Objective A comparison of two method of establishing pressure ulcer rat models to determine which is the most suitable for experimental use.Methods 18 male SD rats were randomly divided into control(n=6),model A(n=6)and model B(n=6)groups.In the control group,iodophor treatment was given after hair removal at the simulated modeling site.In model group A,longitudinal compression was performed by simple deep-tissue foreign body implantation.In model group B,transverse compression was performed via the magnet compression method.The times required to complete the process and for each stage of pressure ulcer model establishment in each group were recorded.The general condition of the rats was observed,and the modeling rate,mortality rate,and infection rate were compared.Results By naked eye,we observed that the model A and model B groups gradually developed redness and swelling,ulceration,bleeding,exudation,and necrosis.Comparison of the whole time to produce pressure uler between model A and model B groups:the difference between the two groups was statitically significant(P＜0.05).Comparison of the time to produce pressure injury between Model A and Model B:The difference between the two groups at stage Ⅰ was not statistically significant(P＞0.05);the difference between the two groups at stage Ⅱ was statistically significant(P＜0 05);the difference between the two groups at stage Ⅲ was statistically significant(P＜0 05);the difference between the two groups at stage Ⅳ was statistically significant(P＜0 05).The mental and sports scores of the rats in the control group were significantly different from those in the model A and model B groups(P＜0.05).The general state of rats in the model group A was significantly different from that in the model B group,and coat color was dimer and activity decreased in the model group A.The modelling rate of rats in both model A and model B groups was 100％.The mortality and infection rates of the model group A were higher than those of the model group B,which were 33.34％and 16.70％,respectively.Conclusions Successful preparation of a four-stage model of pressure ulers in both modalities.The two method have both commonalities and distinct characteristics.The magnet compression method required less time,the rats were generally in good condition,and the mortality and infection rates were low;thus it is suitable for short-term intervention research.The simple deep-tissue foreign body implantation method took longer,required rats to have a certain level of tolerance,had high infection and mortality rates,and is more suitable for use for long-term observations of pressure ulcers.

Objective To explore and analyze the signals of pneumonia-related adverse events(ADEs)caused by endothelin receptor antagonists(ERAs)and provide reference for clinical safe medication.Methods Based on the the U.S.Food and Drug Administration(FDA)adverse event reporting system(FAERS)database,the data from the first quarter of 2015 to the first quarter of 2023 was extracted,and reporting odds ratio,pro-portional reporting ratio,Bayesian confidence propagation neural network and multi-item gamma poisson shrinker were used for mining.Results 7 279 reports of pneumonia-related ADEs with ERAs as the main suspects were extracted,including 3 705 reports of ambrisentan,1 028 reports of bosentan and 2 546 reports of macitentan.There were 68 pneumonia ADEs related to ERAs,including 21 ambrisentan,25 bosentan and 22 macitentan.According to the criteria for judging the signal of ADEs,there were 14 kinds of ADEs that formed signals,and all the systems involved in system organ classification were infections and infectious diseases.Infectious pneumonia accounted for the highest proportion of adverse reactions(93.61％)and caused the most deaths.Conclusion In the real world,ERAs can lead to pneumonia related ADEs.Female,elderly,and high-dose are important factors in the occurrence of pneumonia-related ADEs,which suggests that medical personnel need to individualized use drugs based on the patient's physiological status and drug characteristics when using ERAs to ensure medication safety.

OBJECTIVE To compare efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from PubMed， the Cochrane Library， Web of Science， Embase， Wanfang， CNKI， CBM and VIP database， randomized controlled trial （RCT） and cohort study about 24 h continuous pump （trial group） versus intermittent infusion （control group） of amphotericin B were collected from the inception to Jan. 2023. After literature screening and data extraction， the quality of RCT was evaluated with modified Jadad scale， and the quality of cohort study was evaluated with Newcastle-Ottawa scale. Meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software. RESULTS A total of 7 literature were included， involving 1 RCT and 6 cohort studies with a total of 767 patients. The results of meta-analysis showed that the clinical effective rate [RR＝1.44， 95%CI （1.13，1.83）， P＝0.003] of trial group was significantly higher than that of control group， and all-cause mortality rate [RR＝0.37， 95%CI（0.19，0.72），P＝0.003] and the incidence rate of infusion reaction [RR＝0.28，95%CI（0.18，0.43）， P＜0.000 01] were significantly lower than control group； there was no statistical significance in the incidence rate of renal impairment between 2 groups [RR＝0.71，95%CI（0.45，1.11），P＝0.13] . The sensitivity analysis results showed that the results obtained in this study were robust. CONCLUSIONS The efficacy and safety of 24 h continuous pump of amphotericin B are better than those of intermittent infusion in the treatment of invasive fungal infection.

