Objective To observe the value of nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis(ALNM)of stage cT1N0 breast invasive ductal carcinoma(IDC).Methods A total of 77 cases with pathologically diagnosed stage cT1N0 single breast IDC were retrospectively collected,including 23 cases with and 54 cases without ALNM.Univariate and multivariate binary logistic regression analysis were used to analyze clinical data,laboratory indicators and ultrasonic manifestations,then the independent predictors of ALNM of stage cT1N0 breast IDC were screened to establish laboratory indexes model,ultrasound model and combined model,respectively,and nomogram of the combined model was drawn.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of each model.The consistency of results of combined model and actual results was analyzed using calibration curve.Decision curve analysis(DCA)was used to explore the clinical value of each model.Results Serum carbohydrate antigen 153(CA153)(OR=1.132),platelet-to-lymphocyte ratio(PLR)(OR=1.020)and echo attenuation behind the lesion on ultrasound(OR=8.789)were all independent predictors of ALNM in stage cT1N0 breast IDC(all P＜0.05),and the area under the curve(AUC)of laboratory indexes model,ultrasound model and combined model for predicting ALNM of stage cT1N0 breast IDC was 0.757,0.616 and 0.836,respectively.The consistency of the predicted results of combined model and actual results was good.When the threshold was higher than 0.15,the net benefit of combined model was higher than that of the other 2 models.Conclusion Nomogram of ultrasound combined with laboratory indexes could effectively predict ALNM of stage cT1N0 breast IDC.

Objective To observe the value of nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis(ALNM)of stage cT1N0 breast invasive ductal carcinoma(IDC).Methods A total of 77 cases with pathologically diagnosed stage cT1N0 single breast IDC were retrospectively collected,including 23 cases with and 54 cases without ALNM.Univariate and multivariate binary logistic regression analysis were used to analyze clinical data,laboratory indicators and ultrasonic manifestations,then the independent predictors of ALNM of stage cT1N0 breast IDC were screened to establish laboratory indexes model,ultrasound model and combined model,respectively,and nomogram of the combined model was drawn.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of each model.The consistency of results of combined model and actual results was analyzed using calibration curve.Decision curve analysis(DCA)was used to explore the clinical value of each model.Results Serum carbohydrate antigen 153(CA153)(OR=1.132),platelet-to-lymphocyte ratio(PLR)(OR=1.020)and echo attenuation behind the lesion on ultrasound(OR=8.789)were all independent predictors of ALNM in stage cT1N0 breast IDC(all P＜0.05),and the area under the curve(AUC)of laboratory indexes model,ultrasound model and combined model for predicting ALNM of stage cT1N0 breast IDC was 0.757,0.616 and 0.836,respectively.The consistency of the predicted results of combined model and actual results was good.When the threshold was higher than 0.15,the net benefit of combined model was higher than that of the other 2 models.Conclusion Nomogram of ultrasound combined with laboratory indexes could effectively predict ALNM of stage cT1N0 breast IDC.

Objective To explore the application effect of family integrated care (FIC) based on family ward (FW) on premature infants with bronchopulmonary dysplasia.Methods A total of 171 premature in-fants with bronchopulmonary dysplasia and their parents in the neonatology department of a hospital from March 2022 to March 2023 were selected as the research subjects.According to the wishes of parents,they were divided into three groups:NICU-FIC group,FW-FIC group and no accompanying group.In the NICU-FIC group,the parents entered the centrally managed neonatal intensive care unit to take care of premature in-fants at the bedside.The parents in the FW-FIC group shared a single ward with the premature infants,and participated in the care throughout the day.The parents in the unaccompanied group did not participate in the care of premature infants during hospitalization.The conditions of the three groups of premature infants at discharge and on 30 d after discharge were compared among 3 groups.Results A total of 167 premature in-fants completed the trial.At discharge,the breastfeeding rate,total oxygen days,and total hospitalization days of the NICU-FIC group and FW-FIC group were significantly different from those of the unaccompanied group (P<0.05).However,there was no statistically significant difference between the NICU-FIC group and FW-FIC group(P>0.05).After 30 d of discharge,the breastfeeding rate,weight gain,proportion of home oxygen therapy,and readmission rate of the NICU-FIC group and FW-FIC group were significantly different from those of the unaccompanied group (P<0.05).The breastfeeding rate,weight gain and readmission rate in the FW-FIC group were significantly different from those in the NICU-FIC group (P<0.05).Conclusion The FIC method based on the family ward is consistent with the FIC method based on the open neonatal intensive care unit in promoting the clinical prognosis of premature infants with bronchopulmonary dysplasia,moreover the FIC method based on the family ward has better strengthening effect and out-of-hospital continuity.

