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Xi Yang,1,* Ting Yan,2,* Danfeng Shen,3,* Mengyao Sheng,1 Wenya Huang,1 Li Li,1 Dayang Chai4 1Department of Endocrinology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, People’s Republic of China; 2Department of Dermatology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, People’s Republic of China; 3Department of General Surgery, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, People’s Republic of China; 4Department of Cardiology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dayang Chai, Department of Cardiology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Suzhou University, No. 58 Changsheng Road, Taicang, 215400, People’s Republic of China, Email dayangchai@outlook.com Li Li, Department of Endocrinology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, No. 58 Changsheng Road, Taicang, 215400, People’s Republic of China, Email tclili35@163.comPurpose: The aim of the current study was to investigate factors potentially associated with the healing of infected foot ulcers in patients with diabetes after antimicrobial therapy with drugs selected based on antimicrobial susceptibility testing.Patients and Methods: A retrospective study was conducted to analyze clinical data from 99 type 2 diabetes mellitus patients with foot infection admitted to our center from January 2016 to December 2020. Pathogenic characteristics, results of wound discharge testing, and relevant wound surface factors were analyzed. Etiological characteristics and the results of susceptibility testing, wound healing rates, and factors potentially associated with wound healing rates were also analyzed.Results: Baseline data were analyzed via the t-test for independent samples, the Mann–Whitney U-test, and the chi-square test to identify variables significantly associated with prognosis. Least absolute shrinkage and selection operator regression analysis then determined that Wagner grade, essential hypertension, platelets, Gram negative bacteria, and neutrophil-to-lymphocyte ratio were of predictive value. A nomogram plot was built based on these five variables, and it yielded a standard C-index of 0.964, and an internally corrected C-index of 0.931. In multivariate logistic regression analysis Wagner grade (odds ratio [OR] 12.30, 95% confidence interval [CI] 2.471– 61.194, p = 0.002) and platelet level (OR 0.978, 95% CI 0.960– 0.996, p = 0.018) were significantly associated with wound healing outcomes. Restricted cubic spline analysis indicated that there was a linear relationship between wound healing and platelet levels, and that this relationship was strongest in patients classified as Wagner grade 2 with a platelet count ≤ 200 (p for nonlinearity = 0.442).Conclusion: Wagner grade, essential hypertension, platelet count, Gram negative bacteria, and neutrophil-to-lymphocyte ratio could predict the course of healing of infected foot ulcers in type 2 diabetes mellitus patients. When the Wagner grade was 2 and the platelet level was ≤ 200, platelet level was linearly associated with healing outcome, whereby a lower platelet level predicted a worse wound healing outcome.Keywords: diabetic foot ulcer, DFU, platelet, RCS, ulcer healing, Wagner grade

Dongyan Chai,1,2,* Zhihui Liu,3,* Liuyi Wang,3 Hongyan Duan,2,3 Chenglong Zhao,1 Chengyang Xu,2 Dongyan Zhang,1 Qiongrui Zhao,4 Peizhi Ma1 1Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, Henan People’s Republic of China; 2International Medical Center of Henan Province, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China; 3Department of General Practice, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China; 4Department of Clinical Research Service Center, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Peizhi Ma, Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Weiwu Road 7, Zhengzhou, Henan, People’s Republic of China, Tel +86 18538298188, Fax +86 037165580803, Email ma18539298188@163.comBackground: Implementing medication reconciliation (MR) was complex and challenging because of the variability in the guidance provided for conducting. The processes of MR adopted in China were different from that recommended by the World Health Organization. A pilot study to inform the design of a future randomized controlled trial to determine the effectiveness of these two workflows was undertaken.Methods: Patients taking at least one home/regular medication for hypertension, diabetes, or coronary heart disease were recruited at admission, and then were randomized using a computer-generated random number in a closed envelope. In the study group, the pharmacist reviewed electronic medical record systems before communication with patients. In the control group, pharmacists communicated with patients at patient’s admission. The time investment of pharmacists for MR process, the number of unintended medication discrepancies, and physician acceptance were tested as outcome measures.Results: One hundred and forty adult patients were randomized, of which 66 patients in the intervention received MR within 24 hours, while 58 patients in control received MR at some point during admission. The most common condition in the study group was hypertension (coronary heart disease in the control group). The workflow of the study group can save an average 7 minutes per patient compared with the WHO recommended process [17.5 minutes (IQR 14.00, 28.25) vs 24.5 minutes (IQR17.75, 35.25), p = 0.004]. The number of unintended discrepancies was 42 in the study group and 34 in the control group (p = 0.33). Physicians’ acceptance in the study and control groups were 87.5% and 92.3%, respectively (p = 0.87).Conclusion: The results suggest that changes in outcome measures were in the appropriate direction and that the time limit for implementing MR can be set within 48 hours. A future multi-centre RCT study to determine the effectiveness of MR is feasible and warranted.Keywords: medication reconciliation, workflow, prospective studies, pharmacist, randomized controlled trial

