OBJECTIVE To explore optimization pathways for the drug traceability code management model in outpatient pharmacy workflows， providing practical evidence for enhancing the efficiency of pharmaceutical service. METHODS Taking the outpatient pharmacy of the First Affiliated Hospital of Sun Yat-sen University as the research subject， a comprehensive drug traceability system was established through three key interventions： upgrading the information system architecture [including integration of the hospital information system （HIS） with the traceability platform]， workflow optimization （reorganizing the inventory-dispensing-verification tripartite process）， and designing a dual-mode traceability data collection mechanism （primary data capture at dispensing stations and supplementary capture at verification stations）. Operational efficiency differences before and after implementation were analyzed using the medical insurance data and service timeliness metrics in September 2024. RESULTS After the implementation of drug traceability code management， in terms of data collection: Mode Ⅰ （verification-stage capture） uploaded 26 144 records， while Mode Ⅲ （inventory-as-sales capture） uploaded 443 061 records， totaling 469 205 entries； in terms of time efficiency： average drug dispensing time increased from 28.74 s to 43.37 s （enhanced by 51%）. Through dynamic staffing adjustments， patient wait time only extended from 8.04 min to 8.67 min （enhanced by 8%）. CONCLUSIONS Drug traceability code management can be effectively implemented via a “system reconstruction-process reengineering-human-machine collaboration” trinity strategy， leveraging informatization （e.g.， dual-mode data capture） to offset manual operation delays， which validates the feasibility of balancing national traceability demands with service efficiency in outpatient pharmacies.

Objective To systematically analyze the medical radiation exposure levels in a district of Ningbo City and to provide a scientific basis for the reasonable and effective control of medical radiation exposure. Methods Based on the radiological diagnosis frequency and dose information system, basic medical radiation exposure data were collected, such as radiation doses received by patients in various X-ray diagnostic examinations, from all 13 public medical institutions in a district of Ningbo City from January 1 to December 31, 2020. The data were analyzed for the percentage and collective effective dose of various diagnostic examinations, the distribution of examinations by sex and age, and the number of patients undergoing two or more examinations and their cumulative doses within multiple time intervals. Results Among medical X-ray diagnostic examinations in the district, the percentages of CT examination and routine photography examination were 50.88% and 47.93%, respectively, and the collective effective dose of CT examination accounted for 97.75%. By age and sex, the frequency of examination was the highest in the age group of 45-54 years, and the frequency of examination in the male was higher than that in the female before age 55. The annual effective dose for two patients exceeded 100 mSv. Conclusion In this study, CT examination accounted for up to 50.88% of all medical X-ray diagnostic examinations, and contributed 97.75% of the collective effective dose, highlighting the need for particular attention to the justification of medical radiation exposure from CT.

Objective Differential genes related to prognosis of endometrial carcinoma(EC)were screened and prognostic models were constructed.Methods Gene Expression data of EC and normal control samples were downloaded from The Cancer Genome Atlas(TCGA)database and Gene Expression Omnibus(GEO)dataset GSE63678 to screen out common differential genes.LASSO regression analysis was used to screen out the genes with prognostic significance and construct prognostic characteristics.EC patients with complete information were obtained from the TCGA database and randomly divided into the training group and the validation group in a ratio of 1:1.In the training group,survival curves were constructed based on prognostic characteristics.Functional annotation and pathway enrichment analysis were conducted using gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Combined with prognostic features and clinical risk factors,a calibration curve and C-index were used to evaluate the performance of the histogram.Finally,use a verification group for validation.Results A total of 4800 and 257 differentially expressed genes were screened from TCGA and GEO databases respectively,of which 73 up-regulated genes and 52 down-regulated genes were co-expressed.6 prognostic genes(ORMDL2,BNC2,TTK,MAMLD1,KCTD7 and DCLK2)were screened out by LASSO regression analysis.The survival curve showed that the overall survival of patients in the high-risk group was significantly lower than that in the low-risk group(P<0.01).GO analysis and KEGG results exhibited that prognostic signature was associated with cell cycle.The nomogram showed powerful predictive ability in the training and validation groups.Conclusion We constructed a predictive model based on prognostic genes,which can accurately predict the prognosis of patients with EC and provide new theoretical support for clinical diagnosis and treatment.

Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region. Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors. Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation. Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.

ObjectiveTo investigate the pharmacodynamic effect of naringin on mice with alcohol-induced liver injury and provide data support for the development of naringin as an anti-alcoholic and liver-protecting drug. MethodSixty Balb/c mice were randomly divided into six groups according to body weight， namely， the control group， the model group， the naringin low and high-dose group （25， 50 mg·kg^-1）， Haiwang Jinzun tablet positive control group （2 g·kg^-1）， and naloxone positive control group （2 mg·kg^-1）. Each group was given corresponding drugs by injection or gavage， and the control group and the model group were given equal volume of 0.5% sodium carboxymethyl cellulose solution by gavage， once a day for 14 consecutive days. Except those in the control group， mice in other groups were additionally given 56° Chinese Baijiu （13 mL·kg^-1） for 14 days to induce the mouse model of alcoholic liver injury. One day before the last administration， mice were fasted for 12 h. Eyeballs were removed for blood after the last administration of Chinese Baijiu， and the livers were collected and weighed. The activity levels of alanine transaminases （ALT） and aspartate aminotransferase （AST） were detected by automatic biochemical analyzer. Hematoxylin-eosin （HE） staining was performed to determine and compare the pathological changes in liver tissues of mice， and the ratio of positive cells were observed by TUNEL/DAB dual staining method. Western blot was used to determine the expression of apoptosis-related proteins including B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and Cytochrome-C （Cyt-C）. ResultAs compared with the control group， the liver/body ratio of the model group was significantly increased （P<0.01）， and the expression of ALT and AST in the serum was obviously increased （P<0.01）. Further， the model group showed severe loosing of hepatocyte cytoplasm， edematous， steatosis， and apoptosis of hepatocytes， with obvious bleeding phenomena. In addition， the apoptosis of liver cells increased， the Bal-2/Bax ratio was decreased （P<0.01）， and the level of pro-apoptotic protein Cyt-C was increased in the model group （P<0.01）. Compared with the model group， the naringin low and high-dose groups reduced the liver/body ratio （P<0.05， P<0.01）， and the high-dose and low-does group significantly inhibited the activity levels of ALT and AST in the serum of mice （P<0.05， P<0.01）. Moreover， the hepatocyte steatosis was significantly reduced， hepatocyte edema disappeared， and bleeding was improved in the naringin high-dose group， and the TUNEL-positive rate was down-regulated. The naringin low and high-dose groups decreased the Bcl-2/Bax ratio （P<0.05， P<0.01） and enhanced the expression level of Cyt-C （P<0.05）. ConclusionNaringin protects alcohol-induced liver damage by regulating the expression levels of ALT and AST in the serum， improving liver fatty lesions， and reducing hepatocyte apoptosis.

Objective To analyze the factors influencing the levels of occupational exposure in medical radiation workers in China, and to provide a scientific basis for determining the key points of radiation protection in the medical sector. Methods The individual monitoring data on occupational external exposure in medical radiation workers in 2021 were collected from the “National Individual Dose Registry”. The Chi-squared test and logistic regression were used to analyze the factors influencing the levels of occupational exposure in medical radiation workers. Results The Chi-squared test showed that gender, occupational category, medical institution category, region, number of radiation workers per thousand population, and regional per capita GDP were significantly associated with occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv and an annual effective dose limit of 20 mSv (χ² = 21.456−262.329, 7.601−78.650, P < 0.05). The logistic regression analysis further showed that gender, occupational category, region, and number of radiation workers per thousand population were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv (χ² = 14.621−170.857, P < 0.05); gender, occupational category, region, and regional per capita GDP were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 20 mSv (χ² = 5.401−48.709, P < 0.05). Conclusion Male radiation workers in interventional radiology and in central China have high risks of exceeding annual effective doses of 5 and 20 mSv. Moreover, high number of radiation workers per thousand population and regional per capita GDP are associated with low risks. Medical institutions should maintain a sufficient number of radiation workers and strengthen training on radiation protection knowledge for male and interventional radiology workers to enhance their radiation protection awareness. Investigation of the factors contributing to the high occupational exposure in central China should be intensified, and targeted effective measures should be conducted to reduce the occupational exposure in medical radiation workers.

