OBJECTIVE:To investigate the role of clinical pharmacists in anti-infective treatment for the patient with septic shock. METHODS:Clinical pharmacists participated in anti-infective treatment for a patient with septic shock,assisted physicians to formulate individual regimen based on empirical anti-infective treatment,ESBLs producing Escherichia coli and anti-fungal treat-ment. Clinical pharmacists suggested using Itraconazole injection 200 mg,ivgtt,qd,for anti-fungal treatment;Itraconazole cap-sules 200 mg,po,bid,instead of fusidinic for anti-fungal treatment;meropenem 0.5 g,ivgtt,q6 h,for anti-infective treatment. RESULTS:Physicians adopted the suggestion of clinical pharmacists;the infection had been controlled after 16 d treatment and then the patient discharged from the hospital. CONCLUSIONS:Clinical pharmacists participate in clinical treatment,and assist phy-sicians to make a decision and formulate individual regimen,so as to promote rational drug use.

Objective To establish a quality standard for Jianpibushen granules .Methods The five main ingredients of the formulation :Astragalus membranaceus ,Salvia miltiorrhiza Bunge ,Codonopsis pilosula ,Citrus reticulata Blanco and Paeonia lactif lora Pall ,were identified by thin layer chromatography (TLC) respectively .The content of peoniflorin in Paeo-nia lactif lora was determined by high performance liquid chromatography (HPLC) .The separation was performed on Agilent Eclipse Plus C18 column(4 .6 mm × 250 mm ,5 μm) .The mobile phase was acetonitrile and 0 .1% potassium dihydrogen phos-phate solution for gradient elution .The flow rate was 1 ml/min ,the column temperature was 25 ℃ ,the UV detection was per-formed at 230 nm .Results The spots in TLC were clear without interference in negative control .A good linear relationship was shown within the range of 8 .676-277 .632 μg /ml for peoniflorin (r=0 .999 9) .Conclusion This method is simple ,accu-rate and reproducible ,and can be used as an effective quality control of Jianpibushen granules .

Objective To construct a gene delivery carrier with aptamer-polyethylene glycol-dendrimer-polyamidoamine (APT-PEG-PAMAM) ,forming nanoparticles to specifically target prostate cancer cell lines ,carrying prostate cancer cell pro-liferative suppressor microRNA :miRNA-34a .We investigated the transfection efficiency of this gene delivery system as well as functionally studied its inhibitory effect on prostate cancer (PCa) cell proliferation .Methods The construction of APT-PEG-PAMAM gene carrier was identified and confirmed by nuclear magnetic resonance (NMR) .The nano-complex sizes and zeta potential of APT-PEG-PAMAM gene carrier complexes were measured by zeta sizer .The efficiency of gene transfection of APT-PEG-PAMAM /miRNA nano-complexes were investigated by measuring the expression miRNA-34a in prostate cancer cells (PC3 and LNCaP);the PCa specific cell proliferation inhibition of APT-PEG-PAMAM / miRNA-34a nano-complexes were investigated by measuring CCK-8 cell proliferation inhibition experiments by comparing with APT-PEG-PAMAM and APT-PEG-PAMAM /miRNA-34a nano-complexes .Results NMR results demonstrated that APT-PEG-PAMAM /miRNA-34a nano-complexes were successfully synthesized by structural identification .Qualitative and quantitative transfection efficien-cy experiments data show that the cellular uptake of vectors were concentration-dependent ,after the APT further modified it significantly and increased the LNCaP cell transfection efficiency and specificity of PCa cells targeting ability .CCK8 cell prolif-eration assay data indicated that APT-PEG-PAMAM/miRNA-34a has the anti-PCa cells effect .Conclusion APT-PEG-PAM-AM/miRNA-34a may prove to see its efficacy for near future in pre-clinical and clinical study on the treatment of PCa .

