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In order to strengthen the supervision of the use of drugs in hospitals,the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs (the Second Batch) with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List (hereinafter referred to as “the List”) issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual, the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs, and applied the evaluation, formulation and evaluation method of recommendation grading (GRADE) to evaluate the quality of evidence formed, focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs, key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication, further improve the quality of medical services, reduce the risk of adverse drug reactions and drug abuse, promote rational drug use, and improve public health.
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Objective:To understand the effects of paliperidone palmitate (PP) long-acting injection on hospitalization, psychiatric symptoms, individual and social function of community patients with schizophrenia.Methods:From March 2021 to September 2022, 239 patients with schizophrenia in the community of Zhongshan city were treated with PP injection in a 1-month dosage form for 1 year.The hospitalization rate was compared before and after the treatment.The brief psychiatric rating scale (BPRS), modified overt aggression scales(MOAS), clinical global impressions-severity(CGI-S), and personal and social performance scale (PSP) were used to evaluate psychiatric symptoms and personal social function at baseline, at the end of the 8th week, the end of the 6th month and the end of the 12th month after treatment.Repeated measurement analysis of variance was used to compare the results at different times of treatment, and Logistic regression analysis was used to analyze the factors affecting treatment by SPSS 26.0.Results:One year after treatment the number of hospitalization was lower than that before (0(1) times, 0(0) times)( Z=-4.43, P<0.01), and the hospitalization days was lower than before (43(83.3) days, 0(0) days)( Z=-8.65, P<0.01) for the schizophrenic patients.The total BPRS score for schizophrenic patients decreased from (45.3±9.2) to (27.5±9.0) after 1 year of treatment( χ2=465.20, P<0.01), and the external aggressive behavior score was lower than the baseline score (1(7), 0(0))( F=308.36, P<0.01). The total effective rates were 30.5%(73/239), 77.4%(185/239) and 81.6%(195/239) after 8 weeks, 6 months and 1 year of treatment, respectively.The impairment in the four aspects of personal and social functioning were improved to varying degrees (all P<0.01). The severity of the disease was reduced 1 year after treatment.And the proportions of partial to very severe, moderate, none or mild were 10.0%(24/239), 56.5%(135/239), and 33.5%(80/239). Ordinal logistic regression analysis showed that younger age at treatment ( β=-0.08, OR=0.93, 95% CI=0.87-0.99) and older age at first onset ( β=0.07, OR=1.07, 95% CI=1.01-1.14) were associated with better treatment outcomes. Conclusion:Long-term injection of paliperidone palmitate can effectively improve the mental symptoms and individual social function of community patients with schizophrenia.
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Objective@#To study the correlation of occupation musculoskeletal disease (OMD) and safety behavior in assembly line workers.@*Methods@#Selected assembly line workers of 3 manufacturing factory in Pacity as the objects of this study by judgement sampling. Questionnaires were used for messages collection including the general sociodemographic characteristic, OMD condition, occupational safety behaviors.@*Results@#This study shows that, 826 OMD workers were found that the annual prevalence was 38.03%. The scores of work posture, handling habits, health habit in OMD group was lower than non-OMD group (P<0.01) but personal protection behavior was higher than non-OMD group (P<0.01) . Test of binary logistic regression revealed that age, workage, work posture, handling habits were the factors of OMD (P<0.01) .@*Conclusion@#Safety behaviors were the potent factors of OMD that work posture and handling habits should be broadcast.
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OBJECTIVE: To investigate the prevalence of occupational musculoskeletal disorders(OMD) in workers of manufacturing industry,and to analyze its influencing factors.METHODS: A total of 1 168 first-line workers from 3manufacturing enterprises were selected as study subjects using convenient sampling.The self-designed questionnaire was used to investigate the basic information and the ergonomics of work process.The Nordic Musculoskeletal Questionnaire was used to investigate the prevalence of OMD.The workers were divided into non-OMD group and OMD group.RESULTS: The prevalence of OMD in these 1 168 workers was 34.9%.Comparing with the non-OMD group,the score of using auxiliary tools to carry the weights in the OMD group was higher(P<0.01),and the scores of straight waist and bent knees when transporting heavy object was lower(P<0.01).Logistic regression analysis showed that male workers had a higher risk of OMD than female workers(P<0.05).The longer the length of service,the greater the risk of OMD(P<0.01).Shift workers had the higher risk of OMD than non-shift workers(P<0.01).The higher scores of using auxiliary tools to carry the weights and straight waist and bent knees when transporting heavy object(it mean that less use of the above labor behavior and posture),the greater the risk of OMD(P<0.05).CONCLUSION: Sex,length of service,shift,labor behavior and posture are the influencing factors of OMD.
