OBJECTIVE To reduce dispensing errors in pharmacy intravenous admixture service （PIVAS） of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis （FMEA） model. Potential failure modes that might lead to dispensing errors in each link were determined， and failure causes were analyzed. The severity， incidence and detection degree of potential failure modes were quantitatively scored， and their risk priority number （RPN） was calculated to screen failure modes that needed to be improved in priority； the corresponding improvement measures were developed by 6S management method from six aspects， namely， finishing （seiri）， rectifying （seiton）， sweeping （seiso）， sanitation （seiketsu）， literacy （shitsuke） and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN， 32 potential failure modes were selected， of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method， the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation （P＜0.05）. CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication.

Objective:To investigate the molecular epidemiological characteristics of coxsackievirus A16 (CVA16) in Fujian province from 2020 to 2023.Methods:The epidemiological characteristics of CVA16 associated hand, food and mouth disease (HFMD) in Fujian province from 2020 to 2023 was analyzed. The complete VP1 gene of CVA16 was amplified by RT-PCR and then sequenced, and genetic evolution was analyzed by MEGA X and other softwares.Results:From 2020 to 2023, there were 13 120 cases of HFMD in Fujian province, and the proportion of HFMD which caused by CVA16 was 16.5% (2 160/13 120). From 2020 to 2023, the proportion of accounted cases was 4.7% (94/2 019), 14.1% (457/3 243), 47.6% (1 521/3 199) and 1.9% (88/4 659) respectively. HFMD caused by CVA16 was mainly concentrated in children aged 1 to 5 years, and most of them were 3 years old. The genetic evolution and genotype analysis of 92 complete VP1 gene sequences obtained from 2020 to 2023 showed that the genetic distance between CVA16 strains in Fujian province and the prototype strain was far away. The CVA16 genotype in Fujian province from 2020 to 2023 has three clusters of B1a, B1b and B1c, among which the composition ratio of B1a and B1b in Fujian province in 2020 was 40% and 60% respectively. In 2021, B1a and B1b accounted for 81.8% and 18.2% respectively. Only B1a in 2022; in 2023, there were B1a, B1b and B1c, which respectively accounted for 44.4%, 7.4% and 48.2%. During the period from January to September, B1a was the main cluster. After October we observed an emergence of B1c cluster, which had never been found in Fujian province and was rare in China, was detected and became the dominant cluster.Conclusions:The evolutionary cluster of CVA16 dominant changed from B1b in 2020 to B1a in 2021-2023. After October 2023, the newly discovered B1c became the dominant cluster in Fujian province.

Background Based on numerous epidemiological studies, radionuclide ¹³¹I can result in thyroid disease. Objective To study the contamination level of thyroid ¹³¹I in ¹³¹I treatment associated radiation workers in nuclear medicine departments in Shanghai. Methods Based on a general survey on basic situation of nuclear medicine in Shanghai, the level of internal exposure of radiation workers involved in ¹³¹I treatment was assessed with questionnaires and on-site monitoring. A portable γ spectrometer was used for on-site detection, the intake and annual effective dose were estimated according to the measurement results. Physical examination reports were collected for radionuclide positive workers, and chromosome testing was performed. Results There were 579 nuclear medicine workers and 175 were engaged in ¹³¹I treatment in Shanghai. ¹³¹I was detected in thyroid of 18 workers, with a detection rate of 10.3%. Among them, the detection rates of thyroid ¹³¹I in nurses and cleaners were 23% and 25% respectively. The mean measured activity of thyroid ¹³¹I was 306.1 Bq and the maximum measured activity was 3716.9 Bq (nurse). The maximum intake was estimated at 37544 Bq and the median was 786.4 Bq. The average annual committed effective dose was 1.22 mSv and the maximum value was 14.87mSv. The chromosomal aberration rates of all detected workers were negative, and all blood indicators were normal except one with low hemoglobin. Conclusion The annual dose of nuclear medical staff engaged in ¹³¹I treatment does not exceed the national standard limit, but the internal exposure of nurses and cleaners should not be ignored. On the basis of strengthening protection and decontamination, routine internal exposure monitoring should be carried out.

