OBJECTIVE To investigate the effect of the medical intelligent dispensing machine in the dispensing of pharmacy intravenous admixture services（PIVAS） parenteral nutrition drugs. METHODS From December 1st to 31st， 2023， 14 PIVAS staff members in Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected to participate in manual dispensing and dispensing with the medical intelligent dispensing machine in the form of rotation. Ten prescribed formulas are prepared daily by each of the two groups. The dispensing efficiency and quality of specified parenteral nutrition drugs were compared between 2 groups， and the effects of the introduction of medical intelligent dispensing machine on the cleanliness class were also compared. RESULTS The medical intelligent dispensing machine group prepared a total of 310 bags of parenteral nutrition solution， while the manual dispensing group prepared a total of 306 bags； the time for drug dispensing per bag， the residual amount of drug liquid， the number of dispensing punctures， the leakage rate of finished infusion inlet and desquamation rate of vial glue plug in the medical intelligent dispensing machine group were less or lower than manual dispensing group （P＜ 0.05）. Before and after the introduction of the medical intelligent dispensing machine， the qualified rate of sedimentation bacteria detection in mixing operation room and horizontal laminar flow clean workbench in both groups was 100%. CONCLUSIONS The application of medical intelligent dispensing machine in the dispensing of PIVAS parenteral nutrition drugs can improve the efficiency of drug dispensing and improve the quality of finished infusion without affecting the cleanliness level of operation room and horizontal laminar flow clean workbench.

Objective:To evaluate the detection performance of left ventricular ejection fraction (LVEF) in patients with chronic renal failure (CRF) by an artificial intelligence (AI) model based on yolox framework integrating left ventricular segmentation and critical point detection.Methods:From January 2019 to June 2023, a total of 4 284 echocardiographic images of 2 000 adults aged 18-80 years without segmental wall motion abnormalities, structural heart disease, cardiac surgery or cardiomyopathy were collected in Henan Provincial People′s Hospital to delineate the endocardial membrane, as a training set, an AI model based on yolox framework integrating left ventricular segmentation and critical point detection was established. The images were divided into the training set( n=1 675) and the test set( n=325) in a ratio of about 5∶1. All 228 echocardiographic images of 100 normal adult volunteers who were treated in Henan Provincial Chest Hospital from May 2020 to May 2021 were collected as external test set validation. All 792 echocardiographic images of 204 patients treated in Henan Provincial People′s Hospital from April 2019 to June 2023 were continuously enrolled to evaluate the measurement efficiency of AI model. Spearman correlation statistical method was used to analyze the consistency of AI model measurement with manual measurement and TomTec software measurement methods of 3 senior echocardiographic professionals. Subjects were divided into clear image group, unclear image group, normal LVEF group and reduced LVEF group, the differences of general data between the two groups were compared. The correlation coefficient(ICC) within the group was calculated to analyze the consistency, so as to evaluate the model performance. Results:LVEF measured by AI model was significantly correlated with both manual measurement and TomTec model measurement ( rs=0.834, 0.826; all P<0.01). ICC values of the clear image group and the unclear image group were 0.96 and 0.97, respectively. ICC values for all subjects, normal LVEF group and reduced LVEF group were 0.96, 0.90 and 0.96, respectively. Conclusions:The AI model based on yolox framework integrating left ventricular segmentation and critical point detection has good diagnostic performance in the automatic measurement of LVEF in patients with CRF.

This paper reported 3 cases of poisoning caused by chlorfenagyr. Chlorfenapyr poisoning has gradually increased in clinical practice. The early stage after poisoning is digestive tract symptoms, followed by sweating, high fever, changes in consciousness, changes in myocardial enzymology, etc. Its main mechanism of intoxication is uncoupling oxidative phosphorylation. Since there is no specific antidote after poisoning, the fatality rate of chlorfenapyr poisoning remains high. The therapeutic measures are early gastrointestinal decontamination, symptomatic and supportive treatments, and early blood purification may be an effective treatment.
Humans ; Pyrethrins ; Gastrointestinal Tract ; Insecticides ; Poisoning/diagnosis*

China/epidemiology* ; Humans ; Mycobacterium Infections, Nontuberculous/microbiology* ; Nontuberculous Mycobacteria/classification* ; Transients and Migrants

