OBJECTIVE To provide a reference for the safe clinical use of meropenem. METHODS The relationship of adverse reactions was analyzed based on a case of febrile neutropenia after using meropenem in an infant after congenital heart surgery by clinical pharmacists. By retrieving Chinese and English databases， case reports of adverse reactions induced by meropenem in blood system were summarized and analyzed. Relevant risk signals of adverse events were excavated from the FDA Adverse Event Reporting System， and the characteristics of meropenem-induced hematologic adverse reactions were summarized. RESULTS This case was assessed as “very likely” according to the Naranjo’s assessment scale by clinical pharmacists. A total of 16 patients were included in the literature analysis， of which one was febrile neutropenia， 13 patients had grade 4 serious adverse reactions that were life-threatening or required urgent treatment. All adverse reactions improved after drug withdrawal. Data mining revealed that the median occurrence time of hematologic adverse events induced by meropenem was 6 d； neonatal thrombocytopenia， intravascular hemolysis and neutrophil count decrease were the top 3 signals of risk intensity for adverse events. CONCLUSIONS Early use of meropenem may induce serious life-threatening hematological adverse reactions， especially in infants and elderly， those who use higher doses of meropenem， those who have previous antibiotic allergies， those with complex underlying diseases， those who use multiple antibiotics in combination， and those who experience high fever and bleeding after medication.Close monitoring should be provided in clinical practice.

Objective: To study the effect of a space stabilizing device on the capacity for osteogenesis in the bone-grafted area. Methods: Patients with anterior teeth defects as well as labial alveolar ridge defects were randomly divided into two groups: the experimental group was treated using a space stabilization device after guided bone regeneration whereas the control group received regular guided bone regeneration. The CBCT data was analyzed prior to, immediately and 6 months after procedure to compare the osteogenesis with or without the device. Results: Seventeen bone-grafted sites were examined(7 in the experimental group and 10 in the control group). At 2 mm and 4 mm below the alveolar ridge, the horizontal bone resorption rate in the experimental group was significantly lower than the corresponding level in the control group(P=0.001). The horizontal bone resorption rate at 2 mm below the alveolar ridge of each group was significantly higher than that at 4 mm below the alveolar ridge in corresponding groups(P=0.003). Conclusion The space stabilizing device used in this study has a positive clinical impact on preserving space stability and minimizing bone resorption.

Objective:To retrieve, evaluate, and integrate the best evidence for preoperative evaluation and management of adult day surgery patients.Methods:The guidelines, evidence summary, systematic review, expert consensus and randomized controlled trial on preoperative evaluation and management of adult day surgery patients were systematically searched on Guidelines International Network, Chinese Clinical Guidelines Library, Clinical Practice Guideline of Canadian Medical Association, Scottish Intercollegiate Guidelines Network, Yimaitong, New Zealand Guidelines Group, China Ambulatory Surgery Alliance, National Institute for Health and Clinical Excellence, Chinese Medical Journal Network, Agency for Healthcare Research and Quality, UpToDate, Cochrane Library, Australian Joanna Briggs Institute Evidence-Based Healthcare Center Database, British Medical Journal (BMJ) Best Practice, PubMed, Web of Science, CINAHL, Elsevier, Embase, Medline, WanFang Data, China National Knowledge Infrastructure, China Biomedical Literature Database and other databases. After conducting methodological quality evaluation, evidence was extracted and integrated based on the theme. The search period was from the establishment of the database to May 15, 2023. Two researchers trained in evidence-based knowledge conducted a rigorous literature quality evaluation, evidence extraction, and integration of all included literature.Results:A total of 12 articles were included, including two guidelines, six evidence summaries, three expert consensus and one randomized controlled trial. A total of 24 pieces of evidence were collected from five aspects, including evaluation timing and evaluation method, evaluation personnel, evaluation location, evaluation content, education and training, and quality improvement.Conclusions:The best evidence for preoperative evaluation and management of adult day surgery patients provides evidence basis for clinical medical and nursing staff to conduct preoperative evaluation and management comprehensively and effectively.

