OBJECTIVE To explore the effects of multi-disciplinary comprehensive management team of tertiary hospital collaborated with the pharmacists from community health service center （hereinafter referred to as “community pharmacists”） on elderly patients with hypertension in the community. METHODS Elderly patients with hypertension from May 2020 to May 2021 in Yuhua Community Health Service Center of Nanjing were divided into control group （76 cases） and observation group （76 cases） according to the management style. The control group was treated with regular community medical services and the observation group received regular community medical services plus pharmaceutical care provided by the comprehensive management team collaborated with community pharmacists. The compliance， blood pressure control status and hypertension-related complications were compared between 2 groups before management and after 24 months of management. RESULTS After 24 months of management， the compliance and blood pressure compliance rates in both groups were higher than before management； meanwhile， the observation group was significantly higher than control group at the corresponding period （P＜0.05 or P＜ 0.01）. The blood pressure levels of both groups were significantly lower than before management， and the systolic blood pressure as well as the incidences of the whole complications and cerebrovascular injury in the observation group were significantly lower than control group at the 583867635@qq.com corresponding period （P＜0.05）. There was statistical significance in the effects of the rate of reaching the standard of blood pressure on the complications （P＜0.01）. CONCLUSIONS The hypertension management mode of comprehensive management team collaborated with community pharmacists can significantly improve the compliance and blood pressure compliance rate of elderly patients with hypertension， and reduce the incidence of hypertension-related complications.

Severe acute pancreatitis-associated acute lung injury (SAP-ALI) is a serious disease associated with high mortality. Emodin has been applied to alleviate SAP-ALI; however, the mechanism remains unclear. We report that the therapeutic role of emodin in attenuating SAP-ALI is partly dependent on an exosomal mechanism. SAP rats had increased levels of plasma exosomes with altered protein contents compared to the sham rats. These infused plasma exosomes tended to accumulate in the lungs and promoted the hyper-activation of alveolar macrophages and inflammatory damage. Conversely, emodin treatment decreased the plasma/pancreatic exosome levels in the SAP rats. Emodin-primed exosomes showed less pro-inflammatory effects in alveolar macrophages and lung tissues than SAP exosomes. In detail, emodin-primed exosomes suppressed the NF-κB pathway to reduce the activation of alveolar macrophage and ameliorate lung inflammation by regulating PPARγ pathway, while these effects were amplified/abolished by PPARγ agonist/antagonist. Blockage of pancreatic acinar cell exosome biogenesis also exhibited suppression of alveolar macrophage activation and reduction of lung inflammation. This study suggests a vital role of exosomes in participating inflammation-associated organ-injury, and indicates emodin can attenuate SAP-ALI by reducing the pancreatic exosome-mediated alveolar macrophage activation.

Objective:To explore the effect of narrative nursing in patients with retinal detachment undergoing surgery.Methods:From February 2020 to August 2021, 40 patients with retinal detachment who underwent surgical treatment in the Department of Geriatrics and Ophthalmology of Beijing Tongren Hospital, Capital Medical University were selected as the research object by the convenient sampling method. According to the random number table method, the patients were divided into the observation group and the control group, 20 cases in each. The patients in the control group were given routine nursing, and the patients in the observation group received narrative nursing on this basis. Before and after the intervention, Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Memorial University of Newfoundland Scale of Happiness (MUNSH) , and Generic Quality of Life Inventory-74 (GQOLI-74) were used to investigate the two groups of patients. The hospitalization time and complications of the two groups of patients were recorded.Results:At discharge, the SAS and SDS scores of the observation group were lower than those of the control group, the GQOLI-74 and MUNSH scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The hospitalization time of the observation group was shorter than that of the control group, and the difference was statistically significant ( P<0.05) . There was no significant difference in the number of cases of postoperative intraocular hypertension between the two groups ( P>0.05) . Conclusions:Narrative nursing can effectively relieve anxiety and depression in patients with retinal detachment surgery, improve patients' well-being and quality of life, and shorten hospitalization time.