OBJECTIVE: To establish a new mechanical model of distal humerus in children with epiphysial cartilage, stimulate supracondylar humerus fracture and perform three dimensional finite elements, and study effect of pins numbers, pin tract, outlet height and pin configurations on stability of fixation. METHODS: Three dimensional computed tomography (CT) data of 6-year-old boy with distal humerus was downloaded from picture archiving and communications systems software (PACS), the data of picture was imported into Simpleware and SolidWorks 2016 software to establish distal humerus fracture in children contained ossific nucleus of the capitellum (ONC) and distal cartilage. Normal extense supracondylar humerus fracture model was established to stimulate configurations of crossed and lateral pinning fixation, 30 N was added on the direction of flexion extension and varus valgus, while 50 N was added on the direction of internal and external turning. Stability was analyzed by displacement degree of distal fracture. RESULTS: Among 2-pin configurations, 2-crossed pins were more stable against rotation forces which could resist rotation stress over 2 585 Nmm/ °, while low position through ONC of 2-divergent lateral pins were more stable, which could resist stress of 45 N /mm and 190 N /mm during the test of resistant strains and varus-valgus stress. The third pins was added into the more stable lateral 2-pins, the stability in all directions were increased obviously, and 3 crossed pins is the most stable, stress of flexion-extension, varus-valgus and internal-external turning were 198 N /mm, 395 N /mm and 6 251 Nmm/ °. CONCLUSION Two-divergent lateral pins could provide enough stability for supracondylar humerus fracture in children. In two-crossed pins, the upper border of MDJ could provide the best stability. Three-crossed pins could offer the best stability against both translation and rotation forces.
Biomechanical Phenomena ; Bone Wires ; Child ; Finite Element Analysis ; Fracture Fixation, Internal ; Humans ; Humerus ; Male

Objective: To explore the effect of Acori Tatarinowii Rhizoma on intestinal absorption of ginsenosides in Dingzhi Xiaowan,and reveal the mechanism of Acori Tatarinowii Rhizoma acting as " adjuvant drug" in this formula. Method: The contents of ginsenoside Rg₁,Re and Rb₁ were measured by UPLC-MS/MS and the absorption of three ginsenosides in different intestine segments was investigated by rat single pass intestinal perfusion in situ,including absorption rate constant(K_a) and apparent permeability coefficient(P_app).Everted intestinal sac model was used to investigate the absorption dosage of three ginsenosides affected by volatile oil from Acori Tatarinowii Rhizoma and verapamil[Ver,a P-glycoprotein(P-gp) inhibitor]. Result:P_app values of three ginsenosides were ≤ 0.191×10^-3 cm·min^-1 in Dingzhi Xiaowan when lack of Acori Tatarinowii Rhizoma.Compared with lack of Acori Tatarinowii Rhizoma in Dingzhi Xiaowan group,the K_a and P_app values of lack of volatile oil from Acori Tatarinowii Rhizoma in Dingzhi Xiaowan group slightly increased without significant difference in the four intestinal segments,but when the prescription had Acori Tatarinowii Rhizoma,the K_a increased by 3.97-8.35 fold and the P_app increased by 3.99-8.49 fold.The results of everted intestinal sac test showed that volatile oil of Acori Tatarinowii Rhizoma could significantly promote the intestinal absorption of ginsenoside Rg₁,Re and Rb₁,but there was no dose-dependent. Conclusion:Volatile oil of Acori Tatarinowii Rhizoma can promote the intestinal absorption of three ginsenosides in Dingzhi Xiaowan,and the mechanism may be related to the inhibiting function on P-gp.

ObjectiveTo investigate the value of Barcelona Clinic Liver Cancer (BCLC) staging system versus Hong Kong Liver Cancer (HKLC) staging system in predicting the prognosis of patients with hepatocellular carcinoma (HCC). MethodsA retrospective analysis was performed for the clinical data of 436 previously untreated patients with HCC who were admitted to The Affiliated Tumor Hospital of Guangxi Medical University from July 2008 to July 2013, and the staging score was determined according to the HKLC and BCLC staging systems. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare the cumulative survival rate between the patients with different HKLC or BCLC stages. The Cox proportional hazards model was used to calculate the likelihood ratios (LR χ2) of the two systems. The area under the receiver operating characteristic curve (AUC) and C-index were used to analyze the discriminability and trend of the HKLC and BCLC staging systems. ResultsThere was a significant difference in survival rate between the patients with adjacent HKLC stages (all P＜0.05), and there was also a significant difference in survival rate between all patients with adjacent BCLC stages (all P＜0.001), except between those with stage 0 and stage A HCC. The Cox proportional hazards model showed that the HKLC system (LR χ2=131.14) had a better homogeneity than the BCLC system (LR χ2=100.69). The C-index of the BCLC and HKLC systems was 0.703 (95% confidence interval ［CI］: 0.675-0.731) and 0.720 (95% CI: 0.692-0.748), respectively, and there was a significant difference in C-index between the two systems (P＜0.001). There was a significant difference in the AUC of 1-year cumulative survival rate between the BCLC system and the HKLC system ［0.783 (95% CI: 0.745-0.821) vs 0.811 (95% CI: 0774-0849), P=0.026］. ConclusionBoth BCLC and HKLC staging systems have a good value in predicting the prognosis of HCC patients, but the HKLC staging system has a higher value than the BCLC staging system.

