OBJECTIVE To improve the efficiency and quality of dispensed oral drug management in the inpatient pharmacy， and ensure the safety of drug use in patients. METHODS SWOT （strength， weakness， opportunity， threat） analysis method was used to analyze the internal strengths and weaknesses， as well as the external opportunities and threats in the construction of a closed-loop management system for dispensed oral drugs in the inpatient pharmacy of our hospital， and propose improvement strategies. RESULTS & CONCLUSIONS A refined， full-process， closed-loop traceability management system for dispensed oral drugs in the inpatient pharmacies was successfully established， which is traceable in origin， trackable in destination， and accountable in responsibility. After the application of this system， the registration rate of dispensed drug information and the correctness rate of registration content both reached 100%. The proportion of overdue drug varieties in the same period of 2024 decreased by 77.78% compared to March 2020， the inventory volume decreased by 29.50% compared to the first quarter of 2020， the per-bed medication volume decreased by 32.14% compared to the first quarter of 2020； the average workload per post in the same period of 2023 increased by 49.09% compared to 2019， the dispensing accuracy rate reached 100%， and the improvement rate of quality control problem increased by 25.25% compared to 2021. This system effectively improves the safety and accuracy of dispensed oral drug management in the inpatient pharmacy.

AIM: To compare the effectiveness of foldable capsular body(FCB)with traditional scleral buckling(SB)in the treatment of experimental retinal detachment animal models.METHODS: After successfully establishing rhegmatogenous retinal detachment(RRD)animal models, 24 New Zealand white rabbits were randomly divided into three groups(RRD models group, SB group, and FCB group), with 8 rabbits in each group. The FCB and SB groups underwent SB and FCB surgeries for the RRD animal models, while the RRD models group only consists of RRD models without any surgical intervention during the follow-up period. The follow-up duration was 3 mo. Wide-field neonatal fundus imaging system and ophthalmic B-ultrasound were used to assess the fundus conditions before and after surgery. The Icare® TONOVET Plus tonometer was utilized to evaluate intraocular pressure changes before and after surgery. The Eaton and Draize scoring systems were selected to monitor postoperative inflammatory reactions.RESULTS: The retinal reattachment rates in the FCB and SB groups were 87.5% and 75.0%, respectively, with no statistically significant difference between the groups(P>0.05). The intraocular pressure in both the FCB and SB groups increased postoperatively compared to preoperative levels(P<0.01), and there were no significant differences in intraocular pressure at any time points during the follow-up period between the groups(P>0.05). The intraocular pressure in the RRD models group remained at a low level throughout the follow-up period. The average surgical time for the FCB group was 16.87±2.29 min, which was shorter than 46.25±4.74 min in the SB group(t=-15.166, P<0.001). According to the Eaton and Draize scoring systems, the FCB group had lower grades of conjunctival hyperemia and edema in the early postoperative period compared to the SB group, indicating milder inflammatory reactions(P<0.05).CONCLUSION: Both FCB and SB are effective in treating experimental RRD. Compared to SB, FCB is simpler to operate, and also has a shorter surgical time and milder postoperative inflammatory reactions.

