OBJECTIVE To provide reference for improving the pre-prescription review system and reducing the occurrence of medication error by analyzing the drug-related problems （DRPs） in the pre-prescription review orders of pediatric outpatient clinics using the Pharmaceutical Care Network Europe （PCNE） classification system. METHODS The data of pre-prescription review orders were retrospectively collected from outpatient department of Shanghai Children’s Medical Center， Shanghai Jiao Tong University School of Medicine from July 2022 to June 2023； DRPs in the pre-prescription review orders were classified and summarized by using the PCNE classification system （version 9.1）， and then analyzed in terms of types and causes of issues， and the acceptance of interventions. RESULTS A total of 66 017 DRPs orders were included， involving 41 165 patients. The proportion of DRPs orders in children aged ≤5 years old was the highest （58.25%）， followed by children aged 6-12 years old （33.52%）； the department with the highest proportion of DRPs was internal medicine of pediatrics department （71.41%）； the department with the highest incidence of DRPs was thoracic surgery department （9.73%）； top three drug categories of DRPs orders were systemic anti- infective drugs （25.26%）， Chinese patent medicines （24.74%） and respiratory drugs （22.38%）. Referring to PCNE classification system， the types of DRPs mainly focused on treatment safety （64.86%）； the reasons of DRPs orders mainly focused on dose selection （82.09%）， of which 41.26% were due to excessive drug dosage； 92.13% of interventions could be accepted and fully executed by doctors. CONCLUSIONS DRPs orders identified by the pre-prescription review system can be effectively analyzed by using PCNE classification system. Pharmacists should focus on medication use in children aged ≤5 years old， update and develop personalized prescription review rules timely， and meet the rational needs of clinical medication for children.

Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization(TACE)combined with lenvatinib and camrelizumab in the treatment of advanced hepatocellular carcinoma(HCC).Methods The clinical data of a total of 63 patients with advanced HCC,who received TACE combined with lenvatinib and camrelizumab(triple therapy)or TACE combined with lenvatinib(dual therapy)at the Jingmen Municipal People's Hospital of China between April 2020 and December 2021,were retrospectively analyzed.Triple therapy group had 30 patients,and dual therapy group had 33 patients.The post-treatment tumor response,disease progression-free survival(PFS),overall survival(OS),and the incidence of adverse drug reactions were recorded.Results The median follow-up period of the two groups was 14 months(range of 4-26 months).Compared with the dual therapy group,in the triple therapy group the objective response rate(ORR)was remarkably higher(83.3%vs.57.6%,P=0.026),the disease control rate(DCR)was obviously higher(93.3%vs.69.7%,P=0.039),the median PFS was significantly longer(8.0 months vs.5.0 months,P＜0.01),and the median OS was strikingly longer(24.0 months vs.12.0 months,P=0.004).No statistically significant difference in the incidence of adverse drug reactions existed between the two groups(P＞0.05).Conclusion For the treatment of advanced HCC,TACE combined with lenvatinib and camrelizumab is clinically safe and effective.(J Intervent Radiol,2024,32:57-62)

Objective:To establish a calculation model of drug preparation difficulty coefficient for outpatient pharmacy intrave -nous admixture center ( OUIVA) in a children's hospital, and construct the performance model .Methods: All the prescriptions in a week in OUIVA of Shanghai children's medical center were randomly selected .According to the actual difficulty level in the process of outpatient and emergency drug preparation , a basic drug difficulty coefficient and difficulty coefficient addition method was constructed . The difficulty index of every prescription was calculated .All the prescriptions in a week were randomly selected , and according to the difficulty coefficient analysis method , the daily difficulty coefficient of the prescriptions was calculated in order to build a performance model for OUIVA in the hospital .Results:The difficulty coefficient of medicine mainly included four basic difficulty coefficients and nine difficulty addition coefficients .According to the statistics , the average difficulty coefficient of daily prescriptions was (3.83 ± 2.86 )with the highest difficulty coefficient of 35, and the prescription data showed that there was significant difference between outpa -tient and emergency prescriptions and daytime blood tumor prescriptions .Conclusion:A performance model based on the difficulty co-efficient for OUIVA in children ' s hospital is a more scientific reflection to the daily work .

Objective:To analyze the dosage distribution and the frequency of each dosage of high-risk tablets in the hospitalized patients in a children's hospital,and study whether the existing specifications of high-risk tablets meet the pediatrics clinical needs. Methods:All the prescriptions including high risk tablets were analyzed from 2014 to 2016 in Shanghai children's medical center. The frequency of every dosage of every drug was analyzed,and the current specifications were judged according to the frequency. New specifications were proposed when the existing specifications did not match the clinical needs. The new frequency of the proposed speci-fications was re-accounted for all the three-year prescriptions in order to evaluate whether the proposed new specifications met the clini-cal needs. Results:Among the five kinds of high-risk oral tablets,methotrexate tablets and vitamin A acid tablets were in accordance with the actual clinical requirements. Mercaptopurine tablets should add two specifications including 12.5 mg and 17 mg,and warfarin sodium tablets should add one specification(1.25 mg). Hydroxyurea tablets(250 mg) and warfarin sodium tablets(1 mg) were rec-ommended used in the children's hospital. Conclusion:The existing specifications of high-risk oral tablets can't fully meet the clini-cal needs,therefore,specifications still needs to be adjusted.

