In order to optimize the management mode of drug dispensing in inpatient pharmacy, in April 2023, a tertiary hospital constructed and initiated the whole-process intelligent drug dispensing mode in inpatient pharmacy. By jointly applying hospital information system, pre-approval system, paperless dispensing traceability system, and intelligent distribution system, a standardized business process of " pharmacist confirms orders → medication retrieval/verification/packaging → logistics distribution → nurse verification/dispensing" had been established, achieving visibility, controllability, and traceability of the entire drug dispensing process, ensuring drug safety of wards. Before the implementation of this mode (June 2022 to January 2023), the average number of dispensing orders per month in the hospital′s inpatient pharmacy was 8 498, with an error rate of 3.23% and an average completion time of 15.50 min per order; After implementation (June 2023 to January 2024), the average number of orders per month was 10 099, with an error rate reduced to 0.63%, and the completion time for each order was shortened to 10.10 min. The application of the whole-process intelligent drug dispensing mode had reduced dispensing error rates, and improved work efficiency, which could provide references for other public hospitals to promote intelligent drug dispensing.

Objective To analyze the effect of nursing interventions based on the Information-Motivation-Behavioral Skills (IMB) model in patients with functional dyspepsia, in order to improve their psychological state and gastrointestinal motility, and provide reference for clinical nursing. Methods A total of 160 functional dyspepsia patients admitted to the First Affiliated Hospital of Xinxiang Medical College from December 2022 to June 2023 were chosen as the study subjects. They were randomly divided into control group and observation group, using a random number table method, with 80 cases in each group. Patients in control group were given routine nursing intervention, and patients in the observation group were treated nursing intervention based on IMB model. The psychological state, gastrointestinal motility andquality of life of the two groups were compared before and after intezrvention. Results After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in two groups were decreased, and the observation group was lower than that in the control group (P < 0.05). After intervention, the levels of gastrointestinal hormone nitric oxide (NO), serum motilin (MTL) andserum gastrin (GAS) in two groups were improved, and the levels of all indexes in the observation group were better than those in the control group (P < 0.05). After intervention, gastrointestinal quality of life index (GIQLI) of two groups was improved, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05). Conclusion Nursing interventions based on the IMB model are beneficial for alleviating anxiety and depression in patients with functional dyspepsia, effectively enhancing gastrointestinal motility and vitality, and improving their quality of life.

ObjectiveTo review the drug information and research progress on oral Chinese patent medicines in the treatment of cardiac arrhythmia to identify existing problems and provide references for follow-up research. MethodChinese patent medicines against cardiac arrhythmia were retrieved from the three major drug catalogues，Yaozh.com，and relevant guidelines with arrhythmia as the retrieval term. The instructions for included Chinese patent medicines were retrieved through Yaozh.com and specific information was extracted. The research articles on Chinese patent medicines included were retrieved from the five databases，and the information meeting the inclusion and exclusion criteria was extracted and displayed in the form of text description and graphs after statistical analysis. ResultSixty-five oral Chinese patent medicines were included in this study，with the main functions of activating the blood and resolving stasis. The average daily cost of medicines was 8.17 yuan，and there were 42 medicines with an average daily cost of less than 10 yuan，showing a moderate medicine cost. A total of 351 research articles on Chinese patent medicines were screened out，including 259 randomized controlled trials （RCTs），16 non-RCTs，eight non-controlled trials，62 systematic reviews，two guidelines，and two expert consensuses. Eighteen types of Chinese patent medicines were involved，whose clinical trials had been conducted in 28 provinces，cities，autonomous regions，and municipalities in China. Wenxin granules and Shensong Yangxin capsules were the top medicines under investigation，accounting for 75.21% of all research articles. Among the included studies，the most common comparison design was Chinese patent medicine combined with western medicine vs western medicine （64.25%）. The outcome evaluation was mainly based on clinical efficacy，symptom efficacy，arrhythmia efficacy，adverse reactions，and heart rate changes. ConclusionThe number of clinical studies of oral Chinese patent medicines against cardiac arrhythmia varies greatly，but traditional Chinese medicine （TCM） syndrome differentiation thinking is less considered in practical application. Due to unstandardized clinical research and low-quality literature，further advancement is required in the future.

