Objective:To share a drug treatment experience for multiple drug resistant Pseudomonas aeruginosa.Methods:A retrospective analysis of the pharmaceutical care participated by clinical pharmacist for one case of intervertebral space infection with multiple drug resistant Pseudomonas aeruginosa was carried out.Results:Pharmacists participated in the whole treatment process,made the combined antimicrobial regimen (fosfomycin + ceftazidime + ciprofloxacin),and adjusted the time sequence.As a result,satisfactory curative effect was obtained.Conclusion:The infection with multiple drug resistant Pseudomonas aeruginosa may be treated with the three-drug therapy.Clinical pharmacists can play a positive role in the treatment of complicated infections.

Objective To evaluate the diagnostic value of puncture feeling combined with fine-needle aspiration cytology (FNAC) for thyroid nodules.Methods One thousand and fourteen thyroid nodules were retrospectively analyzed.Eighty-six thyroid nodules were performed repeat FNAC.All nodules were confirmed by pathology,the agreement of puncture feeling at different time was evaluated by Kappa test.Results There were 751 malignant nodules and 263 benign nodules.Sensitivity and accuracy of FNAC combined with puncture feeling were higher than those of single FNAC or single puncture feeling (x2 =11.609,4.433 and P =0.00,0.04;x2 =19.369,6.697 and P =0.00,0.01,respectively).There were no statistically differences in the sensitively and accuracy between single FNAC and puncture feeling (x2 =1.230,0.242 and P =0.27,0.62,respetively).The Kappa values of inter-observer and intra-observer were 0.829(P =0.00) and 0.885(P =0.00) respectively with statistically significance.Conclusions Puncture feeling combined with FNAC can improve the sensitivity and accuracy in the diagnosis of thyroid nodules,the reproducibility of puncture feeling is excellent.

OBJECTIVE:To evaluate the rationality of cefoxitin use in our hospital. METHODS:Evaluation index and evalua-tion criteria were established on the basis of DUE. The relative weight of evaluation index were calculated by using attribute-based AHM weight method,and the gas between medical orders and complete rational ones were evaluated by using TOPSIS processing method. The proportion of rational medical orders were calculated to evaluate the rationality of drug use. RESULTS:Among 116 medical records,there were 19%reasonable medical orders(including 4.3%complete reasonable medical orders,5 cases),50%ba-sically reasonable medical orders(58 cases)and 31% unreasonable medical orders(36 cases). CONCLUSIONS:It is reasonable and feasible to use AHM weighted TOPSIS method to evaluate the rationality of cefoxitin. The utilization of cefoxitin in our hospital is basically reasonable,but there are still many problems.

Objective To determine whether low frequency ultrasound mediated microbubbles destruction (UMMD) could inhibit VX2 orthotopic hepatic tumor growth in rabbit models.Methods Twenty-four New Zealand white rabbits were implanted with VX2 tumor in left hepatic lobe to establish a homograft rabbit model of liver neoplasms in situ,which were randomly divided into four groups(6 rabbits in each group):group A (intravenous saline only),group B (intravenous microbubbles only),group C (intravenous saline+ low frequency focused ultrasound exposure),and group D (intravenous microbubbles+low frequency focused ultrasound exposure).After 3 days consecutive treatment,tumor volume(TV),and peak intensity (PI) were monitored by conventional ultrasound and contrast enhanced ultrasound(CEUS) on 0,1,7,14 and 21 days after treatment.The rabbits were euthanized at the end of the experiment.Tumor tissues were evaluated by HE stain.Results The parameters of TV and PI of each tumor had no significant difference among four groups before treatment(all P>0.05).TV had no significant difference among four groups on 1 day after treatment(all P>0.05);PI in group C and group D were significantly lower than those in group A and group B (all P<0.05).TV and PI in group D were significantly smaller than those in other groups on 7,14,21 days after treatment(all P<0.05).There was no statistical difference in TV and PI among group A,group B and group C(all P>0.05).The pathological changes of necrosis tissue,hemorrhagic damage of microvessel and thrombosis were observed in the tumors of group D only,whereas these changes occurred rarely in other groups.Conclusions UMMD can inhibit the growth of VX2 hepatic tumors in rabbits,and be used as a promising novel therapeutic strategy to liver neoplasms.

