OBJECTIVE To develop a whole-process intelligent model of pharmaceutical care for peritoneal dialysis （PD） patients， and to provide a reference for clinical pharmacists to provide standardized PD pharmaceutical care. METHODS The pharmaceutical care mode of PD patients at home and abroad was investigated and analyzed. Based on the actual situation of the First Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”）， with “home→PD center outpatient→ inpatient department” as the main node， the recycling process of medication reconciliation was optimized. The whole-process intelligent pharmaceutical care model of PD was illustrated by improving the Chinese version of the drug-related problems （DRPs） classification tool， developing the corresponding pharmaceutical care process， and presenting specific cases. RESULTS Based on the medication therapy management （MTM） platform， our hospital had built a closed-loop PD whole-process intelligent pharmaceutical care model of “in-hospital pharmaceutical care （building document）-PD outpatient MTM-home pharmaceutical care （online App management）”. A “double cycle” workflow of “admission→discharge→outpatient” medication reconciliation cycle and “discovery-analysis-intervention-follow-up-record-evaluation” DRPs cycle was formed. CONCLUSIONS The establishment of the whole-process intelligent pharmaceutical care model for PD in our hospital provides experience for standardizing pharmaceutical care for PD patients， and can reduce DRPs.

Objective: To explore the prognostic factors of extracellular NK/T cell lymphoma (ENKTL) treated with pegaspargase/L-asparaginase. Methods: The clinical data of 656 ENKTL patients diagnosed at 11 medical centers in the Huaihai Lymphoma Working Group from March 2014 to April 2021 were retrospectively analyzed. The patients were randomly divided into two groups: a training set (460 cases) and a validation set (196 cases) at 7∶3, and the prognostic factors of the patients were analyzed. A prognostic scoring system was established, and the predictive performance of different models was compared. Results: Patients' median age was 46 (34, 57) years, with 456 males (69.5% ) and 561 nasal involvement (85.5% ). 203 patients (30.9% ) received a chemotherapy regimen based on L-asparaginase combined with anthracyclines, and the 5-year overall survival rate of patients treated with P-GEMOX regimen (pegaspargase+gemcitabine+oxaliplatin) was better than those treated with SMILE regimen (methotrexate+dexamethasone+cyclophosphamide+L-asparaginase+etoposide) (85.9% vs 63.8% ; P=0.004). The results of multivariate analysis showed that gender, CA stage, the Eastern Cooperative Oncology Group performance status (ECOG PS) score, HGB, and EB virus DNA were independent influencing factors for the prognosis of ENKTL patients (P<0.05). In this study, the predictive performance of the prognostic factors is superior to the international prognostic index, Korean prognostic index, and prognostic index of natural killer lymphoma. Conclusion: Gender, CA stage, ECOG PS score, HGB, and EB virus DNA are prognostic factors for ENKTL patients treated with pegaspargase/L-asparaginase.
Male ; Humans ; Middle Aged ; Asparaginase/therapeutic use* ; Prognosis ; Retrospective Studies ; Lymphoma, Extranodal NK-T-Cell/drug therapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Etoposide ; Cyclophosphamide ; Methotrexate/therapeutic use* ; DNA/therapeutic use* ; Treatment Outcome

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

【Objective】 To analyze the hepatitis B virus (HBV) infection data of blood donors from 18 domestic blood stations, so as to investigate the HBV infection situation of blood donors. 【Methods】 The positive rate of HBV and its distribution characteristics of regions, the percentage of HBsAg+ ELISA in first-time vs repeated blood donors, and the percentage of HBsAg-/HBV DNA+ blood donors of 18 domestic blood stations during 2017 to 2020 were collected from the Working Platform for Practice Comparison of Blood Centers, and the HBV infection among blood donors were statistically analyzed. 【Results】 From 2017 to 2020, the positive rate of HBV in blood donors among 18 domestic blood stations was 13.48/10 000-144.02/10 000, with the average HBV positive rate in eastern, central and western region at 26.14/10 000, 51.98/10 000 and 41.00/10 000, respectively. The HBsAg+ rate by ELISA among first-time and repeated blood donors was 14.55/10 000-305.39/10 000 vs 1.04/10 000-87.43/10 000 The HBsAg-/HBV DNA+ yield was 1.80/10 000-35.31/10 000. 【Conclusion】 The distribution of HBV infection in blood donors has regional characteristics, and HBV prevalence was low in repeated blood donors. HBsAg ELISA combined with HBV DNA detection can better ensure blood safety.

