OBJECTIVE To upgrade the drug traceability code management system for a pediatric hospital under the “payment by code” background， aiming to comprehensively enhance traceability integrity， efficiency， and compliance. METHODS Taking Xiamen Children’s Hospital as the implementation setting， a before-and-after control design was adopted to construct an intelligent drug traceability code management system through systematic upgrades involving the technology platform， core mechanisms， and coordination with medical insurance. Key interventions included： upgrading a traceability code management platform and designing a dynamic code pool； innovating differentiated traceability mechanisms for routine， split-dose， and special drugs； establishing a tiered early-warning and emergency response system； and constructing a data coordination and quality control system. The drug traceability code upload rate served as the primary outcome. Process indicators such as the root causes distribution of failed uploads and the duration of medication returns， and a comprehensive outcome （the number of insurance-flagged abnormal prescriptions） were also analyzed. The data between the baseline period （April 2025） and the observation period （June-August 2025） were compared and evaluated. RESULTS After the upgrade， the overall upload rate of drug traceability codes increased from 9.21% （baseline） to 99.86% （August 2025）. The upload rate of traceability codes in previously unmanaged areas， such as the inpatient pharmacy and pharmacy intravenous admixture services， soared from 0 to nearly 100%. The proportion of non-uploads due to system issues fell from 66.44% （June 2025） to 2.62% （August Additionally， the number of insurance-flagged） abnormal prescriptions dropped sharply from 2 275.00 in the first “payment by code” policy month （July 2025） to 212.00 by the end of the observation period （August 2025）， a 90.70% decrease. CONCLUSIONS The developed management system effectively addresses complex scenario challenges such as high-frequency drug splitting. It significantly enhances traceability code upload performance and ensures a high degree of compliance with medical insurance data requirements. These outcomes contribute to proactive risk mitigation against insurance claim denials and demonstrate a concurrent optimization of pharmacy operations.

OBJECTIVE To analyze the current status and associated factors of human rabies immunoglobulin （HRIG） use in children with rabies-exposure， so as to provide a reference for the rational use of HRIG.METHODS Clinical data of children with rabies-exposure who were admitted to the outpatient and emergency departments of Xiamen Children’s Hospital from January to December 2024 were retrospectively collected. HRIG use in these children was analyzed， and univariate and multivariate Logistic regression analyses was used to identify independent risk factors for non-use of HRIG among children indicated for it.A questionnaire survey was conducted to assess 42 surgeons’ knowledge of rabies-post-exposure prophylaxis，self-rated factors influencing HRIG use，and reasons for non-use in high-risk exposure scenarios.RESULTS A total of 564 pediatric patients were enrolled， of whom 122 met the indications for HRIG use； however， only 24 received HRIG， yielding an actual utilization rate of 19.67%. Multivariate Logistic regression analysis showed that head and facial exposure was an independent risk factor for non-use of HRIG [OR＝7.77， 95%CI （1.11， 54.27）， P ＝0.039]. The questionnaire survey revealed that surgeons had the lowest awareness rate regarding the time to antibody production after rabies vaccination （35.71%）， followed by the appropriate timing of HRIG administration （50.00%）. Among the self-rated factors influencing HRIG use by surgeons， wound depth and bleeding status had the highest mean scores （2.95 points）. The primary reasons for non-use HRIG in special cases and grade Ⅲ exposure pediatric patients were the judgment that the offending animal was healthy or posed low risk，accounting for 45.24% and 38.10%， respectively； followed by parental refusal due to cost， pain， or other concerns，accounting for 26.19% and 33.33%， respectively.CONCLUSIONS The actual utilization rate of HRIG among children meeting the indications for HRIG use in our hospital was relatively low. Head and facial exposure was an independent risk factor for non-use of HRIG. Some surgeons had insufficient understanding of the time to antibody production after rabies vaccination and the appropriate timing of HRIG administration. Animal-related risk assessment and parental preferences may influence the use of HRIG.