One undescribed and two known furocoumarins were isolated from the stems of the Clausenalansium through a series of isolation and purification approaches including HPD-100 macroporous resin column, silica gel, reverse phase C₁₈ and so on. Their structures were determined to be 8-[(2S,3S,6E)-2,3-epoxy-3,7-dimethyl-oct-6-enyloxy] psoralen (1), 8-(7',8'-epoxygeranyloxy) psoralen (2) and 8-[(2E)-6-oxo-3,7-dimethyloct-2-enyloxy] psoralen (3) by spectroscopic methods. Compound 1 is a new furocoumarin. Compound 2 showed cytotoxicity to H460 (IC₅₀ = 43.94 μmol·L^-1) and compound 3 showed cytotoxicity to HeLa (33.76 μmol·L^-1) through the cytotoxic tests against five human cancer cell lines (H460, H7402, HCT-8, HeLa and MCF-7) for all compounds.

OBJECTIVE: To investigate the viral etiology and allergen distribution in infants and young children at high risk of asthma during a wheezing episode. METHODS: A total of 135 infants and young children at high risk of asthma were enrolled who were admitted due to asthmatic bronchitis or asthmatic bronchopneumonia between April 2016 and August 2017. Fluorescent probe PCR was used to measure influenza A (Flu A), respiratory syncytium virus (RSV), adenovirus (ADV), parainfluenza virus (PinF), human rhinovirus (HRV), human partial lung virus (hMPV) and human bocavirus (HBoV) in nasopharyngeal aspirates. ImmunoCAP was used to measure inhaled allergens, food allergens, and total IgE concentration. RESULTS: Among the 135 patients, the overall virus detection rate of nasopharyngeal aspirates was 49.6%, and HRV had the highest detection rate of 25.2%, followed by HBoV (9.6%), RSV (8.1%), PinF (5.9%), Flu-A (3.7%), ADV (1.5%) and hMPV (0.7%). The 1-3 years group had a significantly higher detection rate of HRV than the <1 year group (P<0.05). The positive rate of allergen screening was 59.3%, with 44% for inhaled allergens and 89% for food allergens. Among the inhaled allergens, dust mites had the highest positive rate of 77%, followed by mould (37%), pollen (26%) and animal dander (9%). Among the food allergens, egg white had a positive rate of 73% and milk had a positive rate of 68%. The <1 year group had a significantly higher positive rate of inhaled allergens than the 1-3 years group (P<0.05). The 1-3 years age group had a significantly higher level of T-IgE than the <1 year group (P<0.05). The positive virus group had a significantly higher positive rate of inhaled allergens than the non-virus group (P<0.05). The children with the second wheezing episode had significantly higher positive rates of inhaled allergens and food allergens and level of T-IgE than those with the first wheezing episode (P<0.05). The children with the second wheezing episode also had significantly higher positive rates of dust mites and mould than those with the first wheezing episode (P<0.05). CONCLUSIONS Early HRV infection and inhaled allergen sensitization are closely associated with the development of wheezing in infants and young children at high risk of asthma.
Allergens ; Animals ; Asthma ; Child ; Child, Preschool ; Egg Hypersensitivity ; Humans ; Infant ; Pyroglyphidae ; Respiratory Sounds

BACKGROUNDHigh rate of in-stent restenosis (ISR) remained an unsolved clinical problem in clinical practice, especially among patients with diabetes mellitus (DM). Diabetic patients often had hypertriglyceridemia with elevated levels of very low-density lipoprotein cholesterol (VLDL-C). Increasing evidence suggested that VLDL-C was known as a significant risk factor for atherosclerosis and had been recommended as a treatment target by current dyslipidemia guidelines. However, the role of VLDL-C in the occurrence and development of ISR in coronary artery disease (CAD) patients with DM had not been studied. The aim of this study was to evaluate the association between the elevated levels of VLDL-C and the risk of ISR in CAD patients with DM.

METHODSA total of 1390 diabetic patients, who underwent coronary drug-eluting stent (DES) implantation at Beijing Anzhen Hospital and followed up by angiography within 6-24 months, were consecutively enrolled. Patients' demographic and clinical characteristics, including age, gender, CAD risk factors, family history, life style, medical history, and coronary angiographic information, were collected carefully at baseline percutaneous coronary intervention and follow-up angiography. Multivariate Cox's proportional hazards regression modeling using the step-wise method (entry, 0.05; removal, 0.05) was used to determine the independent risk associated with ISR in diabetic patients.

RESULTSFinally, 1206 of patients were included in this study. ISR occurred in 132/1206 diabetic patients (10.9%) by follow-up angiography. Patients with ISR had elevated median serum VLDL-C levels compared with those without ISR (0.65 mmol/L vs. 0.52 mmol/L, P = 0.030). The multivariate regression analysis showed that VLDL-C was significantly associated with the risk of ISR in diabetic CAD patients (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.03-1.29, P = 0.017). The HR for the risk of ISR associated with VLDL-C level ≥0.52 mmol/L was 3.01 (95% CI: 1.24-7.34, P = 0.015).

CONCLUSIONThe elevated level of serum VLDL-C was a significant and independent risk factor for ISR in diabetic CAD patients after coronary DES implantation.