Objective:To evaluate the morbidity and causes of long-term abnormal sensation of breasts after typy Ⅰ dual-plane breast implant augmentation via endoscopic assisted axillary approach.Methods:A retrospective analysis was conducted on 53 patients who underwent endoscopic assisted transaxillary type Ⅰ dual plane breast implant augmentation by a same surgeon from July 2014 to December 2016. All patients were followed up for more than 18 months. Hyperesthesia, hypoesthesia and numbness of nipple-areola complex and imframammary fold and breast pain were accessed.Results:According to the palpation and consultation of the surgeon, a total of 10 patients presented with post-operative long-term abnormal sensation of breasts, of which 6(11.3% of the total number) patients presented with hypoesthesia of nipple-areola complex, 1 patient (1.9% of the total number)presented with hyperesthesia of nipple-areola complex, and 2 patients (3.8% of the total number)presented with hypoesthesia of inframammary fold region. One patient (1.9% of the total number) had long-term postoperative breast pain. According to the questionnaire designed to assess breast sensation, a total of 33 patients (64.7%) presented with long-term postoperative breast pain, a total of 12 patients (23.5%) presented with post-operative long-term hyperesthesia of nipple-areola complex, another 5 patients (9.8%) presented with transient hyperesthesia of nipple-areola complex.Conclusions:It is clear that the incidence of post-operative long-term abnormal breast sensation following endoscopic assisted transaxillary type Ⅰ dual-plane breast implant augmentation is comparatively low and controllable.And the main reason for this complication is the peripheral nerve innervation of the nipple areolar complex.

Objective:To evaluate the morbidity and causes of long-term abnormal sensation of breasts after typy Ⅰ dual-plane breast implant augmentation via endoscopic assisted axillary approach.Methods:A retrospective analysis was conducted on 53 patients who underwent endoscopic assisted transaxillary type Ⅰ dual plane breast implant augmentation by a same surgeon from July 2014 to December 2016. All patients were followed up for more than 18 months. Hyperesthesia, hypoesthesia and numbness of nipple-areola complex and imframammary fold and breast pain were accessed.Results:According to the palpation and consultation of the surgeon, a total of 10 patients presented with post-operative long-term abnormal sensation of breasts, of which 6(11.3% of the total number) patients presented with hypoesthesia of nipple-areola complex, 1 patient (1.9% of the total number)presented with hyperesthesia of nipple-areola complex, and 2 patients (3.8% of the total number)presented with hypoesthesia of inframammary fold region. One patient (1.9% of the total number) had long-term postoperative breast pain. According to the questionnaire designed to assess breast sensation, a total of 33 patients (64.7%) presented with long-term postoperative breast pain, a total of 12 patients (23.5%) presented with post-operative long-term hyperesthesia of nipple-areola complex, another 5 patients (9.8%) presented with transient hyperesthesia of nipple-areola complex.Conclusions:It is clear that the incidence of post-operative long-term abnormal breast sensation following endoscopic assisted transaxillary type Ⅰ dual-plane breast implant augmentation is comparatively low and controllable.And the main reason for this complication is the peripheral nerve innervation of the nipple areolar complex.

OBJECTIVETo study the effect of homoharringtonine (HHT) alone or combined with 3-methyladenine (3-MA) , an autophagy inhibitor, on the apoptosis and autophagy of K562 cells.

METHODSK562 cells were treated with HHT(10 ng/ml) or HHT(10 ng/ml) combined with 3-MA (1.5 mmol/L) for 1 to 8 days. The apoptosis of treated cells was tested by means of flow cytometry(FCM), and the autophagy levels were tested with RT-PCR, Western blot and electron microscopy.

RESULTSIn the early stage of HHT-treated group, the apoptosis rate increased and decreased later. Beclin1 mRNA expression level and the LC3II/I ratio were declined firstly and increased later in HHT group. While combining with autophagy inhibitor 3-MA, both the Beclin1 mRNA expression level and the LC3II/I ratio were declined continually during the treated period. The activated caspase-3 protein expression level was also raised sustainability during both HHT and 3-MA cultured period.