OBJECTIVE To investigate the construction and practice of a drug traceability code management system in pediatric hospitals， providing a reference for promoting drug traceability code collection in healthcare institutions. METHODS Taking the outpatient pharmacy of our hospital as the research subject， a drug traceability code management system was constructed through the upgrade of the hospital information system （HIS）， process optimization， and human-machine collaboration mechanism. The PDCA （plan-do-check-act） cycle management method was applied to continuously optimize this system. Based on operational data from March 2024 to February 2025， the changes in the collection rate of drug traceability codes were analyzed， and the differences in the average patient pickup time， the average pharmacist dispensing time， and the dispensing error rate were compared before and after the implementation of the system. RESULTS In the initial period of trial operation of the drug traceability code management system（June 2024）， the collection rate of drug traceability codes was 57.17%， which subsequently improved to 93.52% by February 2025 following process optimization. Compared with the pre-implementation period （March-May 2024）， there was no significant difference （P＞0.05） in the average patient pickup time during the stable run-in period （August-October 2024）； the overall average pharmacist dispensing time increased significantly （P＜0.001）， but the clinical significance of this increase （0.42 s） was limited； stratified analyses showed a significant increase in the average pharmacist dispensing time for prescriptions involving chronic disease multidrug combinations （[ 23.29±6.83） s vs. （17.87±3.64 ） s， P＜0.001]； the dispensing error rate was reduced from 0.13‰ to 0.03‰ （P＝0.038）. CONCLUSIONS By adopting the strategy of “system reconstruction-process reengineering-human-machine collaboration”， our hospital has successfully established a drug traceability code management system. While complying with national regulatory requirements， we have maintained service efficiency and reduced the medication dispensing error rate.

Objective This study is focused on ultrasound multimodality examination,which refers to the combined use of three ultrasound examination modalities,ultrasound(US),acoustic radiation force impulse(ARFI)imaging,and contrast-enhanced ultrasound(CEUS).The purpose of this study is to analyze the value of applying ultrasound multimodality examination in the differential diagnosis of benign and malignant breast non-mass-like lesions(NMLs).Methods Cases of breast NMLs were analyzed retrospectively,and the nature of all the lesions was verified by pathological examination.Based on the gray-scale ultrasound image characteristics,the cases were classified into types Ⅰto Ⅴ,and type Ⅰ and type Ⅱ were further classified into 4 subtypes,Ⅰa,Ⅰ b,Ⅱ a,and Ⅱ b,according to whether there was also calcification,and the proportion of malignant cases in each subtype was statistically analyzed.Logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS for the diagnosis of malignant cases were established,ROC curves were drawn,the area under the curve(AUC)was calculated,and comparisons were made accordingly.The detection rate of malignant NMLs without calcification(atypical malignant NMLs)by the combination examination of US,ARFI,and CEUS was analyzed.Results A total of 407 cases were included in the study.All subjects were female,aged 22 to 81 years,with the average age being(47.0±1 1.0)years.There were 220 benign cases and 187 malignant cases.Ranked from the highest to the lowest,the malignancy proportion of the different types wasⅠb＞Ⅱb＞Ⅲ＞V＞Ⅰa＞Ⅱa＞Ⅳ.The malignant proportion of the low echo area with calcification was significantly higher than that of the lesions without calcification.The AUC(95％confidence interval[CI])for diagnosing malignant cases with the logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS were 0.895(0.862-0.927),0.908(0.878-0.937),0.921(0.893-0.948),and 0.927(0.902-0.952),respectively.Comparison of the AUC of the 4 regression models showed significant differences(P＜0.001).The detection rate of US for NMLs without calcification was 80.7％.When US was used in combination with ARFI and CEUS,86.4％of the malignant NMLs lesions without calcification could be detected if the lesion CEUS score was 4 or 5 points or if shear-wave velocity(SWV)≥4.28 m/s.Conclusion Breast NMLs with calcification show high risks of malignancy,and a pathological examination is always recommended for a conclusive diagnosis.Ultrasound multimodality examination can improve the diagnostic accuracy of breast NML without calcification.

Liver disease involves a complex interplay of pathological processes, including inflammation, hepatocyte necrosis, and fibrosis. End-stage liver disease (ESLD), such as liver failure and decompensated cirrhosis, has a high mortality rate, and liver transplantation is the only effective treatment. However, to overcome problems such as the shortage of donor livers and complications related to immunosuppression, there is an urgent need for new treatment strategies that need to be developed for patients with ESLD. For instance, hepatocytes derived from donor livers or stem cells can be engrafted and multiplied in the liver, substituting the host hepatocytes and rebuilding the liver parenchyma. Stem cell therapy, especially mesenchymal stem cell therapy, has been widely proved to restore liver function and alleviate liver injury in patients with severe liver disease, which has contributed to the clinical application of cell therapy. In this review, we discussed the types of cells used to treat ESLD and their therapeutic mechanisms. We also summarized the progress of clinical trials around the world and provided a perspective on cell therapy.
Humans ; Cell- and Tissue-Based Therapy/methods* ; End Stage Liver Disease/therapy* ; Hepatocytes ; Mesenchymal Stem Cell Transplantation ; Stem Cell Transplantation

