Objective To understand the current situation of the management of patients'self-provided infusion drugs in secondary and above general hospitals in China,and to provide a theoretical and practical basis for improving the management system.Methods The annual pharmacy professional quality control work survey conducted by the National Pharmaceutical Management Professional Quality Control Center was used to obtain information on the management of patients'self-provided infusion drugs in secondary and above general hospitals in 31 provinces(autonomous regions and municipalities directly under the central government)and the Xinjiang Production and Construction Corps of Chinese mainland from 2020 to 2022,and was summarized and calculated using data-processing software.Results The total number of secondary and above general hospitals included in the analysis from 2020 to 2022 is 4 786,5 063 and 6 041,respectively.In 2022,compared with 2020,the percentage of hospitals allowing patients to use self-provided infused drugs decreased from 55.08％to 48.54％,the percentage of hospitals that have established a system for managing patients' self-provided drugs increased from 81.54％to 98.09％,and the percentage of hospitalized patients' use of self-provided drugs that are all documented in their medical orders increased from 79.76％to 90.72％.The types of drugs that hospitals allow patients to use for self-provided infusion are mainly antitumor drugs,the places where self-provided infusion drugs are dispensed are mainly clinical departments(wards),and the main source of self-provided infusion drugs is self-pickup by patients.Conclusion Hospitals should establish a management system for patients'self-provided drugs,strengthen the information management of self-provided infusion drugs,and ensure drug supply and medication safety for patients.

Objective:To evaluate the clinical effect of transforaminal endoscopic spine system (TESSYS) technique in treating single-level lumbar spinal stenosis (LSS) based on computed tomography (CT) imaging and traumatic stress indicators. Methods:A total of 112 patients with single-level LSS admitted to The Third Hospital of Qinhuangdao from June 2019 to June 2021 were selected,and they were divided into observation group and control group by random number table method,with 56 cases in each group. The observation group was treated with TESSYS technique,and the control group was treated with "broad easy immediate surgery (BEIS)" technique of intervertebral foramen scope. The indicators of CT imaging of spinal canal area and protrusion ratio,as well as traumatic stress indicators included lactate dehydrogenase (LDH),myoglobin (MYO) and cortisol (COR),of two groups were compared before and 1 week after surgery. Oswestry Disability Index (ODI),Visual Analogue Scale (VAS) score and Japanese Orthopaedic Association (JOA) Scores were compared between the two groups. Excellent rates of treatment and postoperative complications of two groups were compared at the 6 th month after surgery. Results:The average hospital stay and operation time of observation group were respectively (4.29±1.08)d and (93.53±22.01)min,which were significantly shorter than (6.61±1.72)d and (112.29±26.68)min of control group,and the intraoperative blood loss of observation group was (30.15±8.26) ml,which was shorter than that (41.35±11.58) ml of control group,and the differences of them between two groups (t=8.548,4.059,5.892,P<0.05),respectively. At the 1st week after surgery,the ODI and VAS scores of observation group were lower than those of control group,and the JOA score was higher than that of control group,and the differences of them between two groups were significant (t=9.443,t=8.969,6.084,P<0.05),respectively. At the 3rd month after surgery,the ODI and VAS scores of observation group were respectively lower than those of control group,and JOA score of observation group was higher than that of control group,and the differences of them were significant (t=9.706,3.753,5.894,P<0.05),respectively. The rate of excellent and good treatment of observation group was 94.64％,which was higher than that (80.36％) of control group,and the differences of them between the two groups were statistically significant (t=5.225,P<0.05). At the 1st week after surgery,the vertebral canal area of observation group was larger than that of control group,and the ratio of protrusion invasion was less than that of control group,and the differences of them between the two groups were statistically significant (t=3.404,5.578,P<0.05),respectively. At the 1st d after surgery,the serum LDH,MYO and COR levels of observation group were lower than those of control group,and the differences of them between two groups were statistically significant (t=7.570,9.687,5.242,P<0.05),respectively. At the 3rd d after surgery,the serum LDH,MYO and COR levels of observation group were respectively than those of control group,and the differences of them between two groups were significant (t=6.856,9.729,2.744,P<0.05). There was no significant difference in complication rate between the two groups (P>0.05). Conclusion:Compared with BEIS technique,TESSYS technique has the advantages of less trauma,faster postoperative recovery and higher excellent and good rate in treating single-segment LSS,which can alleviate stress reaction of early postoperative trauma. Its comprehensively clinical efficacy is ideal.

