OBJECTIVE: To explore the mechanism of electroacupuncture (EA) in promoting recovery of the facial function with the involvement of autophagy, glial cell line-derived neurotrophic factor (GDNF), and phosphatidylinositol-3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling pathway. METHODS: Seventy-two male Sprague-Dawley rats were randomly allocated into the control, sham-operated, facial nerve injury (FNI), EA, EA+3-methyladenine (3-MA), and EA+GDNF antagonist groups using a random number table, with 12 rats in each group. An FNI rat model was established with facial nerve crushing method. EA intervention was conducted at Dicang (ST 4), Jiache (ST 6), Yifeng (SJ 17), and Hegu (LI 4) acupoints for 2 weeks. The Simone's 10-Point Scale was utilized to monitor the recovery of facial function. The histopathological evaluation of facial nerves was performed using hematoxylin-eosin (HE) staining. The levels of Beclin-1, light chain 3 (LC3), and P62 were detected by immunohistochemistry (IHC), immunofluorescence, and reverse transcription-polymerase chain reaction, respectively. Additionally, IHC was also used to detect the levels of GDNF, Rai, PI3K, and mTOR. RESULTS: The facial functional scores were significantly increased in the EA group than the FNI group (P<0.05 or P<0.01). HE staining showed nerve axons and myelin sheaths, which were destroyed immediately after the injury, were recovered with EA treatment. The expressions of Beclin-1 and LC3 were significantly elevated and the expression of P62 was markedly reduced in FNI rats (P<0.01); however, EA treatment reversed these abnormal changes (P<0.01). Meanwhile, EA stimulation significantly increased the levels of GDNF, Rai, PI3K, and mTOR (P<0.01). After exogenous administration with autophagy inhibitor 3-MA or GDNF antagonist, the repair effect of EA on facial function was attenuated (P<0.05 or P<0.01). CONCLUSIONS EA could promote the recovery of facial function and repair the facial nerve damages in a rat model of FNI. EA may exert this neuroreparative effect through mediating the release of GDNF, activating the PI3K/mTOR signaling pathway, and further regulating the autophagy of facial nerves.
Rats ; Male ; Animals ; Rats, Sprague-Dawley ; Electroacupuncture ; Phosphatidylinositol 3-Kinase/metabolism* ; Facial Nerve Injuries/therapy* ; Phosphatidylinositol 3-Kinases/metabolism* ; Beclin-1 ; Glial Cell Line-Derived Neurotrophic Factor ; Signal Transduction ; TOR Serine-Threonine Kinases/metabolism* ; Autophagy ; Mammals/metabolism*

In recent years,the rapid development of medical information technology has made it critical to analyze large-scale diagnosis and therapeutic data and extract rules based on real medical environment.This has become an essential approach for marketing evaluation and regulatory decision-making of drugs and devices both domestically and internationally.Real world study(RWS),as a novel methodology for clinical evaluation of drugs in the field of drug utilization research(DUR),have presented opportunities and challenges for observational studies in assessing actual efficacy or effectiveness.However,despite being a popular methodological approach among scholars in the field,there are still limitations and deficiencies when analyzing population medication characteristics in RWS.Systematic evaluation research methods have not yet been established,leading to inadequate generation of real-world evidence(RWE).The research design,methodological pathways,evaluation indicators,confounding factors,and bias management involved in DUR based on real-world data(RWD)were reviewed in this artical with the intention of providing guidance for further exploration into DUR.

In order to complete the information statistics and submission work of designated hospitals with high quality, a hospital uses the agile business intelligence system to carry out information construction, and realize the statistics, analysis and auxiliary management decision-making of COVID-19 patients′ admission data. Based on the low-load and full-volume data capture mechanism, relevant basic data in the background of the hospital information system was extracted, and the admission information visualization and early warning analysis system was built by establishing data relations, data modeling and other methods. The hospital completed 634 batches of data statistics and reporting tasks of 2 943 patients in a timely and efficient manner, and assisted clinical diagnosis and treatment improvement and hospital leadership decision-making by using data analysis, early warning feedback and other functions.

