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.

BACKGROUND: It has been thought that posterior cervical decompression increases the risk of cervical instability and the stress on posterior longitudinal ligament may change growth factor expression in vivo. However, the association between BMP-4 expression and heterotopic bone formation has not been confirmed. Bone morphogenetic protein 4 (BMP-4) is one of factors that can lead to heterotopic bone formation alone.OBJECTIVE: To observe the effects of posterior cervical decompression on BMP-4 mRNA expression in the posterior longitudinal ligament.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed in Taishan Medical College between January 2005 and December 2006.MATERIALS: A total of 48 adult Sprague Dawley rats of either gender and of clean grade, weighing 270-350 g, were included in this study.METHODS: All rats were randomly and evenly divided into 3 groups: experimental, sham-operated, and blank control. In the experimental group, C36 laminectomy for decompression was performed.In the sham-operated group: only skin incision was made. Rats in the blank control group received no any treatment. Four rats were allocated for each time point (1, 2, 4, and 8 weeks post-surgery) for harvesting posterior longitudinal ligament.MAIN OUTCOME MEASURES: Detection of BMP-4 mRNA expression in the cervical posterior longitudinal ligament by semi-quantitative reverse transcription-polymerase chain reaction.RESULTS: In the experimental group, obvious BMP-4 mRNA expression was found at 1-8 weeks post-surgery. While no BMP-4 mRNA expression was found at all times in the sham-operated and blank control groups.CONCLUSION: Posterior cervical decompression can increase BMP-4 mRNA expression in the posterior longitudinal ligament.Endogenous BMP-4 may contribute to ligamentous ossification and development post-surgery.

Objective To explore clinical practice value of Disease Severity Evaluation Scale (DSAS), and divide patient's nursing level according to the results of DSAS. Methods The assessment group was set up for evaluation of the scale, DSAS was used to determine the nursing level of 3 713 hospitalized patients (age > 18 years old) from 17 clinical departments, from April to May 2014. Results Nursing level determined by DSAS was compared with the standard nursing level, kappa coefficient was 0.72, P < 0.05, suggesting that the consistency was better. According to the kappa coefficient, 17 clinical departments could be divided into three categories, namely the applicability of DSAS were different in different departments. Conclusions DSAS can be used as a objective basis for division of nursing level and has a certain clinical significance. But in order to make it guide clinical work better, scoring system with department characteristic should be developed on the basis of DSAS.

Objective To investigate the feasibility of diffusion-weighted imaging (DWI) for differentia-tion of small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) at 3.0 T MRI. This study also aims to optimize b values. Methods Thirty-six patients with lung cancer proved by pathology were examined by T2WI and DWI (b = 400, 600 and 800 s/mm2) and apparent diffusion coefficient (ADC) values of each lesion were calculated among different b values. The receiver operating characteristic (ROC) curves were used to calcu-late the difference between the ADC of SCLC and NSCLC and to evaluate the diagnostic capability. Analysis of variance was used to determine difference in ADC of NSCLC histological types at the optimal b values. Results The ADC values of SCLC and NSCLC decreased with increasing b values , and the differences were statistically significant (P = 0.002, P < 0.001). ROC analysis showed that the area under curve (AUC) values were 0.775、0.892、0.804 (b = 400, 600, 800 s/mm2, respectively). The AUC with a b value of 600 s/mm2 was the largest. When an ADC of 1.296 × 10-3 mm2/s was considered as a threshold, the sensitivity, and specificity were 76.9%, and 90.0%, respectively. Conclusion DWI reflects the diffusion motion of water protons in lung carcinoma and it has moderate diagnosis potency in differentiating SCLC and NSCLC. The optimal b value is 600 s/mm 2.

Objective:To reveal the relation between RUNX1 and hematopoietic cells by examination of the expression of RUNX1 and its target gene SLC9A3R1 in bone marrow CD34+ cells from patients with psoriasis,as well as the RUNX1 linkage locus between SLC9A3R1 and NAT9.Methods:Bone marrow CD34+ cells were isolated from psoriatic patients and normal persons by immunomagnetic cell selection.Expression of mRNA for RUNX1 and SLC9A3R1 were analyzed using reverse transcriptase-polymerase chain reaction(RT-PCR),the RUNX1 linkage locus between SLC9A3R1 and NAT9 was detected.Results:The positive frequency of RUNX1 in bone marrow CD34+ cells from patients with psoriasis was lower than in normal controls(P

Objective:To observe the effect of Jiedu Huoxue Prescription on gastrin of atrophic gastritis rats. Methods:The atrophic gastritis rats model was established by using combination of MNNG, sodium salicylate, hot saline water and irregular diet. The blood serum gastrin content was detected with RI. Results: Compared with model group, the contents of gastrin in Jiedu Huoxue Prescription group, sanjiu group and weimeisu group increased significantly (P

