OBJECTIVE：To provide reference for promoting individualized medication in clinic. METHODS ：Information on external quality assessment （EQA）projects and approved kits for the guidance of chemical drug use were collected from the websites of National Center for Clinical Laboratories （NCCL） and National Medical Products Administration （NMPA） as of December 31，2019. The number of laboratories participating in each evaluation project was count. Taking EQA projects of clopidogrel and warfarin drug metabolism gene polymorphism detection as examples ，who was with the highest participation rate ， the methods and reagent kits of each laboratory were analyzed so as to analyze the current status of the clinical pharmacogenomics （PGx）in China. RESULTS ：The number of PGx genetic test EQA projects conducted by NCCL increased from 3（2014）to 9 （2019）. The total number of participating laboratories was 926 in 2018，and 1 249 in 2019. The number of laboratories of warfarin and clopidogrel drug metabolism gene polymorphism detection increased from 57 to 300.5 for warfarin and from 124 to 374.5 for clopidogrel. The more widely used methods were fluorescent PCR and PCR-chip hybridization. The number of reagent kits currently approved by NMPA was 7 for warfarin and 15 for clopidogrel ，respectively. But some of the laboratories participating in EQA used self-prepared reagents yet. CONCLUSIONS ：The clinical PGx is in its infancy ，and the awareness of laboratories about EQA is improving；the main method was fluorescence PCR ，but the use of self-made reagents in laboratories is still common ，regulations concerning the approval ，use and supervision still need to be further improved.

Through the literature collection on Chinese marine materia medica,this study analyzed medication rules of Chinese marine materia medica prescription,understood general conditions of Chinese marine materia medica prescription,in order to conduct data mining on medication rules of Chinese marine materia medica prescription.The name of Chinese marine materia medica was used as the search term.Chinese marine materia medica prescriptions were searched in related literatures of Chinese Medicine Code,Chinese Marine Materia Medica,Chinese Materia Medica,Chinese Pharmacopoeia and Great Dictionary of Chinese Medicine.The information was extracted and standardized to construct database for the initial data mining of related information and medication rules of Chinese marine materia medica prescriptions.The results showed that 16715 Chinese marine materia medica prescriptions were screened,which contained 144014 items of data,involving 218 kinds of Chinese marine materia medica.Decoction was the most common dosage form.The amount of Chinese marine materia medica prescription in the Ming and Qing dynasties was the largest.The highest frequency of Chinese marine materia medica in one prescription was 1 to 3 types.The prescription composed all by Chinese marine materia medica occupied 8.065％.Other prescriptions contained the compatibility of Chinese terrestrial materia medica.The prescription containing materia medica half from the sea and half from the land,occupied 7.754％.The Chinese marine materia medica used with the highest frequency in all prescriptions was oyster.The frequently used Chinese terrestrial materia medica was licorice and angelica in Chinese marine materia medica prescriptions.It was concluded that the number of Chinese marine materia medica prescription was large.Its compatibility and clinical application had a certain characteristic,which provided data foundation for the further research and development of Chinese marine materia medica.

Objective To compose a scientific, systematic and operative nursing quality evaluation system for neonatal blood exchange transfusion, and to provide a reference for quality control of clinical nursing practice. Methods Semi-structured interviews were conducted, the related literature was reviewed, and a preliminary Delphi enquiry questionnaire with the frame of structure quality, process quality and outcome quality was ultimately formed. Through Delphi enquiry questionnaires and analytic hierarchy processing method, all the indictors and the weights were affirmed. Results Totally 19 experts participated in the inquiry, the authority coefficients in the 2 rounds were 0.91 and 0.93 respectively, theχ2 test of Kendall′s W coefficients was significance with P<0.01. The nursing quality evaluation system for neonatal blood exchange transfusion was finalized with 3 level-1 indicators, 9 level-2 indicators and 39 level-3 indicators. Conclusions The nursing quality evaluation system developed through this study can provide practical reference to clinical nursing practice.

A simple colorimetric method for detection of isocarbophos was developed based on the enhanced peroxidase-like activity of hemin. Hemin could catalyze the oxidation of peroxidase substrate 3,3′,5,5′-tetramethylbenzidine (TMB) by H2O2, which made TMB to lose one electron and caused reaction solution color changing from initial transparent to blue-green. Adding isocarbophos improved hemin affinity to substrates, which further enhanced peroxidase-like activity of hemin and made TMB to lose two electrons. The color of TMB solution was further changed from blue-green to yellow, and the degree of color change was proportional to the concentration of isocarbophos. Under the optimal conditions, the present analytical method for isocarbophos detection had a dynamic range from 2 μg/L to 100 μg/L with a detection limit of 1.2 μg/L (3σ). The selectivity assay demonstrated that other organophosphorus pesticides exhibited negligible interferences for isocarbophos detection. The application of the proposed method in the practical samples showed that the mean recovery of isocarbophos was in the range of 94.4％-113.0％, thus it could be widely applied to rapidly and sensitively detect isocarbophos in the agricultural products.

Objective To analyze data of fails among oncology inpatients from 2014 to 2015,and to explore the effects of the continuous quality improvement on management of falls among oncology inpatients.Methods According to data of falls among oncology inpatients in 2014,continuous quality improvement was carried out in prevention of falls,including health education,risk assessment process of falls and inter-department cooperation.Results One year after applying the continuous quality improvement for management of falls,the number and the rate of falls among oncology inpatients in the year of 2015 (Number=25,Rate=0.027‰) were significantly lower than those in 2014(Number=55,Rate=0.065‰,x2=15.195,P＜0.001).Conclusion Improvement of management protocol for falls can effectively reduce the rate of falls among oncology inpatients and ensure patient safety.

