Objective:To investigate the ways of pharmaceutical care performed by clinical pharmacists for the patients with severe infection. Methods:Through deciding the anti-infection therapeutic regimen, providing drug counselling and pharmacy education and focusing on adverse drug reactions, pharmacists offered suggestions for one patient with severe legionella pneumonia complicated with AECOPD. Results:The pharmaceutical care performed by clinical pharmacists could solve the problems and improve the compliance, safety, effectiveness and rationality in the drug treatment of the patient. Conclusion:According to the individual condition of patients, clinical pharmacists can realize their own values through looking for the breakthrough points of pharmaceutical care and participating in clinical practice.

OBJECTIVE: To investigate the expression of vascular endothelial growth factor in the nasal mucosa of chronic rhinosinusitis with nasal polys patients, and explored the regulation of clarithromycin on VEGF. METHOD: RT-PCR was used to detect the expression of VEGF in nasal mucosa from healthy control and CRSwNP. Nasal mucosal tissue explant culture measure and ELISA were used to explore the effect of clarithromycin on VEGF expression. RESULT: (1) VEGF mRNA expression level was significantly increased in CRSwNP compared with control and showed a statistic difference (P < 0.01). (2) There was a significant decrease in CRSwNP group undergo clarithromycin treatment on protein expression level of VEGF and showed a statistic difference (P < 0.05). CONCLUSION VEGF were overexpressed in CRSwNP group, which presume that play an important role in the pathogenesis of nasal polyps. Clarithromycin may play a therapeutical role on chronic rhinosinusitis through down-regulated the expression of VEGF.
Adult ; Chronic Disease ; Clarithromycin ; pharmacology ; Female ; Humans ; Male ; Nasal Mucosa ; metabolism ; Nasal Polyps ; complications ; Rhinitis ; complications ; metabolism ; Sinusitis ; complications ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

Objective To compare the difference in quercetin against oxidative stress response in mouse and in NIH-3T3 cells before and after H2O2 treatment,to explore the underlying mechanism for the quercetin antioxidant.Methods The cultured NIH-3T3 cells were randomly divided into 4 groups: quercetin(Q) pre-protective group(Qb) firstly treated with quercetin for 24 h followed by incubation with H2O2 for 30 min;post-protective group(Qa) treated with H2O2 for 30 min followed by incubation with quercetin for 24 h;H2O2 group(H2O2) after exposure to H2O2 for 30 min,incubated with DMEM medium and the control group(C) only cultured with DMEM medium.The survival rate and apoptotic rate were detected respectively with MTT and TUNEL in NIH-3T3 cell sus-pension samples.The expression of cyclin D1,PTEN,NF-?B,HSP-70,BCl-2,BAX and caspase-3 were examined with immunocytochemistry and immunoblotting.Besides,20 Wistar rats were divided into control group and experimental group,the latter was given with quercetin in the doze of 0.13 mmol/kg.The levels of T-AOC,SOD,GSH-Px,GSH,MDA,NOS and NO2-/NO3-were detected both in the cleaved NIH-3T3 cells and in the plasma from both experimental and control animals prior to and post-1 h,2 h and after 24 h.Results When the Qb group was compared with H2O2 or Qa group,the survival rate was higher and the apoptotic rate was lower.When the H2O2 group was compared with C group,the expression of cyclin D1、PTEN or BCl-2 was down-regulated;while that of BAX、HSP-70、NF-?B or caspase-3 was up-regulated;the level of T-AOC,SOD,GSH-Px or GSH was decreased;that of NOS、NO2-/NO3-or MDA enhanced in the cleft NIH-3T3 cells.When the plasma level of the anti-oxidative enzyme system prior to-compared with post-1h and 2h-treatment with Q,the level of T-AOC,SOD,GSH-Px and GSH,especially the former two,were higher;MDA,lower;NOS or NO2-/NO3-promoted.However,the above parameters basically became normal 24 h after treatment with Q.Conclusion Quercetin down-regulates the promoted expression of HSP70,NOS,NO2-/NO3-and NF-?B etc.in H2O2-treatment NIH-3T3 cells.Qb could reverse the H2O2 damage effects more markedly.Moreover,the quercetin exerts anti-oxidant protective effect through modulating the anti-oxidative enzyme system both in vivo and in vitro.However,based on the cell heterogeneity in none-or pre/post-H2O2-treatment state,a difference in quercetin antioxidant response is noted.