Objective:To construct the evaluation index system of pediatric specialized nurses' core competence, so as to provide a basis for accurate measurement of pediatric specialized nurses' core competence.Methods:A research group was established in August 2021. Based on the quality onion model and literature analysis, a qualitative interview was conducted in September 2021 with 10 provincial and above hospitals pediatric specialist nurses, 5 pediatric nursing managers, 5 pediatric chief physicians and 5 primary caregivers for children selected by objective sampling. From September 2021 to February 2022, questionnaires were sent to 16 experts via email or WeChat for three rounds of Delphi expert consultation. The evaluation indexes of pediatric specialized nurses' core competence were determined according to the authority coefficient, Kendall coordination coefficient, coefficient of variation and other factors.Results:Among three rounds of expert consultation, the effective recovery rates of the questionnaire were all 100.00% (16/16) , and the authority coefficients were 0.813, 0.888 and 0.895, respectively, and the Kendall coordination coefficients were 0.175 (χ 2=289.348, P<0.01) , 0.239 (χ 2=408.131, P<0.01) and 0.288 (χ 2=467.280, P<0.01) , respectively. The final evaluation index system of pediatric specialized nurses' core competence included 6 first level indicators, 18 second level indicators and 84 third level indicators. Conclusions:The evaluation index system of pediatric specialized nurses' core competence is scientific and reliable, which can be used as an effective tool to measure the core competence of pediatric specialized nurses.

Macrophages are typically identified as classically activated (M1) macrophages and alternatively activated (M2) macrophages, which respectively exhibit pro- and anti-inflammatory phenotypes, and the balance between these two subtypes plays a critical role in the regulation of tissue inflammation, injury, and repair processes. Recent studies indicate that tissue cells and macrophages interact

Objective:To investigate the influencing factors of hospitalization for pregnant women with influenza A.Methods:From December 2018 to February 2019, 261 pregnant women with influenza A were admitted to Beijing Ditan Hospital, Capital Medical University. The clinical data of age, gestational period, underlying diseases, time from onset to treatment, white blood cell count and lymphocyte count of these patients were collected. Data of out-patients were compared with those of inpatients. Chi-square test and multivariate logistic regression were used to analyze the influencing factors of hospitalization in pregnant women with influenza A.Results:Among the 261 cases of pregnancy with influenza A, 36 cases (13.79%) were hospitalized, of which 10 (27.78%) were hospitalized due to severe influenza complications, the other 26 cases (72.22%) were hospitalized due to pregnancy related adverse events. The proportions of hospitalized patients with age ≥30 years old, gestational period ≥28 weeks, combined with underlying diseases and lymphocyte count <1×10 9/L were 75.00%(27/36), 83.33%(30/36), 16.67%(6/36) and 50.00%(18/36), respectively, which were significantly higher than those of out-patients (47.11%(106/225), 35.56%(80/225), 0.89%(2/225) and 13.22%(16/121), respectively; χ2=9.66, 29.05, 26.00 and 22.12, respectively, all P<0.05). The proportions of inpatients and out-patients with white blood cell count ≥4×10 9/L were 97.22%(35/36) and 97.52%(118/121), respectively, and there was no significant difference ( χ2=0.01, P=0.921). Multivariate logistic regression analysis showed that age ≥30 years (odds ratio ( OR)=5.181, 95% confidence interval ( CI) 1.628-16.489, P=0.005), gestational period ≥28 weeks ( OR=11.054, 95% CI 3.233-37.796, P<0.01), lymphocyte count <1×10 9/L ( OR=6.864, 95% CI 2.237-20.729, P=0.001), and time from onset to treatment <24 h ( OR=0.076, 95% CI 0.012-0.468, P=0.005) were the influencing factors for hospitalization of pregnant women with influenza A. Conclusion:Age ≥30 years old, gestational period ≥28 weeks, lymphocyte count <1×10 9/L and time from onset to treatment <24 h are the influencing factors for hospitalization of pregnant women with influenza A.