Objective: To investigate the trends in mortality and life lost due to cancer among residents in Ouhai District, Wenzhou City from 2013 to 2020, so as to provide the evidence for formulating the cancer control strategy. Methods: The mortality data of cancer patients in Ouhai District from 2013 to 2020 were collected through Zhejiang Provincial Information Management System for Surveillance of Chronic Diseases. The crude mortality, standardized mortality, years of potential life lost ( YPLL ), years of potential life lost rate ( YPLLR ), standardized years of potential life lost ( SYPLL ), standardized years of potential life lost rate ( SYPLLR ), average years of life lost ( AYLL ) and annual percent change ( APC ) were estimated to analyze the trends in mortality and life lost due to cancer. Results: Totally 5 435 deaths occurred due to cancer in Ouhai District from 2013 to 2020, and the crude and standardized mortality rates were 154.10/105 and 119.41/105, respectively. The crude mortality of cancer was higher in men than in women ( 196.26/105 and 111.09/105; χ2=415.623, P<0.001 ). The standardized mortality of cancer among whole populations, the crude mortality in men and the standardized mortality in men showed a tendency towards a reduction ( P<0.05 ), with APC of -3.25%, -2.18% and -4.78%, respectively. The crude mortality of cancer showed an upward trend with age ( χ2trend=9 260.583, P<0.001 ). Lung cancer, liver cancer, stomach cancer, colorectal cancer and esophagus cancer were the five leading causes of cancer-related mortality, which accounted for 66.68% of all cancer mortality. Liver cancer, lung cancer, stomach cancer, colorectal cancer and brain cancer were the five leading causes of life lost, with YPLL of 11 191.50, 8 231.00, 6 000.00, 3 892.00 and 2 693.50 person-years, respectively. Leukemia was the primary cause of AYLL ( 25.17 years per person ). Conclusions Both the standardized mortality and the life lost due to cancer showed a tendency towards a reduction in Ouhai District from 2013 to 2020, and men and the elderly were high-risk populations. Lung cancer, liver cancer, stomach cancer, colorectal cancer, leukemia, brain cancer, and female breast cancer should be listed among cancers in Ouhai District prioritized for control

ObjectiveTo observe the effect of Kinesio taping on salivation after stroke. MethodsFrom October, 2019 to January, 2021, 40 patients with salivation after stroke were randomly divided into control group (n = 20) and experimental group (n = 20). Both groups received routine medicine, routine rehabilitation for dysphagia and rehabilitation nursing, while the experimental group received Kinesio taping in addition, for three weeks. They were assessed with Functional Oral Intake Scale (FOIS), Water Swallow Test (WST) and Teacher Drooling Scale (TDS) before and after treatment. ResultsOne case dropped in the experimental group. The scores of FOIS, TDS and WST improved in both groups after treatment (|Z| > 2.000, P < 0.05), and improved more in the experimental group than in the control group (|Z| > 3.045, P < 0.01). ConclusionKinesio taping may relieve the salivation of patients with dysphagia after stroke.

Objective:To explore the application effect and evaluation of virtual reality technology in oral implant therapy training.Methods:In November 2018, one adult patient (female, 36 years old) with missing right mandibular first molar was treated in the Department of Implantology, School and Hospital of Stomatology, Fujian Medical University. The three-dimensional virtual models of mandible and implant surgery tools were established, and the virtual reality software (Unity 3D 5.5.1) was imported. Combined with the virtual reality head mounted display, a virtual reality training system simulating the dental implant treatment process was independently developed. Ten refresher doctors and 20 graduate students in Department of Implantology, School and Hospital of Stomatology, Fujian Medical University from September 2018 to December 2019 were recruited as the experimental objects (no clinical experience was found). According to the level and seniority of doctors, they were randomly divided into virtual training group and conventional training control group, which made the two groups comparable, with 15 in each group. Subjective scores (including anatomical structure, surgical field of vision, cavity preparation, implant placement and process mastery) were given after the corresponding training in the two groups, and the virtual reality training system was used to test. The mesial and distal direction, buccolingual direction, depth and angle deviation of implants before and after the training were analyzed, and the differences between the two groups were compared.Results:The subjective scores of five dimensions in the virtual training group were significantly higher than those in the conventional training control group ( P<0.05). In the virtual training group, the mesial and distal, buccolingual, depth and angle deviation of implants were (0.73±0.33), (0.78±0.41), (0.61±0.32) mm and 6.66°±3.87°. All of them were significantly lower than those in the control group [(0.85±0.32), (1.12±0.38), (0.89±0.24) mm and 9.68°±3.74°] ( P<0.05). Conclusions:The self-developed virtual reality system of oral implant has good application effect, good operability and predictability. It can be effectively carried out in implant education and training, and it can strengthen skills of doctors, and is conducive to the practical operation.