Objective:To explore influencing factors affecting the prognosis of patients with advanced non-small cell lung cancer (NSCLC) receiving immunotherapy based on hematologic indexes, thus to construct and evaluate a nomogram prediction model.Methods:The clinical data of 80 patients with advanced NSCLC treated with programmed death-1 inhibitor monotherapy or combination regimen from January 2018 to June 2020 at the Affiliated Hospital of North China University of Science and Technology and Tangshan People's Hospital were retrospectively analyzed. Hematologic indexes at the baseline, the optimal remission and the progressive disease (PD) were collected separately, and independent influencing factors for patient prognosis were analyzed using Cox proportional hazards regression model. A nomogram prediction model was constructed based on the results of the multifactorial analysis, and the predictive performance of the model was evaluated by receiver operating characteristic (ROC) curve, concordance index (C-index) and calibration curves.Results:As of the follow-up cut-off date, of the 80 patients, 63 had PD, with a median overall survival (OS) of 16.9 months. Univariate analysis showed that, age ( HR=2.09, 95% CI: 1.17-3.74, P=0.013) , number of treatment lines ( HR=2.23, 95% CI: 1.21-4.12, P=0.010) , lymphocyte to monocyte ratio (LMR) at the baseline ( HR=0.75, 95% CI: 0.57-0.97, P=0.028) , D-dimer ( HR=1.00, 95% CI: 1.00-1.00, P=0.002) and lactate dehydrogenase (LDH) ( HR=1.01, 95% CI: 1.00-1.01, P=0.006) at the optimal remission, haemoglobin ( HR=0.97, 95% CI: 0.96-0.99, P<0.001) , D-dimer ( HR=1.00, 95% CI: 1.00-1.00, P=0.002) , C-reactive protein ( HR=1.01, 95% CI: 1.00-1.01, P=0.011) , albumin (ALB) ( HR=0.91, 95% CI: 0.87-0.96, P=0.001) , neutrophil to lymphocyte ratio (NLR) ( HR=1.16, 95% CI: 1.05-1.27, P=0.002) and LMR ( HR=0.62, 95% CI: 0.42-0.90, P=0.012) at the PD were all influencing factors for the prognosis of advanced NSCLC patients receiving immunotherapy. Least absolute shrinkage and selection operator regression were used to screen the variables for P<0.10 in the univariate analysis, and nine possible influencing factors were obtained, which were age, fibrinogen and LDH at the optimal remission, haemoglobin, D-dimer, C-reactive protein, LDH, ALB and LMR at the PD. Multivariate analysis of the above variables showed that, age ( HR=0.91, 95% CI: 0.86-0.97, P=0.004) , LDH ( HR=1.01, 95% CI: 1.00-1.01, P=0.013) and ALB ( HR=0.82, 95% CI: 0.67-0.99, P=0.041) at the PD were independent influencing factors for the prognosis of patients with advanced NSCLC who received immunotherapy. The area under curve of the nomogram predicting model based on the above indexes, 1- and 2-year OS rates of patients were 0.77 (95% CI: 0.65-0.89) and 0.75 (95% CI: 0.66-0.88) , respectively, and C-index was 0.71 (95% CI: 0.64-0.78) , the calibration curves showed good consistency between predicted and actual probability of occurrence. Patients in the low-risk group ( n=40) had a median OS of 29.9 months (95% CI: 22.5 months-NA) , which was significantly better than that of the high-risk group ( n=40) [13.4 months (95% CI: 11.4-23.5 months) , χ2=11.30, P<0.001]. Conclusion:Age, LDH and ALB at the PD are independent influencing factors affecting the prognosis of patients with advanced NSCLC receiving immunotherapy, and the nomogram model constructed based on the above indexes has good differentiation and calibration for predicting 1- and 2-year OS rates in advanced NSCLC patients receiving immunotherapy.

Objective To compare the clinical effects between sutureless bridge intrascleral fixation and ciliary sul-cus suture suspension of intraocular lens(IOL)1 year postoperatively.Methods In this retrospective study,14 patients(14 eyes)who underwent sutureless bridge intrascleral IOL fixation in the No.988 Hospital of Joint Logistic Support Force of PLA from March 2019 to January 2022 were taken as the intrascleral fixation group and 15 patients(15 eyes)who under-went IOL ciliary sulcus suture suspension in the same period were taken as the suture suspension group.During the 1-year follow-up,the preoperative and postoperative uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA)(logMAR),spherical equivalent(SE),endothelial cell count(ECC),intraocular pressure(IOP)and IOL position were compared between the two groups.Results At 1,6 and 12 months postoperatively,the UCVA in both groups significant-ly increased compared with those before surgery(all P＜0.05),and UCVA in the intrascleral fixation group were better than those in the suture suspension group at all postoperative time points(F=4.560,6.411 and5.373;all P＜0.05).At 1,6 and 12 months postoperatively,there was no significant difference in BCVA in both groups compared with those before surgery(all P＞0.05),but BCVA in the intrascleral fixation group were better than those in the suture suspension group at all postoperative time points(F=6.170,6.957 and 10.624;all P＜0.05).After surgery,eyes in the intrascleral fixation group showed hyperopia drift,while eyes in the suture suspension group showed myopia drift.At 1,6 and 12 months post-operatively,the SE of the intrascleral fixation group were(0.59±0.30)D,(0.57±0.27)D and(0.64±0.29)D,respec-tively,and those of the suture suspension group were(-0.75±0.44)D,(-0.72±0.42)D and(-1.12±0.64)D,re-spectively.At 6 months postoperatively,the ECC of both groups were significantly lower than those before surgery(t=8.579 and 21.929;both P＜0.001).The IOP in both groups were within the normal range preoperatively and stable during the follow-up.The IOL were centrally located without obvious decentration or tilt during the follow-up.In addition,there were no vitreous and retinal complications.Conclusion Both sutureless bridge intrascleral IOL fixation and IOL ciliary sulcus suture suspension can obtain a favorable prognosis of visual acuity with refractive shift,while sutureless bridge in-trascleral fixation shows better clinical outcomes.

