Asthma is the most common chronic respiratory disease in childhood,some children outgrow of the disease in adolescence.Understanding the outcome of childhood asthma is of increasing interest,the prognostic factors for the outcome of childhood asthma in adolescence are sex,onset age,the severity of disease,atopic status,airway responsiveness,lung function,living environment and so on.

OBJECTIVE:To summarize the method and experience of clinical pharmacist participating in pharmaceutical care for a case of refractory class Ⅳ+Ⅴ lupus nephritis (LN). METHODS:Clinical pharmacists and physicians formulated individualized treatment together,i.e. prednisone 30 mg/d+MMF 0.5 g,q12 h+FK506 1 mg,q12 h;on the fifth day of treatment,the patient suf-fered from ardent fever and increase of blood pressure,and clinical pharmacist suggested using linezolid 0.6 g,ivdrip,q12 h+merope-nem1.0 g,ivdrip,q8 h to control pulmonary infection;using Amlodipine besylate tablet 5 mg,po,qd+one Valsartan hydrochlorothia-zide capsule, po,qd+Arotinolol hydrochlorid tablet 10 mg,po,bid to control blood pressure. RESULTS:Multi-target treatment for re-fractory class Ⅳ+Ⅴ lupus nephritis achieved efficacy:the patient got higher plasma albumin and lower 24 h urine protein quantity af-ter 14 days;the patient suffered from secondary pulmonary infection and high blood pressure;physicians adopted the pharmacist’s suggestion so that pulmonary infection and blood pressure had been controlled. CONCLUSIONS:To ensure the effectiveness and safe-ty of the multi-target treatment,clinical pharmacists should formulate individualized treatment,focus on the possible ADR and provide phamaceutical care in the field of blood pressure monitoring,infection control,etc. when participating in multi-target treatment.

Objective To determine the optimized self micro-emulsifying drug delivery system (SMEDDS) formulation of probucol. Methods According to the indexes of mean particle size, zeta-potential, solubility of probucol in blank SMEDDS and the dissolution percentage in 5 minutes of the preparations, the optimized formulation was determined by the central composite design-response surface methodology. Results When the correspondent percentage of olive oil in oil phase (W/W) was 0.33, the percentage of oil phase in formulation (W/W) was 0.5, and the ratio of surfactant to co-surfactant (W/W) was 2.0, respectively. The mean particle size, zeta-potential, solubility of probucol and dissolution percentage in 5 minutes of micro-emulsion was 92.7 nm, -17.38 mV, 65.17 mg/mL and 63.46%, respectively. Conclusions The optimized formulation of the probucol SMEDDS was obtained quickly and conveniently by the central composite design-response surface methodology. The method had a reliable predictability.

This study aimed to investigate the transport characteristics of aripiprazole.A human intestinal epithelial cell model Caco-2 cell in vitro cultured had been applied to study the transport of aripiprazole.The effects of time,concentration of donor solutions,pH,temperature and P-glycoprotein inhibitor on the transport of aripiprazole were investigated.The determination of aripiprazole was performed by HPLC.It is concluded that aripiprazole is transported through the intestinal mucosa via a passive diffusion mechanism primarily,coex- isting with a carrier-mediated transport.The transport of aripiprazole is positively correlated to transport time, concentrations.The P-glycoprotein inhibitor cyclosporine A significantly enhanced the transport amount of aripiprazole.

Objective To observe the cell apoptosis, oxidative stress reaction and expressions of Bcl-2 and Bax in kid?ney of dietary zinc deficiency mice during growth period, and discuss the mechanism of renal cell apoptosis induced by zinc deficiency. Methods Thirty weaning male mice were randomly divided into zinc-deficient group and zinc-adequate group, and 15 mice for each group. Zinc-deficient group was fed with zinc deficiency diet (0.85 mg/kg), while zinc-adequate group was fed with enough zinc diet (30 mg/kg). The TUNEL method was applied to observe the cell apoptosis, and the apoptotic in?dex was measured. The content of SOD and MDA were detected to observe the oxidative stress reaction in kidney. The ex?pression levels of Bcl-2 and Bax protein were detected by Western blot assay. Results Compared with zinc-adequate group, the cell apoptosis and oxidative stress reaction were increased in zinc-deficient group. The expression of Bcl-2 de?creased, and the expression of Bax increased. The ratio of Bcl-2 and Bax declined in kidney of zinc deficiency mice. Conclu?sion Diet zinc deficiency in growth period may result in the decreased antioxidase, the increased oxidative stress reaction, and the changed Bcl-2 and Bax expression, which promote the occurrence of cell apoptosis in kidney.