Premature infants often present with inadequate pulmonary development and are susceptible to chronic respiratory conditions,including bronchopulmonary dysplasia and cystic fibrosis,which necessitate extended periods of oxygen therapy.The implementation of home oxygen therapy has been shown to reduce hospitalization durations and facilitate pulmonary maturation.However,challenges such as excessive oxygen administration and premature discontinuation of therapy pose significant clinical risks.In this review,we critically evaluate the current practices and methodologies associated with home oxygen therapy for premature infants,offering comprehensive insights and strategic recommendations.Our objective is to advance the understanding of neonatal care practitioners and to support the establishment of evidence-based guidelines for the management of home oxygen.

Regional medical alliances help distribute high-quality medical resources to primary healthcare institutions.Under the guidance of " Internet-plus Healthcare" and " Hierarchical Medical System"policies, pharmacists are also exploring new management approaches for discharged patients with chronic diseases.The authors developed a Chronic Care Management(CCM)platform based on mobile App Yi Xing, and carried out full-range CCM for discharged patients in cooperation with pharmacists within the alliance. This CCM practice can contribute to an innovative transformation of pharmaceutical care, deliver high-quality pharmaceutical care to primary institutions, improve patients adherences and efficacy of medication, reduce adverse reactions, and save costs.

OBJECTIVE:To analyze the safety of linezolid (LZD) for elderly patients,and probe into the regularity of adverse reaction (ADR).METHODS:In retrospective study,elderly patients treated with LZD injection or tablets were selected from our hospital during Jan.2014-Dec.2015.The occurrence of ADRs were analyzed statistically.RESULTS:A total of 126 patients were included,the age was from 65 to 94 year-old,and the mean duration of treatment was (9.47 ± 6.31) d (ranged 1-35 d).Forty-five cases suffered from ADR after medication (35.71％),followed by 39 cases of thrombocytopenia (30.95％),9 cases of leukocytopenia(7.14 ％),7 cases of hemoglobin reduction (5.55 ％),6 cases of nausea and vomiting (4.76 ％),4 cases of transaminase elevation (3.17％),4 cases of diarrhea (3.17％),2 cases of lactic acidosis (1.59％),2 cases of skin rash (1.59％) and 1 case of drug fever (0.79％).The incidence of thrombocytopenia in ICU patients was significantly higher than non-ICU patients,with statistical significance (P=0.019).There was no significant difference among different dosage forms of LZD without statistical significance (P=0.218).CONCLUSIONS:Clinicians and pharmacists should closely monitor the application of LZD in elderly patients,pay more attention to ADR induced by LZD,especially in ICU,it induces the high incidence of thrombocytopenia.Meanwhile,it is suggested to monitor serum lactate concentrations regularly during treatment.

Objective To discuss the measures to prevent adverse events caused by misused hyperosmolar drugs. Methods Clinical pharmacists were involved in the treatment of one case of skin necrosis caused by hyperosmolar arginine infu-sion,analyzing the cause of the adverse events and proposing solutions and preventative measures.Results Treatment includs external application of Epson salt,debridements,infection prevention and so on were implemented.All bruises were absorbed with good wound healing.Conclusion Clinical pharmacist should play a role in examining prescriptions and ensuring drug safe-ty for patients.