Issues caused by maxillofacial tumours involve not only dealing with tumours but also repairing jaw bone defects. In traditional tumour therapy, the systemic toxicity of chemotherapeutic drugs, invasive surgical resection, intractable tumour recurrence, and metastasis are major threats to the patients' lives in the clinic. Fortunately, biomaterial-based intervention can improve the efficiency of tumour treatment and decrease the possibility of recurrence and metastasis, suggesting new promising antitumour therapies. In addition, maxillofacial bone tissue defects caused by tumours and their treatment can negatively affect the physiological and psychological health of patients, and investment in treatment can result in a multitude of burdens to society. Biomaterials are promising options because they have good biocompatibility and bioactive properties for stimulation of bone regeneration. More interestingly, an integrated material regimen that combines tumour therapy with bone repair is a promising treatment option. Herein, we summarized traditional and biomaterial-mediated maxillofacial tumour treatments and analysed biomaterials for bone defect repair. Furthermore, we proposed a promising and superior design of dual-functional biomaterials for simultaneous tumour therapy and bone regeneration to provide a new strategy for managing maxillofacial tumours and improve the quality of life of patients in the future.
Biocompatible Materials ; Bone Regeneration ; Bone and Bones ; Humans ; Quality of Life

Objective:To explore a convenient and effective method for calculating intraoperative blood loss in liposuction and volume reduction surgery for establishing intraoperative autologous blood transfusion threshold.Methods:Patients’ clinical, laboratory and surgery related information were collected. The influence of different factors such as the total amount of liposuction, bloody fluid, operation time, and patients’ weight change on blood loss during operation were analyzed. The difference of volume between blood loss recorded by doctors and theoretical calculations was compared. The formula of blood loss during operation was conducted, and then the threshold of autologous blood transfusion was established.Results:A total of 1 136 patients with liposuction due to lymphedema were recruited. There were 65 males and 1 071 females, the median age was 56 years in the non-transfusion group and 55 years in the transfusion group. The total amount of liposuction, bloody fluid, operation time, and body weight changes in patients with liposuction surgery were statistically positively correlated with intraoperative blood loss (spearman coefficient were 0.590, 0.584, 0.560, 0.520, respectively, P<0.01). The theoretical blood loss calculated by the Hemoglobin balance formula is (753.0±418.2) ml. According to the calculated value of blood loss, the intraoperative blood loss fitting formula y(ml)=0.082×total liposuction+ 365, is abtained. The threshold for reinfusion of autologous blood is 2 900 ml of liposuction amount. Conclusions:In this study, a convenient calculation method of blood loss in liposuction and volume reduction surgery was constructed, and a threshold for autologous blood transfusion in surgery was set up. Thus, the indication of early blood transfusion was established.

Objective:To explore a convenient and effective method for calculating intraoperative blood loss in liposuction and volume reduction surgery for establishing intraoperative autologous blood transfusion threshold.Methods:Patients’ clinical, laboratory and surgery related information were collected. The influence of different factors such as the total amount of liposuction, bloody fluid, operation time, and patients’ weight change on blood loss during operation were analyzed. The difference of volume between blood loss recorded by doctors and theoretical calculations was compared. The formula of blood loss during operation was conducted, and then the threshold of autologous blood transfusion was established.Results:A total of 1 136 patients with liposuction due to lymphedema were recruited. There were 65 males and 1 071 females, the median age was 56 years in the non-transfusion group and 55 years in the transfusion group. The total amount of liposuction, bloody fluid, operation time, and body weight changes in patients with liposuction surgery were statistically positively correlated with intraoperative blood loss (spearman coefficient were 0.590, 0.584, 0.560, 0.520, respectively, P<0.01). The theoretical blood loss calculated by the Hemoglobin balance formula is (753.0±418.2) ml. According to the calculated value of blood loss, the intraoperative blood loss fitting formula y(ml)=0.082×total liposuction+ 365, is abtained. The threshold for reinfusion of autologous blood is 2 900 ml of liposuction amount. Conclusions:In this study, a convenient calculation method of blood loss in liposuction and volume reduction surgery was constructed, and a threshold for autologous blood transfusion in surgery was set up. Thus, the indication of early blood transfusion was established.

Objective:To evaluate the efficacy and safety of focused radiofrequency in facial wrinkle and laxity.Methods:Seventeen female patients (47.71±1.56 years of age) were involved in our study during January to June 2018, treated with focused radiofrequency on the whole face. The treatments were performed monthly for three consecutive months. Their photographs were taken before treatment and one week after the last treatment, and then the wrinkle severity rating scale (WSRS) and global aesthetic improvement scale (GAIS) were evaulated.Results:After three times＇ treatment, the wrinkle was improved, WSRS of 1 week after the last treatment (2.71±0.47) was much lower than the baseline (3.00±0.79) ( P<0.05). 88.24% patients were satisfied with the improvement. There was no severe adverse effects during this whole procedure. Conclusions:Focused radiofrequency therapy for facial wrinkle and laxity is effective and safe.