Objective To evaluate the microbial contamination levels of 10 kinds of Chinese herbal pieces,and explore the diversity of fungi and heat-resistant bacteria.Methods The total aerobic microbial count(TAMC),total yeast and mould count(TYMC),total heat-resistant microbial count(THRC)and 3 types control bacteria were detected according to the microbial limit inspection method of Chinese Pharmacopoeia 2020.Besides,the community characteristics of contaminated fungi and heat-resistant bacteria on prepared slices were analysed based on internal transcribed spacer(ITS)and 16S ribosomal DNA(16SrDNA)high-throughput sequencing method.Results The TAMC of 28％(14/50)samples exceeded 106 cfu/g,the TYMC of 20％(10/50)samples exceeded 104 cfu/g,the THRC of 68％(34/50)samples were higher than 10 cfu/g,and the bile-tolerant gram-negitive bacteria were detected in 40％(20/50)of the samples.Escherichia coli were found in 2 batches of the Pogostemon cablin,but Salmonella was not found in any sample.High throughput sequencing results showed that the fungi contaminated distributed in 12 phylums,777 genera and 1 467 species;the heat-resistant bacteria were mainly distributed in 5 phylums,57 genera and 74 species.The decoction pieces contained Aspergillus flavus and heat-resistant pathogens such as Bacillus amyloliquefaciens,Staphylococcus lentus,and Staphylococcus warneri.Conclusion The 10 kinds of decoction pieces are generally contaminated by microorganisms,and some of them contain toxic fungi and pathogenic heat-resistant bacteria,which poses a potential risk of microbial pathogenicity for patients.

Objective:To explore the relationship between AluYb8 insertion in the MUTYH gene and the risk of decreased left ventricular diastolic function in the elderly.Methods:In the retrospective analysis, 498 elderly patients with decreased left ventricular diastolic function(the disease group)and 155 people without left ventricular diastolic function(the control group)were recruited.Polymerase chain reaction was employed to analyze the genotype distribution of AluYb8 insertion in MUTYH gene.Cardiac function was measured by high-resolution color Doppler ultrasound.Results:The frequencies of the A/A, A/P and P/P genotypes were 30.1%(150/498), 48.4%(241/498)and 21.5%(107/498)in patients with decreased left ventricular diastolic function, and 27.7%(43/155), 54.8%(85/155)and 17.5%(27/155)in the control group, respectively.There were no significant differences in genotype( χ2=2.162, P=0.339)and allele frequency( χ2=1.342, P=0.794)between the two groups.Further analysis after stratification revealed that there were statistically significant differences in genotype( χ2=7.173, P=0.028)and allele frequency( χ2=8.352, P=0.015). Multivariate Logistic regression analysis showed that, in elderly patients with diabetes, P-allele carriers had a higher risk of decreased left ventricular diastolic function than non-carriers( OR=3.450, 95% CI: 1.148-10.372, P=0.027). Conclusions:AluYb8 insertion in the MUTYH gene may be associated with the risk of decreased left ventricular diastolic function in the elderly with diabetes.

Objective:To explore the association between non-thyroid illness syndrome(NTIS)and pre-sarcopenia in the elderly.Methods:In the retrospective study, a total of 219 patients aged 60-85 years in Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University from April 2018 to March 2021, included 60 patients with NTIS and 159 patients without NTIS.Clinical data, laboratory results and body composition data were collected.Pre-sarcopenia was diagnosed based on human composition determination data and diagnostic criteria of pre-sarcopenia.Logistic regression analysis, Pearson's correlation analysis and the area under receiver operator characteristic curve(ROC)were used to explore the correlation between serum thyroid hormone levels and diagnostic data level of pre-sarcopenia.Results:Of 54 pre-sarcopenia patients, 30.3%(36/119)were male, 18.0%(18/100)were female with statistically significantly differences( P<0.01). Mean age was higher in both male and female patients in the NTIS group than in the non-NTIS group( P<0.01). The body mass index, levels of triiodothyronine(T3), free triiodothyronine(FT3), hemoglobin, and albumin were lower in NTIS group than in non-NTIS group( P<0.05). The prevalence of presarcopenia in female patients was higher in the NTIS group than in the non-NTIS group[42.9%(10/17) vs.10.6%(8/83), χ2=9.564, P<0.01]. Multivariate logistic regression analysis showed that the risk of pre-morbidity of sarcopenia was significantly higher in NTIS patients than in non-NTIS patients.FT3 was positively correlated with skeletal muscle mass index, fat-free body weight, and phase angle, and negatively correlated with visceral fat area( r=-0.17, P<0.05). While, free thyroxine(FT4)was negatively correlated with skeletal muscle mass index( r=-0.21), fat-free body weight( r=-0.16)and phase Angle( r=-0.2, P<0.01 or P<0.05), and was positively correlated with body fat percentage and visceral fat area( r=0.20 and 0.22, respectively, P<0.01). The use of area under ROC curve(AUC)of FT3 predicting sarcopenia stage showed that the AUC was 0.768(95% CI: 0.691~0.844). Conclusions:In elderly patients, NTIS is correlated with the pre-sarcopenia in the elderly, and FT3 and FT4 are related to muscle mass.The low level of FT3 can predict the pre-validation of pre-sarcopenia.

