OBJECTIVE:To investigate the characteristics of pharmaceutical care for critical patients with multi-drug resistant Acinetobacter baumanni infection.METHODS:Retrospective analysis was applied to analyze the distribution of pathogenic bacteria,drug resistance,therapeutic results and pharmaceutical care in 36 critical patients with multi-drug resistant Acinetobacter baumanni infection.RESULTS:Multi-drug resistant Acinetobacter baumannii had severe drug resistance to antibiotics.It is difficult for critical patients to treat Acinetobacter baumannii infection after infection.CONCLUSION:Clinical pharmacist should be engage in clinical practice,give full play to their clinical expertise and enhance pharmaceutical care.It is very important for prevention of multi-drug resistant strains and appropriate use of drugs that clinical pharmacist be involved in formulating therapeutic regimes for multi-drug resistant Acinetobacter baumannii infection and strengthen pharmaceutical care.

Objective To detect the genetic diversity and prevalent strains of Mycobacterium tuberculosis isolates from Tibetan patients in Tibet and to analyze factors associated with prevalent strains.Methods A total of 577 Mycobacterium tuberculosis isolates were genotyped by spacen oligonucleotide typing (spoligotyping) and the results were analyzed with BioNumerics software (Version 5.0) and compared with the international spoligotype database of SITVIT2.Results Among the 577 cases of Tibet patients,329 were male and 248 were female.Based on spoligotyping,23 different spoligotypes were identified among 577 Mycobacterium tuberculosis isolates,with a genetic diversity of 3.99 ％.The majority (97.57％,563/577) of the isolates belonged to four known families,such as Beijing family,T family,CAS family and MANU2 family.The remaining 14 isolates had 11 novel spoligotypes.522 (90.47％)isolates belonging to Beijing family presented with 7 spoligotypes,resulting in the genetic diversity of Beijing family of 1.34％.With high similarity,Beijing family strains could be clustered into one genotype;among non-Beijing family strains,strains belonging to T family and MANU2 family were similar and could be clustered into one genotype.Changdu had the highest prevalence (97.83％) of Beijng family strains.In this study,the occurrence of Beijing family strains was not associated with age,sex,bacillus CalmetteGuerin vaccination or treatment history (P=1.00,0.36,0.83 and 1.00,respectively).Conclusions In this study,the genetic diversity of Tibetan Mycobacterium tuberculosis is low and Beijing family strains are highly prevent in Tibet,by classical spoligotyping.

Objective To identify the relationship among chronic inflammatory state, malnutrition and cardiovascular diseases in peritoneal dialysis patients. Methods Cardiovascular diseases and dialysis regime in 90 clinically stable continuous ambulatory peritoneal dialysis (CAPD) patients were investigated. Then, dietary energy intake (DEI) and protein intake (DPI) through dietary diaries were measured. The serum albumin (Alb), prealbumin(PA), transferring (TF), lean body mass (LBM), LBM% and the normalized protein equivalent of total nitrogen appearance (nPNA) were examined or calculated. Subjective global assessment (SGA) was also evaluated. Serum interleukin-6 (IL-6), tumor necrotic factor-?(TNF-?) and C-reactive protein (CRP) were measured as markers of chronic inflammation. Serum leptin and plasma NPY were detected too. Results Serum IL-6 and TNF-? levels of CAPD cases were (17. 17?27.72) pg/ml and (34. 21?25. 92) pg/ml, which were significantly higher as compared to control group. Serum CRP level in CAPD patients was (9. 88?20. 93)mg/L. There were 24 patients(26. 67% ) with CRP above normal level. 55 patients(61. 11% ) had cardiovascular diseases. The patients with angina pectoris, old myocardial infarction and chronic heart failure had higher CRP levels than those without above complications ( P

