Objective:To construct and implement a multidisciplinary pain management model during the perioperative period based on the project-achieving quality control circle, so as to improve the quality of patient pain management during the perioperative period.Methods:Using the convenient sampling, 310 surgical patients from the Department of Gastrointestinal Surgery, Hepatobiliary Surgery, Thoracic Surgery, Urology Surgery and Joint Surgery of Liaocheng People's Hospital from June to July 2020 were taken as the pre-improvement group, and the routine perioperative pain management model was implemented. Starting from August 2020, a project-achieving quality control circle was carried out, following the steps of theme selection, topic clarification, goal setting, formulation of strategies, investigation of the best strategies, implementation of strategies, and confirmation of effectiveness, to implement a multidisciplinary pain management model during the perioperative period. A total of 310 surgical patients admitted to 5 departments from February to March 2021 were included in the improvement group.Results:The implementation rate of multidisciplinary pain management plan, the rate of out-of-bed activity within 24 hours after surgery, the rate of excellent postoperative rehabilitation compliance, and the average sleep score of patients in the improvement group all increased, with statistical differences ( P<0.05). After improvement, the awareness rate of pain knowledge among medical and nursing staff, the accuracy rate of nurses' rest and active pain assessment records, and the score of nurse pain knowledge all increased, and the differences were statistically significant ( P<0.05) . Conclusions:The construction and implementation of a multidisciplinary pain management model during the perioperative period based on the project-achieving quality control circle can effectively improve the quality of pain management for surgical patients, accelerate patient recovery, and improve the pain management of medical and nursing staff.

OBJECTIVE：To provid e reference for pharmaceutical workers to better understand Novel Coronavirus Infection ： Expert Consensus on Guidance and Prevention Strategies for Hospital Pharmacists and the Pharmacy Workforce （hereinafter referred to as “expert consensus ”），and to apply and practice in specific work ，so as to give full play to the role of pharmacists to help fight the epidemic.METHODS ：The background of the formulation and revision of the expert consensus were introduced ，and its main contents and viewpoints were interpreted. RESULTS & CONCLUSIONS ：The text of expert consensus is divided into 8 parts，mainly including disease diagnosis and treatment [SARS-CoV- 2 infection related background ，clinical manifestations and diagnosis， treatment]，hospital pharmacy （prevention and control strategy ，work guidance ），drug and facility support management（key drug/facility/equipment support ，management and use of the drug in special circumstances ），information sources and related resources ，etc.，which comprehensively and detailedly provide information ，guidance and strategies for coronavirus SARS-CoV-2 infection prevention and control to play the role of pharmacists in hospital pharmacy well ，do well in the protection of staff in different pharmaceutical posts ，drug security work in response to epidemic situation ，and develop pharmaceutical care. So far，the understanding of SARS-CoV- 2 in the pharmaceutical industry is relatively limited. Based on the accumulated experience and progress in epidemic prevention and control ，the expert consensus will be updated and improved continuously ，so as to provide guidance and help for hospital pharmaceutical personnel.

OBJECTIVE： To provide reference for improving emergency capacity of the hospital pharmacy department in response to the novel coronavirus pneumonia （COVID-19） epidemic. METHODS ：According to the related regulations and requirements of Law of the People ’s Republic of China on the Prevention and Control of Infectious Diseases ，combined with the situation of COVID- 19 epidemic prevention and control ，and management experience of relevant hospitals ，on the basis of in-depth analysis of drug supply and quality assurance ，drug dispensing management ，provision of clinical pharmaceutical services and other related material support of hospital pharmacy department，integrated emergency management model was constructed for COVID- 19 epidemic prevention and control ，and the precautions and response measures of each link were sorted out. RESULTS ：Integruted emergency management mode for COVID-19 epidemic prevention and control in hospital pharmacy department included but was not limited to human resource management，drug and disinfection products supply management （mainly including key treatment drugs and disinfection product list formulation，control，inventory increase ，etc.）；drug dispensing management （mainly including prescription ，pharmacy window ， planning quantitative reserve ， drug return ， etc.）；clinical pharmaceutical care management （mainly including providing pharmaceutical information support ，online pharmaceutical service ，monitoring drug safety ，etc.）；personnel protection and disinfection （mainly including personnel protection ，environment and window ，equipment and container ，paper prescription disinfection，etc.）；special management of donated drugs ；prevention and control knowledge training ；pharmaceutical education and scientific research management ，etc. CONCLUSIONS ：The integrated emergency management model for epidemic prevention and control is helpful for hospital pharmacy to manage public health emergencies. During the outbreak of COVID- 19，hospital pharmacy department should start integrated emergency management mode for epidemic prevention and control ，strengthen the risk control of each link ，and play a good role in the key functional departments in the special period.

