Objective: To study the entry points of pharmaceutical care performed by clinical pharmacists for patients in ICU.Methods: Clinical pharmacists participated in the medication treatment process of one case of patient with torsade de pointes by providing individualized pharmaceutical service, including antiarrhythmic drug selection, anti-infection therapy adjustment and electrolyte disorder rectification.Results: The therapeutic effect and medication safety of the patient were both improved by giving clinical pharmaceutical care.The vital signs of the patient were stable, and then the patient transferred from ICU and continued to be treated with rehabilitation therapy.Conclusion: Clinical pharmacists can play an active role in the rescue of ICU patients by the pharmaceutical thinking and provide efficient pharmaceutical care with high quality.

Objective To study on antibacterial effect of active ingredient of se-enriched Macleya cordata.Methods Penicillin sodium and saline as control, detected the average inhibition zone diameter of se-enriched Macleya cordata group ( containing 0.96 mg/mL sanguinarine) on 9 common bacteria with disc agar diffusion method;20% methanol and saline as control, se-enriched Macleya cordata group which the average inhibition zone diameter was minimum, without se-enriched Macleya cordata group and penicillin sodium were diluted with 20% methanol, made concentration of 0.48, 0.24,0.12,0.06, 0.03 mg/mL.minimal inhibitory concentration ( MIC) of each treatment group was determined by agar dilution method, evaluated antibacterial effect of se-enriched Macleaya cordata group.Results se-enriched Macleya cordata group could improve antibacterial effect significantly, the average inhibition zone of 100 μg/mL sodium selenite treatment group was minimum(Φ15.33 mm);MIC of se-enriched Macleya cordata group on E.coli O1 , E.coli P22 , E.Dublin reduced from 0.96 to 0.24 mg/mL;MIC of S.typhimurium and S.suipare were 0.12 mg/mL;MIC of S.aureus and S.suis were 0.06 mg/mL; MIC of E.Dublin and L.murrayi were less than 0.03 mg/mL.Conclusion Se-enriched Macleya cordata improves the antibacterial effect signififcantly, and it lays the theoretical foundation for development and utilization of se-enriched Macleya cordata for future.

Objective To describe our experience and method of reconstruction after resection of tumors around inner canthus and nasion in the elderly. Methods The line between outer and inner canthus was considered during reconstruction.If the surface of wound after resection was above this line,glabellar flap was used to reconstruct the upper part and the residual defect was repaired with advancement of lower eyelid and rotation of flap.If the surface of wound was below this line,lower eyelid flap was used and the residual defect was reconstructed with glabellar flap. Results All flaps survived without any significant complications.9 cases among 15 patients were followed up from 1 to 24 months.Repaired tissues all matched well with surrounding tissue in color,texture,and outline.Eyelid and medial canthal were not disturbed and there was no tumor recurrence.Scars were smoothy,soft and hidden with satisfactory appearance and vision. Conclusions Single local flap or combined local skin flaps around the nasion and inner canthus is one of reconstruction methods to get satisfactory cosmetic effect or facial morphology.

Objective To establish a fluorosis model induced by coal burning and in ameloblasts of rat offsprings.Methods High fluoride air model was established based on the burning coal habit of the epidemic areas.Fluoride feed was made of corn dried by coal burning.Thirty-six SD rats were divided into 3 groups by random number table method according to body weight in a male and female ratio of 2 ∶ 1∶ in the high fluoride air room and rats were feed food with fluorine at 40 mg/kg (high fluoride group),25 mg/kg (low fluoride group);in the normal air room and rats were feed food with fluorine at 0 mg/kg (the control group),12 rats in each group.Mating litter in a ratio of 2 ∶ 1 at the end of 8 weeks.The offsprings were killed on postnatal day 3 and 7 to make mandible sections.Specimens were prepared for light microscope examination to observe the morphological changes of ameloblasts in the tooth germ.Results At the end of 0,2,4,6 and 8 weeks,serum fluoride of the high fluoride group were (0.031 ± 0.003),(0.060 ± 0.006),(0.085 ± 0.006),(0.110 ± 0.007) and (0.134 ± 0.008) mg/L;serum fluoride of the low fluoride group were (0.031 ± 0.003),(0.046 ± 0.005),(0.077 ± 0.006),(0.091 ± 0.007) and (0.104 ± 0.007) mg/L;serum fluoride of the control group were (0.030± 0.003),(0.037 ± 0.002),(0.044 ± 0.002),(0.046 ± 0.003) and (0.049 ± 0.003) mg/L.At the end of 2,4,6 and 8 weeks,serum fluoride of high fluoride group and low fluoride group were significantly higher than that of control group (all P ＜ 0.05).At 7 d,offspring rats in high fluoride group,adamantoblasts were in distortions and vacuole changes,but offspring rats in low fluoride group and the control group had no abnormality.Conclusion By providing rat with high fluoride air and food,we could establish a fluorosis model induced by coal burning in ameloblasts of rat offsprings.

