Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

Objective:To design a set of new type of surgery instrument for pectus excavatum(PE),so as to improve safety and effectiveness of minimally invasive operation in surgery for PE.Methods:The design of the new type of surgical instrument for PE adopted multifunctional orthopedic board that combined both penetrating and supporting functions.The T type handle,special sealing screw for single hole,setscrew and stator,which were convenient for operation,were equipped for the orthopedic board.The new type of surgical instrument was applied in clinical PE surgery since November,2010,and a total of 1398 PE surgeries were conducted in the 10 years,which included 1078 surgeries with single hole,and 320 surgeries with multi holes.The success rate of PE surgery with single hole mode was assessed.Results:In 1398 PE surgeries,the number of PE patients,whose ages were less or equal to 12 years old,and who all adopted single hole mode,was 887 cases,and the success rate of surgery with single hole was 100%.In addition,the number of PE patients,whose age was larger than 12 years old,was 511 cases,and the surgery with single hole was successfully applied in 191 cases of them,and the success rate of surgery with single hole was 37.4%.Conclusion:The the new type of surgical instrument for PE by surgery with single hole and multi holes has mature technique,and it is safety and effectiveness,which has higher clinical application value.

Objective:To design a set of new type of surgery instrument for pectus excavatum(PE),so as to improve safety and effectiveness of minimally invasive operation in surgery for PE.Methods:The design of the new type of surgical instrument for PE adopted multifunctional orthopedic board that combined both penetrating and supporting functions.The T type handle,special sealing screw for single hole,setscrew and stator,which were convenient for operation,were equipped for the orthopedic board.The new type of surgical instrument was applied in clinical PE surgery since November,2010,and a total of 1398 PE surgeries were conducted in the 10 years,which included 1078 surgeries with single hole,and 320 surgeries with multi holes.The success rate of PE surgery with single hole mode was assessed.Results:In 1398 PE surgeries,the number of PE patients,whose ages were less or equal to 12 years old,and who all adopted single hole mode,was 887 cases,and the success rate of surgery with single hole was 100%.In addition,the number of PE patients,whose age was larger than 12 years old,was 511 cases,and the surgery with single hole was successfully applied in 191 cases of them,and the success rate of surgery with single hole was 37.4%.Conclusion:The the new type of surgical instrument for PE by surgery with single hole and multi holes has mature technique,and it is safety and effectiveness,which has higher clinical application value.

Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

Objective To explore the risk factors of early acute renal injury(AKI)in patients with hypertensive intracerebral hemorrhage(HICH).Methods Ninety HICH patients admitted to the Hai'an People's Hospital from July 2020 to June 2022 were enrolled.Based on the diagnostic criteria of the Kidney Disease Prognosis Quality Initiative Guidelines,the patients were divided into AKI group(n=21)and non-AKI group(n=69).Univariate and multivariate logistic regression analyses were used to evaluate whether urinary neutrophil gelatinase-associated lipocalin(NGAL),urinary microalbumin creatinine ratio(ACR),and serum homocysteine(Hcy)were independent risk factors affecting the early onset of AKI in HICH patients.The predictive value of urinary NGAL,urinary ACR,and serum Hcy for the early onset of AKI in HICH patients were evaluated by the receiver operating characteristic(ROC)curves.Results The proportions of blood transfusion or mannitol use,urinary NGAL,urinary ACR and serum Hcy in the AKI group were significantly higher than those in the non-AKI group(P<0.05).Multivariate logistic regression analysis showed that blood transfusion or mannitol use(OR=3.556,95% CI:1.608-7.864),urinary NGAL(OR=1.005,95% CI:1.002-1.008),urinary ACR(OR=1.812,95% CI:1.251-2.625),and serum Hcy(OR=1.923,95% CI:1.455-2.542)were independent risk factors for early onset of AKI in patients with HICH(P<0.05).ROC curve analysis showed that the areas under the curves of urinary NGAL,urinary ACR,and serum Hcy for the prediction of early onset of AKI in patients with HICH were 0.786(95% CI:0.680-0.892),0.676(95% CI:0.553-0.799),and 0.737(95% CI:0.631-0.843),respectively;the area under the curve of the 3 indicators was 0.914(95% CI:0.823-1.000).Conclusion Urinary NGAL,urinary ACR,and serum Hcy are independent risk factors for the onset of early AKI in patients with HICH.Each factor has certain predictive value for the onset of early AKI,and the combination of the 3 factors has higher value in predicting the onset of early AKI.

