Objective To explore the predictive value of the nomogram model based on multimodal MRI signs for adverse pregnancy outcomes in placenta accreta spectrum disorders(PAS).Methods The clinical and MRI data of 60 patients with PAS diagnosed by surgery and/or pathology were collected.Multivariate logistic regression was used to analyze the independent risk factors of adverse pregnancy outcomes in PAS.According to the results of multivariate logistic regression analysis,the nomogram prediction model of adverse pregnancy outcomes in PAS was constructed.Results Placenta/uterine protrusion[odds ratio(OR)=6.717,P=0.015],abnormal blood vessels in the placenta(OR=7.929,P=0.009),and diffusion weighted imaging(DWI)placental spike/nodular protrusion into the muscular layer(OR=12.134,P=0.003)were independent risk factors for adverse pregnancy outcomes in PAS.Based on the results,a nomogram prediction model was constructed.The area under the curve(AUC)of the model for predicting adverse pregnancy outcomes of PAS was 0.907,with a sensitivity of 0.906 and a specificity of 0.821.Conclusion The nomogram model constructed based on multimodal MRI signs has certain value in predicting adverse pregnancy outcomes of PAS.

Objective To explore the predictive value of the nomogram model based on multimodal MRI signs for adverse pregnancy outcomes in placenta accreta spectrum disorders(PAS).Methods The clinical and MRI data of 60 patients with PAS diagnosed by surgery and/or pathology were collected.Multivariate logistic regression was used to analyze the independent risk factors of adverse pregnancy outcomes in PAS.According to the results of multivariate logistic regression analysis,the nomogram prediction model of adverse pregnancy outcomes in PAS was constructed.Results Placenta/uterine protrusion[odds ratio(OR)=6.717,P=0.015],abnormal blood vessels in the placenta(OR=7.929,P=0.009),and diffusion weighted imaging(DWI)placental spike/nodular protrusion into the muscular layer(OR=12.134,P=0.003)were independent risk factors for adverse pregnancy outcomes in PAS.Based on the results,a nomogram prediction model was constructed.The area under the curve(AUC)of the model for predicting adverse pregnancy outcomes of PAS was 0.907,with a sensitivity of 0.906 and a specificity of 0.821.Conclusion The nomogram model constructed based on multimodal MRI signs has certain value in predicting adverse pregnancy outcomes of PAS.

To improve patient-centered pharmaceutical management and pharmaceutical service capabilities in the pharmaceutical department of medical institutions,automation and information technology are indispensable.The Pharmacy Administration-Automation and Information Technology is one of the social organization standards of the Chinese Hospital Association as part 4-4 of Pharmaceutical Administration and Pharmaceutical Practice in Healthcare,which standardizes 32 key elements in four aspects:basic requirements for automation construction in medical institutions,construction of automation hardware equipment,construction of intelligent information platform,and quality management and continuous improvement.It can be used to guide medical institutions at all levels to select and optimize pharmacy automation equipment and information platforms.This article introduced the construction methods and contents of the pharmacy automation and information technology standards,to deepen the understanding of peers on this standard and promote its implementation.This article aimed to promote the modernization,informatization,and intelligence of pharmaceutical services in medical institutions,and improve the quality and efficiency of overall medical pharmaceutical administration and service.

