Objective:To investigate the expulsion rate of GyneFix postpartum intrauterine device (PPIUD) placed immediately after cesarean section within one year and its influencing factors.Methods:A prospective cohort study was conducted. Women who volunteered to use a GyneFix PPIUD placed immediately after cesarean section (within 10 min after placenta delivery) for postpartum contraception were recruited from September 2017 to November 2020. The relevant information was collected through questionnaires before, during and 24 h after cesarean section. Outpatient follow-up was conducted at 42 d, 3 months, 6 months and 12 months after delivery to obtain information on expulsion of GyneFix PPIUD and unwanted pregnancy. Life table and Cox regression model were used to analyze the cumulative expulsion rate and related influencing factors.Results:A total of 470 subjects were recruited and 461 (98%) subjects were eligible for this study. The cumulative expulsion rate of GyneFix PPIUD within one year after cesarean section was 8.4% (95% CI: 7.0%-9.8%). Multivariate Cox regression analysis showed that women aged >35 years had significantly lower risk of PPIUD expulsion than those aged <25 years ( HR=0.16, 95% CI: 0.04-0.64). The risk of GyneFix PPIUD was not statistically significantly associated with cesarean section history and breastfeeding mode (all P>0.05). Nevertheless, this risk was statistically significant between hospitals. The Pearl index of contraceptive failure of the device was 2.37 (95% CI: 1.09-4.50) per 100 person-years. The rate of contraceptive failure was not associated with maternal age, breastfeeding mode, and history of cesarean delivery (all P>0.05). Conclusion:The one-year cumulative expulsion rate of GyneFix PPIUD placed immediately after cesarean section is 8.4%. Young mothers were at a higher risk of expulsion than their older counterparts. The device users should be counseled regarding the signs of expulsion. In case of expulsion, women should be offered reinsertion or other contraceptive methods. The training of service skills of GyneFix PPIUD should be strengthened in order to mitigate the risk of the device expulsion.

Objective:To investigate the expulsion rate of GyneFix postpartum intrauterine device (PPIUD) placed immediately after cesarean section within one year and its influencing factors.Methods:A prospective cohort study was conducted. Women who volunteered to use a GyneFix PPIUD placed immediately after cesarean section (within 10 min after placenta delivery) for postpartum contraception were recruited from September 2017 to November 2020. The relevant information was collected through questionnaires before, during and 24 h after cesarean section. Outpatient follow-up was conducted at 42 d, 3 months, 6 months and 12 months after delivery to obtain information on expulsion of GyneFix PPIUD and unwanted pregnancy. Life table and Cox regression model were used to analyze the cumulative expulsion rate and related influencing factors.Results:A total of 470 subjects were recruited and 461 (98%) subjects were eligible for this study. The cumulative expulsion rate of GyneFix PPIUD within one year after cesarean section was 8.4% (95% CI: 7.0%-9.8%). Multivariate Cox regression analysis showed that women aged >35 years had significantly lower risk of PPIUD expulsion than those aged <25 years ( HR=0.16, 95% CI: 0.04-0.64). The risk of GyneFix PPIUD was not statistically significantly associated with cesarean section history and breastfeeding mode (all P>0.05). Nevertheless, this risk was statistically significant between hospitals. The Pearl index of contraceptive failure of the device was 2.37 (95% CI: 1.09-4.50) per 100 person-years. The rate of contraceptive failure was not associated with maternal age, breastfeeding mode, and history of cesarean delivery (all P>0.05). Conclusion:The one-year cumulative expulsion rate of GyneFix PPIUD placed immediately after cesarean section is 8.4%. Young mothers were at a higher risk of expulsion than their older counterparts. The device users should be counseled regarding the signs of expulsion. In case of expulsion, women should be offered reinsertion or other contraceptive methods. The training of service skills of GyneFix PPIUD should be strengthened in order to mitigate the risk of the device expulsion.

A 78-year-old female patient with acute cerebral infarction received butylphtha-lide soft capsules 0.2 mg thrice daily. One week later,she experienced fatigue and anorexia. Two weeks later,she presented with yellowish skin and sclera. Laboratory tests revealed the following levels:aminotransferase (ALT)1 574 U/L,aspartate aminotransferase(AST)1 135 U/L,direct bilirubin(DBil)58.8 μmol/L, indirect bilirubin(IBil)62. 0 μmol/L. Liver damage was diagnosed and considered to be related to butylphthalide soft capsules,and then the medication was discontinued. The patient was given IV infusions of reduced glutathione 1.8 mg,Shuganning injection(舒肝宁注射液)10 ml,polyene phosphorylcholine 232.5 mg and magnesium isoglycyrrhizinate 150 mg once daily. On day 4 after symptomatic treatment,she had an ALT level of 840 U/L,an AST level of 640 U/L,a DBil level of 50.1 μmol/L,an IBil level of 57.1 μmol/L. On day 17,the yellowish skin and sclera significantly improved,the diet returned to normal and physical strength recovered,the results of reexaminination showed ALT 64 U/L,AST 41 U/L,DBil 13.9 μmol/L,IBil 18.6 μmol/L.