Objective To study the influence of parental generation coal-burning-borne fluorosis on tooth development of their offspring.Methods High fluoride air model was established on the basis of burning coal habit of the epidemic areas.Fluoride feed was made of coal drying corn from the epidemic areas.Totally 48 SD rats were randomly divided into 4 groups with male to female ratio of 1:1 by random number table method.Rats in high,middle and low fluoride groups were put in the high fluoride air room and feed food with 40,25 and 10 mg/kg fluorine,and the control group was put in normal air room and feed normal food.After 8 weeks,rats were mating and parturition.Tooth eruption time of offspring rat was observed;and dental fluorosis incidence,the tooth length and fluorine content were observed at 21 d.Results In high and middle fluoride groups [(6.83 ± 0.94),(6.25 ± 1.06) d],tooth eruption time of offspring rat was later than that of control group [(5.34 ± 0.89) d,all P ＜ 0.01].At 21 d,dental fluorosis was observed in the lower incisors of the high and middle fluorine groups;compared with control group [(5.21 ± 0.19) mm,(223.00 ± 14.08) μg/kg],the tooth length was decreased [(4.83 ± 0.22),(4.96 ± 0.25) mm,P ＜ 0.01or ＜ 0.05],and tooth fluoride content was increased [(362.64 ± 20.35),(289.79 ± 19.18) μg/kg,all P ＜ 0.01].Dental fluorosis incidence of offspring rats was positively correlated with the fluorine dose (r =0.704,P ＜ 0.01).Conclusion Parental generation rats’ intaking excessive fluoride can affect offspring rats tooth development and dental fluorosis,which is related to the fluorine dose.

This study was aimed to summarize the adverse drug reaction (ADR) caused by the toxicity of Tripterygium Wilfordiiand its preparations, in order to explore possible relationship betweenTripterygium Wilfordiifactors and reported ADR. Relevant articles on toxicity ofTripterygium Wilfordiiand its preparations were systematically searched in 5 databases, including the Pubmed, CNKI,Wanfang Data, VIP Data and Sinomed from the database was established until Feb 25th, 2014. And then, the randomized controlled trials (RCTs) were systematically collected, analyzed and summarized. The results showed that there were 260 RCTs with 13301 patients included. The outcome of data analysis showed that ADR rates of digestive system and reproductive system of RCT1 and RCT2 were different. ADR rates (per hundred people) in RCT1 and RCT2 were as follows: digestive system were 14.73 and 12.26, reproductive system were 8.25 and 8.00, liver was 6.50 and 5.66, kidneys were 6.79 and 3.03, blood system were 6.73 and 6.50, cardiovascular system were 2.35 and 0.67, skin and mucous system were 11.42 and 4.78, respectively. Articles on rheumatoid arthritis (RA) of both RCT1 and RCT2 were the highest, which occupied 22.17% in RCT1 and 63.16% in RCT2. The corresponding ADR rates were 34.18 and 27.26. The standard deviation (SD) of 7 disease types, which were RA, IgA nephropathy, nephritis, nephrotic syndrome (NS), diabetic nephropathy, psoriasis, lichen and rashes, as well as uterine fibroids, was 8.69 in RCT1. The SD of RA, IgA nephropathy, psoriasis, lichen and rashes was 7.11 in RCT2. It was concluded that the possible ADR distribution ofTripterygium Wilfordiiand its preparations were the highest in the digestive system, reproductive system and liver. Besides, different diseases (i.e., RA, nephritis, NS, and etc.) had huge differences with their correspondent ADR rates. Therefore, it was suggested that specific measures should be taken to select the appropriateTripterygium Wilfordiipreparation, protect the stomach and liver during the application ofTripterygium Wilfordiiand its preparations. During medication, attentions should be paid to the reaction of patients. Stop the medication when necessary to minimize ADR rates to the lowest.

