OBJECTIVE To investigate the pharmaceutical affairs management in healthcare institutions from Haidian district of Beijing， and propose countermeasures and suggestions for improving the related work. METHODS The current status of pharmaceutical affairs management in 66 healthcare institutions from Haidian district of Beijing was surveyed through on-site inspections， and the results were statistically analyzed. The inspection items included six special projects： pharmaceutical affairs management and organizational structure of pharmacy departments； drug quality management and control， prescription review， clinical application management of antimicrobial drugs， management of adverse drug events， and management of special drugs. These areas were further divided into a total of 27 specific inspection sub-items. RESULTS & CONCLUSIONS The total proportion of healthcare institutions that fully complied or basically complied with each special project was 90.9%， 97.0%， 86.3%， 90.9%， 90.9%， and 96.9%， respectively. The overall comparison among healthcare institutions that fully or substantially met the standards across medical institutions at different levels showed that the performance of tertiary healthcare institutions was better than that of secondary and primary healthcare institutions. The pharmaceutical affairs management in healthcare institutions within the jurisdiction was proceeding in an orderly manner. There is still room for improvement in further establishing and perfecting the functions of the pharmaceutical affairs management committee， implementing the 2021 Edition of Management Regulations for β -lactam Antimicrobial Skin Tests， enforcing the adverse drug reaction management system， and strengthening the refined management of narcotics and psychotropic drugs.

ObjectiveTo investigate and analyze an outbreak of rotavirus infectious diarrhea in a prison in Chongqing Municipality, to provide a basis for adult rotavirus surveillance and prevention, and to explore the public health problems in special settings. MethodsA retrospective survey was conducted to collect and analyze data on individual cases with diarrheal disease on-site. The clinical characteristics, as well as the temporal, spatial and geographical distribution patterns of the epidemic were described. Multi-pathogen detection tests were conducted both on diarrhea cases and environmental samples, with viral genotyping performed on positive samples. A case-control analysis was performed to identify the causes of the outbreak, and an SEIR model was adopted to predict the outbreak trend and evaluate the effectiveness of interventions. ResultsA total of 65 cases were found among the inmates, with an attack rate of 2.03%. The predominant clinical manifestations included diarrhea (89.23%), watery stool (73.85%), and dehydration (18.46%). The epidemic curve indicated a “human-to-human” transmission pattern, with an average incubation period of 5‒6 days. The attack rates among chefs in the main canteen (80.00%, 8/10) and caterers (28.33%, 17/60) were significantly higher than those of other inmates （P<0.05）. Multi-pathogen polymerase chain reaction (PCR) testing detected positive for group A rotavirus, with the viral genotyping identified as G9P [8] strain. Factors such as unprotected "bare-handed" food distribution among cases with diarrhea (OR=9.512, 95%CI: 4.261‒21.234) and close contact with diarrhea cases (OR=3.656, 95%CI: 1.719‒7.778) were the possible cause of the outbreak. The SEIR model (r₀=5, α=0.3, β₁=0.08, β₂=0.04) was constructed using prison inmates as susceptible population, aiming at fitting the initial transmission trend of the outbreak, and the epidemic rate declined rapidly after intervention measures were implemented (r_t≈0). ConclusionThis rare rotavirus infection diarrhea outbreak among adults in confined settings suggests that the construction of public health prevention and control systems in prison may be overlooked. Cross infection during meal processing and distribution in the canteens of such settings is likely to be the cause of the outbreak. Given the potential neglect of public heath system construction in special settings, it is imperative to enhance the surveillance and monitoring of rotavirus and other intestinal multi-pathogens among adults, as well as the construction of public health prevention and control systems in these special settings.

【Objective】 To evaluate the safety and efficacy of modified ultrasound-guided needle-like visible nephroscope (Needle perc) holmium laser lithotripsy in the treatment of 1-2 cm calyceal calculi, and provide a reference for the selection of clinical treatment methods. 【Methods】 The clinical data of 60 patients with single intrarenal calyceal calculi (the largest diameter 1~2 cm) treated in our hospital during Jan.2022 and May 2023 were retrospectively analyzed.The patients were divided into ureteroscopic holmium laser lithotripsy group (flexible ureteroscope group) and Needle perc group, with 30 patients in either group.The clinical data of the two groups were compared. 【Results】 Compared with the flexible ureteroscope group, the Needle perc group had shorter overall hospitalization time [(3.00±1.25) d vs. (4.00±1.25) d], shorter operation time [(44.63±5.42) min vs. (48.50±7.24) min], lower hospitalization expenses [(15 518±441) yuan vs. (16 872±903) yuan], higher stone-clearance rate [93.3% (28/30) vs. 50.7% (15/30), P<0.001], less increase of procalcitonin after operation [(0.02±0.01) vs. (0.12±0.18), P=0.007], and lower incidence of complications [3.3% (1/30) vs. 26.7% (8/30), P=0.030]. 【Conclusion】 The modified ultrasound-guided Needle perc holmium laser lithotripsy is safe and effective in the treatment of 1-2 cm lower calyceal calculi, with high stone removal rate and low complication rate.

