目的   分析布鲁氏菌病的临床表现以及实验室检查结果中的关键特征，系统总结布鲁氏菌病的诊断流程和治疗策略。方法   选择2013年11月—2023年11月在延边大学附属医院通过血清虎红平板凝集试验（RBT）及试管凝集试验（SAT）检测技术确诊的70名布鲁氏菌病住院病例，对患者的流行病学资料、临床表现特征以及常规实验室检查结果进行回顾性分析，进而总结临床特点。结果  70例布鲁氏菌病患者中，男性占84.29%，中位年龄45岁（IQR 35~58岁）；91.43%具有牛/羊接触史。急性期占92.86%，主要症状为发热（100%）、多汗（88.57%）、关节痛（84.29%）及肝脾肿大（55.71%），90%为不规则热型。误诊率27.14%，多误诊为败血症或骨关节疾病。联合抗菌药物治疗（利福平+多西环素）有效。结论   延边州布鲁氏菌病非典型症状（如不规则热型）增加导致误诊率高。流行病学史（牛/羊接触史）是诊断关键。需强化对有牛羊接触史人群的防护意识及措施，提高临床对接触史线索和不规则热型等非典型表现的识别能力，规范治疗并控制传染源以遏制疫情。

   Objective  To analyze the clinical manifestations of  brucellosis and the  key characteristics in laboratory testing，and systematically summarize the diagnostic process and treatment strategies of brucellosis．Methods  The 70 patients with brucellosis diagnosed via rose bengal test（RBT）and standard agglutination test（SAT） were at Yanbian University Affiliated 

Hospital from November 2013 to November 2023．This study conducted a retrospective analysis of the epidemiological data，clinical manifestations and routine laboratory pathological examination data of these patients，and the characteristics of clinical changes were summarized．Results  Among the 70 patients with brucellosis，84.29% were male，with a median age of 45（IQR 35-58）；91.43% patients had a history of cattle/sheep exposure．The acute phase accounted for 92.86%，and the main symptoms were fever（100%），sweating（88.57%），arthragia（84.29%），hepatosplenomegaly（55.71%），and 90% were irregular fever．The misdiagnosis rate was 27.14%，and most of them were misdiagnosed as sepsis or osteoarthritis．Combined treatment with antibiotics（rifampin + doxycycline）was effective．Conclusions  The increase in atypical symptoms（such as irregular heat type）leads to a high misdiagnosis rate．Epidemiological history（cattle/sheep contact）is the key to diagnosis．It is necessary to strengthen occupational protection and atypical case identification，standardize treatment and control the source of infection to curb the epidemic．

目的 观察康柏西普玻璃体腔注射治疗湿性老年性黄斑变性病变对于视网膜神经纤维厚度的影响。方法 对2016年10月—2017年10月在汕头大学附属韶关市粤北人民医院采用康柏西普玻璃体腔注射治疗湿性老年性黄斑变性35例38眼中符合标准的患者18例（18眼）的临床资料进行回顾性分析,患者行最佳矫正视力、眼压（NCT）检查、OCT、荧光眼底血管造影（FFA）检查后,均接受0.05 mL康柏西普玻璃体腔注射,分别注射后1和2月观察患者最佳矫正视力 （BCVA）、视网膜神经纤维厚度（RNFL）变化。结果 18眼共接受康柏西普玻璃体腔注射54次,所有患眼均注射3次。注射3个月后,OCT检查结果显示有18眼视力有提高,CRT厚度有下降。第1次注射时和注射后1个月、2个月的BCVA分别为0.1（0.04,0.12）,0.20（0.10,0.30）和0.25（0.12,0.30）,总体比较差异有统计学意义（χ²=13.880,P<0.001）;第1次注射时和注射后1个月、2个月的CRT（μm） 319.50（269.50,390.50）, 271.00（219.00,296.25） 和234.50（182.75,273.25）总体比较差异有统计学意义（χ²=11.978,P<0.05）,第1次注射时和注射后1个月、2个月后的 ARNFL（μm）86.00（76.25,98.00） 83.00（76.00,95.50）和 83.00（76.25,94.75） 总体比较差异无统计学意义（χ²=11.978,P>0.05）,第1次注射时和注射后1个月、2个月眼压（kPa）2.27（1.97,2.44）,16.0（13.7,17.0）,和 2.00（1.84,2.31） 总体比较差异无统计学意义（χ²=1.604,P>0.05）。结论 玻璃体腔注射康柏西普治疗湿性老年性黄斑变性对视网膜神经纤维厚度无明显的损害,安全且有效,但仍需要大样本量及长期随访观察。