Objective:To observe clinical and pathological features of pancreatic solid-pseudopapillary tumor ( SPPT) , and to find some useful immunohistochemical methods for its differential diagnosis.Methods: The clinical features of 14 SPPT patients were obtained. Each case underwent microscopic observation and immunohistochemical staining. The primary antibodies were CgA, Syn, E-cadherin, β-catenin and Cyclin Dl. These results were compared with 5 pancreatic well-differentiated tumors and well-differentiated carcinomas ( WET/WEC). Results: SPPT mainly involved young women, and the head of pancreas was the commonest location. Tumors were always in solid and cystic gross appearance.Although the tumor' s borderlines seemed clear, focal infiltrations could often be identified. The histological features of SPPT were similar in some aspects to those of WET/WEC, especially the solid pattern of WET/WEC. Both of them could express CgA and Syn. But all SPPTs lost E-cadherin membranous signals, and even had some nuclear signals (5/14) , while all WET/WECs remained the same staining pattern with normal pancreas cells, β-catenin positive signals in SPPTs were located both in nuclei and plas mas. WET/WECs' positive signals were all in membranes and plasmas, but negative ones in nuclei. Perinuclear dot-like signals could also be seen in the majority cells, which were similar to normal islet cells' staining pattern. SPPTs' nuclear positive rates of Cyclin Dl were usually more than 70% (12/14). WET/WECs' rates were all lower than 30%. Conclusion: Comprehensive analysis of patients'clinical, pathological features and immunohistoehemistry results, including E-cadherin, β-catenin and Cyclin Dl, was helpful to the diagnosis of SPPT and its differential diagnosis of WET/WEC.

Objective To investigate the effect of lipid soluble fraction in the radix of Salvia miltiorrhiza (FSM) on conditioned place preference (CPP) in mice induced by morphine and preliminarily identify the fraction in the radix of S. miltiorrhiza. MethodsMorphine or NS was sc injected every other day to induce the obvious CPP in mice for 6 d. Before 30 min of sc injecting morphine, mice were ip administered different doses of lipid soluble fraction in the radix of S. miltiorrhiza. RP-HPLC method was used to identify the major component in the lipid soluble fraction in the radix of S. miltiorrhiza. ResultsThe staying time in morphine-paired white compartment was significantly prolonged. After treatment with lipid soluble fraction in the radix of S. miltiorrhiza (40 mg/kg, ip), the staying time in morphine-paired white compartment was significantly shortened (P

Objective To assess the effectiveness of continuous aspiration of subglottic secretions (CASS)in preventing ventilator-associated pneumonia.Methods The relevant randomized controlled trials were searched in the Cochrane Library,Pubmed,CNKI,VIP and Wanfang databases.The experimental group received CASS and the control group did not(NASS group).Two reviewers selected studies according to the inclusion and exclusion criteria,the quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted by using RevMan 5.2.Results Sixteen randomized controlled trials met the inclusion criteria and enrolled 2 576 patients.According to the meta analysis,compared with NASS,CASS reduced the incidence of ventilator-associated pneumonia,shortened the length of stay in the intensive care unit and the duration of mechanical ventilation.There was no effect on hospital mortality.Conclusions Continuous aspiration of subglottic secretions appears effective in preventing ventilator-associated pneumonia,decreasing the duration of intensive care unit length of stay and mechanical ventilation among critically ill patients with mechanical ventilation.

Objective To explore the changes of index of heart function and major cardiovascular events (nonfatal myocardial infarction, stroke, and cardiovascular death) to H-type hypertension patients with left ventricular hypertrophy caused by Tianma Gouteng Decoction.Methods 126 H-type hypertension patients with left ventricular hypertrophy from January 2014 to May 2014 in our hospital were divided into observation group and control group,63 cases in each group.Control group was treated with conventional western medicine, observation group was treated with Tianma Gouteng Decoction on the basis of control group.The levels of plasma homocysteine (Hcy), left ventricular ejection fraction (LVEF),the E/A, and the incidence of major cardiovascular events were recorded and compared between the two groups.Results Compared with pre-treatment, the levels of Hcy in the two groups were significantly decreased(P<0.05), and the effect of observation group was better (P<0.05).After the treatment, the E/A and LVEF of the two groups were significantly improved (P<0.05); the E/A ratio and LVEF in observation group were significantly higher than those in control group (P<0.05).The incidence of major cardiovascular events in observation group was significantly lower than that in control group (6.35%VS 19.05%,P<0.05).Conclusion Tianma Gouteng Decoction can significantly reduce the Hcy of patients who get H-type hypertension, improve diastolic and systolic function and lower the occurrence of major cardiovascular events.

Objective To analyze the viewpoints of the graduate students on the effective ap-proaches in cultivating their innovations. Methods Using Eugenie Creativity Test scale and self-made questionnalre, the graduate students in a medical university were surveyed on their general informa-tion, innovation levels and viewpoints of the important links and effective approaches in cultivating the innovations. The statistical software package-SPSS 16.0 was used for questionnalres. The statistical analysis was based on chi-square test for categorical data in the levels of graduate students' innovation and variance analysis for quantitative data in graduate students' understanding of the importance of cultivating approaches. Results 1 000 questionnalres were given out and effective questionnalre 936 copies were collected. The innovations of the students were malnly medium (557/936, 59.6%) and strong (356/936, 38.0%). They thought research and practice were the most important (F=225.49, P=0.00) in the tralning links and strengthening the tutorial staff was the foremost in the cultivating ap-proaches, which was followed by the sorted tralning (F=50.36, P=0.00). Conclusion The views of the graduate students on the cultivation jobs should be pald attention to. According to this study results, the management of research and practice, tutorial staff and assorted tralning should be fully considered to advance their innovations.