Objective To explore the role and mechanism of tumor necrosis factor ligand -related molecule 1A (TL1A) in chronic experimental colitis associated intestinal fibrosis .Methods The model of chronic experimental colitis-associated intestinal fibrosis was induced by dextran sodium sulfate (DSS).The mice with high TL1A (L-Tg) expression in lymphoid cells and wild -type mice with the same genetic background were divided into wild type control group, wild type DSS group, transgenic control group and transgenic DSS group.The changes of body mass, length of colon, disease activity index (DAI) and colonic pathological score were compared among different groups .The degree of colonic inflammation was evaluated by Hematoxylin -Eosin (H-E) staining.The degree of intestinal fibrosis was assessed by Masson staining and Sirius red staining .The expression of vimentin, αsmooth muscle actin ( α-SMA), type Ⅰ collagen, Ⅲ collagen and transforming growth factor-β1 ( TGF-β1 ) /Smad3 in colon tissue was examined by immunohistochemistry .T test was performed for statistical analysis.Results The body mass of the transgenic DSS group decreased by (9.6 ± 1.8)％, which was more than wild-type DSS group (6.2 ±1.3)％, the difference was statistically significant (t =3.751, P <0.01).The DAI score and colonic pathological score of transgenic DSS group were both higher than those of wild-type DSS group (7.33 ±0.58 vs.6.00 ±1.00, and 14.00 ±1.05 vs.11.75 ±0.50, respectively), and the differences were statistically significant (t =2.818 and 4.739, both P <0.05).The results of Masson staining and Sirius red staining showed aggravation of intestinal fibrosis .The results of immunohistochemical staining showed that the cumulative positive absorbance values of vimentin , α-SMA, TGF-β1 and Smad3 of wild-type DSS group were lower than those of transgenic DSS group (0.650 ±0.050 vs. 0.800 ±0.020, 0.390 ±0.040 vs.0.600 ±0.040, 0.550 ±0.040 vs.0.730 ±0.040, 0.590 ±0.020 vs. 0.830 ±0.040), and the differences were statistically significant (t =6.823, 9.093, 7.794 and 10.390, all P <0.01).Conclusion TL1A may promote the proliferation and activation of fibroblasts through TGF -β1 /Smad3 pathway, leading to the genesis and development of experimental colitis associated intestinal fibrosis .

Objective To analyze the echocardiography features of unilateral absence of pulmonary artery ( U APA ) features and improve the prenatal diagnosis accuracy of U APA by analyzing fetal echocardiography features . Methods Fetal echocardiographic features were analyzed retrospectively in 6 cases with prenatal diagnosis of U APA between June 2012 and October 2018 . A t the same time ,ultrasonic manifestations of 3 patients whose antenatal examinations were performed in other hospitals and diagnosed as UAPA in our hospital were retrospectively analyzed . T he fetal echocardiography characteristics of UAPA were summarized . Results Among the 6 fetuses with UAPA ,4 cases were diagnosed as isolated unilateral absence of proximal right pulmonary artery ,1 was unilateral absence of proximal left pulmonary artery with tetralogy of Fallot ( T O F ) and 1 was isolated unilateral absence of proximal left pulmonary artery . Characteristic sonographical findings included : ① When other intracardiac abnormalities were absent ,the inner diameter and proportion of the heart cavity was normal . ② M ulti‐view showed that the normal confluence structure disappeared at the branch of the main pulmonary artery ,and the diameter of normal pulmonary artery branch was widened . ③On the basis of three vessels and trachea view ( 3V T ) ,moved the probe up and dow n to make a transverse scan ,two‐dimensional and color Doppler flow imaging ( CDFI ) showed a large vessel ( the brachiocephalic trunk artery ) originating from the aortic arch w hich had dual vascular features ,it means that it was difficult to distinguish the pulmonary artery branch from the aortic branch . ④ On coronal view of the large vessel ,two‐dimensional and CDFI clearly showed that the large vessel originating from the aortic arch was the brachiocephalic trunk artery ,and the pulmonary artery branch connected with the brachiocephalic trunk artery by the ipsilateral vertical arterial duct ( DA ) which originated from the root of brachiocephalic trunk artery ,but the left pulmonary artery branch connected with the ventral side of the aortic arch by the left DA in UAPA fetus with T O F . ⑤Spectrum Doppler of the anomalous vessels of the lungs confirmed that it was the pulmonary artery ,and the blood flow of the anomalous PA branch was isolated and no exact connection with the main pulmonary artery . Conclusions U APA can be accurately diagnosed prenatally by echocardiography . T he brachiocephalic trunk artery coronary view is very important for the diagnosis of this disease .Early diagnosis plays an important role in prenatal counseling and prognosis assessment .