Objective To observe the effect on the thickness of retinal nerve fibers in the patients with wet age-related macular degeneration by adopted intravitreal injection with Conbercept. Methods We analyzed 18 cases （18 eyes） that conform to the standard from 35 cases（38 eyes） retrospectively,who were treated with wet age-related macular degeneration by adopted intravitreal injection with Conbercept in Shaoguan Yuebei People's Hospital Affiliated to Shantou University from October in 2016 to October in 2017.After undergoing best corrected visual acuity （BCVA）,intraocular pressure （IOP） and fluorescein angiography （FFA）,all of them were adopted intravitreal injection with 0.05mL Conbercept. We observed the changes of best corrected visual acuity （BCVA） and retinal nerve fiber thickness （RNFL） after 1 and 2 months of adopted intravitreal injection with 0.05 mL Conbercept. Results 18 eyes were adopted intravitreal injection Conbercept 54 times totally. All the eyes were injected three times. After 3 months of injection,OCT showed that the visual acuity of 18 eyes improved and the thickness of CRT decreased. The BCVA values at the first injection,after the first injection and after the second injection were 0.1（0.04,0.12）,0.20（0.10,0.30）和0.25（0.12,0.30）respectively. The overall difference was statistically significant （χ²=13.880,P< 0.001）. CRT（μm）values at the first injection,after the first injection and after the second injection were 319.50（269.50,390.50）,271.00（219.00,296.25） and 234.50（182.75,273.25）respectively. The overall difference was statistically significant （χ²=11.978,P< 0.05）. ARNFL（μm）values at the first injection,after the first injection and after the second injection were 86.00（76.25,98.00）,83.00（76.00,95.50） and 83.00（76.25,94.75）respectively. There was no significant difference （χ²=11.978,P> 0.05）. The IOP（mmHg）values at the first injection,after the first injection and after the second injection were 17.0（14.8,18.3）,16.0（13.7,17.0）,和 15.0（13.8,17.3）respectively. There was no significant difference（χ²=1.604,P>0.05）. Conclusion There was no obvious damage to the retinal nerve fiber by adopted intravitreal injection with Conbercept to treat the patients with wet age-related macular degeneration. That’s safe and effective,but need a large sample to follow-up for a longtime.

      目的 分析药库药品验收及出入库环节存在的问题并拟定方法,提升工作效率,使其进一步科学化、精细化。方法 中国医学科学院肿瘤医院深圳医院药学部选定药品验收及出、入库和点收平均时间和入库差错率为改善前后对比指标,开展PDCA 循环（计划-执行-检查-行动）分析医院药库在药品验收、入库、出库,发放点收存在的问题及原因,制定整改对策并实施,以2022年3月和6月的药品验收及出入库数据及对比指标,比较 PDCA 循环管理实施前后的质量改进效果。结果 药库在通过PDCA循环管理对策实施后,通过流程改进和信息化手段的引入,药品验收及出、入库和点收平均时间下降了54%,入库差错率下降了80%,达到预定目标,工作效率提升明显。结论 开展 PDCA循环管理活动可有效提升药品验收及出入库效率,减少人员成本支出,保障了药品的及时供应,亦能有效提高药师的工作积极性和团队凝聚力。

Objective To analyze the problems existing in drug acceptance, inbound and outbound, to improve work efficiency and make it more scientific and refined. Methods The average time of acceptance, inbound, outbound,s tock checking and inbound error rate before and after improvement were compared, PDCA（Plan, Do, Check, Action） cycle model was applied to analyze problems in drug acceptance, inbound,outbound, distribution and stock checking, countermeasures were formed. Data in March and June 2022 was used as comparative indicators to compare the quality improvement effects before and after the implementation of PDCA cycle management. Results After implementing the PDCA cycle management strategy, and improving the process and applying information technology, the average time for drug acceptance, inbound, outbound, stock checking was reduced by 54%, and the error rate of inbound was reduced by 80%, achieving the predetermined goals and significantly improving work efficiency. Conclusions The application of the PDCA cycle management model can effectively improve the efficiency of drug acceptance, inbound and outbound, reduce personnel costs, ensure the timely supply of drugs, and also effectively improve pharmacists’work enthusiasm and team cohesion.