between patients with and without postoperative vitreous hemorrhage.Sex (x2=0.021,P=0.884),diabetes duration (t=0.87,P=0.386),hypertension (x2=2.004,P=0.157),HbA1c (t=1.211,P=0.229),creatinine (t=0.851,P=0.397),preoperative oral anticoagulants (x2=0.985,P=0.321),preoperative vitreous hemorrhage (x2=0.369,P=0.544),PRP (X2=1.122,P=0.727),NVI (x2=2.635,P=0.105),lens status (x2=0.172,P=0.679),hypotony postoperatively (x2=1.503,P=0.220),laser points (x2=1.391,P=0.238) and combined phacoemulsification surgery (x2=0.458,P=0.499) were not associated with PVH.Multivariate logistic regression analysis revealed the more PVH appeared in younger (OR=1.065,P=0.009) and NVD bleeding (OR=6.048,P=0.001) patients.Conclusion Younger age and NVD bleeding are the important risk factors for PVH after minimal vitrectomy without endotamponade in PDR.

Objective To evaluate the performance of an artificial intelligence ( AI ) assisted diagnosis system for diabetic retinopathy ( DR) based on deep learning theory. Methods Diagnostic performance of a robot assisted diagnosis system called SongYue for DR was trained by using 25297 retinal images tagged by fundus doctors from multiple hospitals in China. Four types of DR detection model consisting of abnormal DR,referable DR,severe non-proliferative and proliferative DR as well as proliferative DR according to fundus leisions identification were established. The ability of the system to distinguish DR was determined by using receiver operator characteristic (ROC) analysis,sensitivity and specificity of the system. Results SongYue system achieved an area under the ROC curve ( AUC) of 0. 920 for successfully distinguishing normal images from those DR with a sensitivity of 96. 0％at a specificity of 87. 9％. The AUC of SongYue for referable DR was 0. 925,sensitivity was 90. 4％,and specificity was 95. 2％. For severe non-proliferative and proliferative DR,AUC was 0. 845,sensitivity was 72. 7％,and specificity was 96. 2％. For proliferative DR, AUC was 0. 855, sensitivity was 73. 5％, and specificity was 97. 3％. Conclusions SongYue robot assisted diagnosis system has high AUC,sensitivity and specificity for identifying DR, showing good clinical applicable benefits.

OBJECTIVE: To study a surgical and repairing method for defects after the resection of basal cell carcinoma of external nose. METHOD: There are 26 cases of basal cell carcinoma that tumors have been resected completely after operation. For defect repairing in those 26 cases, 2 cases adopt direct suture method; 2 cases use skin graft repairing methods; 18 cases employ naselabial skin flap repairing method; 4 cases choose forehead pedicle skin flap repairing methods. RESULT: the wound of all the 26 cases was primary healed. Additionally, skin flap and skin graft were all survived. Follow-up studied in patients 1 to 3 years after the surgery showed that the local scar was not obvious and no tumor recurred or transferred. CONCLUSION Different surgical and repairing methods are performed to obtain a satisfactory results based on the area of defect and its location in nose. Naselabial skin flap is especially an ideal method to repair defects.
Carcinoma, Basal Cell ; surgery ; Cicatrix ; Forehead ; Humans ; Neoplasm Recurrence, Local ; Nose ; Nose Neoplasms ; surgery ; Reconstructive Surgical Procedures ; Skin ; Skin Neoplasms ; surgery ; Skin Transplantation ; Surgical Flaps ; Wound Healing

In order to study the efficiency of small interfering RNA (siRNA) transfer mediated by cationic liposome, we used luciferase siRNA to evaluate the gene silencing activity in the Hep-2 cells, which were stably transduced with a luciferase gene. The pDNA transfection was studied, and siRNA arrearage assay was conducted to determine the capability of cationic liposome with siRNA. Different concentrations of siRNA was used to silence luciferase gene' activity, and then the result was examined by microplate reader. Cell viability was analyzed after transfection by MTT assay. The results suggested that Lipofectamine 2000 could transfer the pDNA efficiently, and have strong binding capacity with siRNA. The silencing efficiency of luciferase was obtained with low concentration of siRNA. The cell viability was influenced by RNA interference (RNAi) very slightly, but the cell survival rate decreased with the increase of siRNA concentrations. It was well concluded that by optimizing the experimental conditions, cationic liposome can transfer low concentration siRNA to silence target gene's activity efficiently.
Cations ; chemistry ; Drug Carriers ; Genetic Vectors ; Hep G2 Cells ; Humans ; Lipids ; chemistry ; Liposomes ; chemistry ; Luciferases ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

