Objective To discuss the pharmaceutical care protocol and methods for clinical pharmacists taking part in cancer pain management. Methods A patient developed delirium and drowsiness after using oxycodone hydrochloride prolonged-release tablet ( OXYCONTIN) and morphine hydrochloride tablet for pain titration treatment. The clinical pharmacist analyzed the reasons of delirium and drowsiness,and suggested a dose reduction of OXYCONTIN or converting OXYCONTIN to another opioid analgesic. Results The suggestion of the clinical pharmacist was partly accepted. After adjusting the treatment, the delirium and drowsiness disappeared gradually, and the pain was well controlled. Conclusion In clinical practice, especially when faced with a rare adverse drug reaction, clinical pharmacists are helpful for ensuring the safety and effectiveness in pain management, as well as improving the level of the treatment, by the implementation of individualized drug therapy.

Objective To investigate the changes of plasma cytokines and myocardial enzymes in different doses of fentanyl in patients undergoing valve replacement under cardiopulmonary bypass (CPB) and evaluate its anti-inflammatory and myocardial protective effects.Methods Thirty ASAⅡ-Ⅲ patients undergoing elective valve replacement under CPB were studied. We excluded patients having infection, abnormal immunological function of receiving steroid or immune- modulatory drugs. The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam modulate 0.1 mg ?kg-1 , fentanyl 10 ?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with continuous infusion of fentanyl and intermittent i.v. boluses of midazolam and vecuronium. The total dose of fentanyl amounted to 30, 60 and 100 ?g?kg-1 (group 1, 2 and 3, n = 10) and was infused before CPB was started. MAP, CVP, HR, ECG, SpO2, PETCO2 and naso-pharyngeal and rectal temperature were continuously monitored during operation. Blood samples were taken before anesthesia (T1 ,baseline) , before CPB (T2 ) , 30 min and 2 h after release of aortic cross-clamping (T3 , T4 ) and 24 h after operation (T5 ) for determination of plasma levels of TNF-?, IL-6, IL-10 and creatine kinase (CK) and CK-MB activity.Results The three groups were comparable with respect to age, body weight, aortic cross-clamping time, CPB time and duration of operation. The plasma levels of TNF-?, IL-6, IL-10, CK and CK-MB activities were significantly increased after CPB compared to baseline (T1) (P

Patients found two years left of the new biology, surface erosion,exudates long. Postoperative pathology examination: inflammatory fibrous background visible uniform small cells arranged in cords, pseudorosette formation region is considered not except basal cell carcinoma , neuroendodrne carcinoma. Diagnosis of immunohistochemical support of basal cell carcinonma.
Carcinoma, Basal Cell ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Skin Neoplasms ; diagnosis ; pathology

0.05),and no adverse reaction was found in both groups.Conclusion:Jianpi Xiaozhang Granule and motilium have obvious and similar therapeutic effect on functional dyspepsia with stagnation of Qi due to spleen deficiency.

Objective To evaluate the application of 3D DSA in diagnosis of intracranial aneurysm. Methods Conventional DSA and 3D DSA were performed in 15 cases with subarachnoid hemorrhage. Results Of 15 cases, by 3D DSA, 12 ones were diagnosed as intracranial aneurysm, and the remaining 3 ones were suspected, while 7 ones could be diagnosed by conventional DSA. Conclusion 3D DSA can improve the diagnosis of intracranial aneurysm.

Objective:To investigate the in vitro effect of capsaicin on four major rat cytochrome P450 ( CYP) enzymes using a cocktail probe drug method. Methods:The in vitro incubation was divided into capsaicin group and the control group. Rat liver micro-somes, probe drugs, capsaicin at various concentration ( buffer solution in the control group) and cofactors were cultured altogether for 20 min. After the culture, the concentration of metabolites was determined by HPLC to assess the activities of enzymes. IC50 value of capsaicin on every isoform was calculated using Graphpad prism 5. 0. Capsaicin and hepatic microsomess were pre-incubated respec-tively for 0, 5, 10, 15, 20 and 30 min, and then the relative activity of the four isoforms at different time was calculated. Results:The activity of the rat liver microsomes enzyme CYP450 isoforms (CYP1A2, CYP2C11, CYP2E1 and CYP3A2) was all inhibited by capsaicin in vitro with IC50 value of 36. 21, 17. 19, 51. 64 and 18. 86 μmol·L-1 , respectively. Pre-incubation could not increase cap-saicin inhibitory activity against the four CYP enzymes. Conclusion:Capsaicin shows inhibition on CYP1A2, CYP2C11, CYP2E1 and CYP3A2 in rat liver microsomes in vitro without pre-incubation time-dependent property.

Objective To evaluate the diagnostic value of shear wave elastography on deep venous thrombosis in different stage.Methods Models of rabbits'deep venous thrombosis have been established to noninvasively measure Young's moduli of thrombosis in day 1 ,4,7,10 and 14 respectively by shear wave elastography.Results The elastic modulus of thrombosis increased with increment of the stages of thrombosis.Specifically,the mean Young's moduli of thrombosis increased from (4.0±1 .42)kPa (day 1)to (25.71 ±6.09)kPa (day 14),with statistical differences between each two observation time points (P <0.05).Conclusions Shear wave elastography can effectively reflect the elasticity of thrombosis in different stages,and the stage of thrombosis can be estimated judging by quantitative ultrasound elasticity preliminarily.

Objective To explore osculating value method combined with rank sum ratio method in evaluation of nursing quality in the hospital nursing management application, to provide a scientific basis for decision making. Methods By reference, from the working efficiency, the quality of nursing, 3 dimensions of nursing skill training, the choice of 11 commonly used in the evaluation of nursing quality indicators, the raw data of each index was normalized, the school of nursing quality with 2004-2013 years of osculating value method analysis was assessed, the development of nursing quality combined with rank and file classified score method. Results The nursing quality of the overall upward trend, according to the grading each year osculating value and ranking in 2011, nursing quality best, osculating value was 0.000, the worst quality of nursing in 2004, osculating value was 3.248;the annual nursing quality grading was reasonable, 2011, 2012 and 2013 were in good quality grade, 2004, 2005 and 2006 were of poor quality grades, the rest of the year at a medium level, with statistically significant difference of the file, P<0.05. Conclusion Osculating value method combined with rank sum ratio method in comprehensive evaluation of nursing quality in the hospital has the objectivity and practicability.

Epidermal Growth Factor ; therapeutic use ; Humans ; Recombinant Proteins ; therapeutic use ; Tympanic Membrane ; injuries ; Tympanic Membrane Perforation ; drug therapy