Objective: To investigate the epidemiologic features of respiratory viral etiology in hospitalized children with acute respiratory tract infection (ARTI) in Shijiazhuang. Methods: A total of 28 512 cases of hospitalized children with clinical diagnosis of ARTI in Children′ s Hospital of Hebei Province from 2014 to 2017 were recruited into this study. One nasopharyngeal swab was collected from each patient. Immunofluorescence assay was used to detect seven kinds of respiratory viruses, including respiratory syncytial virus (RSV), parainfluenza virus (PIV) type 1-3, influenza virus type A, B (FluA, FluB) and adenovirus (ADV). Results: At least one viral pathogen was identified in each of 9 263 out of 28 512 patients and the overall positive rate was 32.5%. Of 9 263 virus-positive patients, 9 070 (97.9%) had mono-infection. The most frequently detected virus was RSV, followed by PIV-3 and FluA. The positive rates of RSV and PIV-1 showed annually decreasing tendency, meanwhile the positive rate of FluA increased in the nearly two years. The detection rate of ADV and PIV-1 increased every other year. There was a significant difference in the positive rate among different years (P<0.05). The overall positive rate decreased along with the age increased (linear by linear association χ²=1191.289, P<0.05). The detection rates of RSV and PIV-3 were the highest in groups of <1 year old and 1-3 years old and decreased along with the age increased. The preschool children were more susceptible to developing FluA, FluB and ADV related diseases. There was a significant difference in the positive rate among different age groups (P<0.05). The viral distribution was uneven in different seasons, and the infection peaked in winter, the difference was statistically significant (P<0.05). The epidemic seasons of RSV and FluA were winter, and FluB infection was epidemic in winter and spring. The positive rates of PIV-1 and PIV-2 were most common in summer and autumn. PIV-3 was usually prevalent in spring and summer and ADV was prevalent sporadically. Conclusions RSV is the most common pathogen in hospitalized children with clinical diagnosis of ARTI during 2014-2017 and the positive rate of which showed an annually decreasing tendency. The positive rate of FluA increased in the nearly two years. Children in infancy are susceptible to the seven common respiratory viruses and winter is the epidemic season for these viruses.

Objective To study chronic nephrotoxicity of Penthorum chinense. To provide a scientific evidence for the development and application of Penthorum chinense in food and drug. Methods 48 SD rats were randomly divided into 4 groups (n=12), 0. 9% sodium chloride solution saline group and three Penthorum chinense treat groups. The Penthorum chinense groups were treated by intragastric administration with 5,10,20 g·kg-1 crude drug once a day for 3 months. The levels of Urea, UA, Cre in serum were detected, and the HE dyeing was chosen to observe the kidney morphology. Results The body weight, nephritic organ quotiety, and the level of Urea, UA, and Cre in each exposure group have no statistically significant difference compared with 0. 9% sodium chloride solution group (P>0. 05). There were no obvious kidney morphology changes in the Penthorum chinense group(F=1. 37,P=0. 268). Conclusion The kidney morphology and function of rat shows no apparente injury after long-term intragastric administration of Penthorum chinense.