A 78-year-old female patient with acute cerebral infarction received butylphtha-lide soft capsules 0.2 mg thrice daily. One week later,she experienced fatigue and anorexia. Two weeks later,she presented with yellowish skin and sclera. Laboratory tests revealed the following levels:aminotransferase (ALT)1 574 U/L,aspartate aminotransferase(AST)1 135 U/L,direct bilirubin(DBil)58.8 μmol/L, indirect bilirubin(IBil)62. 0 μmol/L. Liver damage was diagnosed and considered to be related to butylphthalide soft capsules,and then the medication was discontinued. The patient was given IV infusions of reduced glutathione 1.8 mg,Shuganning injection(舒肝宁注射液)10 ml,polyene phosphorylcholine 232.5 mg and magnesium isoglycyrrhizinate 150 mg once daily. On day 4 after symptomatic treatment,she had an ALT level of 840 U/L,an AST level of 640 U/L,a DBil level of 50.1 μmol/L,an IBil level of 57.1 μmol/L. On day 17,the yellowish skin and sclera significantly improved,the diet returned to normal and physical strength recovered,the results of reexaminination showed ALT 64 U/L,AST 41 U/L,DBil 13.9 μmol/L,IBil 18.6 μmol/L.

OBJECTIVE:To provide reference for rational use of parenteral nutrition. METHODS:Combining with the pa-tients'nutritional status,clinical diagnosis and lab examination,5770 parenteral nutrition medical orders were collected from our hospital during May 2015-Apr. 2016,and then analyzed in respects of the stability of drug use,rationality of drug selection and pharmacoeconomics. RESULTS:The qualified stability of nutrient solution in 5770 parenteral nutrition medical orders accounted for 89.46%. The rates of reasonable drug selection in patients with abnormal liver function,renal function,hyperemesis gravidarum,pan-creatitis,complete fasting,long term parenteral nutrition (>14 d) and triacylglycerol >4.5 mmol/L were 76.19%,63.16%, 75.00%,78.95%,65.95%,64.06%and 50.00%,respectively. Four kinds of drugs were with same effect and dose,price difference between 4-34 times,the rate of inappropriate drug selection ranged 7.58%-61.64%. CONCLUSIONS:Parenteral nutrition design need to not only consider about nutritional status,clinical diagnosis and lab examination,but also take into account high efficiency,safety, economy and the stability of whole nutrient solution.

Objective To investigate the fine management in the role of infection control management and the effect evaluation in pharmacy intravenous admixture services. Methods From July 2013 to June 2016, infection control management were reviewed retrospectively in pharmacy intravenous admixture services:routine management (from July 2013 to December 2014) and fine management (from January 2015 to June 2016). The settlement of air bacteria formation rate, hand hygiene compliance and accuracy of drug-care workers, and worker′s hand colonization monitoring data before and after the fine management were compared. Results After the implementation of fine management, the settlement of air bacteria formation rate was reduced from 10.42%(120.0/1152) to 4.45%(51.3/1152); there was significant differences (t=3.417, P<0.01).The hand hygiene compliance of drug-care workers increased from 81.50%(1172/1438) to 95.56%(1314/1375), the difference was statistically significant (χ2=1.353, P<0.01);the accuracy rate increased from 86.09%(1109/1172) to 95.13%(1250/1314), the difference was statistically significant (χ2=60.975, P<0.01); workers′ hands colonies number after fine management decreased than before, and there was significant differences (χ2=41.163, P<0.01). Conclusions The fine management has a higher application value in the infection control management of pharmacy intravenous admixture services, which can reduce the settlement of air bacteria formation rate, workers′ hands colonies number, improve hand hygiene compliance and accuracy of drug-care workers, further standardize the worker′s behavior, provide a more secure configuration environment, and guarantee the quality of drug configuration.