Objective To summarize the medical rescue of Chinese Government Medical Team (Chongqing) in Nepal earthquake region in order to explore the work pattern of transnational medical rescue,and improve the rescue efficiency.Methods From the experience about the post-earthquake medical rescue of Chinese Government Medical Team (Chongqing) in Nepal in 2015,several aspects were worthy to summarize such as the establishment of medical team,the layout of camp site,the work algorithm and process,with the analysis of injury feature and outcome of treatment.Results Under the setting of efficient organization and rational assignment of professional work,special working rules,the mutual transfer treatment and multi-disciplinary treatment were employed for 737 emergency patients.Of them,128 patients were hospitalized (including 63 patients completely recovered,56 patients were of clinical improvement,and 9 patients were critically ill transferred to other hospital for advanced treatment),and post-traumatic complication occurred in 48 cases without death.In addition,148 operations were carried out successfully.Conclusions The earthquake disaster has specific feature such as suddenness,a host of casualties and poor rescue conditions,and overseas rescue is with the presence of the language barrier,the difference in living habit,and the lack of coordination with local rescue system,therefore,rationally assigning personnel and resources and establishing work pattern with flexibility,orderly and good communication are the key to promote the efficiency of transnational medical rescue for the injured patients in earthquake region.

OBJECTIVETo study the immunohistochemical expression of S100A1, GLUT-1 and Cavolin-1 and its diagnostic significance in renal tumors with oncocytic features.

METHODSTissue microarray and immunohistochemical staining for S100A1, GLUT-1 and Cavolin-1 were carried out in 59 cases of renal tumors with oncocytic features, including 19 cases of renal oncocytoma, 15 cases of clear cell renal cell carcinoma (CCRCC) with eosinophilic cells, 11 cases of eosinophilic variant of chromophobe renal cell carcinoma, 7 cases of oncocytic papillary renal cell carcinoma and 7 cases of epithelioid angiomyolipoma.

RESULTSS100A1 was expressed in renal oncocytoma, with a positive propotion of 16/19 (including 14 cases showing widespread and strong positivity). On the other hand, the rate of expression of S100A1 was 2/11 in eosinophilic variant of chromophobe renal cell carcinoma, 10/15 in CCRCC with eosinophilic cells, 3/7 in oncocytic papillary renal cell carcinoma and 6/7 in epithelioid angiomyolipoma (P>0.05). The difference of S100A1 expression between renal oncocytoma and eosinophilic variant of chromophobe renal cell carcinoma was statistically significant. GLUT-1 was located in cell membrane, with a positive rate of 13/15 in CCRCC with eosinophilic cells, 7/19 in renal oncocytoma, 4/7 (weak) in oncocytic papillary renal cell carcinoma, 1/11 in eosinophilic variant of chromophobe renal cell carcinoma and 0/7 in epithelioid angiomyolipoma. The rate of expression of Cav-1 was 6/15 in CCRCC with eosinophilic cells, 2/7 in oncocytic papillary renal cell carcinoma, 5/7 in epithelioid angiomyolipoma, 2/11 (weak) in eosinophilic variant of chromophobe renal cell carcinoma and 0/19 in renal oncocytoma. S100A1 showed high sensitivity and 50% specificity in the diagnosis of renal oncocytoma. GLUT-1 and Cav-1 showed high specificity and sensitivity in the diagnosis of CCRCC and epithelioid angiomyolipoma.

CONCLUSIONSS100A1 is widely expressed in various oncocytic renal neoplasms and helpful in differential diagnosis of renal oncocytoma from eosinophilic variant of chromophobe renal cell carcinoma, but not from other 3 oncocytic renal tumors. Overexpression of GLUT-1 can be used in distinction between CCRCC and renal oncocytoma. Cav-1 is widely expressed in CCRCC and epithelioid angiomyolipoma but not in renal oncocytoma. Cav-1 expression thus rules out renal oncocytoma.

Adenoma, Oxyphilic ; diagnosis ; metabolism ; Angiomyolipoma ; diagnosis ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Renal Cell ; diagnosis ; metabolism ; Caveolin 1 ; metabolism ; Diagnosis, Differential ; Glucose Transporter Type 1 ; metabolism ; Humans ; Immunohistochemistry ; Kidney Neoplasms ; diagnosis ; metabolism ; S100 Proteins ; metabolism ; Sensitivity and Specificity

Sestrins is a stress-induced protein family, which is characterized by increased expres-sion in disease or stress, and plays its role in anti-inflammation, anti-oxidation and anti-aging, but its spe-cific molecular mechanisms and signal pathways are very complex. This review summarizes the related re-searches on sestrin in the past few years, and analyzes its specific functions and recent research progress in combination with its molecular structure.

The clinical characteristics of the pneumonia includes hyperthermia, cough and pectoralgia, etc with simultaneous mixed signs of inflammatory infiltration, consolidation, cavity/air sac and abscess in pulmonary CT scan, and these signs change rapidly. Respiratory failure and septic shock frequently occur in severe such patients, resulting in refractory management and relatively long therapeutic course. The timely diagnosis, use of sensitive antibiotics, respiratory and nutritional support, etc comprehensive effective measures can elevate the rescue success rate with severe hematogenous staphylococcus aureus pneumonia.