CONCLUSIONSHHT can induce apoptosis of K562 cells, but the sustaining effect of HHT can induc autophagy of K562 cells, the combination of HHT with 3-MA may enhance the cytotoxicitic effect of HHT on K562 cells.

This study was aimed to explore the change of K562 cell apoptosis at different time point after homoharringtonine (HHT) treatment and its mechanism. After treatment of K562 cells with 10 ng/ml HHT, the cell viability was tested with MTT assay; the expression of caspase-3 was detected with Western blot; the BCL-2 expression was analyzed with flow cytometry; the autophagosome was observed by electron microscopy. The results showed that the viability of K562 cells reduced gradually from day 1 to day 5 and ascended from day 6 to day 8 after HHT treatment. At the same time, the cleaved caspase-3 expression level of K562 cells increased gradually from day 1 to day 7, but reduced at the day 8 (P < 0.05). From day 1 to day 8 after HHT treatment, the BCL-2 expression level declined firstly and then went up (P < 0.05). Autophagosome was also seen remarkably at day 8 after HHT treatment. It is concluded that the apoptosis level of K562 cells after being treated with HHT enhances firstly and then declines , which may be associated with higher autophagy level in the late stage of HHT treatment.
Apoptosis ; drug effects ; Autophagy ; Caspase 3 ; metabolism ; Cell Proliferation ; drug effects ; Flow Cytometry ; Harringtonines ; pharmacology ; Humans ; K562 Cells ; Proto-Oncogene Proteins c-bcl-2 ; metabolism

OBJECTIVETo explore the optimal surgical approach for Siewert II and III adenocarcinoma of esophagogastric junction (AEG).

METHODSClinical data of 135 patients with Siewert II and III AEG treated in our hospital from August 2007 to August 2012 were analyzed retrospectively. Of 135 patients, 57 received transthoracic path for the stomach and proximal gastrectomy, second station lymph node resection (transthoracic group), and 78 cases received transabdominal hiatal approach (transabdominal group). The intraoperative lymph node harvested, postoperative complications and 5-year survival rate were compared between the two groups.

RESULTSThere were no significant differences in the residual tumor positive margin and anastomotic leakage rate between the two groups (both P>0.05). Compared with transthoracic group, transabdominal group had more lymph node dissected (11.1±0.2 vs. 10.4±0.3, P=0.033], less postoperative cardiac [2.6% (2/78) vs. 19.3% (11/57), P<0.01] and pulmonary [7.7% (6/78) vs. 21.1% (12/57), P<0.05] morbidity, and short postoperative hospital stay [(13.4±0.1) d vs. (16.4±0.3) d, P<0.01]. A total of 128 cases were followed up for median 38 months (6 to 72 months). The 5-year survival rate in transthoracic group and transabdominal group was 29.8% and 34.6% respectively, without significant difference (P>0.05).

CONCLUSIONFor the treatment of patients with Siewert II and III AEG, transabdominal hiatal approach can remove more lymph nodes, reduce postoperative cardiopulmonary morbidity and shorten hospital stay.

Adenocarcinoma ; surgery ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; pathology ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate

Objective To prepare serum calibrators for CRP measurement.Methods Fresh serum without infectious diseases , hemolysis, lipemia and choloplania were collected and divided into 3 groups, low, medium, and high, according to the CRP concentration.Each serum pool was mixed , filtered, sterilized and aliquoted.The materials were tested for homogeneity and stability.The values of the CRP was assigned by particle enhanced immunonephelpmetry , and calibrated with international reference materials.The expanded uncertainty was evaluated.Results The materials were tested to be homogeneous (Ubb﹤Ur, P>0.05) with Ubb values being 0, 0.125, 0, Ur values being 0.046, 0.213, 0.785, and F values being 0.803, 1.686, 0.966 in CL, CM, CH groups respectively.Stability study, where F values are 0.609, 0.259, and 1.557 at 22-25℃, 1.217, 4.583, and 0.893 at 2-8℃(P>0.05), showed that the materials were stable for at least 3 days at 22-25 ℃or 30 days at 2-8 ℃, respectively.The certified values of the 3 levels materials for CRP were ( 2.64 ±0.14 ) , ( 31.17 ±0.63 ) , ( 73.85 ±1.74 ) mg/L, respectively.Conclusion The calibrators prepared for serum CRP measurement were homogeneous , stable and accurately assigned and can be used to calibrate the CRP measure system.