The new era imposes heightened demands on medical professionals,who must not only possess a solid theoretical foundation but also exhibit strong practical skills and innovative capabilities.The quality of medical func-tional laboratory construction is crucial for cultivating high-caliber medical talents.In light of the current developmental status and trends regarding functional experiment teaching within Chinese higher education institutions,particularly the disparities in development across various regions and institutions,the Functional Experiment Teaching Committee of the Chinese Pathophysiology Society has developed an expert consensus on laboratory construction standards.This consensus was established through comprehensive investigations,research,and extensive discussions to provide a reference for di-verse institutions to continuously enhance their levels of laboratory construction.

OBJECTIVE To explore the distribution of pathogens isolated from the cardiac surgery children with postoperative catheter-related bloodstream infection(CRBSI)and observe the transforming growth factor β1(TGF-β1)gene polymorphisms and the change of high-sensitivity C-reactive protein(hs-CRP),Smad homologue 2 and Smad 3 levels.METHODS A total of 88 children who received peripherally inserted central catheter(PICC)puncture after cardiac surgery and were complicated with postoperative CRBSI in the First People's Hospital of Zunyi from Aug.2019 to Oct.2023 were assigned as the infection group.Meanwhile,110 children who were trea-ted with PICC and did not have postoperative CRBSI were randomly chosen as the non-infection group.The base-line data,TGF-β1 gene polymorphisms and the levels of hs-CRP,Smad 2 and Smad 3 were compared between the two groups.The distribution of the pathogens isolated from the infection group was observed.The values of hs-CRP,Smad 2 and Smad 3 in diagnosis of the postoperative CRBSI in the cardiac surgery children were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of patients with intravenous cathe-ter indwelling no less than 10 days,length of intensive care unit(ICU)stay no less than 5 days,the frequencies of CC genotypes and C allele at TGF-β1+869C/T locus were higher in the infection group than those in the non-infection group(P＜0.05).Acinetobacter baumannii was the predominant species of pathogen isolated from the infection group,accounting for 24.20％.The levels of serum hs-CRP,Smad 2 and Smad 3 of the infection group were(24.65±7.65)mg/L,(13.54±2.45)pg/ml and(13.65±2.65)pg/ml,respectively,higher than those of the non-infection group(all P＜0.001).The area under the curve(AUC)of the joint detection of hs-CRP,Smad 2 and Smad 3 was highest in diagnosis of the postoperative CRBSI in the cardiac surgery children(P＜0.05).CONCLUSIONS A.baumannii is dominant among the pathogens isolated from the cardiac surgery children with postoperative CRBSI.The postoperative CRBSI may be associated with the intravenous catheter in-dwelling time and length of ICU stay.The C allele at TGF-β1+869C/T locus may be the susceptibility gene for the postoperative CRBSI.The joint detection of hs-CRP,Smad 2 and Smad 3 has the highest value in diagnosis of the postoperative CRBSI.

Objective To explore the correlation between central venous oxygen saturation(ScvO2),blood lactate(Lac),arterial oxygen saturation(SaO2)and mechanical ventilation time in infants with congenital heart disease(CHD).Methods Eighty-four CHD children treated in the First People's Hospital of Zunyi were enrolled between January 2020 and December 2024.According to postoperative mechanical ventilation time,they were divided into prolongation group(28 cases,mechanical ventilation time≥72 h)and non-prolongation group(56 cases,mechanical ventilation time<72 h).The clinical data,score of risk adjustment for congenital heart surgery(RACHS-1),levels of ScvO2,and Lac and SaO2 in the two groups were compared.The risk factors of postoperative mechanical ventilation time were analyzed by multivariate logistic regression analysis,and predictive value of ScvO2,Lac and SaO2 for prolonged mechanical ventilation time was analyzed by ROC curves.The clinical outcomes in the two groups were recorded.Results There were significant differences in age,preoperative pneumonia,RACHS-1 grading,and levels of ScvO2,Lac and SaO2 among children with different mechanical ventilation time(P<0.05).Multivariate logistic regression analysis showed that ScvO2,Lac and SaO2 were independent influencing factors of postoperative mechanical ventilation time(P<0.05).ROC curves analysis showed that area under the curve(AUC)values of ScvO2,Lac,SaO2 and combined detection for predicting prolonged postoperative mechanical ventilation were 0.846,0.863,0.839 and 0.917,and the best cut-off values were 67.64％,1.51mmol/L and 96.06％,respec-tively(P<0.05).The failure rate of weaning in the prolongation group was higher,and stay time in PICU and actual length of hospital stay were longer than those in non-prolongation group(P<0.05).Conclusion The levels of ScvO2,Lac and SaO2 are related to mechanical ventilation time in CHD infants.They are all independent risk factors affecting prolonged mechanical ventilation and can be applied as auxiliary detection indexes to predict the prolonga-tion of mechanical ventilation in clinical practice.

