OBJECTIVE:The aim of this study was to assess the irrational use of vancomycin to treat infections of the patients with severe renal dysfunction.METHODS:Combining the results of blood concentration monitoring for vancomycin and the clinical symptoms with Micromedex Kinetidex,we evaluated whether the vancomycin was administered rationally when the infected patients with severe renal dysfunction were treated.RESULTS:It really existed that the vancomycin was irra?tionally used among these three patients:①The first loading doses did not match the saturation principle.②Administration interval did not be regulated in time along with the T 1/2 change.③The clinical doctors did not clearly understand that the hem_ odialysis can not efficiently remove vancomycin from the blood.CONCLUSION:For the infected patients with severe renal dysfunction,it is necessary to monitor the serum concentration of vancomycin in order to insure the rational use of vancomycin to treat these infected patients.

Objective To investigate the preventive effect of self-made water bag combined with massage with Sanyrene on post-stroke pressure sores? Method A total of 60 post-stroke patients lying in bed were randomly divided into the control group and the observation group,30 cases in each? The control group received routine preventive nursing and the observation group were managed with self-made water bag and massage with sanyrene to prevention pressure sores? The two groups were compared in terms of sensation of humid skin and incidence of pressure sores? Result The sensation of humid skin was significantly better and the incidence of pressures sores was significantly lower than those is the control group(all P < 0?05)? Conclusion The self-made bag with massage with Sandrine may be effective in preventing post-stroke pressure sores in bedridden patients and is worthy of clinical application?

Objective To study the incidence frequency of prothrombin G20210A (FⅡ G20210A)mutation in the patients with pulmonary thromboembolism(PTE)in northeast China,and to clarify the predictive value of FⅡG20210A mutation detection in PTE of the population in northeast China.Methods 60 PTE patients(PTE group) and 80 sex-matched healthy controls(control group)from the same geographic area were selected.All the patients were diagnosed by lung ventilation/perfusion scan and/or multi-slice CT pulmonary angiography(CTPA)as well as medical history.The genome DNA was extracted from the whole blood using alcohol.Polymerase chain reaction (PCR),restriction fragment length polymorphisms(RFLP)analysis with HindⅢ restriction enzyme and sepharose gel electrophoresis were used to identify the F Ⅱ G20210A mutation in PTE group and control group. Results After digested by HindⅢ restriction enzyme,only the fragments of 407 and 99 bp were found in PTE group.The frequency of FⅡ G20210A mutation was 0%,there was no statistical difference compared with contol group(P>0.05).There were no heterozygote and homozygote mutation of FⅡ G202210A gene in PTE group and control group.Conclusion The incidence of FⅡ G20210A mutation in the PTE patients in northeast China is very low,and the detection of FⅡ G20210A mutation may have no predictive value in PTE of the population in northeast China.

Objective To investigate the association among oligospermatism,azoospermatism in male sterility patients and micro-deletion in AZF gene of Y chromosome and to establish a integrate clinical diagnostic method for screening micro-deletion in AZF gene in Chinese.Methods PCR method was used to detect micro-deletion in AZF gene in 62 oligospermatism and azoospermatism patients and 20 normal male controls.Results 13.64%(6/44) of oligospermatism patients and 22.22%(4/18) of azoospermatism patients presented micro-deletion.However,micro-deletion was not found in 20 normal male controls.Furthermore,micro-deletion occur mostly in AZFc region.Conclusion Micro-deletion of AZF gene from Y chromosome is one of the major risks for oligospermatism and azoospermatism.

Objective: To study the correlation between the level of T-bet expression and liver damage in peripheral plasma cells of patients with autoimmune hepatitis (AIH) in order to provide reference for the study of pathogenesis and development of diseases. Methods: The peripheral venous blood and clinical examination data of 29 cases with AIH and 6 healthy volunteers were collected. The percentage of subpopulations of peripheral blood B cells and the proportion of T-bet⁺ cells in each subgroup were detected by flow cytometry. Plasma cells (CD19⁺CD10^-CD27^hiCD38^hi), primary B cells (CD19⁺CD10^-CD27^-IgD⁺), transitional B cells (CD19⁺CD10⁺), and memory B cells (CD19⁺CD10^-CD27⁺IgD^-) were the included subsets of B cells. Serum immunoglobulin G (IgG) and alanine aminotransferase (ALT) levels, the proportion of B cells in peripheral blood subsets and IgG level, the proportion of T-bet⁺ cells in each subset and the proportion of T-bet⁺ plasma cells in each subset in B cells, the proportion of T-bet⁺ plasma cells and the level of serum ALT were analyzed for correlation analysis. Statistical analysis was performed using two independent sample t-tests and linear regression. Results: The serum IgG level of AIH patients with abnormal ALT (19.47 ± 1.039)g/L was significantly higher than that of normal ALT patients (15.5 ± 1.069)g/L, and the difference was statistically significant (t = 2.65, P < 0.05). The percentage of peripheral plasma cells in B cells of AIH patients (2.80 ± 0.14) % was higher than that of healthy volunteers (0.73 ± 0.09) %, and the difference was statistically significant (P < 0.01). The percentage of T-bet⁺ cells in peripheral plasma cells of AIH patients (23.54 ± 1.61) % was higher than that of healthy volunteers (6.59±0.59) % , and the difference was statistically significant (P < 0.01). The correlation analysis showed that the proportion of T-bet⁺ cells in peripheral plasma cells of AIH patients was positively correlated with the proportion of plasma cells to B cells (r = 0.224 7, P < 0.01), and the percentage of peripheral plasma cells to B cells was positively correlated with the level of serum IgG (r = 0.299 1, P < 0.01). Serum IgG level was correlated with the level of ALT, reflecting an indicator of liver damage (t = 2.65, P < 0.05). Conclusion The increase of T-bet expression in the peripheral plasma cells of AIH patients is associated with liver damage, which is a new mechanism of AIH pathogenesis and disease progression.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.