OBJECTIVE To introduce the development of an intelligent prescription review decision-support system for anti-tumor drugs and assess its clinical application outcomes. METHODS Relevant data sources， including national and local pharmaceutical administration policies， clinical practice guidelines/consensus， hospital information systems data， and genetic testing results， were integrated. Adhering to the principles of structure， standardization and dynamic updating， a knowledge base covering chemotherapeutic， targeted and immunotherapeutic agents was constructed using a dual-dimensional modeling approach that combined “drug attributes” and “clinical contexts”. This knowledge base was then embedded into the hospital’s electronic medical order system to establish the prescription review decision-support system. The application and performance of the system were evaluated at Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. RESULTS A knowledge base containing 18 318 prescription review rules for anti-tumor drugs was constructed， and a closed-loop prescription review system was successfully established， encompassing pre-prescription real-time intervention， in-process interactive review， and post-prescription evaluation and analysis. From 2021 to 2024， the system generated a total of 57 879 alerts for prescriptions of five typical categories of anti-tumor drugs. For platinum-containing prescriptions， 22 577 alerts were generated， with Cisplatin for injection （lyophilized） being the most frequently alerted drug （13 445 alerts）， and “ototoxicity risk due to combined use” alerts remained high （7 682 alerts）. For methotrexate-containing prescriptions， 3 721 alerts were recorded， primarily related to “precaution-related issues” （76.4%， 2 843/3 721）. For doxorubicin-containing prescriptions， 17 301 alerts were triggered， primarily related to “dosage and administration” （14 315 alerts）. For human epidermal growth factor receptor 2-targeted agents-containing prescriptions， 1 007 alerts were issued， mostly related to “reimbursement restrictions” （956 alerts）. For programmed death-1/programmed death-ligand 1 inhibitors-containing prescriptions， the alerts increased year by year， totaling 13 273 alerts， primarily related to “inappropriate indication” （9 118 alerts）. Over the 4 years， the physician response rates to system alerts were 21.4%， 27.1%， 33.5% and 51.6%， respectively. CONCLUSIONS An intelligent decision-support system for anti-tumor drug prescription review， encompassing a closed-loop process of “real-time pre-event intervention， interactive in-event prescription review， post-event evaluation and analysis”， has been successfully constructed and implemented throughout the entire workflow. There is a discernible trend in this hospital， where the focus on monitoring anti-tumor drugs is shifting towards immunotherapy drugs. Additionally， the acceptance rate of physicians regarding prescription review opinions has been steadily increasing year by year.

OBJECTIVE: To observe the clinical efficacy of electroacupuncture combined with ear tip bloodletting for insomnia with phlegm-fire disturbing heart. METHODS: A total of 60 cases with insomnia of phlegm-fire disturbing heart were selected, and the treatment of electroacupuncture combined with ear tip bloodletting was delivered. Acupuncture was applied at Yintang (GV24⁺), Shenting (GV24), Sishencong (EX-HN1) and bilateral Shenmen (HT7), Quchi (LI11), Zhaohai (KI6), Shenmai (BL62), Fenglong (ST40), Neiting (ST4), Yintang (GV24⁺) and Shenting (GV24) were connected to electroacupuncture, continuous wave, 2 Hz in frequency. In addition, bloodletting was applied at ear tip. The treatment was given for 4 weeks. Before treatment, and after 1,4 weeks into treatment, the scores of Pittsburgh sleep quality index (PSQI), Athens insomnia scale (AIS), insomnia severity index (ISI) and TCM syndrome were compared, and the clinical efficacy was evaluated in the patients. RESULTS: After 1,4 weeks into treatment, the scores of PSQI, AIS, ISI and TCM syndrome were decreased compared with those before treatment in the patients (P<0.05). Of 60 cases, 30 cases were cured, 19 cases markedly effective, 9 cases effective and 2 cases failed, and the total effective rate was 96.7% (58/60). CONCLUSION Electroacupuncture combined with ear tip bloodletting can improve the sleep quality and clinical symptoms in patients with insomnia of phlegm-fire disturbing heart.
Humans ; Male ; Female ; Electroacupuncture ; Middle Aged ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Adult ; Bloodletting ; Acupuncture Points ; Aged ; Combined Modality Therapy ; Treatment Outcome ; Young Adult