Hepatitis B virus (HBV) DNA replication takes place in the viral capsid that consists of 180 or 240 copies of HBV capsid (HBc or core) protein. The monomeric core protein contains an apical loop region that forms the spikes on the surface of viral capsid upon core dimerization and capsid assembly. To investigate the impact on HBV DNA replication through gene engineering at the spike of HBV capsid. plasmids expressing engineered HBc with linker-fused enhanced green fluorescent protein (EGFP) or shortened EGFP insertion at the spike region were constructed by Restriction Digestion and Ligation-independent Cloning (RLIC). The wildtype or mutant HBc construct was cotransfected with HBV1.1c(-), a plasmid containing 1.1 unit-length HBV genome with deficiency in HBc expression, into HEK293 cells, respectively. GFP signal was observed through a fluorescence microscope and HBV DNA replicative intermediates were assayed by Southern blotting to determine the expression and functions of different recombinants. Our results demonstrated that the RLIC method was effective to generate deletion or insertion in the apical loop region of HBc. Both HBc-EGFP recombinants with different linkers produced green fluorescence but with different subcellular distribution pattern. However, HBV DNA replication was not detected with the trans-complementation of these two HBc recombinants. In addition, other recombinants including the one only with the deletion of aa79-80 failed to support HBV replication. Taken together, our results suggest that RLIC is a robust method which can be broadly applied in gene engineering; different peptide linkers may have different influences on the functions of an engineered fusion protein; and HBc aa79-80 play a critical role for HBc to support HBV DNA replication.
Capsid Proteins ; genetics ; Cloning, Molecular ; Genetic Engineering ; methods ; Green Fluorescent Proteins ; biosynthesis ; genetics ; HEK293 Cells ; Hepatitis B Core Antigens ; biosynthesis ; genetics ; Hepatitis B virus ; genetics ; physiology ; Humans ; Mutation ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transfection ; Virus Replication

OBJECTIVE:To explore the establishment of DUE criteria for the evaluation of glucocorticoids(GCs)use in oncol-ogy department of our hospital,and to evaluate the rationality of glucocorticoid use. METHODS:DUE criteria for GCs in our hos-pital was established preliminary,and used to evaluate medication indication,medication course,medication results,etc. Medical records of 300 patients receiving GCs were collected from oncology department of our hospital during Apr. to Dec. in 2013(before intervention)and Jun. 2014 to Mar. 2015(after intervention)via hospital information system. The application of GCs was evaluat-ed. RESULTS:Pexamethasone sodium phosphate injection was used most frequently in our hospital(82.34%),followed by Dexa-methasone acetate tablet(15.33%)and prednisone asetate tablets(2.33%). The mest common purpose of GCs use in oncology de-partment of our hospital is radiotherapy and chemotherapy induced vomiting prevention and treatment(55.55% of total case),fol-lowed by anti-inflammatory therapy(14.19%)and chemotheraphy drug pretreatment(12.76%). After intervention,rational use of GCs for tumor had been improved greatly,and the rate of unqualified drug dosage and medication course decreased from 6.87% to 3.95%,and that of decreased from 3.58% to 2.74%. CONCLUSIONS:The establishment of DUE criteria and continuous criteria improvement during clinical rational drug use guidance can promote rational use of GCs in oncology department.

