Objective:To investigate the changing trends and influencing factors of two kinds of absorbable hemostatic gauze in clinical use based on real-world data,so as to provide a reference for the refined management of absorbable hemostatic gauze.Methods:Data of surgical samples of a total of 34658 pieces of absorbable hemostatic gauzes,whose brand include brand A and brand B,in 27,468 surgeries of the Affiliated Wuxi People's Hospital of Nanjing Medical University between January 1,2015 and December 31,2023 were selected.In them,12729 surgeries used hemostatic gauzes(18,457 pieces)of brand A,and 14,739 surgeries used hemostatic gauzes(16,201 pieces)of brand B.The changing trends of the usage and cost of two kinds of absorbable hemostatic gauzes were compared and analyzed,which correlations of that with the different indicators of workload also were compared and analyzed.Results:The usage amount of absorbable hemostatic gauze of brand B increased annually,which had higher average costs per surgery but lower average usage amount per surgery.Brand B was mainly used in surgery of level-4.Both the usage amounts of brand A(18,457 pieces)and brand B(16,201 pieces)showed a positive correlation with the proportion of patients with difficult and critically ill(r=0.232,0.593,P<0.05),as well as with the proportion of medical consumables expenditure(r=0.334,0.491,P<0.05).Compared to brand A,brand B demonstrated a stronger positive correlation with the proportion of patients with difficult and critically ill,and the proportion of consumables expenditure.However,there was no significant correlation between the usage amount of each brand and the number of inpatients who received surgeries(P>0.05).The usage amount of absorbable hemostatic gauze of each brand was negative correlation with the proportion of pharmaceutical expenditure(r=-0.538,-0.696,P<0.05).Conclusion:The evaluation based on real-world data for clinical use of absorbable hemostatic gauze can reveal that brand B is gradually replacing brand A in clinical application.In clinical practice,the surgery with higher-level more prefers to use brand B.This result can guide management departments to monitor the use of absorbable hemostatic gauze.However,the balance between clinical demand and cost-effectiveness also should be considered,so as to promote the rational use of hemostatic materials,and ensure effective allocation for resource.

Objective:To investigate the changing trends and influencing factors of two kinds of absorbable hemostatic gauze in clinical use based on real-world data,so as to provide a reference for the refined management of absorbable hemostatic gauze.Methods:Data of surgical samples of a total of 34658 pieces of absorbable hemostatic gauzes,whose brand include brand A and brand B,in 27,468 surgeries of the Affiliated Wuxi People's Hospital of Nanjing Medical University between January 1,2015 and December 31,2023 were selected.In them,12729 surgeries used hemostatic gauzes(18,457 pieces)of brand A,and 14,739 surgeries used hemostatic gauzes(16,201 pieces)of brand B.The changing trends of the usage and cost of two kinds of absorbable hemostatic gauzes were compared and analyzed,which correlations of that with the different indicators of workload also were compared and analyzed.Results:The usage amount of absorbable hemostatic gauze of brand B increased annually,which had higher average costs per surgery but lower average usage amount per surgery.Brand B was mainly used in surgery of level-4.Both the usage amounts of brand A(18,457 pieces)and brand B(16,201 pieces)showed a positive correlation with the proportion of patients with difficult and critically ill(r=0.232,0.593,P<0.05),as well as with the proportion of medical consumables expenditure(r=0.334,0.491,P<0.05).Compared to brand A,brand B demonstrated a stronger positive correlation with the proportion of patients with difficult and critically ill,and the proportion of consumables expenditure.However,there was no significant correlation between the usage amount of each brand and the number of inpatients who received surgeries(P>0.05).The usage amount of absorbable hemostatic gauze of each brand was negative correlation with the proportion of pharmaceutical expenditure(r=-0.538,-0.696,P<0.05).Conclusion:The evaluation based on real-world data for clinical use of absorbable hemostatic gauze can reveal that brand B is gradually replacing brand A in clinical application.In clinical practice,the surgery with higher-level more prefers to use brand B.This result can guide management departments to monitor the use of absorbable hemostatic gauze.However,the balance between clinical demand and cost-effectiveness also should be considered,so as to promote the rational use of hemostatic materials,and ensure effective allocation for resource.

Objective To explore the effect of training mode based on action learning on improving the practicing ability of hospital pharmacists.Methods Thirty pharmacists who received training from September 2022 to December 2023 at Panzhihua Central Hospital were randomly divided into an education reform group(16 cases)and a routine group(14 cases).The education reform group adopted a routine teaching method based on action learning,while the routine group adopted a routine teaching method.The differences between the two groups of pharmacists in theoretical knowledge,practical operation,pharmaceutical services,emergency response,and comprehensive quality were compared.Results The pharmacists in the education reform group were better than the routine group in prescription review,clinical medication analysis,pharmaceutical services,emergency response,andcomprehensive quality.The difference was statistically significant(P＜0.05).Conclusion The teaching model based on action learning can effectively enhance the higher order thinking ability of pharmacists and help them better apply medical knowledge and skills to serve patients and physicians.