OBJECTIVE To identify and characterize the chemical ingredients of Anchang formulation,further screen the active ingredients of this formulation treating ulcerative colitis by network pharmacology,and explore the potential targets and pathways,provi-ding scientific basis for its mechanism research and clinical application.METHODS Chemical ingredients in Anchang formulation were acquired by Ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS)technology and literature retrieval.The potential active ingredients and key targets for the treatment were obtained from Swiss Target Prediction,GeneCards,STRING,and then Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment were analyzed in the DAVID database.The interactions between the active ingredients and the core targets were verified by using the AutoDock software.The RAW 264.7 murine-derived macrophage inflammation model was also established to val-idate the anti-inflammatory activity of the pre-screened chemical ingredients and further explore the related mechanisms.RESULTS In this study,108 chemical ingredients of Anchang formulation were characterized by UPLC-Q-TOF-MS technology,and expanded to 134 through literature search.The component-target network where 39 core active components were screened was further constructed,and 15 key therapeutic targets were screened by the protein-protein interaction network constructed.The enrichment analysis of KEGG pathway indicated that Anchang formulation can regulate TNF,PI3K-Akt,MAPK,cancer and other related signaling pathways and ex-ert a therapeutic effect.The results of cell experiments showed that Anchang formulation and its active ingredients could inhibit the re-lease of NO,TNF-α and IL-6 in the LPS-induced RAW 264.7 cell inflammation model.CONCLUSION Based on the concept of"ingredient-target-pathway",this study evaluates the anti-inflammatory effect of Anchang formulation and its active ingredients,pre-dicts the potential mechanism of treatment for UC,and provides a theoretical basis and research ideas for the quality control of the for-mulation and its treatment for UC.

OBJECTIVE To identify and characterize the chemical ingredients of Anchang formulation,further screen the active ingredients of this formulation treating ulcerative colitis by network pharmacology,and explore the potential targets and pathways,provi-ding scientific basis for its mechanism research and clinical application.METHODS Chemical ingredients in Anchang formulation were acquired by Ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS)technology and literature retrieval.The potential active ingredients and key targets for the treatment were obtained from Swiss Target Prediction,GeneCards,STRING,and then Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment were analyzed in the DAVID database.The interactions between the active ingredients and the core targets were verified by using the AutoDock software.The RAW 264.7 murine-derived macrophage inflammation model was also established to val-idate the anti-inflammatory activity of the pre-screened chemical ingredients and further explore the related mechanisms.RESULTS In this study,108 chemical ingredients of Anchang formulation were characterized by UPLC-Q-TOF-MS technology,and expanded to 134 through literature search.The component-target network where 39 core active components were screened was further constructed,and 15 key therapeutic targets were screened by the protein-protein interaction network constructed.The enrichment analysis of KEGG pathway indicated that Anchang formulation can regulate TNF,PI3K-Akt,MAPK,cancer and other related signaling pathways and ex-ert a therapeutic effect.The results of cell experiments showed that Anchang formulation and its active ingredients could inhibit the re-lease of NO,TNF-α and IL-6 in the LPS-induced RAW 264.7 cell inflammation model.CONCLUSION Based on the concept of"ingredient-target-pathway",this study evaluates the anti-inflammatory effect of Anchang formulation and its active ingredients,pre-dicts the potential mechanism of treatment for UC,and provides a theoretical basis and research ideas for the quality control of the for-mulation and its treatment for UC.