BACKGROUND:In recent years, neural stem cels are considered to be ideal for the treatment of spinal cord injury, but the proportion of its natural differentiation into neurons in the host body is relatively low, which severely restricts the therapeutic effect on spinal cord injury. OBJECTIVE:To investigate the effect of erythropoietin on the differentiation of neural stem cels in vitro. METHODS:Under sterile condition, neural stem cels from the hippocampus of neonatal Wistar rats were isolated, cultured and identified by immunofluorescencein vitro. The third generation of neural stem cels were randomly divided into 0.5, 5, 50 U/mL erythropoietin groups and control group (with no erythropoietin). RESULTS AND CONCLUSION:Compared with the control group, the differentiation rate of neural stem cels was significantly improved in the 0.5, 5, 50 U/mL erythropoietin groups (P< 0.05); moreover, the differentiation rate of neural stem cels in the 5, 50 U/mL erythropoietin groups was higher than that in the 0.5 U/mL erythropoietin group (P < 0.05). In addition, there was no significant difference between the 5, 50 U/mL erythropoietin groups (P > 0.05). These findings indicate that erythropoietin can effectively induce the differentiation of neural stem cels into neurons in vitro, and moreover, it can significantly improve the differentiation rate of neural stem cels into neurons.

Objective To present the technique and short-term results of retroperitoneal laparoscopic renal cryoablation for small renal tumors. Methods Ten selected patients cases with 11 renal tumors were included in present study. There were 3 cases of left renal tumor, 6 cases of right renal tumor and 1 case of bilateral renal tumors. Tumors were located at the upper pole (2), middle (6), or lower pole (3). All tumors were located distant from the collecting system, without evidence of metastatic disease. Mean tumor size was 2. 8 cm (range: 1.5-4.0). All the patients were managed with a double freeze-thaw cycle of retroperitoneal laparoscopic renal cryoablation. The preoperative Hb was (137± 21)g/L, ESR was (27±12)mm/1 h, SCr was (92±41)μmol/L, GFR was (42±10)ml/min.All the patients were taken routine biopsies. Results Cryoablation was technically successful in all 10 patients (11 tumors). The mean time of the operations was (101 ± 31) min, and the mean blood loss was (42±21) ml. None of the cases received blood transfusion post-operation. No operative complication was seen. The postoperative hospital stay was (4±2) d. The postoperative Hb was (129 ±18)g/L,ESR was (31±14)mm/1 h,SCr was (95±39)μmol/L,GFR was (40±11)ml/min. There was no statistic change of Hb, ESR, SCr and ECT-GFR after operations(P＞0. 05). The biopsy results revealed that 8 tumors were renal clear cell carcinomas, and 2 tumors were papillary renal cell carcinomas, and 1 tumor was renal angiomyolipoma. All the patients had a minimum follow-up of 6 months (mean 16, range 6 to 21). Follow-up magnetic resonance imaging at 1, 3, and 6 months identified the punched-out, nonenhancing, spontaneously resorbing, renal cryolesions. Follow-up biopsie of the cryoablated tumor site was negative in the only patient who have undergone the biopsy. No evidence of local or port-site recurrence was found, and no metastatic disease. ConclusionsRetroperitoneal laparoscopic renal cryoablation for small renal tumors could be an accurate and effective intervention with a relatively low incidence of complications. Critical long-term data regarding laparoscopic renal cryoablation are awaited.

Objective To study the possibility of inducing human umbilical cord blood mesenchymal stem cells(MSCs) to differentiate into neuron-like cells by lithium chloride(LiCl) in vitro.Methods Human umbilical cord blood was collected from mature neonates.All samples were obtained sterilely with 20 U/ml heparin.The cord mononuclear cells were isolated with lymphocyte separation medium(density 1.077 g/ml), then purified by wall sticking screening and expanded with slight sugar DIEM containing 15% FBS.The third passage of the expanded MSCs were pre-inducted with DIEM containing 15% FBS and 20 ng/ml bFGF for 24 hours, then induced with DIEM without serum but 3 mol/L LiCl for 6 days in group A.The MSCs were induced with DIEM containing 3 mol/L Licl for 7 days in group B.The MSCs were normally cultured with DIEM containing 15% FBS in group C.The morphological changes of the cells were observed under phase contrast microscope.The neuron specific markers containing neuron specific enolase(NSE), microtubule associated protein2(MAP2) and glial fibrillary acid protein(GFAP) were evaluated by indirect immunocyto-chemistry staining.Results After inducted for 3 days, morphological changes were observed obviously in group A and B.6 days later, the differentiated cells showed typical neuronal morphology.The expression of NSE and MAP2 were positive for the majority cells in group A and B, and that of group A[(73.6 ± 7.8)%, 75.5 ± 8.5)% respectively]were obviously higher than group B[(31.0 ± 4.3)%,(33.5 ± 5.0)% respectively], few expressed GFAP in both groups.Conclusion The combination of LiCl and growth factor may induce the human umbilical cord blood MSCs into neuron-like cells in vitro.