Objective:To analyze the differential expressions of ferroptosis related genes (FRGs) in proliferative lupus nephritis and its correlation with clinical indices (PLN) by analyzing the gene expression omnibus (GEO) database.Methods:The GSE65391 dataset was downloaded from GEO database, differential FRGs of PLN were screened by limma package of R language. Wilcoxon rank-sum test was used to analyze the differentially expressed genes in peripheral blood between 514 PLN patients and 72 healthy controls. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis of differential FRGs were determined with the clusterProfiler package. Hub genes were determined using random forest (RF), support vector machine (SVM), xgboost (XGB) and generalized linear model(GLM) machine learning algorithms. Finally, Spearman rank correlation analysis was used to analyze the correlation between hub genes and clinical indices.Results:A total of 38 differential FRGs of PLN patients were screened out, of which 16 were up-regulated and 22 were down-regulated. Biological process was enriched in cellular response to chemical stress, cellular component was enriched in transcription regulator complex, molecular function was enriched in DNA-binding transcription factor binding. KEGG enrichment analysis showed that FRGs were mainly involved in NOD-like receptor signaling pathway. GLM algorithm was selected to predict gene essentiality according to the area under the receiver operating characteristic (ROC) curve, 10 hub genes were determined, of which MYB was the most important. MYB was positively correlated with SLEDAI ( r=0.21, P<0.001), ALT ( r=0.20, P<0.001), AST ( r=0.18, P<0.001), LDH ( r=0.31, P<0.001), Cr ( r=0.24, P<0.001) and ESR ( r=0.22, P<0.001) and negatively correlated with albumin ( r=-0.28, P<0.001). Conclusion:FRGs may provide new insight into the potential mechanisms of the pathogenesis of PLN.

Objective:To summarize the evidence related to the guidance and management of breastfeeding in pregnant women with gestational diabetes mellitus.Methods:UpToDate, BMJ Best Practice, CINAHL, PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure, and other databases and professional websites were searched by computer for evidence on breastfeeding guidance and management for pregnant women with gestational diabetes mellitus, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus and randomized controlled trials. The search period was from database establishment to April 1, 2023. Two researchers independently conducted literature quality evaluation, evidence extraction, and integration.Results:A total of 23 articles were included, including 4 clinical decision-making articles, 4 guidelines, 4 evidence summaries, 6 systematic reviews, 1 expert consensus and 4 randomized controlled trials. A total of 21 best pieces of evidence were summarized from six aspects of support and education, knowledge and skills, safety issues, feeding issues, dietary care, and blood glucose monitoring.Conclusions:This study summarizes the best evidence on breastfeeding guidance and management for pregnant women with gestational diabetes and suggests that the medical staff should apply the proof according to the clinical situation and the patient's wish.

Objective:To systematically integrate qualitative research on the psychological experience of non-suicidal self-injury (NSSI) in adolescents.Methods:A comprehensive literature search was conducted in databases including China National Knowledge Infrastructure, WanFang data, VIP, China Biology Medicine disc, PubMed, Web of Science, Embase, and Cochrane Library for qualitative studies on the psychological experience of NSSI in adolescents and the search period covered the inception of the databases until June 27, 2023. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016 edition). The results were integrated using the Meta-synthesis method.Results:A total of 15 studies were included, comprising ten phenomenological studies, one descriptive qualitative study, one mixed-method study, one narrative study, one exploratory study, and one grounded theory study. Thirty-one findings were extracted and synthesized into ten categories, resulting in three main themes: triggers of adolescent NSSI, NSSI as a coping strategy, and the internal conflict and struggle of adolescents engaging in NSSI.Conclusions:Adolescents engaging in NSSI experience complex psychological and sensory responses. Healthcare professionals should closely monitor adolescents' emotional changes, enhance psychological assessments, and guide them in coping with negative emotions effectively to improve their physical and mental health.

