Objective To construct a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer and to evaluate its efficacy.Methods Through literature review and Delphi expert correspondence,a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer was constructed.By the convenience sampling method,200 consecutive children who received chemotherapy in the neurosurgery department of a tertiary children's hospital in Zhejiang province from February 1 to October 31,2023 were included as the application subjects,with 100 cases in an experimental group and 100 cases in a control group.The experimental group applied the non-drug intervention program of acute chemotherapy-related nausea and vomiting in children with cancer,and the routine measures were applied in the control group.The incidence of nausea and vomiting,severity of vomiting,compliance rate of normal sleep duration and incidence of negative emotions were compared between the 2 groups.Results The recovery rate of the valid questionnaire in 2 rounds of expert letter inquiry was 100％,and the expert authority coefficient was 0.836.The Kendall harmony coefficients were 0.471 and 0.820(P＜0.001),and the final non-drug intervention program for pediatric acute chemotherapy-related nausea and vomiting included 5 primary,14 secondary and 18 tertiary items.The results showed that the incidence of nausea,vomiting and negative emotions in the experimental group were lower than that in the control group,with statistically significant differences(P＜0.05).The severity of vomiting was less than it in the control group,with statistically significant difference(P＜0.05).The standard rate of normal sleep time was higher than that of the control group,and the difference was statistically significant(all P＜0.05).Conclusion The non-drug intervention program of chemotherapy-related nausea and vomiting in children is scientific and feasible,and the implementation of the program can reduce the incidence of nausea,vomiting and negative emotions,reduce the severity of vomiting,and improve the standard rate of normal bedtime in children.

Lung cancers are the leading cause of cancer deaths worldwide and pose a grave threat to human life and health. Non-small cell lung cancer (NSCLC) is the most frequent malignancy occupying 80% of all lung cancer subtypes. Except for other mutations (

Objective To analyze the risks of hypertonic glucose injection (20％) (hypertonic glucose) in clinical application using failure mode and effect analysis (FMEA) method and improve the relevant management measures.Methods A study group on risk prevention strategies of hypertonic glucose was established in the First People's Hospital of Hefei.Domestic and foreign literature on medication error cases,preventive measures or management strategies,and data from questionnaires and on-the-spot investigations were collected.The failure modes in the process of hypertonic glucose application were analyzed and assessed.Severity (S),frequency of occurrence (O),and likelihood of detection (D) of the risks related to these failure modes were scored and the risk priority numbers (RPN) were determined.The failure modes with higher RPN were screened out and the corresponding prevention strategies were formulated.The incidence of medication errors and potential hazards,cognition rate of knowledge on drugs,qualification rate of drug storage,and satisfaction rate for management measures before and after the improvement were analyzed comparatively.Results According to the results from literature search,questionnaires,and on-the-spot investigations,a total of 24 failure modes were found in the 6 links relevant with hypertonic glucose application in clinical,which included links of prescription writing and delivery,pharmacist dispensing,nurse dispensing,post-administration monitoring,drug management,and information technology.Ranking the RPN from high to low,7 major failure modes with higher RPN were selected from the 24 failure modes,including the existence of drugs with similar name and drugs with similar package,wrong drug dispensing,absence of post-administration monitoring,lack of marked labels for drugs,garbles caused by lack of medication knowledge,and untimely record and report of medication errors.The incidences of medication errors and potential safety hazards before and after management improvement were 3.2％ (7/216) and 0.4％ (1/234),respectively and the difference had no statistical significance (P =0.058).The average cognitive rates of physicians,nurses and pharmacists before and after the improvement were 65.2％ (15/23),54.2％ (13/24),67.9％ (19/28) and 95.8％ (23/24),91.7％ (22/24),95.5 ％ (21/22),respectively and the differences were statistically significant (P 50.05 for all).The qualification rates of drug storage before and after management improvement were 70.2％ (151/215) and 98.7％ (230/ 233),respectively and the difference was statistically significant (P 5 0.05).The average satisfaction degrees of medical staff with hyperosmotic glucose management were 81.3％ (61/75) and 95.7％ (65/70),respectively before and after the management improvement and the difference was statistically significant (P 5 0.05).Conclusion Failure modes in the process of hypertonic glucose use can be effectively identified using the FMEA method,and the risk events can be effectively reduced after the corresponding improvement measures.