Objective: To provide data support for AIDS prevention and control by investigating HIV testing among technician school students in Guangzhou. Methods: A total of 1 112 students were investigated with a questionnaire about AIDS knowledge, attitude, sexual behavior and HIV testing through a stratified cluster random sampling method in October 2018. A Logistic regression analysis was conducted for influencing factors of students’ HIV testing. Results: The HIV testing rate of technician school student was 10.3%. The HIV testing rate (12.1%-24.3%) of male, under 18 years of age, with monthly living expenses over 3 000 yuan and with poor family atmosphere was higher than that of the corresponding group (6.6%-8.4%), the difference were statistically significant (χ2=12.07,7.25,10.73,9.77, P<0.05). Multivariate Logistic regression analysis showed that <18 years of age, willingness to participate in relevant AIDS prevention activities, homosexuality, “support for multiple sexual partners” and having sexual behavior were associated with more HIV testing(P<0.05). Conclusion The incidence of sexual behavior of students in technician school is high while the rate of HIV testing is low, especially for male and male homosexuals.The health and education departments should strengthen students’ AIDS counseling and testing services and raise students’ awareness of AIDS risk in order to improve the coverage of students’ HIV testing.

Objective To investigate the common initial clinical presentations of primary Sj(o)gren's syndrome (pSS) with pulmonary complications,and to explore the differences between patients with extraglandular manifestations at disease onset (EGM) and those with glandular manifestations at disease onset (GM).Methods A total of 1 341 hospitalized SS patients from 2003 to 2012 were retrospectively reviewed.Of them,102 hospitalized patients with pSS'associated lung disease were analyzed and included.Case control study was performed to explore the differences between the EGM group and the GM group.Results Fifty-one percent of patients were presented with EGM at onset,with significantly shorter disease duration [36 (12,156) m vs 102 (48,159) m,x2=-2.41,P=0.016].Although the mean diagnose time was similiar,only 4％ of the EGM group could be confirmed the pSS diagnose at onset,which was significantly less frequently than that of the GM group (34％,22=15.29,P＜0.01).Case control study revealed that hyperglobulinemia,elevated RF titers and anti-SSA and/or anti-SSB test positive were less predominant in the EGM group [IgG 16(12,21) g/L vs 21 (15,28) g/L,x2=-2.15,P=0.032;22 (20,171) U/ml vs 104 (20,238) U/ml,x2=-l.98,P=0.048;33％ vs 72％,x2=15.78,P＜0.01].The predicted value of TLC and FVC were lower [(87±23)％ vs (97±20)％,x2=-1.96,P=0.050;(8±28)％ vs (100±27)％,x2=-1.70,P=0.089] and HRCT score was higher in EMG group [12(88,15) vs 8(5,13),x2=-1.82,P=0.070].Conclusion EMG at onset is the common initial manifestation of pSS'associated lung involvement.Pulmonary complication is more progressively and severe than those with MG at onset.Anti'SSA positive,elevated RF titer and hyperglobulinemia are not predominant for patients with EMG at onset.

OBJECTIVE:To explore the effects of extracts from Siegesbeckiae herba (HS) on doxorubicin (DOX)-induced chronic myocardial injury in mice. METHODS:48 mice were randomly divided into 3 groups. Mice in blank control(Con)group received distilled water once every day,ig,and normal saline(2 mL/100 g)once every day,ip,for 8 weeks;mice in DOX mice received distilled water(2 mL/100 g)once every day,ig,and DOX(3 mg/kg)once every week,ip,for 8 weeks;mice in DOX+HS group received HS(340 mg/kg)once every day,ig,and DOX(3 mg/kg)once every week,ip,for 8 weeks. After administra-tion,body mass,heart coefficient,cardiac function changes,serum biochemical index levels [alanine aminotransferase(ALT),as-partate aminotransferase (AST), creatine phosphokinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH)and total cholesterol(TC)] of mice were determined. RESULTS:Compared with Con group,body mass of mice in DOX group was decreased(P<0.01);heart coefficient was increased(P<0.05);heart rate slowed down,R-wave was increased(P<0.05 or P<0.01);serum biochemical indexed were increased,there was significant difference in AST(P<0.01). Compared with DOX group,heart coefficient of mice in DOX+HS group was decreased (P<0.01);heart rate was increased (P<0.01);serum biochemical indexes were decreased,there was significant differences in CK,LDH,TC(P<0.01). CONCLUSIONS:HS has cer-tain protective effects on DOX-induced chronic myocardial injury in mice.