OBJECTIVE：To evaluate th e eff ects of infusion sequence regulation on the promotion of intravenous rational drug use. METHODS ：The intelligent control of infusion sequence was realized with Markov chain machine learning method on the basis of intelligent reminder manual labeling infusion sequence. Selected from Binhu Hospital of Hefei during Jan. to Sept. 2017， 164 800 inpatients’medication orders were collected as data before intelligent control of infusion sequence ，and 264 600 inpatients’ medication orders were collected as data after intelligent control of infusion sequence. The correct rate of incompatibility ，storage time limit ，administration frequency ，chronopharmacology，preventive drugs ，drug interaction ，auxiliary drugs and infusion sequence for intravenous irritant drugs were compared before and after regulation ；the times of flushing tube ，the cost of flushing tube infusion and the change of liquid property in the infusion tube were compared before and after regulation. RESULTS ：The correct rate of incompatibility ，storage time limit ，administration frequency ，chronopharmacology，drug interaction and infusion sequence for auxiliary drugs after regulation were significantly higher than before regulation ；the correct rate of infusion sequence for preventive drugs and intravenous irritant drugs ，the times of flushing tube ，the cost of flushing tube infusion and the case number of the liquid change （proportion） in infusion tube were significantly lower than before regulation （P＜0.001）. CONCLUSIONS：Intelligent regulation of infusion sequence can improve the rationality of intravenous medication sequence to a certain extend.

OBJECTIVE：To design and upgrade the finished infusion label in P IVAS of Hefei Binhu hospital ，so as to improve the safety and effectiveness of intravenous medication. METHODS ：By investigating the experience and suggestions about the use of infusion labels by pharmacists and clinical nurses in PIVAS ，taking clear ，concise，focused，rational layout ，comprehensive information as improving principle ，the infusion label was designed and upgraded. The effect of upgrading were evaluated by the recognition rate of label scanning ，scanning time and rate on label （94 701，113 759 groups，respectively），and the correct rate ， time and rate of drug delivery checking in 30 days before and after upgrading ，as well as satisfaction degree ，which made among PIVAS pharmacists （30），nurses（50）and patients （49）. RESULTS ：The upgraded label simplified part of the content and optimized the layout structure ，removed redundant content ，focused on the patient safety information that nurses needed to pay attention to when checking ，and added the marking of infusion sequence and precautions. By changing the barcode into two-dimensional code and adding hidden display function ，more information about drugs and rational drug use related to the infusion of patients was provided. Compared with original label ，after upgrading ，the recognition rate of new label scanning increased from 99.27％ to 99.96％，the scanning time reduced from 3 518.75 s/d to 2 110.10 s/d，and the scanning rate increased from 0.57 group/s to 0.95 group/s；the correct rate of drug delivery checking increased from 99.73％ to 99.91％，the time of drug delivery checking decreased from 5 423.55 s/d to 4 818.85 s/d，and the speed of drug delivery checking increased from 0.36 group/s to 0.41 group/s. The satisfaction degree of pharmacists ，nurses and patients were increased from 70.00％ to 93.33％，from 62.00％ to 90.00％，from 20.40％ to 89.80％，respectively. CONCLUSIONS：The design and upgrading of infusion labels can improve the working efficiency of staff ，and improve the quality of pharmaceutical care and nursing care ， and satisfaction， promote the improvement on the safety and effectiveness of intravenous medication for patients.

Objective To explore the main causes of the overuse of proton pump inhibitor (PPIs) in domestic hospitalized patients. Methods The electronic medical records of patients in 20 general hospitals from January 1, 2015 to March 31, 2018 were analyzed. The distribution of indications of PPIs, the distribution of different uses of PPIs, the most often diseases of patients using the off-label medications, surgeries and combined medication, etc. were analyzed. Results The number one indication of PPIs was the prevention of NSAIDs-related ulcer, which accounted for 40.9% of the patients and 34.2% of them was off-label users. Among the off-label patients, lansoprazole was the most highly used, which accounted for 48.1%. The most often diseases, surgeries and combined medications of the patients using PPIs were the diseases of esophagus, stomach and duodenum, gallbladder and biliary surgery and mineral supplement. Conclusion The prevention of drug-induced ulcers and the off-label use is the main reasons for the huge amount of PPIs usage. The application of lansoprazole is not standardized; The main causes of the off-label PPIs usage are gastrointestinal discomfort, fasting, surgery and glucocorticoids.