OBJECTIVE To provide reference for improving work efficiency and promoting the rapid development of pharmacy department. METHODS AB working system was established in pharmacy department， and task division and working process were formulated. The response time of role B， management performance， the construction of discipline platform， scientific research achievements and other indexes were analyzed comparatively before （2016-2020） and after （2021） the implementation of AB working system. RESULTS Compared with before the implementation， the response time of role B was shortened to 0.5 h； the score of management performance was increased from 27.67 to 73.00； scientific research projects， SCI papers and discipline construction funds had increased significantly after the implementation. CONCLUSIONS The practice of AB working system should shorten the response time and be beneficial to build a high-quality management personnel， improve the management level and work efficiency， promote rapid development of pharmacy department.

OBJECTIVE To evaluate the efficacy ，safety，and economy of selexipag in the treatment of pulmonary arterial hypertension（PAH）. METHODS After literature screening ，data extraction and quality evaluation ，the results of included studies were analyzed descriptively by retrieving PubMed ，Embase，Web of Science ，Cochrane Library ，Epistemonikos，SinoMed， CNKI，VIP，Wanfang data ，CBM，official websites of domestic and foreign health technology assessment institutions and relevant database. RESULTS&CONCLUSIONS A total of 7 literature were included ，involving 6 meta-analysis and 1 pharmacoeconomic study. In terms of efficacy ，selexipag could improve patients ’exercise tolerance and hemodynamic indexes ，and reduced the incidence of clinical worsening events and hospitalization . However，intravenous/subcutaneous administration of prostacyclin analog had better effects in improving WHO functional class and reducing all -cause mortality （P＜0.05）. There were no statistically significant differences in the impact on outcome indexes between selexipag and other targeted agents （P＞0.05）. In terms of safety ， the incidence of adverse drug events and drug withdrawal due to adverse reactions was increased by selexipag （P＜0.05），but there were no significant differences between the effects of selexipag and other targeted drugs on adverse events ，serious adverse events and drug withdrawal due to adverse reactions （P＞0.05）. In terms of economy ，based on the background of Canada ’s health system，it was not economical for selexipag to treat PAH ，and there was a lack of economic research based on China ’s national conditions. Further comparative studies on the efficacy and economics of selexipag and prostacyclins in the real world are needed .

OBJECTIVE To systematically evaluate the adverse effects of drug-resistant tuberculosis （DR-TB） drugs on pregnant women and fetuses ，so as to provide evidence-based reference for clinical medication. METHODS PubMed，Cochrane Library，Embase，CBM，CNKI，Wanfang database and VIP were searched by computer to collect randomized controlled trials （RCTs），cohort studies ，case-control studies ，case series and case reports about pregnant women exposed to DR-TB drugs. The retrieval time limit was from the establishment of each database to August 20，2021. After selecting the literature and extracting the data，the bias risk assessment tool recommended by 6.2 version of Cochrane system evaluator manual was used to evaluate the quality of the included RCTs ；Newcastle-Ottawa scale was used to evaluate the quality of the included cohort studies and case-control studies ；IHE scale issued by the Canadian Institute of Health Economics （IHE）was used to evaluate the quality of the included case series and case reports. RevMan 5.1 software was used for Meta-analysis of non-comparative binary data. RESULTS A total of 13 literature were included ，including 7 case series and 6 case reports ，involving 203 patients and 204 newborns；among them，there were 6 literature about non-comparative binary data. The results of meta-analysis showed that after exposure to DR-TB drugs，no newborn had birth defects ；the mortality of pregnant women was 0.09[95％CI（0.06，0.15），P＜0.000 01]；the neonatal mortality was 0.02[95％CI（0，0.06），P＜0.000 01]；the incidence of preterm birth was 0.14[95％CI（0.03，0.43），P＝0.02]；the incidence of infants with low birth weight was 0.17[95％CI（0.04，0.51），P＝0.06]；the incidence of growth retardation was 0.15[95％CI（0.09，0.22），P＜0.000 01]；the incidence of stillbirth was 0.05[95％CI（0.02，0.09），P＜0.000 01]；the incidence of abortion was 0.08[95％CI（0.05，0.14），P＜0.000 01]. CONCLUSIONS Pregnant women exposed to DR-TB drugs can cause pregnant women ’s death and abortion ，neonatal death ，premature birth ，infants with low birth weight ，growth retardation and stillbirth，but there is no neonatal birth defect ；these adverse outcomes may be related to the history of DR-TB.