Objective To explore the effect of Botulinum toxin type A (BTX-A) injection combined with rehabilitation training and medicated bath on spasm for children with cerebral palsy. Methods 80 children with spastic and mixed cerebral palsy were randomly divided into two groups with 40 cases in each group. The control group received physical therapy, and the observation group received BTX-A injection and rehabilitation training and medicated bath. They were assessed with modified Ashworth scale (MAS) and Gross Motor Function Measure (GMFM-88) before and 3 months after treatment. Results The scores of MAS and GMFM were better in 2 groups after treatment (P<0.05) and the observation group was better than that of the control group (P<0.05). Conclusion BTX-A injection combined with medicated bath can reduce muscle tension, improve gross motor function of children with spastic and mixed cerebral palsy.

Objective To observe the different cerebral activations between pre-administration and post-administration of tryptophan-depleted amino acid mixture (TRP-)/balanced amino acid mixture (BAL) in healthy volunteers through functional magnetic resonance imaging (fMRI) when they received electrical stimulation at the same time. Furthermore, the effects of 5-hydroxytryptamine (5-HT) were explored in pain modulation network. Methods Two-phase crossover design was adopted. Six right-handed healthy volunteers participated in the experiment. TRP- and BAL were administered to each participant according to the Young's method. Volunteers were scanned under fMRI with or without administration of TRP- or BAL when receiving electrical stimulation simultaneously. Analysis of functional neuroimages (AFNI) software was used to show the different activations in the human brain between pre- and post-administration of TRP-/BAL. Then all the results were analyzed by SPSS 14.0. Results (1) Bilateral primary somatosensory cortex (SⅠ) and secondary somatosensory cortex (SⅡ) were activated during pre-administration and post-administration of TRP-, but the activated volumes of bilateral SⅠ and SⅡ during post-administration of TRP- were found significantly larger than that during pre-administration of TRP (P＜0.05). (2) All the activated regions showed no difference between pre- and post-admini-stration of BAL. (3) There were significant differences of pain threshold between pre- and post-admini-stration of TRP- (P＜0.01), which meant that pain threshold reduced remarkably after TRP- administration, while it showed no difference between pre- and post-administration of BAL (P＞0.05). Conclusion 5-HT plays an important role in pain modulation in the central nervous system, TRP- causes acute tryptophan depletion (ATD) through reducing the level of 5-HT in the human brain, which can induce the decrease of volunteers' pain threshold. The activated volumes of bilateral SⅠ and SⅡ display signi-ficant difference between pre- and post-administration of TRP-, suggesting these brain areas may not only involve in the 5-HT related activities but in pain modulation network as well.

Objective:To study the effectiveness of Loop electrosurgical excision procedure (LEEP) in the diagnosis and management of cervical intraepithelial neoplasia(CIN). Methods: 155 patients with CIN were diagnosed by cervical biopsy under colposcopy. All cases were treated with LEEP and the operative time, bleeding volume, cervical biopsy results before and after LEEP were evaluated, and the effects and cervical regeneration were followed up. Results: The mean operative time of LEEP was 6. 8 minutes. The mean bleeding volume was 9.6m1. Pathological diagnosis of CINI CIN Ⅱ CIN Ⅲ after LEEP were positively correlated to directed biopsy by colposcopy. The correlation coefficient was 0.785 ( P < 0.01). The cure rate of LEEP was 98.6%. Among the 151 cases, 134 (88. 7%) were satisfactory cervical regeneration. Conclusions: LEEP is one of the effective and safe methods for the diagnosis and treatment of CIN.

Objective To investigate the effect of Plastrum Testudinis on neural stem cell after focal cerebral ischemia.Methods Rat models of focal cerebral ischemia were established by inserting nylon thread into the anterior cerebral artery.Immunohistochemical method was used to detect the expression of the neuroepithelial stem cell protein(Nestin),neurologic deficit and histological features were also observed.Results Plastrum Testudinis can decrease the neurologic dificit score and promote the expression of Nestin.Conclusion Plastrum Testudinis can alleviate the neurological symptoms and promote the proliferation of neural stem cell after focal cerebral ischemia.