Objective:To compare the effects of desflurane and sevoflurane anesthesia on the sleep quality of sleep-deprived mice.Methods:Thirty-two clean-grade healthy male C57BL/6 mice, aged 10 weeks, weighing 20-25 g, were divided into 4 groups ( n=8 each) by the random number table method: control group (C group), sleep deprivation group (SD group), sleep deprivation+ sevoflurane group (SD+ SEV group), and sleep deprivation+ desflurane group (SD+ DES group). In the four groups, EEG-EMG electrodes were implanted for recording EEG and EMG, and sleep deprivation model was developed by the gentle stimulation method with a brush for 12 h (6: 00-18: 00) after 7 days of adaptation. The 6 h after sleep deprivation was divided into 2 time periods: T 1 period (18: 00-20: 00) and T 2 period (20: 00-24: 00). T 1 period In SD group, mice were allowed ad libitum recovery sleep after sleep deprivation. C group and SD group were exposed to 60% oxygen 1.5 L/min. In SD+ DES group and SD+ SEV group, mice were exposed to 6% desflurane and 2.5% sevoflurane, respectively, for 2 h in 60% oxygen 1.5 L/min following sleep deprivation. T 2 period Four groups were allowed ad libitum recovery sleep with the EEG-EMG signal recording. The percentages and number of wakefulness time, rapid eye movement time and non-rapid eye movement time during each time period were calculated using Lunion Data software. Results:Compared with C group, the percentage of non-rapid eye movement time and the percentage of rapid eye movement time were significantly decreased, and the percentage of wakefulness time was increased during 12 h sleep deprivation in SD group, SD+ SEV group and SD+ DES group ( P<0.05). Compared with T 1 period, the percentage of non-rapid eye movement time was significantly increased, and the percentage of wakefulness time and percentage of rapid eye movement time were decreased in T 2 period in SD group ( P<0.05). Compared with SD group, the percentage of non-rapid eye movement time and percentage of rapid eye movement time were significantly decreased, and the percentage of wakefulness time was increased in T 2 period in SD+ SEV group and SD+ DES group ( P<0.05). There was no significant difference in the percentage of non-rapid eye movement, rapid eye movement and wakefulness time in T 2 period between SD+ SEV group and SD+ DES group ( P>0.05). Compared with SD+ SEV group, the number of non-rapid eye movement in T 2 period was significantly reduced in SD+ DES group ( P<0.05). Conclusions:The effect of desflurane anesthesia in improving sleep quality is better than sevoflurane anesthesia in sleep-deprived mice.

Objective:To study the differences in the cumulative dose between deformable image registration (DIR) and simple dose-volume histogram (DVH) summation in the fractionated brachytherapy of cervical cancer, and to analyze the feasibility of the application of DIR in the dosimetry assessment of targets and organs-at-risk (OARs) in the brachytherapy.Methods:A retrospective analysis was conducted for 13 cases with primary cervical cancer treated with four fractions of interstitial brachytherapy guided by CT images. The four CT images of each cases were registered using an intensity-based DIR. Then, the cumulative doses (the D2 cm 3, D1 cm 3, and D0.1 cm 3 of the bladder, rectum, intestine, and colon and the D90for targets) after DIR were calculated and compared to those obtained using simple DVH summation. Afterward, the correlation between the dose difference and dice similarity coefficient (DSC) was analyzed. With the dose difference (the remaining dose of OARs caused by the DIR) as limits, a new plan was made for the latest CT to calculate the dose increase to targets. Results:Compared to simple DVH summation, DIR allowed the cumulative doses of the D2 cm 3 and D1 cm 3 of bladder to be decreased by (2.47±1.92) and (2.82±2.73) Gy, respectively on average ( t=-3.65, -2.93, P < 0.05), those of the D2 cm 3, D1 cm 3, and D0.1 cm 3 of rectum to be decreased by (2.05 ± 1.61) Gy, (1.51 ± 1.58), and (3.21 ± 2.50) Gy, respectively on average ( t=-4.02, -3.02, -4.06, P < 0.05), and those of the D2 cm 3, D1 cm 3, and D0.1 cm 3 to be decreased by (1.42 ± 0.99), (1.55 ± 1.28) Gy, and (2.43 ± 1.95) Gy, respectively on average ( t=-3.52, -2.96, -3.06, P < 0.05). There was no significant statistical difference in the D90 of targets, the D0.1 cm 3 of the bladder, and the D2 cm 3, D1 cm 3, D0.1 cm 3 of the colon ( P > 0.05) between both methods, and there was no distinct correlation between DSC and dose difference ( P > 0.05). The DIR increased the dose to targets, with a median value of 150 cGy. However, the accuracy of the DIR should be improved. Conclusions:In clinical practice of multiple fractions of brachytherapy for cervical cancer, it′s still recommended to adopt the simple dose summation method to assess the doses to targets and OARs.