Objective To observe the changes of urinary neutrophil gelatinase-associated lipocalin(NGAL)and urinary albumin-to-creatinine ratio(ACR)in patients with acute cerebral infarction and acute kidney injury(AKI).Methods The clinical data of 100 patients with acute cerebral infarction who were admitted to Hai'an People's Hospital from September 2020 to August 2022 were retrospective analyzed.They were divided into AKI group(n=30)and non-AKI group(n=70)according to the occurrence of AKI.The general information of both groups was collected.Multivariate logistic regression analysis was used to assess the risk factors of acute cerebral infarction complicated with AKI.Receiver operator characteristic(ROC)curve was used to evaluate the value of urinary NGAL and ACR in predicting acute cerebral infarction combined with AKI.Results The proportion of patients older than 60 years,the proportions of patients with hypertension,diabetes mellitus,chronic kidney disease,heart failure,and infarct area＞20 cm2,and the levels of urinary NGAL and ACR in the AKI group were higher than those in the non-AKI group(P＜0.05).ROC curve analysis confirmed that urinary NGAL and ACR could be used to predict acute cerebral infarction complicated with AKI,and the area under the curve(AUC)values were 0.718 and 0.883,respectively(P＜0.05).The logistic regression analysis showed that age＞60 years,hypertension,diabetes mellitus,chronic kidney disease,heart failure,infarct area＞20 cm2,urinary NGAL＞278.251 ng/mg,and urinary ACR＞32.414 mg/mmol were the risk factors for acute cerebral infarction combined with AKI(P＜0.05).Conclusion Urinary NGAL and ACR levels are significantly elevated in patients with acute cerebral infarction complicated with AKI,which may be used as effective indicators to evaluate early AKI.

Lung cancer is one of the malignant tumors with the highest incidence and mortality rate worldwide and has a poor prognosis. With the popularization of thin layer CT, more and more early lung cancers are being detected. In recent years, thoracoscopic technology and robotic surgery technology have been innovated, and multiple adjuvant therapies such as chemotherapy, targeted therapy and immunotherapy have progressed rapidly, providing lung cancer patients with multiple treatment options. However, the prognosis of lung cancer patients has not been significantly improved, which is related to the overall poor prognosis of lung cancer patients on the one hand, and the urgent need to find effective predictive markers for patients' prognosis, to accurately screen patients, and to carry out targeted treatment in order to improve patients' prognosis on the other hand. In this paper, we review the progress of tertiary lymphoid structures (TLSs) in lung cancer and discuss the prognostic predictive value of TLSs in lung cancer and their feasibility as biomarkers for adjuvant therapy.

Injury monitoring is an important approach for injury control and is an important part of comprehensive disease monitoring. With the development of medical digitalization, an intelligent injury monitoring system has been created in Yinzhou District, Ningbo City, Zhejiang Province using artificial intelligence techniques based on Ningbo Municipal Health Information Platform and has been applied across the district since 2019. The manual card-reporting mode has been transformed to intelligent card-reporting mode in this system, which achieves functions of epidemiological analyses of the monitoring data, early warning of high-incidence injuries, classified management of injury and quality control of report cards. Nearly 300 thousand cards have been automatically reported since the system was online available since November 2022, and the epidemiological characteristics of injury were preliminarily understood, which provide data supports to early earning and interventions of injury. The intelligent injury monitoring system greatly improves the injury monitoring efficiency and card-reporting quality, and saves a large number of manpower and material resources, which provides a powerful technical support to widespread injury monitoring.

AIM: To compare the results calculated by population pharmacokinetic analysis tools Phoenix NLME, Monolix, R nlmixr package and CPhaMAS cloud platform with the gold standard sofeware NONMEM. METHODS: Fifty sparse sampling data sets based on a one-compartment model and fifty dense sampling data sets based on a two-compartment model were simulated, and the above five analysis tools were used to calculate the population typical value, individual variability and individual pharmacokinetic parameters. RESULTS: The population typical value and individual variability calculated by CPhaMAS and Phoenix NLME had the highest matching degree with NONMEM, followed by nlmixr. Monolix had the lowest matching degree, but Monolix and nlmixr might be more robust. The correspondence between clearance and distribution volume was better than the absorption rate constant. Except the absorption rate constant calculated by Monolix and intercompartmental clearance calculated by nlmixr, the correlation coefficients of individual pharmacokinetic parameters calculated by all analytical tools were greater than 0.99. CONCLUSION: The results calculated by the above four population pharmacokinetic analysis tools are highly correlated with that of NONMEM.

OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with corona virus disease-19 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare, the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.