OBJECTIVE:To investigate the role of clinical pharmacists in the treatment of high paraplegia patient with hospital acquired pneumonia. METHODS:Clinical pharmacists provided suggestions for anti-infective treatment failure of a high paraplegia patient with hospital acquired pneumonia,including anti-infective treatment of imipenem and cilastatin sodi-um 1.0 g,ivgtt,qid,de-escalation anti-infective treatment of cefoperazone sodium and sulbactam sodium 3.0 g,ivgtt,bid+amikacin 0.4 g,ivgtt,bid,and prevention treatment of fluconazole sodium chloride 0.2 g,ivgtt,qd against potential invasive infections with fungi,etc.,assisted physician to improve therapy plan,monitor ADR and guide rational drug use. RE-SULTS:After 3 weeks of treatment,the symptoms had been improved significantly. CONCLUSIONS:Clinical pharmacists provide individual pharmaceutical care to reduce ADR during treatment and improve the effectiveness and safety of clinical treatment.

Objective To explore and improve the hospital consumables logistics distribution and cost control system based on consignment mode to solve the current problems in many hospitals for material management.Methods Improvement measures were taken from the aspects of network information system,inventory management,establishing organization architecture and post responsibility as well as introducing IOT technology.Results The system contributed to optimizing consumables management flow and saved hospital cost.Conclusion The hospital consumables logistics distribution and cost control system based on consignment mode is of great value for the management of hospital consumables.

Recent researches have showed that neural stem cells be isolated not only in the embryonic nervous system but also in adult nervous system. Neural stem cells have some capacity for self-renewal, migration and can differentiate into neurons, astrocyte and oligodendrocyte. This provides a basis in therapy of degenerative diseases and functional recovery of the central nervous system injury. Also helps in the study of determining the postmortem interval ( PMI) and postmortem injury. Distribution, biological characteristic, identification and the factors effecting the proliferation, differentiation and migration with reference to therapy of neural stem cells and applications in forensic pathology are reviewed.

Objective To investigate the expression levels and the roles of IL-17 and IL-23 in children with Mycoplasma pneumoniae (MP) pneumonia. Methods One hundred and three children with pneumonia admitted to pediatric department from February to May in 2012 were divided into MP pneumonia group and non-MP pneumonia group according to the results of MP antibody tests. Meanwhile, 42 healthy children were chosen as normal controls. Serum levels of IL-17, IL-23 and MP antibodies were measured in all children. Immunoglobulin, C reactive protein, total white blood cell count and granulocyte count were detected in children with pneumonia. Results The serum levels of IL-17 and IL-23 were signiifcantly different among three groups (P<0.05). The children in MP pneumonia group had higher levels of IL-17 and IL-23 than those in non-MP pneumonia group (P<0.05). Compared with the control group, levels of IL-17 and IL-23 were higher in two pneumonia groups (P<0.05). There was no signiifcant difference in levels of IL-17 and IL-23 between pneumonia patients with normal and with abnormal levels of immunoglobulin (P>0.05), while IL-17 and IL-23 levels were both positively correlated with granulocyte count (P<0.05).Conclusion IL-17 and IL-23 may be involved in the immune response of MP pneumonia and may contribute to the clearance of pathogens.

Objective To explore the clinical therapeutic effect of combined TUINA with Chinese herbs fumigating in patients with bony arthritis of knee joints.Methods A total of 73 patients with bony arthrithis of knee joints were divided into treatment group(37 cases)and control group(36 cases)randomly.The patients of treatment group were used the combined TUINA with Chinese herbs fumigating and patients in control group were used Chinese herbs fumigating alone.After three courses of treatment,therapeutic effect was compared the two groups patients.Results The results showed that the cure rate in treatment group was higher than control group markedly(P ＜0.01).The improvement rate between the two groups was not significently different.Conclusion The therapeutic effect that combined TUINA with Chinese herbs fumigating for patients with bony arthritis of knee joints is very effective treatment procedure.

Objective To investigate altered levels and clinical significance of serum miR-133a in patients with acute coronary syndrome ( ACS ) and stable coronary artery disease ( SCAD ) .Methods Retrospective study.Serum miR-133a levels were determined by TaqMan quantitative reverse-transcription PCR assay in 64 ACS, 62 SCAD patients who were admitted to Jinling Hospital from October 2011 to October 2012 and 70 normal controls who had contemporaneously visited Jinling Hospital for routine examination .The ACS and SCAD patients were diagnosed according to the European Society of Cardiology guidelines .Serum lipid/lipoprotein profiles , myonecrosis biomarkers and Gensini scores were also analyzed .The area under curve ( AUC) and 95%confidence interval ( CI) were calculated using ROC analyses .The odds ratio ( OR) and 95%CI were calculated using the multivariate logistic regression analyses .Results Compared with the controls [ΔCt:1.00 ±0.05], serum miR-133a levels were significantly increased in both ACS [ΔCt:2.34 ±0.24] (t=6.059, P<0.001) and SCAD [ΔCt:1.45 ±0.13] (t=3.265, P=0.001) patients.The miR-133a levels in ACS patients were significantly higher than in SCAD patients (t=3.133, P=0.002). Serum miR-133a were positively correlated with levels of creatine kinase MB ( CK-MB) ( r=0.402, P<0.001), cardiac troponin I (cTNI) (r=0.410, P=0.001) and Gensini scores (r=0.438, P<0.001). ROC curve analyses showed that the AUC of miR-133a for differentiating coronary artery disease (CAD) and controls was 0.717 (95%CI:0.645-0.788, P<0.001) and the AUC for differentiating ACS and SCAD was 0.667 (95% CI:0.573-0.761, P=0.001).Logistic regression analyses revealed that high miR-133a levels were closely associated with the presence of ACS ( OR=6.00, 95% CI:1.93 -18.67, P=0.002) and SCAD (OR=2.81, 95%CI:1.03-7.68, P=0.044), and also had statistical significance for differentiating ACS and SCAD (OR=2.13, 95% CI:1.20-3.78, P=0.010), after adjustment for the age, gender and serum lipid/lipoprotein levels.Conclusions Serum miR-133a levels were significantly elevated in CAD patients, and ACS patients exhibited the more significant increase .Serum miR-133a may be function as the potential biomarker for the disease assessment and judgement .