In December 2021, a male patient with a large-scale tissue defect in the lower abdomen and multiple abdominal wall hernias caused by a serious traffic accident was admitted to the Department of Plastic Surgery, the First Affiliated Hospital of Army Medical University. The tensor fascia lata myocutaneous flap combined with anterolateral thigh flap was used to repair abdominal wall sunken deformity and abdominal wall hernia successfully. Five months of follow-up showed satisfactory appearance with no recurrence of abdominal wall hernia.

In December 2021, a male patient with a large-scale tissue defect in the lower abdomen and multiple abdominal wall hernias caused by a serious traffic accident was admitted to the Department of Plastic Surgery, the First Affiliated Hospital of Army Medical University. The tensor fascia lata myocutaneous flap combined with anterolateral thigh flap was used to repair abdominal wall sunken deformity and abdominal wall hernia successfully. Five months of follow-up showed satisfactory appearance with no recurrence of abdominal wall hernia.

Objective:To analyze the survival of pancreatic cancer cases in Qidong County, Jiangsu Province from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention of pancreatic cancer.Methods:Data from a total of 4 341 registered pancreatic cancer patients in Tumor Registry of Qidong from January 1972 to December 2016 were selected, and all the patients were followed up until December 31, 2021. 1-, 3- and 5-year observed survival rate (OSR) and relative survival rate (RSR) were calculated and tested by Hakulinen likelihood ratio test method using SURV (3.01) software. Age-standardized relative survival rate (ARSR) was calculated according to the International Cancer Survival Standard (ICSS). Joinpoint (4.7.0.0) software was used to conduct the annual percentage change (APC) of pancreas cancer survival rate.Results:1-, 3- and 5-year OSR of pancreatic cancer were 13.82%, 5.87% and 4.70%, and 1-, 3- and 5-year RSR were 14.50%, 6.80% and 6.02%, respectively. 1-, 3- and 5-year RSR increased from 11.76%, 4.84% and 3.29% in 1972—1976 to 18.80%, 7.39% and 6.49% in 2012—2016. The uptrends of RSR were statistically significant (χ 2=59.84, P<0.001). 1-, 3- and 5-year RSR for male were 14.31%, 6.40% and 5.82%, and 1-, 3- and 5-year RSR for female were 14.74%, 7.28% and 6.26%, respectively. There was no statistically significant difference on RSR between male and female (χ 2=6.68, P=0.463). The 5-year RSR for the age group of 45-54, 55-64, 65-74, and ≥75 years old were 8.14%, 6.74%, 4.69% and 5.24%, respectively, and the survival rate was decreased with age. There was a statistically significant difference on RSR among different age groups (χ 2=19.52, P=0.012). 1-, 3- and 5-year ARSR of pancreas cancer were 14.67%, 6.84% and 6.04%. For male, 1-, 3- and 5-year ARSR were 14.36%, 6.42% and 5.79%, and for female were 15.25%, 7.55% and 6.47%, respectively. Period trend analysis showed that the APC of 1-, 3- and 5-year ARSR was 0.91% ( t=1.94, P=0.094), -0.22% ( t=-0.30, P=0.774) and -0.77% ( t=-0.95, P=0.374) from 1972 to 2016 in Qidong. The APC of 5-year ARSR in male and female were -1.50% ( t=-1.31, P=0.232) and 1.11% ( t=0.37, P=0.722); there were no statistically significant increase or decrease for both male and female among ARSR in nine periods (5 years as a period). The APC of 5-year RSR among 45-54, 55-64, 65-74 and ≥75 years old were 2.46% ( t=0.57, P=0.588), 3.16% ( t=0.87, P=0.413), 0.95% ( t=0.26, P=0.805) and -2.56% ( t=-2.61, P=0.035), respectively. Except for ≥75 years old age group who had a statistically significant downward trend, there were no statistically significant upward trend in the other age groups. Conclusions:The overall survival rate of pancreatic cancer in Qidong from 1972 to 2016 has been at a low level, and it is necessary to introduce a standardized multi-disciplinary treatment mode to improve treatment efficacy and survival rate.