Objective To investigate the relationship between the trauma severity and the usage of antibacterial drugs and to provide reference for standard protocol of proper antibiotic use in wound care.Methods ICD-10 and AIS were used to set up the relationship and to analyze the use of antibiotics in patients with different trauma score.Results 25 035 trauma patients were enrolled in this study.Those patients were divided into five groups according to the AIS score with least severe as group 1 to most severe as group 5.The patient percentage in group 1 to 5 was 21.92％,67.73％,8.86％,0.97％ and 0.52％ respectively.The five most frequently used antibiotic classes are second generation cephalosporins,third generation cephalosporins,first generation cephalosporins,fluoroquinolones and penicillin/beta lactamase inhibitor combination, accounted for 29.69％,22.57％,20.33％,4.66％ and 4.47％ of total DDDs of antibacterial drugs.Individually, the top 10 antibiotics are cefuroxime (12.21％), cefazolin (8.31％), ceftriaxone (7.74％), cefathiamidine (7.34％), cefotiam (4.87％), ceftazidime (3.68％), amoxicillin/clavulanic acid (3.63％), levofloxacin (3.59％), cefoxitin (3.56％), flucloxacillin (3.52％);gentamicin (2.27％), ornidazole (2.00％) and cefoperazone/tazobactam (1.44％) were used most in their categories respectively.The variety and quantity of antibacterial drugs used for different trauma patients were different.Conclusion The trauma score based on ICD-AIS can reflect the severity of trauma.The use of antibiotics in patients with different trauma score can provide reference for the clinical applications of antibiotics in wound care.

Objective To investigate the usage of intravenous infusion and the antibiotic intravenous infusion in different hospitals nationwide ,and to evaluate the influence of the hospital bed number ,hospital area and hospital grade on the clinical application of intravenous infusion .Methods Intravenous infusion volume ,rate and other related indexes were analyzed based on the inpatient information obtained from the regional medical big data net for 156 hospitals .Results 1323852 inpatients were included in this study .93 .13％ of those patients received intravenous infusion therapy .The average daily infusion volume was 782 .67 ml per bed .The average infusion time was 7 .39 days per patient .44 .78％ of inpatients received intravenous antibi-otic treatment .The average daily antibiotic infusion volume was 92 .48 ml per bed .Conclusion Generally ,the inpatient per-centage of intravenous infusion was getting higher in China .The greater infusion volume in larger hospitals suggested that the patient′s condition is relatively more serious in the larger hospital .The higher grade hospitals used smaller antibiotic infusion rate and volume ,indicating the antibiotic use in high grade hospitals is relatively more standardized .

OBJECTIVE:To provide evidence for rational use and clinical monitoring of Alprostadil lipid-micro injection (Li-po-PGE1). METHODS:Adult inpatients receiving Lipo-PGE1 from hospital information system(HIS)of 159 hospitals were select-ed as research subject. Based on frequency statistics,population,clinical diagnosis,and average daily dose of Lipo-PGE1 were all studied. RESULTS:A total of 71687 adult inpatients were included,and the male was more than female,mostly aged 61-75. The hospitalization duration was 8-14 d(45.01%),most of patients were recovered(68.20%). Lipo-PGE1 was wildly used in the clin-ic,and was used for 871 kinds of clinical diseases in total;top 3 diseases were cerebral infarction(9.06%),non-insulin dependent diabetes mellitus (8.65%) and chronic ischemic heart disease (8.08%). The average daily dose of different diseases and different hospitals were significantly different,mostly≤12.5μg. CONCLUSIONS:As adjuvant drug,medical institutions and related super-vision departments should formulate reasonable monitoring index and strengthen medication guidance and evaluation of Lipo-PGE1.

Objective To assess differences between the medicine treatment level of military inpatients in military hospi-tal in 2009 and 2011 ,provide references for reasonable adjustments of health policy in future .Methods Medicine treatment da-ta from acute simple appendicitis ,coronary heart disease ,chronic bronchitis and type 2 diabetes from 16 military hospitals were excavated and analyzed by statistical methods to provide a comparative study of the medicine treatment level in 2009 and 2011 . Results 3748 cases from 16 hospitals showed the significant difference in the level of the medicine treatment in 2009 and 2011 , such as medicine cost ,medicine varieties ,primary medicine costs ,hospital daily medication cost ,and the date in 2011 is higher than 2009 .Conclusion It was showed that the medicine treatment level in four common multiple diseases in the military in 2009 and 2011 was changed .A long-term stability mechanism should be established for the evaluation of military medicine sup-port level ,which could provide strong evidence for future medicine policy adjustment .