Objective To obtain the specific antigens of the expressed major capsid proteins from Noroviruses with different sub-genotypes in Beijing area. Methods The full-length genes of the major capsid proteins (VP1)were obtained through the amplification of the VP1 encoding gene in the recombinant plasmids pBST-CR2987(G Ⅱ-3)and pBST-CR2932(GⅡ-4),which represented different Norovirus geno-types. The full-length genes were sub-cloned into the expression vector pET-30a(+),resulting in a recombinant plasmid, with which the BL21 competent cells were transformed, and the expression of the gene was induced by adding IPTG to the growth culture. The expression of the major capsid proteins were analyzed with Coomassie blue staining after SDS-PAGE, and assayed by Western blot with serum from human. Results (1)The major capsid protein genes of CR2987 and CR2932 were sub-cloned into expression vector pET-30a(+). The VP1 encoding genes were 1647 bp in length for CR2987 and 1623 bp for CR2932. The open reading frames(ORF)coded for 549 and 541 amino acids for these two proteins, respectively. (2)The expressed VP1s were present primarily as inclusion bodies,and the maximal amount of the expressed proteins occurred at 4-6 h after IPTG induction.(3)These VP1s could be recognized by specific immune serum against VP1 of Norovirus as well as His-tag antibody. Conclusion The VP1s of CR2987 and CR2932 are expressed in BL21 E.coli cells.The expressed VP1s could react with specific immune serum against VP1 of Norovirus, indicating that the expressed VP1s are of antigenicity.

ObjectiveTo explore the relationship between the weight-bearing of affected side and the functional mobility in stroke patients.Methods36 hemiparetic stroke patients participated in this study. They were asked to measure the ration of the weight-bearing of affected side on the undisturbed and maximum situations, as well as the time for Timed "Up and Go" Test (TUGT) and Sit-to-Stand Test. The correlation between the ration of the weight-bearing of affected side on maximum situations and the time for the TUGT and Sit-to-Stand Test were analysed statistically with Spearman's correlation in those stroke patients whose ration of the weight-bearing of affected side on undisturbed situations was less than 50%.ResultsThere were correlation between the ration of the weight-baring of affected side on maximum situations and the time for the TUGT (r=-0.605, P<0.01) and the time for the Sit-to-Stand Test (r=-0.456, P<0.05).ConclusionA good relationship exists between the weight-bearing of affected side and the functional mobility in stroke patients.

BACKGROUND: Long-term sustained release naltrexone has been reported in clinical application near one year that it can improve emotional state and relieve addiction; therefore, the effect of long-term sustained release naltrexone on memory restoration at neuropsychology level were explored. OBJECTIVE: To observe the effect of long-term sustained release naltrexone on memory ability of opioid addicts. DESIGN, TIME AND SETTING: A contrast observational study was performed at Drug Rehabilitation Centers of Wuhan, Changde, Zhengzhou, and Jiangyang between October and December 2006. Healthy controls were tested in Shenzhen Hospital of Peking University in October 2006. PARTICIPANTS: A total of 88 males with opioid addicts were divided into naltrexone group (n=35), compulsory detoxification group (n=26), and non-treatment group (n=27). Another 22 healthy subjects were considered as the controls. METHODS: At 6-12 months before testing, naltrexone (3.1 g) was subcutaneously implanted into bilateral abdominal wall in the naltrexone group; patients in the compulsory detoxification group underwent completely compulsory detoxification for 6 months, and the examination results, including diamorphine, methadone, and buprenorphine in urine, were negative on the immediately testing day. Event related potential and its wave form were recorded from the opioid addicts in the three groups and from healthy controls who finished semantic recognition between new and old words using portable-type event related potential working system. MAIN OUTCOME MEASURES: Correct rate and response time of semantic memory; latency and amplitude of language related potential-N400. RESULTS: ①There were significant differences in correct rate and response time between three expedmental groups and healthy control group (P ＜ 0.001 ); in addition, correct rate was significantly increased, and response time was significantly shortened in the naltrexone group compared to compulsory detoxification group and non-treatment group (P＜ 0.05). ② N400 latency in the three experimental groups was significantly longer than healthy control group (P ＜ 0.01), while N400 amplitude in the naltrexone group was increased, which was no significant difference compared to healthy control group (P> 0.05) but was significant difference compared to compulsory detoxification group and non-treatment group (P ＜ 0.01). CONCLUSION: Long-term sustained release naltrexone can effectively improve neural function and enhance semantic memory of the opioid addicts.

The PBL education about the chapter of TB in microbiology for medical English-class students was conducted.The results was analyzed by questionaire,showing that PBL helps to stimulate students' learning enthusiasm and improve the comprehensive ability and enhance the teachers' awareness of the responsibility.