Objective To analyze the risks of hypertonic glucose injection (20％) (hypertonic glucose) in clinical application using failure mode and effect analysis (FMEA) method and improve the relevant management measures.Methods A study group on risk prevention strategies of hypertonic glucose was established in the First People's Hospital of Hefei.Domestic and foreign literature on medication error cases,preventive measures or management strategies,and data from questionnaires and on-the-spot investigations were collected.The failure modes in the process of hypertonic glucose application were analyzed and assessed.Severity (S),frequency of occurrence (O),and likelihood of detection (D) of the risks related to these failure modes were scored and the risk priority numbers (RPN) were determined.The failure modes with higher RPN were screened out and the corresponding prevention strategies were formulated.The incidence of medication errors and potential hazards,cognition rate of knowledge on drugs,qualification rate of drug storage,and satisfaction rate for management measures before and after the improvement were analyzed comparatively.Results According to the results from literature search,questionnaires,and on-the-spot investigations,a total of 24 failure modes were found in the 6 links relevant with hypertonic glucose application in clinical,which included links of prescription writing and delivery,pharmacist dispensing,nurse dispensing,post-administration monitoring,drug management,and information technology.Ranking the RPN from high to low,7 major failure modes with higher RPN were selected from the 24 failure modes,including the existence of drugs with similar name and drugs with similar package,wrong drug dispensing,absence of post-administration monitoring,lack of marked labels for drugs,garbles caused by lack of medication knowledge,and untimely record and report of medication errors.The incidences of medication errors and potential safety hazards before and after management improvement were 3.2％ (7/216) and 0.4％ (1/234),respectively and the difference had no statistical significance (P =0.058).The average cognitive rates of physicians,nurses and pharmacists before and after the improvement were 65.2％ (15/23),54.2％ (13/24),67.9％ (19/28) and 95.8％ (23/24),91.7％ (22/24),95.5 ％ (21/22),respectively and the differences were statistically significant (P 50.05 for all).The qualification rates of drug storage before and after management improvement were 70.2％ (151/215) and 98.7％ (230/ 233),respectively and the difference was statistically significant (P 5 0.05).The average satisfaction degrees of medical staff with hyperosmotic glucose management were 81.3％ (61/75) and 95.7％ (65/70),respectively before and after the management improvement and the difference was statistically significant (P 5 0.05).Conclusion Failure modes in the process of hypertonic glucose use can be effectively identified using the FMEA method,and the risk events can be effectively reduced after the corresponding improvement measures.

OBJECTIVE:To know the utilizatior of Shenfu injection(SFI)in our hospital,and provide reference for ratio-nal use of SFI. METHODS:In respective study,patients received SFI from the Hospital Information System(HIS)in surgery department in our hospital from Jan. 2013 to Dec. 2014 were analyzed statistically in aspects of general situation,indications, usage and dosage,course of treatment,drug combination,etc. And the incidence of ADR/ADE was monitored. RESULTS:The 1 247 surgery inpatients used SFI distributed in thyroid and galactophore department(634 cases),comprehensive minimal-ly invasive department (292 cases),gastrointestinal surgery department (250 cases),urology department (64 cases) and car-diothoracic surgery department(7 cases),including 466 male and 781 female,the ratio of male to female was 1∶1.68,aver-age age was 58.50 years;it mainly used in perioperative medication (78.11%) and treated for tumors (11.23%),treatment course concentrated on 2-7 d(71.45%),dosage mainly was 100 ml(70.01%);combination medication were mainly pantopra-zole sodium,Fructus bruceae injection,Xueshuantong for injection(lyophilized),etc. The nonstandard phenomenon was exist-ed in indications,dosage,solvent selection,medication frequency,drug combination,etc. There were no obvious ADR/ADE related to SFI. CONCLUSIONS:More attention must be paid to the irrational use of SFI in surgery clinic of our hospital,the safety of traditional Chinese medicine injection in clinical use should be correctly understood,achieve dialectical therapy and rational drug use.

OBJECTIVE:To investigate the clinical application of warfarin in inpatients of our hospital,and provide reference for standardized application in clinic. METHODS:Totally 267 inpatients records used warfarin in our hospital from Jan. 2013 to Jun. 2014 were investigated to retrospectively analyze the indications,dosage,international normalized ratio(INR)monitoring and bleeding complications of warfarin. RESULTS:Warfarin was mainly used for patients with deep vein thrombosis,cerebral infarc-tion,rheumatic heart disease and pulmonary embolism in our hospital;the dosage of inpatients was in the range of 0.625-6.875 mg with average daily dosage of (2.15 ± 0.72) mg;the INR lower than 1.8 accounted for 52.8%,the INR in the range of 1.8-3.0 (reaching the standard) accounted for 31.8% and INR higher than 3.0 accounted for 15.4%;incidence of adverse reactions was 5.6%,mainly subcutaneous blood spots (petechiae) and urine occult blood,and incidence of severe hemorrhage (intracerebral hemorrhage) was 0.7%. CONCLUSIONS:At present,the clinical application of warfarin is still deficient,and qualified rate of INR is still low. It's important to actively carry out medication intervention and clinical pharmaceutical care.