Objective:To investigate the clinical efficacy of minimally invasive double anchoring combined with percutaneous kyphoplasty (PKP) for Kümmell disease.Methods:The clinical data of 24 patients with Kümmell disease who were treated with minimally invasive double anchoring combined with PKP in Cangzhou People's Hospital from October 2022 to March 2024 were retrospectively analyzed. Among them, there were 2 T 10 vertebrae, 5 T 11 vertebrae, 7 T 12 vertebrae, 6 L 1 vertebrae, and 4 L 2 vertebrae. There were 6 males and 18 females. The average age was 72.05±4.52 years (range, 66-80 years). The bone mineral density T value was -3.41±0.77 (range, -2.5-4.5). The stages of Li's Kümmell disease included 13 cases of stage II and 11 cases of stage III. The operation time, intraoperative blood loss, and volume of bone cement injected were recorded. The vertebral index, vertebral angle and Cobb angle of diseased segment were measured before and after operation. The visual analogue scale (VAS) was used to assess the degree of pain, the Oswestry disability index (ODI) and the Japanese Orthopaedic Association (JOA) low back pain scale were used to assess spinal function. The Medical Outcome Study short form 36 item health survey (SF-36) was used to assess the general health status of the patients. The postoperative symptom recovery was evaluated by Odom criteria. Results:The mean operative time of the 24 patients was 35.32±6.86 min, the injected volume of bone cement was 4.39±1.72 ml, and the intraoperative blood loss was 16.56±5.21 ml. All patients were followed up for 10 to 14 months, with an average of 11.7 months. Postoperative CT examination showed that the screw positions were satisfactory, and no loosening or displacement of bone cement mass occurred. On the first day after surgery, the vertebral body index, vertebral body angle and Cobb angle of diseased segment were 77.71%±2.75%, 12.40°±1.53° and 25.77°±4.49°, respectively, which represented significant improvements from the preoperative values of 43.09%±5.66%, 22.12°±2.92° and 46.98°±5.68° before surgery ( P<0.05). At the last follow-up, the values were 76.18%±2.32%, 12.41°±2.53°, 26.14°±4.87°, respectively, which were significantly improved compared with those before surgery ( P<0.05), but there was no statistical significance compared with the first day after surgery ( P>0.05). The VAS, ODI and JOA scores on the first day after surgery were 2.11±0.87 points, 22.46±5.49 points and 27.68±2.45 points, respectively, which were significantly improved compared with those before surgery 7.50±0.98 points, 76.25±8.56 points and 14.96±4.91 points ( P<0.05). At the last follow-up, the values were 2.26±0.88, 23.87±3.25 and 26.58±2.77, respectively, which were significantly improved compared with those before surgery ( P<0.05), and there was no statistical significance compared with the first day after surgery ( P>0.05). All 24 patients completed SF-36 scale assessment, and the results showed that there were statistically significant differences in physiological function, physiological role, physical pain, general health status, social function scores and mental health between the patients before surgery and the last follow-up ( P<0.05), while there were no statistically significant differences in vitality and emotional function ( P>0.05). At the last follow-up, the Odom criteria showed excellent results in 18 cases, good in 4 cases, and fair in 2 cases. Conclusions:The application of minimally invasive double anchoring (single nail fixation) combined with PKP in the treatment of Kümmell disease can effectively prevent the loosening and displacement of bone cement masses, and the fixation effect is satisfactory, which can restore the height of the injured vertebrum, reduce kyphosis and improve spinal function. The clinical symptoms of the patients were significantly improved, and the quality of life was enhanced.

Objective To explore the correlation between central venous oxygen saturation(ScvO2),blood lactate(Lac),arterial oxygen saturation(SaO2)and mechanical ventilation time in infants with congenital heart disease(CHD).Methods Eighty-four CHD children treated in the First People's Hospital of Zunyi were enrolled between January 2020 and December 2024.According to postoperative mechanical ventilation time,they were divided into prolongation group(28 cases,mechanical ventilation time≥72 h)and non-prolongation group(56 cases,mechanical ventilation time<72 h).The clinical data,score of risk adjustment for congenital heart surgery(RACHS-1),levels of ScvO2,and Lac and SaO2 in the two groups were compared.The risk factors of postoperative mechanical ventilation time were analyzed by multivariate logistic regression analysis,and predictive value of ScvO2,Lac and SaO2 for prolonged mechanical ventilation time was analyzed by ROC curves.The clinical outcomes in the two groups were recorded.Results There were significant differences in age,preoperative pneumonia,RACHS-1 grading,and levels of ScvO2,Lac and SaO2 among children with different mechanical ventilation time(P<0.05).Multivariate logistic regression analysis showed that ScvO2,Lac and SaO2 were independent influencing factors of postoperative mechanical ventilation time(P<0.05).ROC curves analysis showed that area under the curve(AUC)values of ScvO2,Lac,SaO2 and combined detection for predicting prolonged postoperative mechanical ventilation were 0.846,0.863,0.839 and 0.917,and the best cut-off values were 67.64％,1.51mmol/L and 96.06％,respec-tively(P<0.05).The failure rate of weaning in the prolongation group was higher,and stay time in PICU and actual length of hospital stay were longer than those in non-prolongation group(P<0.05).Conclusion The levels of ScvO2,Lac and SaO2 are related to mechanical ventilation time in CHD infants.They are all independent risk factors affecting prolonged mechanical ventilation and can be applied as auxiliary detection indexes to predict the prolonga-tion of mechanical ventilation in clinical practice.