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Objective To explore the therapeutic regimens and contraception methods in systemic lupus erythematosus ( SLE) patients with planned pregnancy . Methods Case report of a SLE patient expecting her second child and review of relevant literature were presented. The prognosis for pregnancy in SLE patients was discussed, the safety profile of medications used to treat SLE during pregnancy was analyzed and the efficacy, side effects of different contraceptive methods were compared. Results For SLE patients with high disease activity, the use of progestin-only contraceptives were advised to avoid thromboembolic risk and risk of disease flare. Patients were usually treated with high doses of systemic glucocorticoids in combination with mycophenolate mofetil (induction therapy) to control the disease.Pregnancy should be avoided until the disease was inactive for at least six months with a low-dose glucocorticoid (eg, 5 to 15 mg of prednisone per day).Azathioprine (not exceed 2 mg·kg-1 ·d-1 ) for maintaining remission was considered relatively safe during pregnancy, the use of cyclosporine or tacrolimus may also be acceptable in patients intolerant to azathioprine. Conclusion Ideally, all pregnancies in patients with SLE should be planned during periods of disease quiescence for at least six months. The safety and efficacy of medications and contraceptive methods must be reviewed and adjusted prior to conception with the goal of maintaining disease control and optimizing maternal outcomes.
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In order to favor the growth and development of the fetus,the maternal-placental-fetal unit is characterized by profound physiologic changes.These adaptations may affect maternal and fetal absorption,distribution,placental transfer,metabolism and excretion of drugs.When evaluating drug use in pregnancy,understanding both pregnancy physiology and the gestation-specific pharmacokinetics of different drugs is necessary to achieve effective treatment and limit maternal and fetal risk.This topic will focus on the pharmacokinetics and safety of drugs during pregnancy in light of changes in maternal physiology and function of placental.
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Objective To explore the therapeutic regimens and contraception methods in systemic lupus erythematosus ( SLE) patients with planned pregnancy . Methods Case report of a SLE patient expecting her second child and review of relevant literature were presented. The prognosis for pregnancy in SLE patients was discussed, the safety profile of medications used to treat SLE during pregnancy was analyzed and the efficacy, side effects of different contraceptive methods were compared. Results For SLE patients with high disease activity, the use of progestin-only contraceptives were advised to avoid thromboembolic risk and risk of disease flare. Patients were usually treated with high doses of systemic glucocorticoids in combination with mycophenolate mofetil (induction therapy) to control the disease.Pregnancy should be avoided until the disease was inactive for at least six months with a low-dose glucocorticoid (eg, 5 to 15 mg of prednisone per day).Azathioprine (not exceed 2 mg·kg-1 ·d-1 ) for maintaining remission was considered relatively safe during pregnancy, the use of cyclosporine or tacrolimus may also be acceptable in patients intolerant to azathioprine. Conclusion Ideally, all pregnancies in patients with SLE should be planned during periods of disease quiescence for at least six months. The safety and efficacy of medications and contraceptive methods must be reviewed and adjusted prior to conception with the goal of maintaining disease control and optimizing maternal outcomes.