Objective: To investigate whether grain-sized moxibustion at Xinshu (BL15) and Shenshu (BL23) can alleviate cognitive decline and other pathologic features in early-stage Alzheimer disease (AD) using transgenic mice with 5 familial AD mutations (5XFAD). Methods: The genotype of transgenic mice was detected by polymerase chain reaction. A total of 40 transgenic mice (1.5 months old) were randomly and equally allocated to an AD model group (5XFAD group) or a grain-sized moxibustion group (5XFAD + GM group), with 20 wild-type (WT) mice (C57BL/6J) serving as the normal control group (WT group). Mice in the 5XFAD + GM group were treated by grain-sized moxibustion at bilateral Xinshu (BL15) and Shenshu (BL23). Mice in the WT group and 5XFAD group received no treatment but were restrained to ensure exposure to a similar experimental condition. Cognitive function and memory were assessed with the Morris water maze and Y-maze tests. The amyloid β 40 (Aβ40) and amyloid β 42 (Aβ42) levels in the brain were evaluated by enzyme-linked immunosorbent assay; amyloid plaque deposition in brain tissue sections was detected by thioflavin-S staining; the expression of glial fibrillary acidic protein (GFAP), cluster of differentiation 11b (CD11b), brain-derived neurotrophic factor (BDNF), and choline acetyltransferase (ChAT) in the hippocampus and prefrontal cortex was analyzed by immunohistochemistry. Results: In the Morris water maze test, compared with the 5XFAD group, mice in the 5XFAD + GM group had a shorter escape latency and more target area crossings and spent more time in the target quadrant (P<0.05). In the Y-maze test, compared with the 5XFAD group, the number of training times of the 5XFAD + GM group was significantly decreased (P<0.05), together with more correct responses (P<0.05). Compared with the 5XFAD group, the levels of Aβ40 and Aβ42 in the brain tissue of the 5XFAD + GM group were significantly lower (P<0.05); in the hippocampus and prefrontal cortex, the total number of amyloid β plaque deposition were significantly lower (P<0.05); the expression levels of GFAP and CD11b were significantly reduced (P<0.05); and the expression levels of ChAT and BDNF were significantly increased (P<0.05).Conclusion: Grain-sized moxibustion at Xinshu (BL15) and Shenshu (BL23) greatly improves learning and memory functions, decreases the levels of Aβ40 and Aβ42, inhibits amyloid β plaque deposition, decreases the expression of GFAP and CD11b, and increases the expression of ChAT and BDNF in AD mice to inhibit the progression of AD.

Objective:To explore the risk factors influencing the prognosis for patients with hepatocellular carcinoma (HCC) recurrence after liver transplantation and summarize the relevant diagnostic and therapeutic experiences.Methods:The clinicopathological features with diagnosis and treatment plan of 102 recurrent HCC patients fulfilling the Fudan Criteria were compared for survival rate (univariate analysis) and independent prognostic indicators were obtained by Cox multivariate analysis.Results:The 1/3/5-year overall survival rates were 92.2%, 48.6% and 34.6% and the 1/3/5-year survival rates with tumor were 63.2%, 31.0% and 16.7% respectively. Cox regression analysis indicated that patient age, whether tumor can be surgically resected or not and personalized diagnostic & therapeutic plan based upon targeted therapy were independent prognostic factors affecting the overall survival rates and survival rates with tumor.Conclusions:Although HCC recurrence and metastasis after liver transplantation seriously influence patient prognosis, satisfactory outcomes may be obtained for some patients through active, effective and precise managements.