Considerable attention has been directed toward studying the impact of diabetes on the central nervous system. The current study investigates the biochemical changes in the brain tissue of streptozotocin (STZ)-induced diabetic rat using 31P magnetic resonance spectroscopy (31P MRS). The 31P NMR spectra of the whole brain show no significant changes of phosphomonoesters and phosphodiesters levels one week after STZ induction, suggesting no apparent structural changes in cell membranes. The results identifies the increased level of adenosine diphosphate, negligible changes of phosphocreatine ( PCr ) and adenosine triphosphate ( ATP) , but the decreased ratio of PCr/ATP, indicating that PCr plays a role of balancing the energy. Moreover, the decreased pH value indicates the changes of the intracellular environment in STZ-diabetic brains in rats. After 15 weeks of STZ injection, the metabolism of phospholipid membrane and brain energy metabolism has been obviously disturbed. Our study successfully shows that 31 P MRS can not only study phospholipid and energy metabolism non-invasively, but also measure intracellular pH and other important biochemical information. All of these spectroscopic characterizations contribute significantly to the understanding of pathogenesis and evolution of diabetes, and provide theoretical basis for early diagnosis and clinical treatment in diabetes.

Objective To apply intervention of integrated pharmaceutical care (IPC) for asthma-COPD overlap syn-drome patients,so as to reduce the side effects of drugs,enhance medication compliance,promote reasonable drug application,cut down the medical expenses in ACOS patients. Methods A total of 60 ACOS patients were randomly divided into IPC group (group A) (n=34) and contrast group(group B) (n=26).The patients in group A were given IPC measurements such as noso-comial guidance,classroom teaching,regular follow-up,life coaching and psychological advice.While the patients in group B were not given any intervention measures. Results In group A,patients' awareness rate of action and side-effects of drugs were ob-viously increased;Knowledges of inhalation preparation were greatly improved;the ratio of ADRs was significantly reduced;The FEV1 and the value added of FEV1 was dramatically improved.Furthermore,the differences showed statistical significance as com-pared with group B(P<0.05).Total medical costs and anti-bacterial drug costs per year were significantly lower in group A than group B. Conclusion IPC is beneficial to enhance drug compliance,promote reasonable drug application and bring down the medical expenses in ACOS patients.

OBJECTIVE Vascular dementia(VaD)is associated with cerebral hypoperfusion,which results in long-term cognitive impairment and memory loss.Neuroin-flammation is an important mechanism of vascular demen-tia.Cornel iridoid glycoside(CIG)is the major active con-stituent isolated from the ripe fruit of Cornus officinalis.Previous studies have shown that CIG enhances neuro-logical function in VaD rats.In the present research,we attempted to clarify the molecular processes underlying the role of CIG on neuroinflammation in VaD.METHODS In vivo,we created a chronic cerebral ischemia rat model by ligation of the bilateral common carotid arteries(2VO).The rats were divided into sham operation,2VO,2VO + CIG(60 and120 mg·kg-1·d-1),and 2VO+ butylphthalide(100 mg·kg-1·d-1)groups and then treated rats with differ-ent concentrations of CIG.In vitro,BV2 microglia cells were induced with bacterial lipopolysaccharide(LPS)and interferon-γ(IFN-γ)to construct the model of microglias with analog neuroinflammation.Histopathology and biel-schowsky silver staining were used to detect myelin integrity and neuronal loss.Immunofluorescence was used to observe changes in microglia.Magnetic Luminex Assay was used to detect changes in inflammatory fac-tors.Western blotting,ELISA or calpain activity assay was used to measure the expression and activity of cal-pain,as well as the expression of NLRP3 inflammasome protein.Furthermore,NLRP3 overexpressing cells were used to further elucidate the potential anti-inflammatory molecular mechanism of CIG.RESULTS ① CIG improved neuronal impairment in the brain of 2VO rats.②CIG increased white matter(WM)integrity in 2VO rats.③ CIG reduced microglia inflammatory response in the cortex and hippocampus of 2VO rats.④ CIG inhibited calpain activity in the cortex and hippocampus of 2VO rats.⑤ CIG exerted anti-inflammatory effects on BV2 cells stimulated by LPS and IFN-γ.⑥ CIG Inhibited the expression and activity of calpain in LPS/IFN-γ-activated BV2 cells.⑦ The main component of CIG had a weak binding force to calpain1.⑧ CIG inhibited the activation of the NLRP3 inflammasome.⑨CIG reduced the activity of calpain induced by NLRP3 overexpression.CONCLU-SION CIG inhibits microglial polarization into a proinflam-matory state by attenuating the assembly of the NLRP3 inflammasome and calpain activation,thus reducing brain inflammation,WM injury,and the loss of neurons.To sum up,the present study suggests that CIG inhibits neuroinflammation.The NLRP3/calpain pathway may be the main pathway by which CIG protects against neuroin-flammation.