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<p><b>OBJECTIVE</b>To investigate the effect of CCM3 gene defection on lead induced cell genotoxicity in mouse embryonic fibroblasts.</p><p><b>METHODS</b>C57 female mice were mated with CCM3 gene heterozygous male mice. E13.5 embryos were taken to isolate primary mouse embryonic fibroblasts. After genotyping, wild type and heterozygous cells were treated with different doses of lead acetate. Cell viability, genotoxicity and protein expression were detected by MTS assay, CB micronucleus method and Western blot, respectively.</p><p><b>RESULTS</b>Mouse embryonic fibroblasts with lead acetate treatment for 24 h, wild-type cells 100.00 µmol/L lead acetate-treated group (69.16±1.36) and the control group (100.00±2.33) compared to cells decreased by 30%, CCM3 heterozygous type cell 100.00 µmol/L lead acetate-treated group (87.16±5.50) and the control group (100.00±2.06) compared to cells decreased by 13%, the difference was statistically significant (F values were 98.59, 82.63, P<0.001). Lead acetate treatment after 48 h, wild-type cells 100.00 µmol/L lead acetate-treated group (51.99±5.62) and the control group (100.00±3.11) compared to cells decreased by 50%, heterozygous type cells 100.00 µmol/L lead acetate treatment group (66.33±4.06) and the control group (100.00±5.72) compared to cells decreased by 35%, the differences were statistically significant (F values were 82.63, 36.86, P < 0.001). The results of CBMN test showed that with increased dose, micronucleus cell rate of two genotypes showed an increasing trend, in the wild-type cells, the micronucleus cell rate (/1 000) for the control group, 29.6±2.2, 6.25 µmol/L dose group 47.3±6.6, 25 µmol/L dose group 55.5±9.1, 100.00 µmol/L dose group 66.8±3.5; heterozygous cells micronucleus cell rate (/1 000) for the control group, 35.3±5.6, 6.25 µmol/L dose of 50.0±8.3, 25.00 µmol/L dose group 57.0±8.5, 100.00 µmol/L dose group 58.8±2.1. Micronucleus cell rates (/1 000) were significant differences, in 100.00 µmol/L dose groups of two genotypes. Western blot results showed that wild-type cells CCM3 expression 100.00 µmol/L lead acetate-treated group (0.70±0.03) was 1.32 times higher than the control group (0.53±0.07), heterozygous cells CCM3 expression 100.00 µmol/L lead acetate-treated group (0.48±0.02) was 1.77 times higher than control group that of 0.27±0.04, there was statistically significant difference (F values were 14.77, 25.74, P < 0.001); wild-type cells γ-H2AX expression 100.00 µmol/L lead acetate-treated group (0.69±0.03) was 1.06 times higher than the control group (0.65±0.07), heterozygous cells γ-H2AX expression 100.00 µmol/L lead acetate-treated group (0.99±0.04) was 1.55 times higher than the control group CCM3 expression levels (0.64±0.06), there was statistically significant difference (wild-type cells: F = 7.08, P = 0.012, heterozygous type cell: F = 13.49, P = 0.002).</p><p><b>CONCLUSION</b>CCM3 gene may play a role in lead-induced genetic toxicity of mouse embryonic fibroblasts, CCM3 gene-lead interactions effects on mouse embryonic fibroblasts cell toxicity.</p>
الموضوعات
Animals , Female , Male , Mice , Apoptosis Regulatory Proteins , DNA Damage , Embryo, Mammalian , Fibroblasts , Genotype , Membrane Proteins , Mice, Inbred Strains , Micronuclei, Chromosome-Defective , Organometallic Compounds , Proto-Oncogene Proteinsالملخص
Objective To explore the application effects of quality control circle (QCC) on improving accuracy of pupil observation for nurses in the department of neurosurgery. Methods Quality control circle was established. The theme of the activity was determined according to urgency and circle capacity, and activity proposal was decided. Investigation on current situation was carried out, and objective was set according to the focus on improvement and circle capacity. Reasons were analyzed, and feasible strategies were proposed and implemented. Accuracy of pupil observation before and after the QCC activity was compared, and the effects after the implementation of QCC was confirmed. Results As for tangible results, the scores of examination on specialized theoretical knowledge for nursing practitioners was (83.11±4.55) before the QCC activity, and the scores were (90.59±3.57) after the activity, the specialized theoretical knowl-edge for nursing practitioners significantly improved, and the difference was statistically significant (P<0.05). Accuracy of pupil observation was 47.50% before the QCC activity, and the accuracy was 90.83% after the activity, the accuracy of pupil observation after the activity significantly improved compared to that before the activity, and the difference was statistically significant (P<0.05). As for intangible results, self scores from the circle members in 8 aspects including a-bility of solving problems, responsibility, ability of coordination and communication, team coherence, confidence, enthu-siasm, ability of applying quality control circle and happiness were all higher than those before the activity, and the differences were statistically significant (P<0.05). Conclusion The activity of QCC is able to improve the level of spe-cialized nursing knowledge for nurses in the department of neurosurgery, enhance the ability of scientific research, un-derstanding of QCC, application ability and execution for nursing practitioners, and improve the accuracy of pupil ob-servation.