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Background and objective It has still been controversial to treat N2-IIIa non-small cell lung cancer (NSCLC) patients by surgery or non-surgery. We retrospectively analysed the survival of 121 stage N2-IIIa NSCLC patients treated with surgery and explored their postoperatively long-term prognostic factors.Methods All of 1,290 patients in Beijing Cancer Hospital underwent resection by single-surgeon-team, among which 121 cases with stage N2-IIIa were enrolled in the study. We retrospectively analysed the impact of gender, age, smoking, perioperative chemotherapy, incision, histological type, vascular tumor emboli, pTstage and tumor size on survival of stage N2-IIIa patients, and compared the survival between pa-tients with single-and multi-station N2 metastasis, and between intraoperatively or postoperatively pathological N2 (IIIa1/a2) and preoperative N2 (IIIa3/a4). Univariate analysis was conducted byKaplan-Meier curve, and signiifcance test was performed byLog-rank test andCox regression factor analysis was applicated for multivariate analysis.Results hTe 5-yr of all the 121 cases was 43.6%, with a median survival time being 50.3 mo. Univariate analysis showed the 5-year survival rate in patients with single- and multi- station N2 metastasis were 58.3% and 25.5%, respectively (P=0.001), 5-year survival rate in patients with stage IIIa1/a2 and stag IIIa3/a4 were 52.7% and 38.4%, respectively (P=0.020). Multivariate analysis demonstrated that only single station N2 (HR=0.326, 95%CI: 0.186-0.572, P<0.001) and IIIa1/a2 (HR=0.494, 95%CI: 0.259-0.941, P=0.032) were independent prognostic factors for stage N2-IIIa lung cancer patients. Conclusion The prognosis of stage N2-IIIa NSCLC patients with single-station N2 metastasis were better than those with multi-station N2 metastasis. Besides, IIIa1/a2 patients had a better survival compared with stage IIIa3/a4 patients. A multi-disciplinary comprehensive treatment based on surgery may allow patients with high selective stage N2-IIIa NSCLC to obtain a comparatively satisfying long-term survival.

Objective To investigate the applications of antibacterial agents to outpatients in primary hos -pitals in Hefei City of Anhui Province,and to provide reference for rational use of antibacterial agents.Methods In 2011, fourty-five primary hospitals in Hefei City were selected randomly ,including urban community health service centers (Group A) and township hospitals(Group B),and thirty or fourty outpatient prescriptions were analyzed monthly . Results In Group A, the percentage and intensity of antimicrobial usage , the proportion of the combination and injectable formulation were ( 45.36 ±20.02 )%, ( 89.73 ±25.50 ) DDDs · ( 100 cases ) -1 · d-1 , 13.34%, 23.16%,respectively,and the data in Group B were (61.36 ±17.18)%,(108.46 ±32.27)DDDs· (100 cases) -1 · d-1,29.13%,46.39%,respectively,which the former were significantly lower than the latter.Conclusion In primary hospitals,the applications of antibacterial agents to outpatiants are not rataional ,including high percentages of usage and unreasonable selection of species ,and more supervision and training need to be given to the medical staff , especially in township hospitals .

OBJECTIVETo explore the influence of moxibustion at Shenque (CV 8) point on aging and its mechanism.

METHODSForty-eight health rabbits were randomly divided into 8 groups, ie., group I (normal control group), group II (model group), group III (prevention with moxibustion at Shenque (CV 8) group), group lY (prevention with moxibustion both at Shenque (CV 8) and Zusanli (ST 36) group), group V (prevention with moxibustion both at Shenque (CV 8) and Mingmen (GV 4) group), group VI (treatment with moxibustion at Shenque (CV 8) group), group XII (treatment with moxibustion both at Shenque (CV 8) and Zusanli (ST 36) group), and group VIII (treatment with moxibustion both at Shenque (CV 8) and Mingmen (GV 4) group). The rabbit models of kidney-yang deficiency were created by pouring Hydroxyurea. The serum superoxide dismutase (SOD) activity was detected and the effect of the moxibustion from both prevention and treatment aspects were compared. And then the effect of different compatibility of acupoints was observed.

RESULTSAfter modeling, obvious symptoms of kidney-yang deficiency and decrease of SOD activity (all P < 0.01) were found in groups II, VI, VII and VIII. After the moxibustion treatment, the syndromes of kidney-yang deficiency were significantly improved (all P < 0.01) and SOD activities were increased obviously in groups VI, VII and VIII (all P < 0.01); a few syndromes of kidney-yang deficiency were found in groups III, IV and V after modeling, but with no significant changes of SOD activity (all P > 0.05). There was no significant difference in three moxibustion treatment groups (all P > 0.05).

CONCLUSIONThree acupoints compatibilities of moxibustion treatment can all regulate serum SOD activity in rabbits with kidney-yang deficiency effectively and have the significant effect both at prevention and treatment aspects and there is close relationship between their mechanisms on aging and regulating serum SOD activity.

Acupuncture Points ; Animals ; Disease Models, Animal ; Female ; Humans ; Kidney ; physiopathology ; Male ; Moxibustion ; Rabbits ; Random Allocation ; Superoxide Dismutase ; blood ; Yang Deficiency ; enzymology ; physiopathology ; therapy