Objective:To find out the general regularity of antibiotic encephalopathy caused by cefepime through the case analy -sis, and give reasonable suggestions according to the clinical features .Methods: According to the patient's conditions , the clinical pharmacist consulted a large number of literatures and excluded the other factors such as the clinical manifestation of the patient and the used drugs.The clinical pharmacist analyzed the possibility of drug-induced nervous system damage in the aspects of the administration time, dose, drug interactions and changes of symptoms and signs after the drug withdrawal .Results:The clinical pharmacist performed the rational analysis and judgment , provided suggestions for the doctors , and terminated the nervous system damage caused by cefepime in time.Conclusion:In clinical practice , clinical pharmacists analyze drug therapy events and provide pharmaceutical care , which is beneficial to safe and rational drug use .

Objective: To explore the entry points and monitoring points of individualized treatment for fracture surgery patients with ARDS.Methods: Clinical pharmacists comprehensively assessed the patient's conditions and looked up lots of literatures.Some suggestions on the anti-infection treatment efforts, glucocorticoid use dispute and rational use of ambroxol were offered.The efficacy and adverse reactions of drugs in the treatment process were monitored using some subjective and objective indicators.Results: The consensus about the pros and cons, dosages, as well as the possible dosage decrease of glucocorticoid therapy, the dosages of antimicrobial agents, and the dosages and treatment course of ambroxol was achieved between clinical pharmacists and doctors.As a result, the maximum benefits were obtained for the patient.Conclusion: Clinical pharmacists can explore the treatment and monitoring for specific diseases and find out intervention entry points of clinicians and patients to play a certain role in clinics, and accumulate treatment experience gradually.

Objective To analyze whether routine prophyrlactic antibiotic administration is necessary for the patients undergoing coronary stent implantation. Methods The clinical data of 156 patients from January 2010 to December 2010 (prophylactic antibiotic therapy),and 466 patients from January 2014 to December 2014(no-prophylactic antibiotic therapy), who underwent coronary stent implantation, were retrospectively analyzed. The prophylactic antibiotics and the infection rates in two groups were compared. Results The rate of infections related to coronary stent implantation in no-prophylactic antibiotic therapy group and prophylactic antibiotic therapy group, such as surgical site infection (0.2% vs 1.3%,P>0.05) and catheter-related infection(0.6% vs 1.9%,P>0.05), was not significant different(P>0.05). Similarly, the unrelated to coronary stent implantation was not significant different, too ( P > 0. 05). Conclusion Routine prophylactic antibiotic administration is unnecessary for the patients undergoing coronary stent implantation.

OBJECTIVETo make a comparatively analysis of the effects of 10% KCl injection into the fatal cardiac area and yolk-sac aspiration on multifetal pregnancy reduction.

METHODSTwenty-three patients with multifetus were selected in the investigation. Eight of the patients accepted 10% KCl injection into the fatal cardiac area, and 15 of them received yolk-sac aspiration. The average number of punctures, average time of reduction operation, failure rate of operation, abortion rate, and infection rate were observed.

RESULTSThe average time of reduction operation[(2.8 +/- 0.7) min] of aspiration was significantly lower than that of 10% KCl injection [(5.11 +/- 1.35) min] (P < 0.05). The infection rate of yolk-sac aspiration was 6.7%, lower than that of 10% KCl injection (37.5%) (P > 0.05). Cardic area injection showed a higher infection rate, and no significant difference was observed in the average number of punctures, failure rate of operation and abortion rate(P > 0.05).

CONCLUSIONAlthough both yolk-sac aspiration and cardiac area injection were safe and reliable methods for multifetal pregnancy reduction, the former is worth recommending for its shorter operation time heeded and lower infection rate, especially for the multifetal patients within 60 gestation days.