Objective:To establish a xenograft model of cutaneous squamous cell carcinoma (CSCC) in nude mice, and to explore mechanisms underlying synergistic induction and promotion of CSCC in nude mice by ultraviolet radiation and human papillomavirus (HPV) infection.Methods:The human CSCC A431 cells were divided into 3 groups, namely HPV16 E6 overexpression group (LV-OE-HPV16 E6 group) transfected with adenovirus-mediated HPV16 E6 gene, empty vector group transfected with empty adenovirus vectors, and blank control group remaining untransfected. Using serum-free Dulbecco′s modified Eagle′s medium (DMEM) , A431 cells in the empty vector group and LV-OE-HPV16 E6 group were prepared into single-cell suspensions, which were subcutaneously inoculated into the left buttocks of SKH-1 nude mice separately, namely empty vector group ( n = 16) and LV-OE-HPV16 E6 group ( n = 16) . Tumor growth was observed and recorded for the mice every 3 days. When the tumor size reached 150 mm 3, the modeling was considered successful. After successful modeling, 8 mice in each group were irradiated with ultraviolet light at a dose of 1 440 mJ·cm -2·d -1 for 12 minutes each time, the other 8 mice in each group received no ultraviolet radiation, that is to say, all the 32 mice were divided into 4 groups: empty vector group, empty vector + UV group, LV-OE-HPV16 E6 group, and LV-OE-HPV16 E6 + UV group. After 4-week radiation, these nude mice were sacrificed, tumor weight and volume were measured, a tumor growth curve was drawn, immunohistochemistry study, Western blot analysis and real-time fluorescence-based quantitative PCR (qRT-PCR) were conducted to determine the protein and mRNA expression of Wnt1 and β-catenin in CSCC tissues collected from nude mice, respectively. For normally distributed measurement data, analysis of variance was used for intergroup comparisons, and least significant difference- t test for multiple comparisons; for non-normally distributed measurement data, rank sum test was used for intergroup comparisons. Results:Compared with the empty vector group (2.20 ± 0.24 g) , the tumor weight significantly increased in the empty vector + UV group (2.90 ± 0.36 g, t = 4.39, P < 0.001) , LV-OE-HPV16 E6 group (3.19 ± 0.32 g, t = 6.77, P < 0.001) , and LV-OE-HPV16 E6 + UV group (4.41 ± 0.18 g, t = 20.11, P < 0.001) ; the tumor volume was also significantly higher in the empty vector + UV group (1 033.12 ± 400.15 mm 3, t = 1.90, P < 0.001) , LV-OE-HPV16 E6 group (1 119.21 ± 447.57 mm 3, t = 2.21, P < 0.001) , and LV-OE-HPV16 E6 + UV group (1 464.29 ± 409.98 mm 3, t = 4.22, P < 0.001) than in the empty vector group (688.94 ± 319.31 mm 3) . Immunohistochemical study showed no significant difference in the protein expression of Wnt1 and β-catenin among the 4 groups ( F = 0.76, 0.71, respectively, both P > 0.05) ; Western blot analysis showed significant differences in the protein expression levels of Wnt1 and β-catenin among the 4 groups ( F = 16.74, 49.90, respectively, both P < 0.05) , which were significantly higher in the LV-OE-HPV16 E6 + UV group than in the empty vector group, empty vector + UV group and LV-OE-HPV16 E6 group (all P < 0.05) . qRT-PCR showed a significant difference in the mRNA expression of Wnt1 and β-catenin among the 4 groups ( F = 7.77, 8.38, respectively, both P<0.05) , and the LV-OE-HPV16 E6 + UV group showed significantly increased Wnt1 mRNA expression levels compared with the empty vector group, empty vector + UV group and LV-OE-HPV16 E6 group (all P < 0.05) . Conclusion:Ultraviolet radiation and HPV infection showed synergistic effect on the induction and promotion of CSCC.

Objective To explore the role of pharmaceutical care in the treatment of patients with pulmonary infection secondary to suppurative thrombophlebitis. Methods The treatment of a patient diagnosed with pulmonary metastatic infection secondary to suppurative thrombophlebitis and the whole process of clinical pharmacists participating in the monitoring were analyzed retrospectively. The use of antibiotics was evaluated, and the experience of coagulation management in suppurative thrombophlebitis was explored. Results Based on the infection site, characteristics of septic thrombus, monitoring of vancomycin blood concentration, pharmacokinetics and pharmacodynamics characteristics of antibiotics, clinical pharmacists provided comprehensive pharmaceutical services for clinicians and patients in terms of anti-infection scheme adjustment, optimization of vancomycin individualized treatment, anticoagulant timing. Patient’s systemic infection and septic thrombus can be effectively controlled and which promotes the treatment of patients with suppurative thrombophlebitis. Conclusion Clinical pharmacists can play an important role in the treatment team of severe patients to improve the rational use of antibiotics.

Objective To investigate the role of clinical pharmacists in identifying adverse drug reactions (ADR), to draw clinical attention to the possibility of drug-induced lung injury caused by rhG-CSF, and distinguish them from infectious diseases. Methods A case of rhG-CSF induced acute lung injury was analyzed. After analyzing the relationship between rhG-CSF and acute eosinophilic pneumonia, exploring the possible mechanism, in combination with the patient's condition, the clinical pharmacist put forward the suggestion for the treatment of the disease. Results After receiving rhG-CSF, the patient's eosinophils increased, the pneumonia was aggravated, and the effect of anti-infection treatment was poor. Eosinophils pneumonia associated with rhG-CSF was considered. The patient's pulmonary symptoms improved after treatment with glucocorticoid in combination with withdrawal of antibiotics and antiviral drugs, and eosinophil returned to normal. Conclusion rhG- can cause rare eosinophilic pneumonia. The clinical pharmacist's participation in clinical treatment can help to identify drug-induced diseases, reorient the direction of treatment and ensure the success of clinical therapy.