Objective To investigate the effect of through frontal keyhole approach neuroendoscopic surgery of basal ganglia hemorrhage on nerve conduction tract and prognosis.Methods 56 patients with hypertensive basal ganglia hemorrhage treated in our department from October 2017 to October 2023 were selected and divided into observation group and control group.Among them,28 patients in the control group underwent microscopic surgery through temporal cortex approach,while 28 patients in the observation group underwent endoscopic surgery through frontal keyhole approach.Fractional anisotropy and activities of daily living were compared between the two groups after operation.Results The proportion of FA Ⅰ grade in observation group was 88.9％and 70.0％in GCS Ⅰ grade and GCS Ⅱgrade patients,respectively,while in control group it was 75.0％and 41.7％.The proportion of ADL Ⅰand Ⅱ grade in observation group was 94.4％and 70.0％in GCS Ⅰ grade and GCS Ⅱ grade patients,respectively,whereas in control group it was 81.3％and 41.7％.The integrity of the corticospinal tract and activities of daily living in observation group were better than those in control group,with statistical significance(P＜0.05).Conclusion The surgery of hypertensive basal ganglia hemorrhage with neuroendoscopy through frontal keyhole approach has little influence on nerve conduction tract and the prognosis was better than traditional microscopic surgery through temporal cortex approach.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Objective To investigate the effect of through frontal keyhole approach neuroendoscopic surgery of basal ganglia hemorrhage on nerve conduction tract and prognosis.Methods 56 patients with hypertensive basal ganglia hemorrhage treated in our department from October 2017 to October 2023 were selected and divided into observation group and control group.Among them,28 patients in the control group underwent microscopic surgery through temporal cortex approach,while 28 patients in the observation group underwent endoscopic surgery through frontal keyhole approach.Fractional anisotropy and activities of daily living were compared between the two groups after operation.Results The proportion of FA Ⅰ grade in observation group was 88.9％and 70.0％in GCS Ⅰ grade and GCS Ⅱgrade patients,respectively,while in control group it was 75.0％and 41.7％.The proportion of ADL Ⅰand Ⅱ grade in observation group was 94.4％and 70.0％in GCS Ⅰ grade and GCS Ⅱ grade patients,respectively,whereas in control group it was 81.3％and 41.7％.The integrity of the corticospinal tract and activities of daily living in observation group were better than those in control group,with statistical significance(P＜0.05).Conclusion The surgery of hypertensive basal ganglia hemorrhage with neuroendoscopy through frontal keyhole approach has little influence on nerve conduction tract and the prognosis was better than traditional microscopic surgery through temporal cortex approach.

Background Alcohol dependence and related health problems have attracted greater than ever attention in recent years.Alcohol dependence not only affected personal behavior control ability,but also brought adverse effect to families and society.Objective To analyze the relationship between cognitive function and personality traits among male alcohol-dependent patients with aggressive behavior,in order to provide references for improving the cognitive function of male alcohol-dependent patients with aggressive behavior.Methods Male patients with alcohol dependence attending Hunan Brain Hospital from March 2020 to March 2022 and fulfilling the International Classification of Diseases,tenth edition(ICD-10)diagnostic criteria were enrolled.According to the score of Modified Overt Aggression Scale(MOAS),participants were classified into aggressive behavior group and non-aggressive behavior group at 1∶1 ratio,each with 80 cases.The enrolled subjects were then evaluated using Revised Eysenck Personality Questionnaire Short Scale for Chinese(EPQ-RSC)and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Pearson correlation analysis was utilized to examine the correlation between EPQ-RSC and RBANS scores among alcohol-dependent patients with aggressive behavior.Results Scores on each subscale in RBANS were all lower in aggressive behavior group than those in non-aggressive behavior group(t=2.176,2.580,2.076,2.308,2.193,P<0.05),and scores on each dimension in EPQ-RSC in aggressive behavior group were higher than those in non-aggressive behavior group(t=4.497,5.242,6.459,P<0.01).Pearson correlation analysis denoted that the scores of introversion/extroversion,neuroticism and psychoticism in EPQ-RSC were positively correlated with the scores of immediate memory,visuospatial/constructional ability,language,attention and delayed memory in RBANS among alcohol-dependent patients with aggressive behavior(r=0.294～0.482,0.362～0.511,0.265～0.475,P<0.05).Conclusion The cognitive function may have a certain correlation with personality traits in alcohol-dependent patients with aggressive behavior.