Adult ; Female ; Humans ; Postoperative Complications ; etiology ; Potassium Chloride ; administration & dosage ; Pregnancy ; Pregnancy Reduction, Multifetal ; adverse effects ; methods ; Ultrasonography, Prenatal

Objective To summarize clinical experience of using extracorporeal membrane oxygenation (ECMO) in rescuing children with acute fulminant myocarditis (AFM).Method Data of 12 children with acute fulminate myocarditis (6 boys and 6 girls,median age 8.3 (0.6,13.0) years,median weight 33.1 (6,61) kg) who were rescued with ECMO in Children's Hospital,Zhejiang University from September 2009 to August 2015 were analyzed retrospectively.The analysis focused on the intervene timing of ECMO for the cardiogenic shock and hypoperfusion caused by heart failure and(or) lethal arrhythmia and the essentials of ECMO cardiopulmonary resuscitation (ECPR) for cardiac arrest in pediatric AFM were summarized.Result The median ECMO duration was 110(22,240) h.Ten cases survived and 2 were dead of the total of 12 patients.Six ECPR patients survived and 2 were dead in the total of 8 ECPR patients.The complication of 10 survivors were cannula site bleeding (3 cases),hypematremia and intracranial hemorrhage (1 case),limping (1 case),hoarse voice (1 case),and cerebral injury (1 case).Conclusion The key points of improving ECMO rescuing outcome for the AFM children are grasping the ECMO intervene timing and training skilled ECMO team.For ECPR patients,keeping effective chest compressions resuscitation is the key to achieve survival and improve the quality of life.

Caenorhabditis elegans hid-1 gene was first identified in a screen for mutants with a high-temperature-induced dauer formation (Hid) phenotype. Despite the fact that the hid-1 gene encodes a novel protein (HID-1) which is highly conserved from Caenorhabditis elegans to mammals, the domain structure, subcellular localization, and exact function of HID-1 remain unknown. Previous studies and various bioinformatic softwares predicted that HID-1 contained many transmembrane domains but no known functional domain. In this study, we revealed that mammalian HID-1 localized to the medial- and trans- Golgi apparatus as well as the cytosol, and the localization was sensitive to brefeldin A treatment. Next, we demonstrated that HID-1 was a peripheral membrane protein and dynamically shuttled between the Golgi apparatus and the cytosol. Finally, we verified that a conserved N-terminal myristoylation site was required for HID-1 binding to the Golgi apparatus. We propose that HID-1 is probably involved in the intracellular trafficking within the Golgi region.
Animals ; Brefeldin A ; pharmacology ; Cell Line, Tumor ; Cytosol ; drug effects ; metabolism ; Humans ; Intracellular Space ; drug effects ; metabolism ; Membrane Proteins ; metabolism ; Protein Transport ; drug effects ; Rats ; Vesicular Transport Proteins ; metabolism ; trans-Golgi Network ; drug effects ; metabolism

Whether inhibiting the activity of nuclear factor (NF)-κB potentiates cisplatin-induced apoptosis in non-small cell lung cell line A549 cells was investigated. The recombinant plasmid pcDNA3.1(+)/IκBα expressing IκBα was constructed. The in vitro cultured A549 cells were trans-fected with pcDNA3.1(+)/IκBα alone, or pcDNA3.1(+)/IκBα combined with cisplatin. The mitochondrial membrane potential (△ψm) was determined by rhodamine 123, the activity of caspase-3 was tested by colorimetric assay, and cell apoptosis was detected by flow cytometry with the annexin V/propidium iodide assay. The results showed that the activity of NF-κB in A549 cells was inhibited by transfecting pcDNA3.1(+)/IκBα. Transfection of pcDNA3.1(+)/IκBα alone did not promote apoptosis. Treatment of cisplatin alone had a little effect on cell apoptosis. Transfection of pcDNA3.1(+)/IκBα combined with cisplatin treatment significantly induced apoptosis of A549 cells. It was concluded that inhibiting the activity of NF-κB potentiated cisplatin-induced apoptosis of A549 cells.