Objective: To evaluate the nutritional markers in peritoneal dialysis patients. Methods: We examined SGA, dietary diaries, direct anthropometry, biochemical indices in 90 continuous ambulatory peritoneal dialysis (CAPD) patients. Then, the normalized protein equivalent of total nitrogen appearance (nPNA), lean body mass (LBM) and %LBM were calculated. Results: These patients were classified to three nutritional categories based on SGA (i.e. normal nutrition, mild to moderate malnutrition, severe malnutrition). The dietary protein intake(DPI), dietary energy intake(DEI), serum albumin(Alb), nPNA, LBM and %LBM were significantly different among three groups (P

Objective:To improve the logistics management automation in hospital drugstore using internet drug supply chain coor-dination platform. Methods: According to the correspondent relationship between drug information and drug bar code, drug accept-ance, accurate location and batch input were achieved using bar code technique. Results: The platform could not only enhance the efficiency but also ensure the accuracy of drug information input. Conclusion:The platform provides a practical solution for developing modern pharmaceutical logistics and improving the efficiency of pharmaceutical distribution.

OBJECTIVE: To develope a reversed-phase high performance liquid chromatographic(RP-HPLC) method for the determination of allitridum in human serum.METHODS: The serum sample was injected after being deproteinized with trichloroaceticacid and being extracted with hexane.A Phenomenex C1s was used as the stationary phase and the solution being composed of acetonitrile- 1%HAc(62: 38,V/V)as the mobile phase with a flow rate of 1.2 ml/min .The serum samples were monitored at 240nm.RESULTS: The peak area of allitridum against allitridum concentration was linear with a correlation coefficient of 0.9 977 over the range of 0.29～12.4 μg/ml, the limitation of detection was 0.18 μg/ml.The average recovery was (99.2 ± 6.6) %, within - day RSD＜ 5.5% (n = 5), between - day RSD＜ 5.8% (n = 5) .CONCLUSIONS: This method is rapid, accurate and sensitive,it is very suitable for the investigation on clinical pharmacokinetics of allitridum.

Objective To retrospectively analyze the main factors of abnormal umbilical blood flow in different stage after 24 weeks' gestation,and to evaluate its treatment outcomes.Methods 256 cases with abnormal umbilical blood flow were selected.The abnormality happened in different stages after 24 weeks' gestation and they were inspected and treated routinely.Latency factors of the different stage were analyzed to discover the primary reason,and the treatment outcomes were compared.Results The significant differences of constructional proportion were observed in different stage(x2 =25.60,P ＜ 0.05).The influence factors of different stages were as following:hypertension relative disease (33.33 ％) between 24 and 27 weeks' gestation,the umbilical cord factor (16.67 ％) ; the incidence rate of abnormal umbilical blood was 42％ between 28 and 36 weeks' gestation,including hypertension disease(28.70％),the umbilical cord factor(15.74％) ;umbilical cord (31.37％) between 37 and 40 weeks' gestation,although gestation period hypertension disease reduced,but still accounted for 22.54％,the placenta factor was 12.74％.After treatment,the cure rate had significant differences (x2 =11.16,P ＜0.01),89.58％ (24-27 week),80.55％ (28-36 week),69.60％ (37-40 week).Conclusion The hypertension relative diseases and abnormal cord are the primary factors which caused abnormal umbilical blood,24-37 gestation week is the key stage for the inspection and treatment,especially for the hypertension relative diseases.

