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 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.

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 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.

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.

Objective To explore the relationship between childhood asthma and pregnant and neonatal risk factors, thus provide evidence for early prevention of childhood asthma. Methods 162 children diagnosed asthma and 213 healthy children in pediatric outpatient and the inpatient services of our hospital who was born and living in Baotou city were retrospectively analyzed. The pregnancy related factors (parity, fever during pregnancy, pregnancy-induced hypertension syndrome, gestational diabetes mellitus, history of overdose in early-pregnancy) and the neonatal period related factors (surface defects, asphyxia, rough placenta, birth weight, number of fetus during this pregnancy, gestational age, premature birth, cesarean section) were investigated. The sex and age showed no signiifcance between childhood asthma and control group. Results Eight pregnant and neonatal factors (fever during pregnancy, pregnancy-induced hypertension syndrome, history of overdose in early-pregnancy, surface defects, asphyxia, rough placenta, birth weight, premature birth, cesarean section) showed signiifcant difference between the two groups (P<0.05). Multifactor regression analysis found fever during pregnancy (OR=9.43, 95%CI:3.08~28.82), rough placenta (OR=2.15, 95%CI:1.29~3.59), premature birth (OR=5.16, 95%CI:1.53~17.39) and cesarean section (OR=4.05, 95%CI:2.40~6.86)are independent risk factors for childhood asthma. Conclusions Fever during pregnancy, abnormal placenta;premature birth and cesarean section are likely risk factors of childhood asthma.

BACKGROUND:After internal fixation, limb fracture nonunion is the most common complication. Many factors affect fracture healing, but in recent years researchers have found that serum leptin may be involved in the process of fracture healing to regulate a variety of metabolisms. OBJECTIVE:To analyze the relationship between the changes of serum leptin and fracture healing in patients with long tubular fracture of the limbs after internal fixation. METHODS:Sixty patients with long tubular bone fracture who underwent internal fixation treatment were selected, and divided into two groups, union group (n=30) and nonunion group (n=30), according to the degree of fracture healing at 8 months after operation. Another 30 healthy volunteers served as normal control group. Peripheral blood samples were extracted before and after internal fixation to detect the changes in serum leptin levels using ELISA. RESULTS AND CONCLUSION:Preoperative serum leptin level was higher in the union group and nonunion group than the normal control group as wel as higher in the union group than the nonunion group (P < 0.05). There was no difference in the serum leptin levels in the union group before and after operation, but the nonunion group had a higher preoperative serum leptin level than the postoperative level. These findings indicate that the serum leptin may have an influence on fracture healing.