OBJECTIVE To provide a reference for establishing an automatic checking mode and improving the checking efficiency of the unit dose dispensing system of oral drugs in hospital. METHODS The automatic checking process reengineering team was established in our hospital. ECRSI method was adopted to sort out the verification process and mode of drug bags for the unit dose formula of our hospital through five principles of eliminating， combining， rearranging， simplifying and increasing， and the hardware series problem and the problem of excessive system false-positive proportion were optimized. The drug bags for the unit dose formula were randomly selected from 10 wards， the efficiency and external error rates of manual check and automatic checking mode before and after optimization were compared， and the false-positive reporting failure in automatic checking mode was also compared before and after optimization. RESULTS After the establishment of the automatic checking mode of the unit dose formula for oral drugs， the average checking time of drug bags was significantly shorter than that of manual checking mode in the other 8 wards except for cardiovascular and renal departments （P＜0.05）. After the optimization of the automatic checking mode， the average checking time of drug bags in all wards was significantly shorter than that in manual checking mode （P＜0.05）. Compared with before optimization of the automatic checking mode， the average checking time of drug bags was shortened by 0.43 s， and the average checking time of drug bags in half of the wards was shortened significantly （P＜0.05）. At the same time， the false-positive proportion decreased from 96.83% before optimization to 92.76% after optimization （P＜0.05）. The external error rate dropped from 0.039‰ in manual checking mode to 0.019‰ before optimization and 0.015‰ after optimization （P＜0.05）. CONCLUSIONS Based on ECRSI method， the automatic checking mode for the unit dose dispensing system of oral drugs can effectively reduce the average checking time of drug bags， reduce external error and improve the work efficiency of pharmacists.

Objective:To investigate the relationship between Watchman occluder and structure of mitral valve apparatus in patients with nonvalvular atrial fibrillation after left atrial appendage closure(LAAC) by transesophageal echocardiography.Methods:From January 2018 to December 2020, 29 patients [20 male, 9 female, (69.55±10.06)years old] with nonvalvular atrial fibrillation underwent LAAC in Zhongshan Hospital (implanted Watchman occluder), and all patients underwent pre-operative and follow-up two and three dimensional transesophageal echocardiography(2DTEE, 3DTEE) at 60 days after the operation. The quantitative parameters of mitral valve apparatus were obtained by offline analysis using the MVA module in QLab 13.0 (Philips Healthcare, Andover, MA), the differences between pre-operation and post-operation were compared, and the relationship between occluder compression ratio and mitral valve parameters with significant changes after operation was analyzed.Results:①The values of AL-PM diameter(AL-PM), 3D annulus circumference(3DAC), 2D annulus area(2DAA), 3D annulus area(3DAA), tenting volume(TnV), tenting area(TnA) and commissural diameter(CD) decreased significantly compared with pre-operative values(all P<0.05), while the annulus sphericity index(SPI) increased significantly ( P<0.05). ②In the quantitative mitral value parameters with significant pre- and post-operation changes, TnV was correlated with the occluder compression ratio ( r=0.403, P=0.030), but AL-PM, SPI, 3DAC, 2DAA, 3DAA, TnA, CD were not correlated with it(all P>0.05). Conclusions:3DTEE can accurately evaluate the effect of Watchman occluder on the morphology of mitral valve device. Implanting Watchman occluder in left atrial appendage can make three-dimensional mitral valve apparatus flat and decrease annulus left-right diameter and annulus area; the pre-operative TnV, the more susceptible to the occluder implantation, and TnV is correlated with the compression ratio.

Mitochondria as a signaling platform play crucial roles in deciding cell fate. Many classic anticancer agents are known to trigger cell death through induction of mitochondrial damage. Mitophagy, one selective autophagy, is the key mitochondrial quality control that effectively removes damaged mitochondria. However, the precise roles of mitophagy in tumorigenesis and anticancer agent treatment remain largely unclear. Here, we examined the functional implication of mitophagy in the anticancer properties of magnolol, a natural product isolated from herbal

OBJECTIVE：To evaluate the preventive effect of dexmedetomidine （DEX）on adverse drug reactions induced by carboprost tromethamine used in cesarean section ，and to provide evidence-based reference for rational drug use of cesarean section. METHODS：Retrieved from PubMed ，Cochrane library ，Embase，CNKI，CBM，Wanfang database and VIP during inception to June of 2019，randomized controlled trials about DEX （trial group ）versus normal saline （control group ）in the prevention of adverse drug reactions induced by carboprost tromethamine in cesarean section were collected. After data extraction of included literatures and quality evaluation with modified Jadad scale ，Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 11 RCTs with 714 patients were included in this study. Results of Meta-analysis showed that the incidence of nausea [OR ＝0.09，95％CI（0.06，0.14），P＜0.000 01]，vomiting [OR ＝0.09，95％CI（0.05，0.15），P＜0.000 01]， facial flushing [OR ＝0.15，95％CI（0.10，0.22），P＜0.000 01]，chest distress [OR ＝0.12，95％CI（0.08，0.18），P＜0.000 01]， hypertension [OR ＝0.06，95％CI（0.04，0.11），P＜0.000 01] and tachycardia [OR ＝0.17，95％CI（0.12，0.25），P＜0.000 01] in trial group were significantly lower than control group ，with statistical significance. CONCLUSIONS ：DEX can reduce adverse drug reactions such as nausea and vomiting caused by carboprost tromethamine used in cesarean section.