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<p><b>OBJECTIVE</b>To evaluate the association between occupational stress, social support, and occupational unintentional injuries.</p><p><b>METHODS</b>A 1:1 matched case-control study was conducted in 151 cases of occupational unintentional injuries who were admitted to 6 occupational injury-admitted hospitals in Zhongshan City from October 2013 to December 2013 and 151 matched controls without unintentional injuries in the last year who had matched age, sex, and occupation. Their demographic characteristics, occupational stress (by the effort-reward imbalance questionnaire), and social support were investigated with a structured questionnaire.</p><p><b>RESULTS</b>Analysis of the data showed that there were significant differences in the score of each dimension of occupational stress, the ratio of effort to reward, and the score of superior support between the case group and the control group (P < 0.05). The Cox regression analysis results showed that more extrinsic efforts (OR = 1.47, 95%CI = 1.20∼1.80) and over commitment (OR = 1.30, 95%CI = 1.08∼1.55) were the risk factors for occupational unintentional injuries, while more superior supports (OR = 0.64, 95%CI = 0.48∼0.84) and higher earnings (>3 000 yuan each month) (OR = 0.67, 95%CI = 0.54∼0.84) were protective factors.</p><p><b>CONCLUSION</b>Occupational stress and social support have an influence on the occurrence of occupational injuries.</p>
الموضوعات
Humans , Accidents, Occupational , Case-Control Studies , China , Occupational Diseases , Epidemiology , Occupational Injuries , Epidemiology , Reward , Risk Factors , Social Support , Stress, Psychological , Epidemiology , Surveys and Questionnairesالملخص
@#Objective To observe the expression of microtubule-associated protein 1 light chain 3 II (LC3II) and microtubule-associated protein 2 (MAP-2) in CA1 area of hippocampus in vascular dementia rats. Methods 48 Sprague-Dawley rats were randomly divided into sham group and model group. Meanwhile, each group was further divided into 1, 2, 4 and 8 weeks subgroups (n=6). Vascular dementia model was established by blocking four vessels. The expressions of LC3II and MAP-2 protein were detected with immunohistochemistry in the CA1 area of hippocampus. Results The expression of LC3II significantly increased, and the expression of MAP-2 decreased in the model group compared with the sham group at every time point (P<0.001). The expression of LC3II was negatively correlated with MAP-2 at every time point in the model group (r=-0.723, P<0.05). Conclusion It may play an important role for the occurrence and development of vascular dementia that the expression of LC3II increased and MAP-2 descreased in CA1 area of hippocampus in rats.