OBJECTIVE: Common findings are to be found from 144 different type of medical device manufacturers' audit reports which are from Jan. 2017 to Jun. 2019. Advise is to be provided for medical device manufacturers on continual improvement. METHODS: Classify and analyze the on-site audit findings from different type of medical device manufacturers. RESULTS: The frequency of findings from chapter production management, buildings and facilities, quality control are comparatively high. CONCLUSIONS The key to improve the quality management system is to cultivate the staff sense of continual improvement of quality system, improve the staff ability of finding and solving problems, encourage staff participation in quality system, fit the quality system on product realization.
Industry ; Quality Control ; Time Factors

Objective To establish a high performance liquid chromatography (HPLC) method for determining phenytoin concentration in epilepsy patients' plasma,and compare this method with chemiluminescence microparticle immunoassay (CMIA),and to evaluate the consistency of the two methods.Methods HPLC and CMIA methods were applied to determine the plasma concentration of phenytoin in 60 epileptic patients,respectively.The difference of results was analyzed by two-side paired t-test,and then the correlation and consistency of the two methods were investigated with Passing-Bablok regression and Bland-Altman method.Results There was no significant difference between the results of the two methods (P ＞0.05).The regression equation of the determination results by HPLC (Y) and CMIA (X) was Y=0.992 9X +0.143 7 (R2 =0.992 6,n =60),which indicated the correlation of the two methods was good.Bland-Altman analysis showed that the consistency of the two methods for determining was good.Conclusion HPLC and CMIA method in monitoring plasma concentration of phenytoin have good correlation and consistency.Both methods can be used for therapeutic drug monitoring of phenytoin.

Objective To investigate the clinical characteristics of elderly patients with multiple myeloma and their prognostic factors.Methods 100 multiple myeloma patients with age≥ 60 years and 100 multiple myeloma patients with age <60 years who admitted in our hospital from December 2007 to December 2015 were collected as research subjects.100 patients with age ≥60 years were divided into elderly multiple myeloma group,100 cases with aged <60 years were divided into non -elderly multiple myeloma group.The clinical data and laboratory results of two groups were compared,the prognosis factors in elderly patients with multiple myeloma were analyzed.Results The incidence rate of ISS stage Ⅰ -Ⅱ in elderly multiple myeloma group (45.0%)was lower than non -elderly multiple myeloma group (60.0%),the incidence rate of stage Ⅲ was higher than non -elderly multiple myeloma group (χ2 =4.511,P <0.05).The infection incidence of elderly multiple myeloma group(30.0%)was higher than non -elderly multiple myeloma group(15.0%)(χ2 =10.452,P <0.05 ).The hemoglobin,serum albumin contents of elderly multiple myeloma group [(83.7 ±19.8)g/L,(27.89 ±6.87)g/L]were less than non -elderly multiple myeloma group[(92.1 ±22.5)g/L,(33.15 ±7.69)g/L](t =4.297,4.426,all P <0.05).The calcium content,the propor-tion of bone marrow plasma cells,serum creatinine and blood β-microspheres protein levels of elderly multiple mye-loma group [(2.51 ±0.41)mmol/L,(39.43 ±18.64)%,(182.24 ±125.47)μmol/L,(9.02 ±6.24)mg/L]were higher than non -elderly multiple myeloma group [(2.36 ±0.48)mmol/L,(37.45 ±19.86)%,(143.25 ± 116.43)μmol/L,(5.87 ±3.41)mg/L](t =5.945,4.196,4.375,4.264,all P <0.05).The median survival time of elderly multiple myeloma patients were significantly correlated with the patients'age,the proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin,and ISS staging (χ2 =4.125,3.254,8.542,5.748,9.244,all P <0.05).Conclusion The condition of elderly myeloma patients is more serious,age,proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin and ISS stage affect myeloma patients prognosis.

Objective:To determine the valproate concentration in plasma of epilepsy patients by HPLC, and compare with the re-sults of chemiluminescence microparticle immunoassay ( CMIA) to evaluate the consistency of the two methods. Methods:HPLC and CMIA was respectively applied to determine the plasma concentration of valproate in 230 epileptic patients. The correlation of the two methods was studied by Passing-Bablok regression and Bland-Altman method. Results:The regression equation of the determination re-sults of HPLC (Y) and CMIA (X) was Y=1. 069 7X+2. 338 2 (R2 =0. 969, n=230), which showed promising correlation. Bland-Altman analysis showed that the consistency of the two methods was poor, and the values of HPLC were higher. Conclusion: HPLC and CMIA used for the determination of valproate plasma concentration show good correlation. However, the consistency is poor and there is system error. In the clinical treatment, adjustment and choice should be paid more attention.