Objective To evaluate the safety and short-term efficacy of transrectal ultrasound-guided transperineal cryosurgical ablation(TRUSCSA) for localized prostate cancer. Methods The data of 26 patients who were diagnosed with clinically localized prostate cancer (T_(1a)N_0M_0 - T_(2x)N_0M_0) by biopsy were reviewed. The data of serum prostate-specific antigen (PSA) level, clinical stage and Gleason score were collected. The Gleason score of all cases was ≤7; among them 6 cases were 2 - 4 and 20 cases were 5 - 7. The average pretreatment value of PSA was 11. 9 ng/ml (4. 7 - 19. 2 ng/ml). All the patients were treated with TRUSCSA, with a dual freeze-thaw cycle by using ultrathin 17-gauge cryoneedles. Immediate and delayed morbidities were evaluated. The PSA level was obtained every 3 months for the first 2 years and then every 6 months thereafter, and failure was defined as the inability to reach a nadir of 0. 5 ng/ml or less. All patients were strongly encouraged to undergo routine biopsies despite a stable PSA level. Results The operative time was (102±32)min. The postoperative hospital stay was (6±2)d. After withdrawal of the catheter, 22 cases had good continence) 4 had temporary incontinence for 3 - 7 d. Before operation 9 cases had normal sex life, and among them 5 cases had erectile dysfunction after operation. No one developed urinary retention or urethro-rectal fistula. The follow-up ranged from 6 to 30 months (mean 22). The PSA level at the last follow up visit was less than 0. 5 ng/ml in 23 patients (88%) and 0. 5 ng/ml or more in 3(12%). Postoperative biopsies were taken in 20 cases and the results were negative at the 6th month. Conclusions Transrectal ultrasound-guided percutaneous cryosurgical ablation for clinically localized prostate cancer could be effective and safe. Additional studies with longer follow-up are necessary to determine the sustained efficacy of this procedure.

Objective To evaluate the clinical feasibility of laparoscopic cool-tip radiofrequency ablation (LCRFA)for renal cell carcinoma. Methods Twelve selected cases of primary renal, ceil carcinoma underwent LCRFA. Of them, 4 cases of left renal carcinomas, 7 cases had right renal carci-nomas and 1 case had bilateral renal carcinomas. The maximum diameter of the tumors was 2.1-8. 5 era. Eleven cases were T, No M0 and the other one was T2 N0 M0. Results The mean operation time was 92±24 min, and the mean blood loss was 50±29 ml. None of the cases need blood transfusion post-operation. No laparoscopic operative complications were observed. Six weeks after operation, complete ablation was achieved in 12 lesions and partial ablation in 1, with a complete ablation rate of 92.3%(12/13). There was no statistic change of Hb. ESR. SCr and GFR after operations (P>0.05). Ten cases underwent CT examination 3 months after the treatment ,9 cases showed complete necrosis of tumor,1 case showed partial necrosis. No recurrence was found. All of the 12 cases remained sur-vived during the follow-up for 1-16 months(median,7.8 months). Conelusions LCRFA for renal cell carcinoma is an accurate and effective intervention with a low incidence of complications, and is more accurate than ultrasound-guided pereutaneous radiofrequency ablation.