Objective To study the expressions of Notch receptors (Notch1 and 2) and target gene Hes-1 in bone marrow CD34+ cells from patients with psoriasis. Methods CD34+ cells were isolated from the bone marrow of 12 patients with psoriasis and 19 normal human controls. Western blot was conducted to detect the expressions of Notchl, Notch2 and Hes-1 proteins in CD34+ cells, with the house-keeping gene β-actin as an internal reference. Results In contrast with normal controls, a significant increment was observed in the expressions of Notch1 and Hes-1 proteins in psoriatic patients (0.9488 ± 0.3221 vs. 0.6693 ± 0.1465, 0.8579 ±0.3729 vs. 0.5728 ± 0.1787, both P ＜ 0.05). No significant difference was observed in the expression of Notch2 between psoriatic patients and normal controls (0.7568 ± 0.3461 vs. 0.8312 ± 0.2887, P ＞ 0.05).Conclusion The overexpression of Notch1 and Hes-1 may be associated with the low proliferation activity of psoriatic hematopoietic cells.

Objective To assess the preferential expressions of peripheral blood T cell receptor beta chain variable region (TRBV) subfamilies in patients with psoriasis vulgaris(PV), and to estimate their role in the pathogenesis of psoriasis. Methods Thirty-three upstream primers were designed to target the human functional TRBV genes, downstream primers to target the common T cell receptor beta constant (TRBC) gene,with T cell receptor alpha constant (TRAC) gene as the internal reference. Total RNA was extracted from the peripheral blood T cells of 10 health human controls and 10 patients with PV, and transcribed into cDNA.Then, TRBV genes were amplified by real-time fluorescence quantitative PCR (RFQ-PCR) and the fluorescence intensity of each samples was detected. The expression levels of TRBV genes in the control group were used to calculate the cut-off values (mean expression levels of TRBV subfamilies in the 10 normal controls + 3 standard deviations). When the expression level of a TRBV subfamily from patients with PV was equal to or higher than the cut-off value, it was considered as the preferentially expressed TRBV subfamily. Results The threshold cycle (Ct) value varied from 21 to 24 for TRAC gene. The difference in the Ct value between TRBV subfamily genes and TRAC gene in patients with PV was 2.98 for TRBV2 gene, 3.24 for TRBV5-7 gene, 2.52 for TRBV6-6/6-9 gene, 2.04 for TRBV 12 gene, 3.56 for TRBV 24 gene, and 4.12 for TRBV 29 gene, and the expression levels of these subfamily genes were significantly higher than those in the normal controls (all P ＜ 0.05). According to the above standard, TRBV6-6/6-9, TRBV12 and TRBV29 were considered to be preferentially expressed subfamilies. Conclusions There is a preferential expression of TRBV gene subfamilies in peripheral blood of patients with psoriasis vulgaris, which may play a vital role in the abnormal T cell-mediated immune responses in psoriasis.

Objective To investigate the benefits and challenges of medical student volunteers'involvement in community diabetes education and to provide evidence for future development and suggestions.Methods Self-made questionnaire survey and interview were conducted among members of community health education volunteer in Southeast University.Data concerning basic group composition,major service contents,intention and gain,sources of motivation,knowledge acquisition and skill training were analyzed.Results 88.t04％ volunteers chose professional work as the kind of work they were most interested in,in contrast,69.56％ did nonprofessional work in reality.Initial intention of 66.30％ volunteers was ‘to beautify curriculum vitae'.‘Morality promotion' was taken as major gain by most volunteers (36.96％) while ‘morality promotion' was the initial intention of only 4.89％ volunteers.46.20％volunteers thought that their sources of motivation came from ‘ recognition of society and university'.Through training and voluntary service,it was evident that volunteers gained increased diabetes knowledge,stronger professional identity and confidence as well as deeper understanding of patients' needs,but there were real demand for training in education and clinical skills.Conclusions The introduction of medical student voluntary service into community diabetes education is a win-win cooperation,which can cultivate college students' high morality as well as strengthen the community health education team.However,we still face challenges in volunteer team building and management.

Objective To probe into the variation of CT values of surface enhanced layers of nasopharynx wall,intensified regularity and choosing the best scanning time.Methods 138 patients received conventional plus enhanced CT scan and 58 cases of them received delayed and repeated scans.Results 83% of the cases were correspondent to the surface of nasopharynx and had manifest linear enhancement.After giving contrast injection,it reached 97% at the 74 second.All CT values of the cases were enhanced in the phase of 92～344 second.Conclusion The ratio of linear enhancement is manifestly high,which is very helpful to the CT diangosis of NPC restricted to or under the mucosa.The best acquisition time should be just before or after the 74 second,correspondent to the surface of nasopharynx.The enhancement lasted long.