Objective:To establish a dosimetric method based on the well-chamber to verify the accuracy of the source positioning and dwelling time for the afterloading machine, aiming to provide a new method for the quality control of afterloading machine.Methods:The principle of this method was explained according to the hardware structure of the well-chamber. Then, the precision of this method was analyzed by the simulation test and data fitting. The feasibility test was also performed. And the advantages and disadvantages of this method were compared with those of the traditional method.Results:The precision of this method for detecting the source positioning was 0.07 mm and the dwelling time was 0.09 s, respectively. In the feasibility test, the standard deviation of the measure value was below 3%.Conclusions:The well-chamber method has high precision and convenient operation. It can be applied in the rapid verification of the relative accuracy of the source positioning and dwelling time of well-chamber.

Objective:To evaluate the effect of nicotinamide mononucleotide (NMN) on neurogenesis decline in sleep-deprived infancy rats.Methods:Seventy-eight clean-grade healthy male Sprague-Dawley rats, aged 7 days, weighing 10-15 g, were divided into 3 groups ( n=26 each) using a random number table method: control group (group Con), sleep deprivation group (group SD) and sleep deprivation plus NMN group (group SD+ NMN). Sleep deprivation model was established by gentle stimulation method with a brush (10 h per day) for 14 consecutive days.NMN 500 mg/kg was intraperitoneally injected in group SD+ NMN, while the equal volume of aqua pura was given instead in Con and SD groups.5′-bromo-2′-deoxyuridine (BrdU) 100 mg/kg was intraperitoneally injected immediately after the end of sleep deprivation to label the new-born cells.At 24 h after completion of sleep deprivation, the stem cell pluripotency transcription factor (SOX2) and doublecortin (DCX) positive cells in the hippocampal DG region were counted using immunofluorescence and immunohistochemical methods, and positron emission tomography-computed tomography was used to observe the metabolism of 18F-fluorodeoxyglucose in the hippocampus.At 4 weeks after completion of sleep deprivation, the number of neuronal nuclei antigen (NeuN)/BrdU and glial fibrillary acid protein (GFAP)/BrdU positive cells in hippocampal DG region was recorded using immunofluorescence, and novel object recognition test was performed to evaluate the cognitive function. Results:Compared with group Con, the number of SOX2 and DCX positive cells was significantly reduced, the standard uptake value of glucose in the hippocampus was decreased, the number of NeuN/BrdU and GFAP/BrdU positive cells was reduced, and discrimination index in novel object recognition test was decreased in group SD ( P<0.05). Compared with group SD, the number of SOX2, DCX NeuN/BrdU and GFAP/BrdU positive cells was increased, the standard uptake value of glucose in the hippocampus was increased, and discrimination index in novel object recognition test was increased in group SD+ NMN ( P<0.05). Conclusion:Nicotinamide mononucleotide can promote neurogenesis, thus improving cognitive function, and the mechanism is related to increasing the metabolism of hippocampal glucose in sleep-deprived infancy rats.

Objective: To study the feasibility of using the PTW729 2D array ion-chamber to verify the relative dose distribution calculated with the Acuros BV algorithm. Both advantages and disadvantages of the method were analyzed to provide reference for practical clinical practices. Methods: Based on self-built measurement phantoms, the dose distribution on the same slice of the phantom was measured with PTW729 and film, respectively, under the same measurement condition and plan. The dose distributions obtained by the two method were compared with the result calculated with Acuros BV, separately, by using γ analytical tool. And the stability of the PTW729 was tested. Results: The γ comparison value was 95.9% between the film and Acuros BV, 98.9% between the PTW729 and Acuros BV and 88.0% between the film and PTW729, with 95.0%, 100.0%, and 100.0%, in their stability test respectively. Conclusions PTW729 2D array ion-chamber can be applied to the rapid verification of Acuros BV algorithm-calculated relative dose distribution.

Objective To establish and evaluate a morning check system for linac based on electronic portal image device (EPID).Methods Delivered fluence maps of open and wedge fields at 10 cm×10 cm field size of Synergy Linac were measured by EPID.Figure features from these two images were extracted with matlab codes and analyzed to realize a quick morning check.The repeatability of dose response and mechanical setup,relationship between gray value and machine unit (MU),accuracy of output and field size test were investigated with both EPID and DailyQA3.The status of Synergy linac was monitored both by DailyQA3 and EPID for two months.Results EPID was able to test the linac consistently with a testing error of 0.50 mm,1.00 mm for field size and center,respectively.Both of the test accuracy for flatness and symmetry was 0.17％.The mechanical accuracy test and dosimetric repeatability test were also consistent.The dose response of EPID was linearly related to the linac output (R2＞0.999).EPID was highly sensitive to the change of output and radiation field size.The measurement deviations between EPID and DailyQA3 were consistent and within clinical acceptable tolerance.Conclusions EPID showed great accuracy and stability on monitoring the performance of linac.The established daily check tool based-on EPID is accurate and reliable for clinical usage.