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<p><b>OBJECTIVE</b>To determine the prevalence of occupational musculoskeletal disorders (OMSD) and its risk factors among workers in three manufacturing industries in Zhongshan, China by cross-sectional epidemiological investigation.</p><p><b>METHODS</b>A total of 2 035 workers from the industries of metals (1001 persons), electrical appliances (455 persons), and furniture (579 persons), including 1 402 males and 633 females, were selected; the mean age was 32.9 ± 8.2 years, and the mean length of service was 6.4 ± 5.6 years. A revised Northern Europe Standardized Questionnaire was used for cross-sectional epidemiological investigation of OMSD.</p><p><b>RESULTS</b>The results showed that OMSD in these workers was primarily located in the neck, waist, and shoulder, with annual prevalence rates of 23.1%, 20.1%, and 15.8%, respectively. The overall prevalence of OMSD was 43.1% in metal industry, 44.0% in electrical appliance industry, and 26.6% in furniture industry. OMSD prevalence showed significant differences between different industries (χ(2) = 54.2, P < 0.01). The prevalence of OMSD in the shoulder and back increased with working years (P < 0.05). Logistic regression analysis showed that the risk factors for OMSD were working age >10 years, safety behavior such as "bending down when lifting heavy things from the ground", and different types of industries.</p><p><b>CONCLUSION</b>OMSD is mainly manifested by neck pain, waist pain, and shoulder pain among front-line manufacturing workers in Zhongshan, and working age, poor labor posture, and different types of industries were risk factors for waist pain.</p>
الموضوعات
Adult , Female , Humans , Male , China , Epidemiology , Cross-Sectional Studies , Musculoskeletal Diseases , Epidemiology , Occupational Diseases , Epidemiology , Prevalence , Risk Factorsالملخص
<p><b>OBJECTIVE</b>To evaluate the occupational safety climate in different types of enterprises and its relationship with occupational accidental injury.</p><p><b>METHODS</b>A cross-sectional survey based on self-report questionnaires was performed among 3311 front-line workers from 54 medium and small-sized manufacturing enterprises of different types in Zhongshan, China to investigate the socio-demographic characteristics, safety climate experience in workplace, and incidence of occupational accidental injury in the past year.</p><p><b>RESULTS</b>Analysis of the data revealed that employees in different types of companies perceived different levels of safety climate, according to the scores on four subscales; the European and American enterprises had significantly better safety climate than the Hong Kong and Chinese private enterprises (P < 0.01). The self-reported rates of occupational injury were 3.38%, 4.76%, and 6.72%, respectively, for European and American, Hong Kong, and Chinese private enterprises (χ(2) = 6.78, P < 0.05). After control of such factors as age, sex, income, education level, and marriage, the logistic regression analysis showed that the risk of occupational accidental injury in the European and American enterprises was significantly lower than that in the Chinese private enterprises (OR = 0.57, 95%CI = 0.35-0.91).</p><p><b>CONCLUSION</b>The type of enterprise influences the occupational safety climate and incidence of occupational injury among workers.</p>
الموضوعات
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Accidents, Occupational , China , Cross-Sectional Studies , Europe , Occupational Health , Occupational Injuries , Epidemiology , Surveys and Questionnaires , United States , Workplaceالملخص
OBJECTIVE@#To evaluate the curative effect of endoscopic sinus surgery (ESS).@*METHOD@#Two hundred and fifty-six cases with chronic sinusitis and nasal polyps, undergone ESS from 2001 to 2007 were analysed. There were 106 cases in type 1, 134 cases in type 2 and 16 cases in type 3. Two hundred and forty-six cases undergone ESS with intranasal local anesthesia and potentialized anesthesia. Long-time follow-up was performed at 9 to 42 months (mean = 15 months).@*RESULT@#The results showed that cure rate was 78.3% for type 1, 66.4% for type 2 and 43.8% for type 3. There was significant difference in cure rate between type 1, type 2 and type 3 (P < 0.01). Complication of ESS of 256 cases was 4.3%.@*CONCLUSION@#There was higher efficacy and safety for relief of nasal polyps and for relief of chronic sinusitis with ESS. The difference of clinical type in nasal polyps and chronic sinusitis affected directly surgical result.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Chronic Disease , Endoscopy , Methods , Nasal Polyps , General Surgery , Sinusitis , General Surgery , Treatment Outcomeالملخص
AIM:To explore the effects of galangal (Alpinia officinarum Hance) extract on learning ability and memory consolidation and clearance of the free radical in mice. METHODS:Ninety mice receiving sodium nitrite to form the dysmnesic model ones,which were used to observe the walking behaviours in Morris water maze under the administration of galangal extact. SOD activity and the MDA content were measured with colorimetry,The morphological change in hippocampus slices were assessed using H-E staining and microscopic examination. RESULTS:To compare with the model group,the escape latency was markedly shortened(P