OBJECTIVE To explore the surgical approach and method for treating giant sternal goiter through the neck. METHODS A retrospective analysis was conducted on the clinical data of 31 patients with massive retrosternal goiter admitted to the Department of Otolaryngology Head and Neck Surgery at Southeast University Affiliated Zhongda Hospital from January 2016 to December 2022. RESULTS All patients underwent complete tumor resection through a low neck neck incision,with an average surgical time of 131.64 minutes and an average blood loss of 80 ml. Surgical methods:Total thyroidectomy in 18 cases,left lobe and isthmus resection in 9 cases,and right lobe and isthmus resection in 4 cases. Two cases were transferred to the intensive care unit for transition after surgery,and the remaining 29 cases were all returned to the general ward;No deaths have occurred;Postoperative pathology:The postoperative pathological types were nodular goiter in 21 cases,papillary thyroid carcinoma in 4 cases,follicular thyroid tumors in 2 cases,follicular thyroid carcinoma in 2 cases,large B-cell lymphoma in 1 case,and thyroid borderline tumor in 1 case. Follow up for 6 months to 3 years,with no recurrence cases. CONCLUSION The surgical treatment of huge thyroid nodules behind the sternum through the cervical approach requires thorough preoperative evaluation,understanding of surgical indications,and the use of a low neck incision. During the operation,the main blood vessels supplying the thyroid gland are gradually ligated,separated,and the huge thyroid nodules are pulled out from behind the sternum,successfully and completely removed from the neck,avoiding open chest surgery,reducing the occurrence of related complications,and shortening the patient's course of illness.

OBJECTIVE To explore the clinical characteristics,diagnosis and treatment of primary hyperparathyroidism(PHPT),and to improve the diagnosis and treatment ability of this disease.METHODS The clinical data of 27 patients with PHPT admitted to Southeast University Affiliated Zhongda Hospital from January 2016 to June 2023 were retrospectively analyzed,and the clinical characteristics,preoperative diagnosis,surgical treatment and postoperative follow-up were summarized.RESULTS All patients had elevated serum calcium and parathyroid hormone before operation,and were diagnosed before operation.All patients underwent parathyroidectomy with low neck incision,19 underwent unilateral parathyroidectomy and 8 underwent bilateral parathyroidectomy.PTH was rapidly detected 10 min after resection of the diseased gland,all 27 cases terminated surgery after PTH decreased by more than 50%.All patients experienced no postoperative complications such as hoarseness and coughing due to diet.There were 20 cases diagnosed pathologically as parathyroid adenoma and 7 cases diagnosed as parathyroid hyperplasia after operation.After operation,15 patients had short-term hypocalcemia,the hypocalcemia patients were treated with calcitriol and calcium for 2-4 weeks and their blood calcium returned to normal.and one patient was slightly higher than normal value,the hypercalcemia returned to normal about one week after operation.The remaining patients had normal serum calcium after operation.The parathyroid hormone returned to normal in 27 patients within 6 months.All patients were followed up for 6 months to 6 years,and no one recurred.CONCLUSION Parathyroidectomy is the best treatment for PHPT.Preoperative imaging location and intraoperative PTH measurement are helpful to narrow the exploration range,shorten the operation time and reduce the complications.

Objective To evaluate the effect of combination of uterine artery chemoembolization and curettage in treatment of caesarean scar pregnancy(CSP),and to analyze the possible influence factors.Methods 46 cases with caesarean scar pregnancy treated by the combination of uterine artery chemoembolization and curettage were retrospectively analyzed.Univariate analysis was made on the factors that might influence the efficacy,and the Logistic regression model was constructed for the significant variables.Results All of the patients were terminated pregnancy succesfully .According to the ultrasound recheck,there were no residual gestational sac tissue in 29 patients,and some residual gestational sac tissue in 17 patients.After the application of traditional Chinese medicine or methotrexate and other symptomatic treatment, the pregnancy was terminated.The univariate analysis showed that the number of cesarean section,the gestational sac volume,the gestational weeks,the type of CSP,and the condition of the fetal heart pulsation were related to the presence of residues in the uterus after treatment (P＜0.05).The multivariate analysis showed that gestational sac volume ＞9 cm3 ,gestational weeks ＞ 7 weeks and exogenous CSP were the independent factors leading to intrauterine residual gestational sac tissue.Conclusion Uterine artery chemoembolization combined with curettage is an effective method for treatment of caesarean scar pregnancy.It is proposed that clinical treatment should pay close attention to the factors that may affect the efficacy.