Multiple sclerosis(MS)is a systemic inflammatory illness of the central nervous system that involves demyelinating lesions in the myelin-rich white matter and pathology in the grey matter.Despite signifi-cant advancements in drug research for MS,the dis-ease's complex pathophysiology makes it difficult to treat the progressive forms of the disease.In this study,we identified a natural flavonoid compound icariin(ICA)as a potent effective agent for MS in ameliorating the deterioration of symptoms including the neurological defi-cit score and the body weight in a murine experimental autoimmune encephalomyelitis(EAE)model.These improvements were associated with decreased demyelin-ation in the corpus callosum and neuron loss in the hippo-campus and cortex confirmed by immunohistochemistry analysis.Meanwhile,it was observed that the activation of microglia in cerebral cortex and hippocampus were inhibited followed by the neuroinflammatory cytokines downregulation such as IL-1β,IL-6 and TNF-α after ICA treatment,which was probably attributable to the sup-pression of microglial NLRP3 inflammasome activation.Additionally,molecular docking also revealed the binding force of ICA to NLRP3 inflammasome protein complexes in vitro.Taken together,our findings have demonstrated that ICA,as pleiotropic agent,prevents EAE-induced MS by improving demyelination and neuron loss,which inter-feres with the neuroinflammation via microglial NLRP3 inflammasome activation.

Objective To explore the effects of sound operation on nursing quality in nursing work at spine surgery.Methods Totally 531 cases of patients at spine surgery in our hospital from July 2015 to October 2015 were randomly divided into the control group ( n=264) and the intervention group ( n=267) . Patients in two groups were given routine nursing, and patients in the intervention group also were given sound operation. The incidence of nursing adverse events, the writing quality of nursing documents, the situation of health education, the rate of patient complaints and the satisfaction degree toward nursing were collected and analyzed. Results Nursing adverse events in the intervention group was 1 case ( 0. 4%) which were less than 11 cases (4.2%) in the control group (P<0.05). There were 2 cases (0.7%) of nonstandard nursing documents and 3 cases (1.1%) of lipography in nursing documents in the intervention group, which were less than 11 cases (4.2%) and 16 cases (6.1%) in the control group (P<0.05). There was no case of patient complaints in the intervention group which were less than 4 cases (1.5%) in the control group (P<0.05). The situation of health education in the intervention group was 1 case (0.4%) which was less than 8 cases (3.0%) in the control group (P<0.05). The satisfaction degree toward nursing in the intervention group was 97.75%(261/267)and was 92.80%(245/264) in the control group ( P<0. 05). Conclusions Sound operation in nursing work can effectively reduce nursing adverse events at spine surgery, and it also can improve the quality of nursing.

Objective To explore the effects of family involvement and online extended nursing for postoperative rehabilitation in patients with cervical spinal cord injury (CSCI). Methods Totally 60 CSCI patients who were admitted and received surgery in Honghui Hospital, Xi'an Jiaotong University from October 2013 to July 2016 and their major caregivers after being discharged from hospital were equally divided into an observation group (n=30) and a control group (n=30) according to the random number table. Patients in the control group received conventional instructions 1 day before being discharged from hospital and telephone follow-ups in Week 1, Month 1, Month 3 and Month 6 after being discharged from hospital, while patients in the observation group received extended nursing via WeChat groups on this basis. The quality of life, incidence of complications and compliance of rehabilitation exercise six months after surgery were compared between the patients in the two groups. Results The patients in the two groups showed higher scores in various dimensions indicating the quality of life six months after surgery than they did at discharge, and the patients in the observation group showed higher scores than the patients in the control group (P< 0.05). The patients in the observation group showed lower incidence of abdominal distension, constipation and pressure ulcer complications than the patients in the control group (P<0.05), and the incidence of high fever, pulmonary infection and urinary tract infection tended to decline (P>0.05). The patients in the observation group showed higher compliance of rehabilitation exercise than the patients in the control group (P< 0.05). Conclusions Family involvement and WeChat extended nursing helps to build a long-term service system for CSCI patients and accelerate their postoperative rehabilitation, thus worthy of expansion and application.

Schizophrenia is a common chronic mental disorder.Cognitive dysfunction is one of its core symptoms,which severely affects the social functioning of patients.Currently,antipsychotic medication treatments have poor efficacy in improving cognitive functions.Recent studies have found that metformin can improve cognitive dysfunction in patients with schizophrenia.However,the mechanism of action remains unclear.This review summarizes the therapeutic effects of metformin on cognitive dysfunction in schizophrenia patients such as improving insulin resistance,repairing neuronal damage,regulating neuroimmunity,and combating oxidative stress,thereby providing new insights for the treatment of cognitive dysfunction in schizophrenia.