OBJECTIVE: To assess the value of genetic screening by high-throughput sequencing (HTS) for the early diagnosis of neonatal diseases. METHODS: A total of 2 060 neonates born at Ningbo Women and Children's Hospital from March to September 2021 were selected as the study subjects. All neonates had undergone conventional tandem mass spectrometry metabolite analysis and fluorescent immunoassay analysis. HTS was carried out to detect the definite pathogenic variant sites with high-frequency of 135 disease-related genes. Candidate variants were verified by Sanger sequencing or multiplex ligation-dependent probe amplification (MLPA). RESULTS: Among the 2 060 newborns, 31 were diagnosed with genetic diseases, 557 were found to be carriers, and 1 472 were negative. Among the 31 neonates, 5 had G6PD, 19 had hereditary non-syndromic deafness due to variants of GJB2, GJB3 and MT-RNR1 genes, 2 had PAH gene variants, 1 had GAA gene variants, 1 had SMN1 gene variants, 2 had MTTL1 gene variants, and 1 had GH1 gene variants. Clinically, 1 child had Spinal muscular atrophy (SMA), 1 had Glycogen storage disease II, 2 had congenital deafness, and 5 had G6PD deficiency. One mother was diagnosed with SMA. No patient was detected by conventional tandem mass spectrometry. Conventional fluorescence immunoassay had revealed 5 cases of G6PD deficiency (all positive by genetic screening) and 2 cases of hypothyroidism (identified as carriers). The most common variants identified in this region have involved DUOX2 (3.93%), ATP7B (2.48%), SLC26A4 (2.38%), GJB2 (2.33%), PAH (2.09%) and SLC22A5 genes (2.09%). CONCLUSION Neonatal genetic screening has a wide range of detection and high detection rate, which can significantly improve the efficacy of newborn screening when combined with conventional screening and facilitate secondary prevention for the affected children, diagnosis of family members and genetic counseling for the carriers.
Child ; Infant, Newborn ; Humans ; Female ; Prospective Studies ; Connexins/genetics* ; Connexin 26/genetics* ; Glucosephosphate Dehydrogenase Deficiency ; Mutation ; Sulfate Transporters/genetics* ; DNA Mutational Analysis ; Genetic Testing/methods* ; Deafness/genetics* ; Neonatal Screening/methods* ; Hearing Loss, Sensorineural/genetics* ; High-Throughput Nucleotide Sequencing ; Solute Carrier Family 22 Member 5/genetics*

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.

Objective:To analyze the dose range distribution of abnormal result, the distribution of occupational categories, the incidence of abnormal result of different occupational categories, the causes of abnormal result and the factors influencing abnormal values, on the basis of investigated abnormal result of individual monitoring for occupationally external exposure, in order to provide the scientific basis for the formulation of the relevant regulations and standards and the hospital radiation protection management.Methods:The abnormal result of 389 radiation workers in medical institutions receiving annual individual doses each exceeding 1.25 mSv, reported in 2017 in 19 provinces, were collected and analyzed.Results:Dose distribution range of abnormal result were mainly between 1.25 and 5 mSv; diagnostic radiology workers accounted for the highest fraction, 59.64% of the totals; and interventional radiology workers had the highest incidence, 4.17‰ of abnormal result. The abnormal result was mainly caused by improper wearing or operating personal dosimeters; the abnormal values in the eastern regions were higher than those in other regions, with a median of 6.41 mSv; the abnormal values in the cause-unknown group was higher than those in other groups, with a median of 10.32 mSv.Conclusions:The publicity and training of radiation protection knowledge should be further strengthened to improve the protection awareness of radiation workers. The occupational exposure of interventional radiology workers should receive special attention.