Objective:To evaluate whether posterior cruciate ligament (PCL) avulsion fracture was correlated with intercondylar notch and tibial slope.Methods:A total of 48 patients with PCL avulsion fracture were compared with 48 age- and sex-matched healthy controls without PCL avulsion fracture from January 2012 to October 2018 in our hospital. There were 25 males and 23 females with an average age of 54.35±14.06 years (range 27-82 years) in PCL avulsion fracture group. MRI of the knee joint were acquired in the sagittal, coronal, and axial sequences. The measurements included intercondylar notch's angle, width, and height, medial/lateral condylar widths, condylar width, medial/lateral posterior tibial slopes and coronal tibial slope. Notch shape index and notch width index were also calculated to adjust for size variations. The predictive accuracy of Risk factors were analyzed using the area under the receiver operating characteristic curve (AUC). The differences of morphological measurements between the two groups were compared. The morphological measurements with statistical significance were included for further multivariate analysis. Risk factors of PCL avulsion fracture were determined by binary logistic regression analysis. The inter- and intra-observer reproducibility of the measurements was determined by the intraclass correlation coefficients (ICC).Results:Except for coronal intercondylar notch height (0.709), medial posterior tibial slope (0.699) and lateral posterior tibial slope (0.705), the other intra-observer ICC ranged from 0.802 to 0.980, which indicated that the parameters had desirable reproducibility. Similarly, except for coronal intercondylar notch height (0.700), the other intra-observer ICC ranged from 0.778 to 0.971. Parameters of patients with PCL avulsion fracture, including the axial notch angle (52.56°±6.56°), coronal notch angle (54.81°±7.29°), axial intercondylar notch width (19.62±2.32 mm), axial notch shape index (0.68±0.08) and medial posterior tibial slope (8.27°±3.53°), were all significantly larger than those of the control group. The binary logistic regression analysis showed that the coronal notch angle ( β=0.102, OR=1.108, P=0.030) and medial posterior tibial slope ( β=0.151, OR=1.163, P=0.046) were the risk factors or PCL avulsion fracture. The AUC for coronal notch angle (0.678) and medial posterior tibial slope (0.631) exhibited good predictive power for the occurrence of PCL avulsion fracture. Conclusion:The larger coronal notch angle and medial posterior tibial slope were positively correlated with the incidence of PCL avulsion fracture.

Objective:To explore the clinical characteristics and follow-up outcomes of a pedigree of maturity onset diabetes of the young (MODY) induced by a novel mutation of glucokinase (GCK).Methods:The clinical features and laboratory data of a pedigree diagnosed with GCK-MODY in Peking Union Medical College Hospital was analyzed. Genomic DNA was extracted, and Sanger sequencing was performed to detect the gene mutation of the family members. The proband and her father were followed up for 3 years. Wanfang and PubMed were used to search literatures on follow-up studies for treatment of GCK-MOYD.Results:Both the proband and her father were found to have a novel mutation on the GCK gene located in exo10 c.1348G.T (p. Ala450Thr). The proband was treated with diet and exercise control only. At the end of the follow-up, her fasting plasma glucose (FPG, 6.8 mmol/L), 2 h postprandial plasma glucose (2hPG, 7.4 mmol/L), and glycated hemoglobin (HbA1c, 6.3%) were all within the control targets. Additionally, the levels homeostasis model assessment of insulin resistance (HOMA-IR) tended to improved comparing to that at baseline (4.09 to 2.32), and glucose disposition index (DI) was improved compared with baseline (16.22 to 20.05). As to the proband′s father, the treatment with insulin plus acarbose was converted to sulfonylureas monotherapy. His FPG and 2hPG mostly were within the target range, and the levels of HbA1c were significantly reduced by 0.5%-0.7% when compared to that at baseline. The HOMA-IR or islet beta cell function was comparable to those at baseline.Conclusions:Screening patients whose clinical performance meets GCK-MODY and their family members with proper genetic testing is of great importance to reduce misdiagnosis of GCK-MODY, so as to obtain a better glucose control without unnecessary over-treatment and protect islet beta cell function.