Objective To evaluate the association of the size of thyroid nodules and the diagnostic value of repeat fine needle aspiration cytology(FNAC) in diagnose of thyroid nodules.Methods One hundred and forty-three thyroid nodules in one hundred and thirty-five patients with repeat FNAC and thyroidectomy were retrospectively analyzed.The nodules were divided into three groups according to the largest diameter(L):GroupA,L＜0.5 cm;GroupB,0.5 cm≤L≤1.0cmandGroupC,L＞1.0cm.Yield of FNACs were divided into six levels according to the classification criteria of the Bethesda system,and Level Ⅰ,Ⅲ,Ⅳ,Ⅴ were defined as the indefinite cytological diagnosis.Results The diagnostic rate of repeat FNAC was obviously higher in group B compared with group A and group C,with significantly statistical difference (P ＜0.05).The risk of malignancy for persistently indefinite diagnostic aspirates after repeat FNAC was significantly reduced with statistical difference from the initial indefinite diagnostic aspirates in group B (P ＜0.05),while there was no statistical difference between group A and group C (P＞0.05).The diagnostic accuracy of repeat FNAC in group B was significantly higher than that in group A(P ＜0.05),but not in group C (P ＜0.05).Conclusions The repeat FNAC has a higher efficiency in those nodules with a largest diameter between 0.5 cm and 1.0 cm,and a repeat FNAC can be suggested.

The relationship between abnormal circulating GH-insulin-like growth factor (IGF) axis and hypoglycaemia was explored in 2 cases of non-islet cell tumor associated hypoglycaemia (NICTH). Serum level of IGF-Ⅱ was increased, the levels of GH, IGF-Ⅰ, IGFBP-3 were decreased to some extent, and IGF-Ⅱ/IGF-Ⅰ (molar ratio) was significantly increased in these two cases. In one case, circulating GH-IGF axis returned to normal after complete removal of the tumor. In the diagnosis of NICTH, the abnormal circulating GH-IGF axis is quite valuable and IGF-Ⅱ/IGF-Ⅰ appears to be a more sensitive parameter.

Objective: To evaluate the diagnostic value of BRAF V600E mutation combined with shear wave elastography(SWE) for thyroid nodules of Bethesda Ⅲ diagnosed by fine-neddle aspiration(FNAC). Methods: One hundred and seventeen thyroid nodules diagnosed as Bethesda Ⅲ in the department of ultrasound and confirmed by BRAF V600E gene detection, SWE examination and surgery were collected. BRAF V600E detection, SWE examination and both combined with pathological results were using to retrospective analysis. Results: There were 75 benign nodules and 42 malignant nodules according to pathology. Sensitivity and negative predictive value of BRAF V600E combined with SWE were higher than single BRAF V600E mutation detection and SWE with statistically significant(P=0.01, 0.001; P=0.029, 0.01, respectively). There were no statistically differences between single BRAF V600E mutation detection and SWE for Bethesda Ⅲ nodules(P=0.483, 0.645). Conclusions BRAF V600E mutation detection combined with SWE can improve the sensitivity and negative predictive value in the diagnosis of Bethesda Ⅲ thyroid nodules.

Objective To improve the awareness of clinical manifestation, endocrine changes and prognosis in patients with anorexia nervosa (AN). Methods The clinical features and endocrine functions of 28 patients with AN were analysed, and the prognosis was based on the results of 4 months-7 years follow-up of these patients. The change of serum leptin level was observed during different therapeutic periods in 13 patients. Results Most of AN patients were young women (92.9%, 26/28), age of onset was (19.4?3.8)years old and the duration of follow-up was from 4 months to 7 years. Self-starvation, extreme weight loss and amenorrhoea were the characteristic manifestations. This investigation discovered 24 patients with hypofunctional hypothalamus-pituitary-gonad axis, 12 with hyperfunctional hypothalamus-pituitary-adrenal axis, 9 with decreased levels of thyroid hormones, 2 with increased level of GH (n=10), 8 with decreased level of IGF-Ⅰ (n=10). Leptin levels in AN patients (n=9) weresignificantlydecreasedascomparedwiththecontrol group (n=26) 〔(1.21?0.36 vs 7.70?4.15)?g/L, P