Ting Yan,1,&ast; Chengming Shao,1,&ast; Minjie Zhang,1 Yongxing Ge,1 Tingting Chen,1 Dayang Chai2 1Department of Dermatology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, People’s Republic of China; 2Department of Cardiology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Dayang Chai, Department of Cardiology, The First People’s Hospital of Taicang, The Affiliated Taicang Hospital of Suzhou University, No. 58 Changsheng Road, Taicang, 215400, People’s Republic of China, Tel/Fax +86-512-53101356, Email dayangchai@outlook.comBackground: The COVID-19 pandemic has considerable impact on health care system in the world directly. Although the pandemic has been effectively controlled, people’s lifestyle, stress of job, economic status and health conditions have all changed. Therefore, it is unclear whether the COVID-19 pandemic has affected the distribution of diseases in dermatology outpatient department, especially in the post-pandemic era and how we should respond to these changes.Objective: We aimed to assess the impact of the COVID-19 pandemic on diagnosis of dermatology outpatient department in eastern China.Methods: A pre-post study design was a retrospective study to assess the changes of diseases diagnoses from the outpatient department of Dermatology, Taicang first people’s hospital, Suzhou University, Suzhou, China in the 2021 (Post-COVID-19 pandemic) compared to the 2019 (Pre-COVID-19 pandemic). Statistical analysis was performed using the SPSS 23.0 and Excel 2010. The data were analysed by methods independent t-test and Pearson’s chi-square test. A two-sided p-value of < 0.05 was considered statistically significant.Results: A total of 67,994 patients in 2019 and 67,288 patients in 2021 were included in the study. During the pre-pandemic year, the most common diagnoses in the outpatient department were urticaria, fungal dermatitis, acne, herpes zoster, seborrheic dermatitis. Urticaria, acne, allergic dermatitis, fungal dermatitis, herpes zoster, were statistically more common in the post-pandemic period. Acne, animal-related diseases, allergic dermatitis, insect dermatitis, alopecia, and verruca vulgaris diagnoses were found to increase statistically during the post-pandemic period when compared with the pre-pandemic period.Conclusion: The COVID-19 pandemic had a minimal effect on the average yearly dermatology outpatients department visits, but the distribution of dermatology diagnoses was affected. As a result, governments and health departments may introduce innovative ways and training of medical teams according to the impact of the pandemic to ensure normal medical care.Keywords: COVID-19 pandemic, dermatology outpatient, dermatologic diseases, diagnostic distribution, pre-post study

Zhu Zhu,1 Ping Li,2 Dongxue Chai,2 Wei Luan3 1Department of VIP Clinic, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People’s Republic of China; 2Department of Hemodialysis Center, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People’s Republic of China; 3Department of VIP Medical Office, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People’s Republic of ChinaCorrespondence: Wei Luan, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 of Pujian Road, Pudong District, Shanghai, 200127, People’s Republic of China, Tel/Fax +86 21 6838 3088, Email luanwei_2022@126.comObjective: To investigate the correlation between the frailty status of elderly patients on regular haemodialysis and the quality of life of their family caregivers.Methods: 90 elderly patients with regular haemodialysis and 90 family caregivers of the respective patients were selected from January 2020 to April 2021. The influencing factors of the caregivers’ quality of life and correlation between patient debility and caregiver quality of life were analyzed by general information questionnaire, Tilburg debility index scale, self-care ability scale, family caregiver-related quality-of-life scale and social support scale.Results: The quality of life of the family caregivers of elderly patients on regular haemodialysis is at the medium level (4.50 ± 2.96). Multiple linear stepwise regression analysis shows that the ability of patients to take care of themselves, the degree of patients’ weaknesses, whether they care for non-dialysis patients, the time to care for patients, social support and the type of current residence have significant impacts on the quality of life of the caregivers (p < 0.001). Variance analysis showed that the fitting degree of linear regression equation is relatively high, and the regression equation is significant (F = 9.195, p < 0.001, R = 0.595, R2 = 0.315). The quality of life of caregivers is positively correlated with the ability of the patients to take care of themselves, the length of care, social support and type of current residence (p < 0.05). The degree of weakness in patients is negatively correlated with taking care of non-regular dialysis patients (p < 0.05).Conclusion: The ability of patients to take care of themselves, the degree of weakness of the patients, social support and the type of current residence are the influencing factors of the burden on the family caregivers of maintenance haemodialysis patients.Keywords: maintenance haemodialysis, elderly patients, caregiver, quality of life