OBJECTIVE To reevaluate the system atic evaluation of g emcitabine combined with cisplatin in the treatment of advanced non-small cell lung cancer （NSCLC），in order to provide evidence-based evidence for the treatment of NSCLC. METHODS Retrieved from Wanfang database ，CNKI，VIP，PubMed，Embase，systematic evaluation of gemcitabine combined with cisplatin versus pemetrexed/vinorelbine combined with cisplatin in the treatment of advanced NSCLC was included from the inception to Dec. 2021. RevMan 5.3 system evaluation software was used for meta-analysis of various outcome indicators ； AMSTAR2 scale was used for methodological quality evaluation ，and GRADE tool was used for evidence quality evaluation. RESULTS A total of 9 literatures were included. Meta-analysis showed that the effective rate of gemcitabine combined with cisplatin was significantly lower than pemetrexed combined with cisplatin ，but was similar to vinorelbine combined with cisplatin. The 1-year survival rate of gemcitabine combined with cisplatin was equivalent to that of pemetrexed combined with cisplatin ，but was superior to vinorelbine combined with cisplatin. There was no significant difference in the incidence of nausea and vomiting between gemcitabine combined with cisplatin and pemetrexed/vinorelbine combined with cisplatin. Gemcitabine combined with cisplatin had a higher incidence of thrombocytopenia than pemetrexed/vinorelbine combined with cisplatin. The incidence of neutropenia and leukopenia in gemcitabine combined with cisplatin were higher than pemetrexed combined with cisplatin ，but were significantly lower than vinorelbine combined with cisplatin. The evaluation results of AMSTAR 2 scale showed that 6 systematic evaluation were of low quality in methodology and 3 were of very low quality. The results of the GRADE tool showed that 31％ of the outcome indicators were of medium quality （14 items），27％ were of low quality （12 items），and 42％ were of very low quality（19 items）. Research limitations and publication bias were the most frequently downgraded factors. CONCLUSIONS Gemcitabine combined with cisplatin has advantages over 154854280@qq.com vinorelbine combined with cisplatin in the efficacy and safety of ad vanced NSCLC ，especially in the 1-year survival rate ，the incidence of neutropenia and leucopenia. The efficacy and safety of gemcitabine combined with cisplatin are inferior to those of pemetrexed combined with cisplatin. However ，the methodological quality and evidence level of systematic evaluation are not high on the whole ，and the overall quality of research needs to be improved.

Objective The nursing treatment ability scale of patients with nuclear radiation damagein the hospital was developed to provide an evaluation basis for improving the nursing ability of nurses with nuclear radiation damage. Methods The scale was prepared by literature review, expert interview and expert consultation, and a total of 330 clinical nurses from a third-class hospital was randomly selected as the research objects. The scales were issued for item analysis and reliability and validity test. Results The scales were divided into 6 dimensions, including basic knowledge of nuclear radiation damage, specialized equipment use ability, specialized ward management ability, basic nursing ability, specialized nursing ability and self-ability recognition, with 51 items. After exploratory factor analysis, there were 6 principal components, and the cumulative interpreted variance was 70.757%. The χ², df, χ²/df, CFI, IFI, TLI, NFI, PNFI, PCFI, RMSEA fitting indexes of confirmatory factor analysis were all acceptable. Cronbach's α coefficient was 0.976, the retest reliability was 0.823, and the S-CVI (S-CVI/UA) was 0.84. The evaluation content validityS-CVI (S-CVI/AVE) was 0.98, and the content validity I-CVI of the item level was 0.78～1.00. Conclusion The items and dimension Settings of this scale have been tested, and all indicators met the requirements. The reliability and validity test results were good. It can be used as a scale for preliminary evaluation of hospital nursing ability of patients with nuclear radiation damage.

We compared the ways of deproteinization for crude polysaccharides of Coprinus comatus, and finally selected Sevage method as the optimal method. Two main fractions of Ccp-I-A and Ccp-I-B were obtained after DEAE-52 cellulose and Sephadex G-200 chromatography, both were white-floc, soluble in water, insoluble in absolute ethyl alcohol, acetone and other organic solvents. Additionally, Fehling reagent, CTAB, Sulphuric acid-carbazole, I-KI and FeCl₃ reaction were all negative. GC analysis showed Ccp-I-A was composed of mannitose, glucose and galactose in molar ratios of 2.03:9.52:1, whereas Ccp-I-B was composed of fucose and galactose with molar ratios of 1:5.21. Antioxidant activity test showed that Ccp-I-A and Ccp-I-B had good scavenging abilities on DPPH and ·OH. Compared to Ccp-I-B,the scavenging activity of Ccp-I-A was much stronger, and the scavenging rate could reach 72.1% and 55.3% respectively when the concentration was 300 μg/mL.

Objective To investigate the application and effect of bundle nursing intervention combining with ventilator pipeline disinfection in the prevention of ventilator-associated pneumonia (VAP). Methods A total of 100 cases who had not received bundle nursing intervention combining with ventilator pipeline disinfection in ICU ward,Cangzhou Central Hospital between February 2012 to January 2014 were treated as control group,while another 100 cases who had received bundle nursing intervention combining with ventilator pipeline disinfection in the same ward from February 2014 to January 2016 were treated as observation group. Incidence of VAP,length of mechanical ventilation time and ICU stay of two groups were compared. Results In different models of nursing care,incidence rate of VAP of the observation group and the control group were 9.0% and 24.0%(χ2=3.52,P < 0.05);length of mechanical ventilation time and ICU stay of the observation group were (4.62±2.10) d and (7.30±1.30) d which were shorter than those of the control group (t=2.40,19.30;P < 0.05). Conclusions Bundle nursing intervention combining with ventilator pipeline disinfection could lower the incidence of VAP,shorten the duration of mechanical ventilation time,ICU stay and improve patients' satisfication which is worthy of application in clinic.