Objective To explore the predictive value of fibrin degradation product to albumin ratio(FDP/ALB),neutrophil to lymphocyte and platelet ratio(NLPR)for the severity of elderly community-acquired pneumonia(CAP).Methods 147 elderly CAP patients hospitalized in the Department of Respiratory and Critical Care,Affiliated Hospital of Chengde Medical University from March 2021 to March 2023 were selected and divided into non severe CAP group(n=94)and severe CAP group(n=53)according to the severity of the disease.The general and clinical data of two groups of patients were recorded,and calculated neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein(CRP)to albumin ratio(CAR),FDP/ALB,NLPR,and oxygenation index,the differences between two groups of the above indicators were compared and correlation analysis were conducted;The predictive value of FDP/ALB,NLPR,and other traditional inflammatory indicators on the severity of elderly CAP were compared.Results CRP,procalcitonin(PCT),white blood cells(WBC),neutrophil(NEU),fibrin degradation product(FDP),NLR,CAR,CURB-65 scores,FDP/ALB,and NLPR in severe CAP group were significantly higher than those in non severe CAP group,while lymphocyte(LYM),platelet(PLT)and albumin(ALB)were significantly lower than those in non severe CAP group(P＜0.05);There were no statistically significant differences in age,gender,smoking history,underlying diseases,and PLR between two groups(P＞0.05).Spearman correlation analysis showed a positive correlation between FDP/ALB,NLPR and CRP,PCT,WBC,NLR,CAR CURB-65 scores,while a negative correlation with oxygenation index(P＜0.05).Multivariate Logistic regression analysis showed that FDP/ALB and NLPR were independent risk factors for severe CAP in the elderly(P＜0.05).The analysis of receiver operating characteristic curve showed that the ability of FDP/ALB,NLPR,NLR,CAR,PCT,NEU,CURB-65 score,CRP,and WBC to predict the severity of elderly CAP gradually decreased(P＜0.05).Conclusion The predictive value of FDP/ALB and NLPR for the severity of elderly CAP is significantly better than traditional inflammatory indicators(CRP,PCT,WBC,NEU,NLR,CAR,CURB-65 scores),which should be taken seriously by clinical workers.

Objective To explore the predictive value of fibrin degradation product to albumin ratio(FDP/ALB),neutrophil to lymphocyte and platelet ratio(NLPR)for the severity of elderly community-acquired pneumonia(CAP).Methods 147 elderly CAP patients hospitalized in the Department of Respiratory and Critical Care,Affiliated Hospital of Chengde Medical University from March 2021 to March 2023 were selected and divided into non severe CAP group(n=94)and severe CAP group(n=53)according to the severity of the disease.The general and clinical data of two groups of patients were recorded,and calculated neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein(CRP)to albumin ratio(CAR),FDP/ALB,NLPR,and oxygenation index,the differences between two groups of the above indicators were compared and correlation analysis were conducted;The predictive value of FDP/ALB,NLPR,and other traditional inflammatory indicators on the severity of elderly CAP were compared.Results CRP,procalcitonin(PCT),white blood cells(WBC),neutrophil(NEU),fibrin degradation product(FDP),NLR,CAR,CURB-65 scores,FDP/ALB,and NLPR in severe CAP group were significantly higher than those in non severe CAP group,while lymphocyte(LYM),platelet(PLT)and albumin(ALB)were significantly lower than those in non severe CAP group(P＜0.05);There were no statistically significant differences in age,gender,smoking history,underlying diseases,and PLR between two groups(P＞0.05).Spearman correlation analysis showed a positive correlation between FDP/ALB,NLPR and CRP,PCT,WBC,NLR,CAR CURB-65 scores,while a negative correlation with oxygenation index(P＜0.05).Multivariate Logistic regression analysis showed that FDP/ALB and NLPR were independent risk factors for severe CAP in the elderly(P＜0.05).The analysis of receiver operating characteristic curve showed that the ability of FDP/ALB,NLPR,NLR,CAR,PCT,NEU,CURB-65 score,CRP,and WBC to predict the severity of elderly CAP gradually decreased(P＜0.05).Conclusion The predictive value of FDP/ALB and NLPR for the severity of elderly CAP is significantly better than traditional inflammatory indicators(CRP,PCT,WBC,NEU,NLR,CAR,CURB-65 scores),which should be taken seriously by clinical workers.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

OBJECTIVETo trace the source of human H7N9 cases in Huai'an and elucidate the genetic characterization of Huai'an strains associated with both humans and birds in live poultry market.

METHODSAn enhanced surveillance was implemented when the first human H7N9 case was confirmed in Huai'an. Clinical specimens, cloacal swabs, and fecal samples were collected and screened by real-time reverse transcription-polymerase chain reaction (RT-PCR) for H7N9 virus. The positive samples were subjected to further RT-PCR and genome sequencing. The phylodynamic patterns of H7N9 virus within and separated from Huai'an and evolutionary dynamics of the virus were analyzed.

RESULTSSix patients with H7N9 infection were previously exposed to live poultry market and presented symptoms such as fever (>38.0 °C) and headaches. Results of this study support the hypothesis that live poultry markets were the source of human H7N9 exposure. Phylogenetic analysis revealed that all novel H7N9 viruses, including Huai'an strains, could be classified into two distinct clades, A and B. Additionally, the diversified H7N9 virus circulated in live poultry markets in Huai'an. Interestingly, the common ancestors of the Huai'an H7N9 virus existed in January 2012. The mean nucleotide substitution rates for each gene segment of the H7N9 virus were (3.09-7.26)×10-3 substitutions/site per year (95% HPD: 1.72×10-3 to 1.16×10-2).

CONCLUSIONOverall, the source of exposure of human H7N9 cases in Huai'an was live poultry market, and our study highlights the presence of divergent genetic lineage of H7N9 virus in both humans and poultry specimens in Huai'an.

Adult ; Aged ; Aged, 80 and over ; Animals ; China ; epidemiology ; Evolution, Molecular ; Female ; Humans ; Influenza A Virus, H7N9 Subtype ; classification ; genetics ; isolation & purification ; Influenza in Birds ; epidemiology ; virology ; Influenza, Human ; epidemiology ; virology ; Male ; Middle Aged ; Molecular Epidemiology ; Phylogeny ; Poultry ; Prevalence