Objective To compare the clinical efficacy between single and double volume exchange transfusion for neonatal hyperbilirubinemia,and to verify whether single volume exchange transfusion had advantages in maintaining homeostasis and reducing blood transfusion related complications.Methods Clinical materials of 86 neonates with neonatal hyperbilirubinemia who received blood exchange transfusion,from December 2013 to December 2014,in the diagnosis and treatment center of our hospital were retrospectively analyzed.Cases were divided into the single volume group (35 cases,with a blood volume 80-110 mL/kg) and double volume group (51 cases,with a blood volume 150-180 mL/kg) based on blood volume per kilogram of body weight.Comparisons of the homeostasis changes between pre-transfusion and post-transfusion were performed for each group,and the incidence rate of major adverse events were compared between the two groups.Results (1)In the single volume group and double volume group,the average blood exchange transfusion volumes were (98.16 ± 10.75) mL/kg and (157.78 ± 7.37) mL/kg,the exchange rate of bilirubin were (41.68± 8.52) ％ and (50.22 ± 13.14) ％,and the average time for blood transfusion were (85.60 ±18.66) min and(1 1B.22± 24.81)min respectively,and there were statistically significant differences in the exchange rate of bilirubin and average time for blood transfusion between the two groups (P＜0.05).(2)Compared with pre-transfusion,WBC and platelet (PLT)count,levels of serum total bilirubin (TBIL),albumin,serum potassium,serum sodium,serum chlorine,serum calcium and HCO3-,and pH value were significantly decreased after blood exchange transfusion,while RBC count,PT,APTT and blood glucose were significantly increased in the two groups (P＜0.01).Moreover,the changes of blood glucose,PLT and TBIL in the double volume group were more significantly than those in the single volume group,there were statistically significant differences (P＜0.05).No statistically significant difference was found in the rate of major adverse events between the two groups (P＞0.05).Conclusion Compared with double blood exchange transfusion therapy,single volume exchange transfusion can significantly decrease plasmic bilirubin level with less change of homeostasis,less blood volume for transfusion and less human resources consumption,its value in clinical application is recognized.

This paper introduced the definition of case management, the application of case management model in China and abroad, analyzed the necessity of the implementation of colostomy case management in the field of patients with colostomy, and then discussed the challenges and solving strategies in the delivery of colostomy case management in China in order to provide a theoretical basis for the establishment and promotion of colostomy case management model.

Objective To observe the effects ofYiqi Shuxin Pills on the coronary flow reserve (CFR) of patients with acute coronary syndrome (ACS) in the coronary angiography (CAG); To discuss its relevant mechanism of action.Methods Totally 101 patients with ACS were divided into control group (49 cases) and treatment group (52 cases). Patients in the treatment group were treated with western therapy andYiqi Shuxin Pills, while patients in the control group were treated with western therapy only. After treated for 6 months, CAG was reviewed to compare the CFR in both groups before and after the treatment. The blood-stasis syndrome and qi-deficiency syndrome scores and the level of NO, ET-1, hs-CRP, sVCAM-1, P-selectin in blood of both groups before and after the treatment were observed.Results The blood-stasis syndrome and qi-deficiency syndrome scores in the treatment group were significantly lower than those in the control group (P<0.01); The levels of ET-1, hs-CRP, sVCAM-1, P-selectin were obviously reduced and NO obviously increased in treatment group than those of control group (P<0.05). The CFR in the treatment group was significantly better than that of control group, with statistical significance (P<0.05). ConclusionYiqi Shuxin Pills can improve the state of blood-stasis syndrome and qi-deficiency syndrome, improve vascular endothelial function, relieve inflammatory reaction, lower the expression of platelet, stabilize atherosclerotic plaque of coronary artery, and then improve the CFR of ACS patients in CAG.

Objective:To investigate mechanism of imatinib mesylate induced apoptosis of primary CD3+T cells.Methods:The CD3+T cells were stimulated by 0-100 nmol/L imatinib for 24 h,cell apoptosis was detected by flow cytometry;Caspase-3,Caspase-8, A20 and NF-κB expression levels were detected by Real-time quantitative PCR and Western blot.Results: IM significantly increased apoptosis of T cell;Caspase-3 and A20 gene expression levels were upregulated and NF-κB expression level was downregulated both in gene and protein levels.Conclusion:IM increased apoptosis of T cell by upregulating A20 expression.

Objective To explore the effects of the bio-psycho-social-spiritual health model intervention on the bio-psycho-social-spiritual health model of the patients with cervical cancer.Methods 118 patients with cervical cancer were randomly assigned to the control group (60 cases) and the intervention group (58 cases).All patients received the routing nursing of cervical cancer.In addition the intervention group received the bio-psycho-social-spiritual health model intervention.Functional Assessment of Cancer Therapy-General (FACT-G) was used to investigate their quality of life before being intervened,being intervened for 3 and 6 months.Results The range of FACT-G total score was 44-96 (68.29±11.60).The total scores of FACT-G before the intervention,3 and 6 months after the intervention were 66.82 ±12.21,79.31±5.15 and 89.67±5.21,compared with those of the control group,which were 69.81 ±10.84,74.48±7.97,79.74±7.17,the time effect,Inter group effect and interaction effect were 137.723,10.944 and 14.639,P＜0.01.Conclusions The bio-psycho-social-spiritual health model intervention can improve the quality of life of patients with cervical cancer.