OBJECTIVE:To investigate the role of clinical pharmacists on parenteral nutrition support for liver cirrhosis patients with gastrointestinal bleeding.METHODS:Clinical pharmacists participated in parenteral nutrition support consultation for a liver cirrhosis patient with gastrointestinal bleeding.Based on etiology,liver function,complications and the effects of drugs on liver function,through two consultation,it was suggested to no longer add insulin into the patient's nutrient solution,adjust 20％ Fat emulsion injection(C14-24)250 mL to 20％ Medium-chain and long-chain fat emulsion injection (C8-24) 250 mL,adjust Compound amino acid injection(18AA-V)350 mL to 6 Amino acid injection(6AA)350 mL,adjust Calcium gluconate injection 1.0 g to 0.7g.Sodium glycerophosphate injection 10 mL and Alanyl glutamine for injection 10 g were added,decreasing dripping speed from 2 mL/min to 1.5 mL/min,increase Glucose injection (100 mL:50 g) from 300 mL to 350 mL.Blood glucose was also detected.RESULTS:Physicians adopted the suggestion of clinical pharmacists.The patient's condition and blood glucose control would keep stable till gastrointestinal bleeding was controlled,the diet returned to normal and none of above symptoms occurred again.CONCLUSIONS:The participation of clinical nutrition pharmacists in pharmaceutical care as parenteral nutrition support plays active role on the improvement of patients' nutritive condition and clinical prognosis improvement.

A 52-year-old female patient received compound acetate gossypol tablets 1 pill daily (each one contains acetic acid gossypol 20 mg, vitamin B1 10 mg, vitamin B6 10 mg, potassium chloride 250 mg) for 21 months due to uterine fibroid.The patient developed weakness after 18 months of treatment, muscle soreness and fatigue after about 21 months of treatment.Laboratory tests showed the levels of serum potassium, magnesium, creatine kinase, and myoglobin were 2.0 mmol/L, 0.57 mmol/L, 8 830 U/L, and 977 μg/L, respectively.The compound acetate gossypol tablet was stopped and potassium, magnesium, and other treatments were given.Eight days later, her physical strength recovered, muscle soreness disappeared, and the levels of serum potassium, magnesium, creatine kinase, and myoglobin were 3.6 mmol/L, 0.78 mmol/L, 6 097 U/L, and 113 μg/L, respectively.Treatments of potassium and magnesium supplement continued.Ten days later, her serum potassium was 3.7 mmol/L, magnesium 0.82 mmol/L, creatine kinase 101 U/L, and myoglobin 40 μg/L.

A 52-year-old female patient received compound acetate gossypol tablets 1 pill daily (each one contains acetic acid gossypol 20 mg, vitamin B1 10 mg, vitamin B6 10 mg, potassium chloride 250 mg) for 21 months due to uterine fibroid.The patient developed weakness after 18 months of treatment, muscle soreness and fatigue after about 21 months of treatment.Laboratory tests showed the levels of serum potassium, magnesium, creatine kinase, and myoglobin were 2.0 mmol/L, 0.57 mmol/L, 8 830 U/L, and 977 μg/L, respectively.The compound acetate gossypol tablet was stopped and potassium, magnesium, and other treatments were given.Eight days later, her physical strength recovered, muscle soreness disappeared, and the levels of serum potassium, magnesium, creatine kinase, and myoglobin were 3.6 mmol/L, 0.78 mmol/L, 6 097 U/L, and 113 μg/L, respectively.Treatments of potassium and magnesium supplement continued.Ten days later, her serum potassium was 3.7 mmol/L, magnesium 0.82 mmol/L, creatine kinase 101 U/L, and myoglobin 40 μg/L.

OBJECTIVE: To investigate the maxillary sinus development and provide data for sinus surgery on children. METHOD: Two thousand two hundred and thirty-eight children were randomly selected among those who underwent skull and nasal sinus CT scanning because of certain symptoms and signs. Patients were divided into eighteen age cohorts based on their age at the time of the scan. Anterior-posterior, transverse diameters and vertical height of the maxillary sinus were measured and statistically analyzed. RESULT: The maxillary sinus volume was enlarging even in adult, hut the growth of maxillary sinus was relatively stable in adolescent. The difference of transverse and anterior-posterior diameters of maxillary sinus had no statistical significance between female and male (P > 0.05), while there was statistically significant difference in the vertical height of maxillary sinus (P < 0.05). CONCLUSION The results will aid the physicians when correlating the clinical and radiographic findings of pediatric patients who are being evaluated for sinus disease and potential surgical intervention.
Adolescent ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Male ; Maxillary Sinus ; diagnostic imaging ; growth & development ; Sinusitis ; Tomography, X-Ray Computed ; Young Adult