Objective:To understand the supportive care needs of patients with prostate cancer during their illness, so as to construct the supportive care needs intervention program.Methods:Purposive sampling method was used to conduct semi-structured interviews on 17 patients with prostate cancer from June 2019 to January 2020 in Haikou Hospital of Xiangya Affiliated Hospital of Central South University, and the data were analyzed by content analysis method.Results:Seven themes were extracted: the need of health information, the need of social support, the need of health care services, psychological and emotional need, the need of symptom management, the need of economic support and disease specific need.Conclusions:Patients with prostate cancer have multiple supportive care needs. The results of this study could be important reference for medical staff to provide comprehensive, personalized and humanistic care for patients and improve patients′ the quality of life and medical experience.

Objective: To investigate whether topical mucopolysaccharide polysulfate (MPS) cream can reduce the incidence of eczema and skin atrophy in patients with moderate- or low-risk infantile hemangioma after the treatment with topical beta-blockers or 595-nm pulsed dye laser (PDL) , and to analyze factors influencing the occurrence of eczema and skin atrophy. Methods: A total of 722 patients aged 0- 1 years with moderate- or low-risk infantile hemangioma were enrolled from 5 Children′s Hospitals in China. According to the disease condition and therapy acceptability, these patients were divided into 6 groups to be treated with topical beta-blockers and MPS cream (blocker+ MPS group) , topical beta-blockers (blocker group) , 595-nm PDL and topical MPS cream (PDL+ MPS group) , 595-nm PDL (PDL group) , 595-nm PDL combined with topical beta-blockers and MPS cream (PDL+ blocker+ MPS group) , and 595-nm PDL and topical beta-blockers (PDL+ blocker group) , respectively. All the externally applied agents were applied twice a day, and PDL was performed once every 4 weeks. Efficacy and adverse reactions were evaluated after 3-month treatment. Univariate and multivariate Logistic regression analyses were carried out to analyze factors influencing the incidence of eczema and skin atrophy in patients with infantile hemangioma after treatment, and chi-square test was carried out to compare efficacy among the groups. Results: After 3-month treatment, multivariate Logistic regression analysis for comparing the blocker+ MPS group with blocker group showed that the risk factor for eczema on the surface of hemangiomas was no topical treatment with MPS cream (P= 0.007, OR= 3.887, 95% CI: 1.439-10.493) , while no correlations were observed between the occurrence of skin atrophy on the surface of hemangiomas and analyzed factors. Multivariate Logistic regression analysis for comparing the PDL+MPS group with PDL group showed that no topical treatment with MPS cream (P < 0.001, OR= 7.402, 95% CI: 2.604-21.042) and northern areas (P < 0.001, OR= 67.048, 95% CI: 7.977-563.518) were risk factors for eczema on the surface of hemangiomas, and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P = 0.001, OR = 9.371, 95 CI: 2.590 - 33.900) and abundant blood supply of hemangiomas (P = 0.036, OR = 2.971, 95% CI: 1.075-8.208) . Multivariate Logistic regression analysis for comparing the PDL + blocker+ MPS group with PDL+ blocker group showed that risk factors for eczema on the surface of hemangiomas were no topical treatment with MPS cream (P= 0.005, OR= 3.426, 95% CI: 1.446-8.119) and northern areas (P < 0.001, OR= 31.704, 95% CI: 6.924-145.158) , and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P < 0.001, OR= 6.011, 95% CI: 2.558-14.126) and southern areas (P= 0.022, OR= 3.021, 95% CI: 1.177-7.753) . After 3-month treatment, the response rate was significantly higher in the PDL group than in the PDL+ MPS group (χ²= 4.531, P= 0.033) , and significantly higher in the blocker group than in the blocker+ MPS group (χ²= 4.344, P= 0.037) . There were no significant differences in the response rate or cure rate among the other groups (all P > 0.05) . Conclusion During the treatment of moderate- or low-risk infantile hemangioma with topical beta-blockers or 595-nm PDL, the combination with topical MPS cream can reduce the occurrence of eczema and skin atrophy without affecting the therapeutic effect.