Aim To synthesize 8-bromo-ethoxy Rhein and investigate its mechanisms and inhibition effect on hepatitis B surface antigen ( HBsAg ) and e antigen ( HBeAg) in HepG2.2.15 cells.Methods 8-bromo-ethoxy Rhein was synthesized based on the chemical structure of Rhein , and its structure was identified by IR,1 H-NMR and 13 C-NMR spectra.MTT assay was used to test the inhibitory effect of 8-bromo-ethoxy Rhein on HepG2.2.15 cells.After the cells treatment by 8-bromo-ethoxy Rhein , the HBsAg and HBeAg in cell supernatant were detected by ELISA .The expres-sion of hepatitis B virus X gene ( HBx) was detected by Western blot .The cell cycles were examined with flow cytometry.The intracellular free calcium concentration was detected by laser scanning confocal microscopy . Results The structure of 8-bromo-ethoxy Rhein was confirmed by IR,1 H-NMR and 13 C-NMR.MTT results showed that synthetic product and Rhein could inhibit the cell proliferation in HepG2.2.15 cells.After trea-ted with 8-bromo-ethoxy Rhein and Rhein for 72 h,the half inhibitory concentration 50%( IC50 ) was 14.29 mg? L-1 and 11.59 mg? L-1 , respectively .Using non-cytotoxic dose of 8-bromo-ethoxy Rhein , the inhibitory effect on HBsAg and HBeAg was gradually enhanced with increasing 8-bromo-ethoxy Rhein concentration . The inhibitory effect of synthetic product on hepatitis B virus was better than that of Rhein .8-bromo-ethoxy Rhein could down-regulate the expression of HBx , in-tracellular calcium ion concentration and block the hepatitis B virus ( HBV ) replication.Flow cytometry results showed 8-bromo-ethoxy Rhein didn′t affect the cell cycle .Conclusions Compare with Rhein , the synthesis of 8-bromo-ethoxy Rhein shows stronger inhi-bition on hepatitis B virus in HepG2.2.15, and its mechanisms may involve down-regulating the expres-sion of HBx and reducing calcium ion concentration .

OBJECTIVESTo analyze the survival of breast cancer molecular subtypes and to examine the effect of therapy on the long-term prognosis of different subtypes.

METHODSThis study included 3 586 breast cancer patients with estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) information in Shanghai Breast Cancer Survival Study, a population-based prospective cohort study established in 2002. Molecular subtypes, based on immunohistochemistry were categorized as follows: Luminal A, Luminal B, HER2, and triple-negative subtype. Characteristics and clinical data were collected through questionnaires and medical records at baseline survey and sequential follow-up surveys. Survival rates of different molecular subtypes were analyzed and compared with Log-rank tests. Multiple Cox regression models were used to evaluate the effect of therapy on long-term prognosis of different molecular subtypes.

RESULTSAmong the 3 586 cases, Luminal A, Luminal B, HER2 and triple-negative breast cancer subtypes accounted for 54.5%, 16.6%, 13.9%, and 14.9%, respectively. With a median follow-up of 10.3 years (ranging 0.6 to 12.8 years), the 10-year overall survival (OS) rates for the four subtypes were 82.7% (95% CI: 80.9% to 84.4%), 77.7% (95% CI: 74.1% to 80.8%), 76.3% (95% CI: 72.3% to 79.8%), and 74.8% (95% CI: 70.9% to 78.3%), respectively. The 10-year disease to free survival (DFS) rates were 79.0% (95% CI: 76.7% to 81.0%), 76.0% (95% CI: 71.9% to 79.5%), 73.6% (95% CI: 68.9% to 77.7%), and 74.5% (95% CI: 69.4% to 78.9%), respectively. Significant difference in survival among four subtypes was observed (Log-rank test, P<0.01). Multivariate Cox regression indicated that hormonal therapy can significantly reduce the long-term risk of total mortality and recurrence breast cancer specific mortality among Luminal A subtype patients. Adjuvant chemotherapy could improve the long-term prognosis of triple-negative breast cancer. No benefit from radiotherapy was observed for four subtypes of breast cancer in terms of long-term prognosis.

CONCLUSIONSMolecular subtypes based on ER/PR/HER2 could provide important information to predict breast cancer prognosis. The hormonal status was an important basis for individualized therapy and precision medicine.

Breast Neoplasms ; Chemotherapy, Adjuvant ; Cohort Studies ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Receptor, ErbB-2 ; Receptors, Estrogen ; Receptors, Progesterone ; Survival Rate ; Triple Negative Breast Neoplasms