Objective To observe the application effect of transcutaneous acupoint electrical stimulation in the psychological craving and protracted abstinence symptoms of alcohol-dependent patients. Methods A total of 120 male alcohol-dependent patients who completed the acute alcohol withdrawal phase and were hospitalized in the Department of Alcoholism in Hunan Brain Hospital were selected as the study subjects. They were divided into conventional drug group, transcutaneous acupoint electrical stimulation group and placebo group according to different treatment methods, with 40 patients in each group. The conventional drug group was treated with benzodiazepine drugs for replacement and reduction and supportive symptomatic treatment. The transcutaneous acupoint electrical stimulation group was treated with conventional treatment combined with transcutaneous acupoint electrical stimulation. The placebo group was treated with conventional treatment combined with simulated transcutaneous acupoint electrical stimulation. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Alcohol Urge Questionnaire (AUQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI) score and recurrence conditions were compared before and after treatment among the three groups. Results After treatment, the SAS, SDS, AUQ and VAS scores of the three groups were lower than those before treatment, and the above scores of the transcutaneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group (P < 0.05). After treatment, the scores of sleep quality, the time to fall asleep, sleep duration, sleep efficiency, sleep disturbance, hypnotic drugs, daytime dysfunction and total PSQI score of the three groups were lower than those before treatment, and the above scores of the transcutaneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group (P < 0.05). The recurrence rate of the transcutaneous acupoint electrical stimulation group was lower than that of the conventional drug group and placebo group (P < 0.05). Conclusion Compared with conventional treatment and simulated transcutaneous electrical stimulation, transcutaneous acupoint electrical stimulation is more effective in reducing the severity of protracted abstinence symptoms such as anxiety, depression and insomnia, and is also beneficial in reducing patients' psychological craving, thereby reducing the recurrence rate.

Objective:To investigate the factors that influence the occurrence of complications following deep inferior epigastric perforator (DIEP) flap breast reconstruction, and to determine whether these complications have an impact on the patient's quality of life.Methods:The clinical and follow up data from patients who underwent DIEP flap breast reconstruction at the Department of Breast, Affiliated Cancer Hospital of Zhengzhou University from Dec 2019 to Mar 2023 were retrospectively analyzed.Results:A total of 85 patients underwent DIEP flap breast reconstruction, including 71 stage Ⅰ reconstructions and 14 stage Ⅱ reconstructions. Postoperative complications occurred in 22 cases 25.9%, including flap complications in 11 cases (12.9%) and abdominal donor site complications in 11 cases (12.9%). Univariate and multivariate analyses showed that the overall incidence of complications was associated with high BMI and early surgery ( P<0.05). Flap complications were associated with high BMI, surgery performed at initial phase, and the use of internal mammary vascular branches as recipient vessels ( P<0.05). Abdominal complications were associated with previous abdominal surgery scars ( P<0.05). BREAST-Q scores showed no significant differences between the surgical complication group and the no complication group in terms of breast satisfaction, mental health, physical health-chest, physical health-abdomen, satisfaction with abdomen, sexual health, etc. ( P>0.05). Conclusions:DIEP flap breast reconstruction has a significant learning curve. The patient's own clinical characteristics (such as BMI and abdominal incision scars) and intraoperative choices (such as the selection of recipient vessels) may influence the occurrence of postoperative complications. However, the presence of postoperative complications does not appear to have an impact on patient-reported outcomes.

Objective:To investigate the clinical application effect of internal mammary artery perforator (IMAP) as recipient vessels in breast reconstruction with deep inferior epigastric perforator flap (DIEPF) immediately after breast cancer surgery.Methods:From May 2020 to May 2023, a total of 18 patients with DIEPF breast reconstruction using IMAP as recipient vessels were selected from the Department of Breast Disease of Henan Cancer Hospital. The patients were 31 to 50 years old, with an average of 41.5 years old. The stages of breast cancer were cT is/1-2N 0-2M 0, and all of the patients received immediate breast reconstruction after the breast cancer surgery. The size of flaps were from 9.0 cm × 26.0 cm to 15.0 cm × 38.0 cm. Preoperative chest and abdominal wall CTA were performed to identify the location of intercostal space and the calibre of IMAP. Intraoperatively, the number of IMAP, the diameters of corresponding arteries and accompanying veins in the recipient site were recorded. All patients were included in the scheduled postoperative follow-up through outpatient clinic or via WeChat. The quality of flap survival was evaluated, the condition of breast appearance and recovery of the abdominal donor site were evaluated according to the breast cancer patient reported outcome measures (BREAST-Q). Results:All the 18 patients had the IMAP visualised in surgery, with 13 had the IMAP located at the second intercostal space and 3 at the third intercostal space. The other 2 patients were found with the IMAP located in both the second and third intercostal spaces, in which 1 was found that both of IMAP were suitable for anastomosis. It was also found that there was 1 accompanying vein in 15 breasts and 2 accompanying veins in 2 breasts. One breast had found without an accompanying vein. The diameters of arteries were 1.1 mm±0.1 mm and that of the veins were 1.8 mm±0.3 mm. The average follow-up period was 28 months, ranged from 6 to 40 months. Of the 18 flaps, 17 were completely survived. Venous compromise occurred in 1 flap due to extensive venous thrombosis, and it was replaced with a breast implant. No patient experienced concave deformities in the reconstructed breasts. Seventeen patients with an average BREAST-Q score of 94.4. One patient with a BREAST-Q score of 79.0.Conclusion:IMAP can serve as a reliable recipient vessel for immediate breast reconstruction with DIEPF after breast cancer surgery. With strict selection criteria, this technique could be put on further trials with larger sample size and multi-centres.