Objective: To improve the prenatal diagnosis and differential diagnosis ability for anomalous origin of one pulmonary artery branch from the aorta (AOPA) and unilateral absence of pulmonary artery (UAPA) by comparing and analyzing different types of fetal echocardiography features. Methods: Fetal echocardiographic features were analyzed retrospectively in fetus with prenatal diagnosis of UAPA or AOPA between June 2012 and December 2018, and the different types of fetal echocardiography characteristics and main points of identification were summarized. Results: A total of 6 fetuses with AOPA and 6 fetuses with UAPA were diagnosed.Among the 6 fetuses with AOPA, 5 cases were anomalous origin of right pulmonary artery from the aorta (AORPA), including 3 cases with isolated AORPA and 2 cases combined with Berry syndrome, and 1 case was anomalous origin of left pulmonary artery from the aorta (AOLPA) with an absent pulmonary valve. All 6 cases of AOPA had proximal form. Among the 6 fetuses with UAPA, 4 cases were isolated unilateral absence of right pulmonary artery, 1 case was isolated unilateral absence of left pulmonary artery and 1 case was unilateral absence of left pulmonary artery combined with tetralogy of Fallot (TOF). The main common characteristic sonographical findings included: there was no confluence at the bifurcation of the main pulmonary artery on multiple views, and the affected pulmonary branch was not attached to the main pulmonary artery. The different characteristic sonographical findings in fetus included: the affected pulmonary artery of AOPA arosed from the right posterior or left posterior portion of the ascending aorta on three vessels and trachea view (3VT) and long axial view of left ventricle, and 3VT and the coronary view of brachiocephalic trunk artery showed that the abnormal origin of pulmonary artery branch of UAPA connected with the root of brachiocephalic trunk artery by the ipsilateral vertical arterial duct (DA), and color Doppler flow imaging showed that the blood flow of the affected pulmonary artery branch was isolated in the pulmonary field. Conclusions AOPA and UAPA have many similarities in the characteristics of fetal echocardiography. 3VT and long axial view of left ventricle are the best views for displaying proximal AOPA, 3VT and the coronary views of the root of brachiocephalic trunk artery are the best views for displaying UAPA.

Objective: To investigate the status of frailty in elderly inpatients with type 2 diabetes and its influencing factors. Methods: Collected 126 cases hospitalized elderly patients with type 2 diabetes (from September 2017 to August 2018) general information, glycosylated hemoglobin A1C (HbA1C), comorbidity, nutritional assessment, Mini-Mental State Examination (MMSE), the frailty scale, multiariable Logistic regression was used for the analysis of frailty influence factors. Results: 38.1% (48/126) of elderly in patients with diabetes had no frailty, 25.4% (32/126) of patients with pre-frailty, and 36.5% (46/126) of patients with frailty. Logistic regression analysis showed that poor nutritional status, cognitive impairment and lower scores of instrumental daily living ability were the main risk factors for frailty in elderly diabetes. Conclusion Among elderly in patients with diabetes, the incidence of frailty is high, suggesting that clinical medical staff should identify frailty patients as early as possible, strengthen the integrated management of elderly in patients with diabetes through the multidisciplinary cooperation model, provide individualized guidance, reduce and delay the occurrence of frailty in elderly patients with diabetes.