Objective To determine mitochondria-associated signaling pathway on cell apoptosis in Leptospira interrogans infected murine mononuclear-macrophages. Methods A cell apoptotic model of L. interrogan serogroup Icterohaemorrhagiae strain Lai inducing apoptosis of murine mononuclear-macrophage line (J774A. 1) was established. Pathological changes of mitochondria in the infected cells were observed under transmission electron microscope. Mitochondrial potential and reactive oxygen species(ROS) levels in the infected cells were detected using JC-1 staining method and DCFH-DA fluorescent probe, respectively,and caspase-8/-9 activities in the infected cells were measured using commercial kits. and the apoptosis block effects of caspase inhibitors were determined by flow cytometry. Apoptosis in the infected cells and ap-optosis-blocking effect by caspase inhibitors were detected by flow cytometry. Western blot assay was adopted to examine the levels of cytochrome C (CytC) , AIF, EndoG and Smae in the mitochondria and cytoplasm.The transposition of either AIF or EndoG from the cytoplasm into cell nucleus was determined by immunoflu-orescence staining test. Results L. interrogans strain Lai could induce J774A. 1 cell apoptoais. In the in-fected cells, visible mitochondrial injury, declined mitochondrial membrane potential and elevated ROS level were presented. The activity of caspase-8 but not of caspase-9 was significantly increased. The caspase in-hihitors could not completely block the cell apoptosis. Both the AIF and EndoG was released from the mito-chondria and subsequently transferred from the cytoplasm into the nucleus in the infected cells. However,elevation of CytC level and Smac release in cytoplasm of the infected cells could not be found. Conclusion L.interrogans can induce apoptosis in the infected mononuclear-macrophage via AIF and EndoG belonging to caspase-independent pathway.

Objective To investigate the efficacy of ultrashort and short-acting insulin after subcutaneous insulin infusion pump under glucose monitoring in treatment of diabetes.Methods 110 cases with type 2 diabetes were selected,they were randomly divided into two groups with a random number table:the study group and the control group,55 cases in each group.The study group was treated with short -acting insulin after subcutaneous injection of insulin pump,the control group was treated with short -acting subcutaneous insulin infusion by insulin pump therapy, glucose monitoring system was used to monitor glucose during treatment of the two groups.The clinical efficacy after a month of treatment was observed.Results Before treatment,fasting blood glucose(FPG),postprandial 2 h blood glucose(2h PG),bedtime blood glucose of the two groups had no statistically significant differences.After treatment, FPG and 2hPG,bedtime blood glucose in the study group were (6.01 ±1.06)mmol/L,(7.90 ±0.50)mmol/L, (7.13 ±0.95)mmol/L respectively,which of the control group were (5.98 ±1.04)mmol/L,(7.91 ±0.48)mmol/L, (7.14 ±0.94)mmol/L,which were significantly lower than before treatment (t =9.843,23.669,13.569,9.683, 22.881,13.710,P <0.05),the two groups after treatment showed no significant differences(P >0.05).The blood glucose time and insulin dosage in the study group were (5.59 ±1.30)d,(39.98 ±11.01)u/d,which of the control group were (6.98 ±1.40)d,(51.89 ±11.97)u/d,and there were significant differences between the two groups(t =1.825,5.431,P <0.05).The mean blood glucose,blood glucose standard deviation,time percentage of blood glucose≥10 mmol/L,time percentage of blood glucose≤3.9 mmol/L in the study group were (5.95 ±0.61 )mmol/L, (1.28 ±0.25)mmol/L,(14.16 ±2.13)%,(6.35 ±1.45)%,which in the control group were (6.59 ±0.94)mmol/L, (1.54 ±0.29)mmol/L,(15.15 ±2.14)%,(7.96 ±1.42)% respectively,and the differences were statistically significant between the two groups(t =4.236,503.6,2.432,5.883,P <0.05).Conclusion Glucose monitoring system in monitoring blood glucose is accurate and reliable,ultra -short -acting insulin after subcutaneous insulin pump infusion in treatment of diabetes is better than short -acting insulin.

Objective:To study the trace injection pump in the application of the common problems and treatment measures.Methods: 246 cases of general surgery patients were used trace injection pump problems for retrospective analysis, in order to propose the improvements about engineering and management.Results: The incidence rate of non-standard operation procedures or the incidents are 6.1%, injection pump failure and infusion speed is 2.03%, mismatched injection pump attachments is 1.22% and phlebophlogosis is 0.41%. The non-standard operation procedures and imperfect trace injection pump management are the major problems. Therefore, some solutions are proposed, which includes strengthening technical training for medical staff, standard operation procedures, regular quality monitoring and healthy education to the patients.Conclusion: The operation procedures of trace injection pump should be standard and programmatic. It is of great significance to clinical application of the trace injection pump and to work properly by strengthening operation personnel quality, dealing with problems timely and correctly.