Objective To investigate the protective effect of Honokiol on the airway inflammation induced by particulate matter 2.5(PM2.5)in the asthmatic mice and its mechanism.Methods Fifty male specific pathogen free (SPF)Balb/c mice were randomly divided into 5 groups.Group A:normal control group;group B:asthmatic model group;group C:PM2.5 exposure asthmatic group;group D:TAK -242 group;group E:Honokiol group. Asthmatic mouse models were established by ovalbumin(OVA)sensitization and challenge.On days 0 and 7,the mice in B-E groups were injected intraperitoneally with injection 100 mg/L OVA and aluminum hydroxide for sensitization;on days 14 to 21,10 g/L OVA solution was given 30 min per day to challenge.During challenge phrase,the mice in C -E groups received intratracheal injection of PM2.5,every other day,4 times totally.On this basis,the mice in group D re-ceived TAK-242 intraperitoneal injection,and the mice in group E received honokiol intragastric administration.Group A was given saline instead of OVA.Animals were sacrificed 24 h after the final inhalation challenge,and the bronchoal-veolar lavage fluid(BALF)of the left lung was used for differential inflammatory cell counts.The expressions of Toll-like receptors 4(TLR4)and nuclear factor(NF)-κB at mRNA level were detected by real-time quantitative PCR. Flow cytometry analysis was performed to measure the levels of Th17 and Treg cells.Results Compared with group A,mice in group B and group C expressed more serious disorders of bronchial epithelial cells,alveolar wall congestion and edema,increased mucus secretion in the airway and infiltration of inflammatory cells in the lung,and those in group C were more obvious than those of group B and group E significantly reduced respiratory inflammation;compared with group A[(4.15 ± 1.35)×108/L,0.012 0 ± 0.002 3],the total number of inflammatory cell counts[(16.79 ± 5.62)×108/L and(24.58 ± 13.46)×108/L],eosinophils proportions(0.113 8 ± 0.022 3 and 0.197 8 ± 0.084 9)in group B and group C,were significantly higher,and the differences were statistically significant(all P<0.05);The total number of inflammatory cell counts and eosinophils proportion in group E(8.56 ± 3.28)×108/L and 0.041 5 ± 0.013 5)were significantly lower than those in group C,and the differences were statistically significant(all P <0.05);The expressions of TLR4 mRNA and NF-κB mRNA in group B and C(1.85 ± 0.56,1.82 ± 0.28 and 2.97 ± 0.41,2.83 ± 0.32)were significantly higher,and the differences were statistically significant(all P <0.05);The expressions of TLR4 mRNA and NF-κB mRNA in group E(1.60 ± 0.28,1.54 ± 0.25)was significantly lower than those in group C,and the differences were statistically significant(all P<0.05);the expressions of Th17 in group B and C[(2.89 ± 0.61)% and(4.96 ± 0.27)%]were significantly higher than those of group A[(1.03 ± 0.35)%] (all P<0.05);The expression of Th17 in group E[(1.83 ± 0.23)%]was significantly lower than that of group C,and the differences were statistically significant(P<0.05);the expressions of Treg in group B and C[(4.96 ± 0.35)%and(2.27 ± 0.41)%]were significantly lower than those of group A[(7.37 ± 0.56)%],and the differences were sta-tistically significant(all P<0.05);The expression of Treg in group E was significantly increased[(6.45 ± 0.38)%] compared with that in group C,and the difference were statistically significant(P<0.05);and those of group D and E were improved remarkably.Conclusions Honokiol can relieve PM2.5 exposure of asthmatic airway inflammation through down-regulating the expression of TLR4 and NF-κB and Th17 and regulating the balance of Th17 and Treg cells.

Objective To investigate the anti-inflammatory and immunosuppressive effects of honokiol in a mouse model of particulate matter ( PM ) 2.5-induced asthma .Methods Female SPF BALB/c mice were randomly divided into five groups:normal saline group (group A), ovalbumin (OVA)-sensitized group ( group B), PM2.5-exposed+OVA-sensitized group ( group C), dexamethasone-treated group (group D) and honokiol-treated group (group E).All mice except those in group A were sensitized and challenged with OVA, and the mice in groups C, D and E were exposed to PM2.5 every two days since the first challenge.Samples of lung sections were stained with hematoxylin and eosin (HE) to observe in-flammatory infiltration.Bronchoalveolar lavage fluid (BALF) and PBMCs were collected from each mouse . Expression of RORγt and Foxp3 at mRNA level was detected by quantitative real-time PCR.Flow cytometry analysis was performed to measure the percentages of Th 17 and Treg cells.ELISA was performed to measure the levels of IFN-γ, IL-10 and IL-17 in the supernatants of cell culture .Results Compared with group B , group C showed an enhanced expression of RORγt at mRNA level, increased IL-17 level and up-regulated percentage of Th17 cells (all P<0.05), but a suppressed expression of Foxp3 at mRNA level, decreased IL-10 level and down-regulated percentage of Th17 cells (all P<0.05).No significant difference in the per-centage of Th1 cells or in the expression of Th 1-related cytokines was observed .The expression of RORγt at mRNA level, IL-17 level and the percentage of Th 17 cells were decreased in PM2.5-exposed mice upon honokiol intervention (all P<0.05), while the expression of Foxp3 at mRNA level, IL-10 level and the per-centage of Treg cells were increased after honokiol intervention (all P<0.05).Honokiol had similar efficacy to dexamethasone in the treatment of asthma .Conclusion Honokiol can alleviate airway inflammation in mice with PM2.5 exposure-induced asthma through regulating the percentages of Th 17 and Treg cells.