Objective:To analyze the safety of generics and lactation of commonly used drugs in outpatient and emergency department of a children's hospital in Shanghai to formulate the related high-risk medicines list. Methods:According to the drug directory for outpatient and emergency department in the sample hospital,the medication assistant software was used to check the safety level of the related drugs used during pregnancy and lactation. Drugs with pregnancy safety grade D or X,and the lactation safety grade L4 or L5 involved in the high-risk pregnancy or breast-feeding drug list. Results:Of the 151 kinds of infusion medicines commonly used in outpatient and emergency department in the sample hospital, a total of 118 kinds were with a specified level of pregnancy safety,which accounted for 78.15%,and a total of 86 kinds were with a clear indication of the safety level of lactation,which accounted for 56.95% of the total number of medicines. A total of 25 kinds of drugs labeled pregnancy safety grade D or X, which accounted for 16.56%, and 21 species were with lactation safety L4 or L5, which accounted for 13.90% of the total number of drugs. The drugs with high pregnancy or lactation risk in the outpatient and emergency department of the sample children's hospital were anti-tumor drugs,anti-infective drugs,some cardiovascular drugs and central nervous system drugs. Conclusion:There are still many deficiencies in the information about the safety of pregnancy or breast-feeding in the existing medicines used in the sample hospital,which need to be improved.

Objective To explore the impact of family education methods and parental rearing or not on the psychological problem tendency of primary school students.Methods The mental health test (MHT) was used on getting mental health data of the 2 838 primary school students from Dongguan city.Results (1) The results of MHT showed that 94.28％ of primary school students had no psychological problems,the tendency rate of psychological problems was 4.29％,and 1.43％ of them were suffering from serious psychological problems.Learning anxiety,physical symptoms and allergy tendency were more prominent.(2) The total MHT scores of primary school students with authoritarian,democratic,permissive and neglected family education methods were (34.84±14.58),(31.04±13.60),(35.19±12.82) and (41.19±13.10)respectively.There was no statistically significant difference in the terrorist tendency dimension scores of primary school students with different education methods (F=2.33,P=0.054),and the differences in the MHT total score and other dimensions were statistically significant (F=4.35-16.88,P＜0.01).(3) There were statistically significant differences in the scores of the total score of psychological problem tendency,dimensions of learning anxiety,anxiety to people,allergy tendency and impulse tendency of primary school students who were parental rearing or not (t=2.09-3.67,P＜0.05).However,there was no statistically significant difference in the dimensions of loneliness tendency,self-accusation tendency,physical symptoms and terrorist tendency (P＞0.05).Conclusion Family education methods and parenting styles has a impact on the mental health of primary school students.

Objective: To study the correlation between the empty bottle volume, negative pressure and gas production of the freeze-dried powder in the out-patient pharmacy intravenous admixture center of a children' s hospital in order to provide reference for the drug production. Methods:20 ml Syringes were used to measure the volume of empty bottles, negative pressure and produced gas. The relationship between the theoretical drug dissolution volume and the actual dissolution volume was compared, and the precautions for the drug production were put forward. Results:Among the tested 30 drugs, 6 ones were with the actual dissolution volume half of the theoretical dissolution volume, 8 ones were with negative pressure in the bottles, and 3 ones were with produced gas after dissol-ving. It was appropriate that the empty bottle volume be 4 ml larger than the theoretical dissolution volume, and it was appropriate that the negative pressure volume of drugs was slightly larger than the theoretical dissolution volume. Negative pressure should be still kept in the bottles after the gas production. Conclusion:The design of part of freeze-dried powder injection needle shows defects resulting in drug mixing difficulties to a certain extent.

Objective To develop a field psychological emergency rescue chest to improve mental health service during disaster relief.Methods The instruments and medicine involved in for mental health were determined based on service orientation,function design and expert survey,and the psychological emergency rescue chest was developed based on optimization of the external and internal structures of field Ⅳ-type chest.Results The chest developed was composed of office instruments,psychological devices,logistics instruments and first-aid medicine for mental health.conclusion The chest gains advantages in design,structure,size,transport,utilization,equipped devices and function integration,and thus is worthy promoting for field mental health service during disaster relief.

Objective To summarize and analyze the effect of hand hygiene(HH)cost on the incidence of health-care-associated infection (HAI),evaluate continuous improvement method,and provide data for hospital manage-ment.Methods The cost of HH project and incidence of HAI in a hospital from January 2013 to June 2014,as well as HH compliance in the first half year of 2014 were investigated.Results Semiannual statistics were performed, the cost of HH project in the first half of 2013,second half of 2013,and first half of 2014 were 283 490,414 232, and 522 345 yuan respectively,compared with the first half of 2013,the cost of HH in the first half of 2014 in-creased by 84.26%;incidence of HAI were 3.13%,3.33%,and 3.03% respectively,difference was significant(χ2=10.37,P <0.001).In the first half of 2014,HH compliance rate increased from 35.00% in January to 59.49% in June.The top three factors that affecting the implementation of HH were busy work,had no time for handwashing;inadequate HH facilities or supplies;inadequate knowledge about HH.Conclusion Increasing the investment of HH products can improve HH compliance and reduce the incidence of HAI.

Alzheimer's disease (AD) is the general neurodegenerative disease in the elderly. Alterations of microtubule associated protein tau are closely related to the onset and progression of AD. The role of tau protein in the development of AD has been a focus in the current study of AD, with an emphasis on the identification of compounds that inhibit tau protein phosphorylation and aggregate, and accelerate tau protein depolymerization. The current research status of tau protein as target of AD preventive and therapeutic drug was also reviewed.