Objective:To analyze the participation of clinical pharmacist in the process of diagnose and treatment of typical critical patients and summarize the clinical and pharmaceutical thoughts of clinical pharmacist in pharmaceutical care in order to provide better service for clinics .Methods:Through the participation of clinical pharmacist in the process of diagnose and treatment of one patient with hypernatronemia complicated with demyelination after liver abscess drainage , and combined with the results of laboratory tests and imaging examination and drug treatment regimen , clinical pharmacists analyzed the radical causes of apostasies and feasible therapeutic measures, and then provided the reasonable suggestions for the medication .Results: Clinical pharmacist paid close attention to the medication history and disease evolution of the patient , assessed the therapeutic efficacy timely , communicated and discussed with clin-ical doctors actively , and then made out individualized treatment schedule for the patient , which obtained promising effects .Conclu-sion:Clinical pharmacist should grasp the principal contradictions and pay attention to details , which can play an important role in the treatment course of severe patients .

Objective To investigate the clinical significance of the changes of hypersensitive C-reactive protein (hs-CRP) and myocardial enzyme spectrum,cardiac troponin Ⅰ (cTn Ⅰ) in patients with Henoch-Schnlein purpura.Methods 100 patients with Henoch-Schnlein purpura were selected.50 patients only skin involved were selected as the simple group,50 patients accompanied by other organs involved were selected as mixed group.50 healthy people in the same period were selected as the control group.The serum hs-CRP,myocardial enzyme spectrum and cTn Ⅰ were tested and compared.Results The hs-CRP,serum myocardial enzyme spectrum and cTn Ⅰ levels of mixed and simple group were significantly higher than the control group(all P ＜ 0.05) ; Serum CK-MB,cTn Ⅰ and hs-CRP levels of the mixed group were significantly higher than those of simple group (all P ＜ 0.05).The abnormalities number of CK-MB and cTn Ⅰ respectively accounted for 33％ (33/100) and 32％ (32/100) ;The constituent ratio of the number of abnormal serum CK-MB and cTn Ⅰ of the mixed group was significantly higher than the simple group (x2 =4.047,3.908,all P ＜ 0.05) ;The Pearson correlation analysis showed that the relationship between the serum hs-CRP and CK-MB,cTn Ⅰ levels was linear,which were positively correlated (r =0.872,0.801,all P ＜ 0.05).Conclusion Patients with allergic purpura should early detect the serum levels of hs-CRP,myocardial enzyme spectrum and cTn Ⅰ,and treat the myocardial injury in time.

Fibroblast growth factor receptor ( FGFR) is one of the molecules involved in tumor formation , and plays an impor-tant role in cell proliferation , angiogenesis and migration .In this article, we review the role of FGFR signal pathway in breast cancer , the correlation with the risk and prognosis , the function of FGFRs as potential therapeutic targets for breast cancer and discuss various treatment strategies of targeted FGFR 1 in clinical trials .

Objective To learn the clinical effect and adverse reaction of hydromorphone for continuous epidural analgesia after cesarean section,and to provide effective anesthesia method for clinical.Methods 116 cases of cesarean section were randomly divided into observation group(65 cases) and control group(51 cases),continuous epidural analgesia was used in the two groups after operation.Among them,hydromorphone + ropivacaine was used for the observation group,morphine + ropivacaine was used for the control group.The analgesic effect and sedation degree of the two groups were evaluated.The adverse drug reactions were observed,and satisfaction of the patients after the operation was investigated.Results 6,9,24 hours after operation,the VAS pain scores of the observation group were lower than those of the control group,the differences were statistically significant(t=3.236,4.970,2.547,all P<0.05).3,6,9,24,48 hours after surgery, the differences of Ramsay sedation score between the two groups were not statistically significant(t=0.717,1.502,0.714,1.051,0.589,all P>0.05).The difference of postoperative first exhaust time between the two groups was not statistically significant(t=0.730,P>0.05).The satisfaction degree of the observation group was significantly higher than that of the control group,the difference was statistically significant(t=2.301,P<0.05).The incidence rate of adverse reactions of the observation group was 7.69%,which of the control group was 11.76%,the difference was not statistically significant(x2=0.552,P>0.05).Conclusion For continuous epidural analgesia after cesarean section,hydromorphone can effectively relieve the pain after operation,the safety of the process is high,and it has good clinical application value.

Objective To observe therapeutic effect of naoxintong on the patients with cerebral infarction.Methods 69 patients with cerebral infarction were randomly allocated to naoxintong group or control group. All patients were treated with 20ml shuxuening injection into veins and aspirin 100mg once a day, and those in naoxintong group were treated with naoxinting moreover. Neurological deficit scores (NDS) were evaluated before and after 1 month and 2 months of treatment Results Effective rate and notable effective rate of naoxintong group after 2 months of treatment were 97% and 88% ,obviously higher than those of control group 79% and 52%. Conclusion Nongxintong treatment for cerebral infarction was effective.

Objective:To summary the antibacterial agent therapy adjustment performed by clinical pharmacists in the collabora-tive rounds. Methods:Combined with physicians, clinical pharmacists participated in the ward round and antibacterial agent selection for one case of hospital-acquired pneumonia, meanwhile, pharmaceutical care was performed for the patient. Results:Clinical pharma-cists chose appropriate antibacterial agents for the patient to cover the suspected pathogens and control the infection in time through par-ticipating in the ward round and paying attention to the disease course progress, medical history and medication history. Conclusion:Clinical pharmacists can enhance the quality of drug therapy through participating in the drug therapy, providing the proposal for the antibacterial agent use and performing pharmaceutical service for physicians and patients.

To analyze the effect of pre-surgical status on the post-surgical stereopsis in surgically aligned adult con-comitant strabismus.By using Titmus and Randot stereo tests,we measured near stereo acuity of 99 adults who had constant exotropia and were successfully aligned by surgery.A covariance analysis showed that the post-surgical stereo acuity was significantly determined by the type of strabismus (i.e.,whether that's intermittent or not;P =0.001),the duration of pre-surgical exotropia (P =0.002)and the year on-set (P =0.048)but not by the pre-surgical deviation (P =0.133).We conclude that the stereopsis of adult concomitant strabismus can be reestab-lished by surgery,while the extent of such an improvement is determined by the type of strabismus,the duration of pre-surgical exotropia and the year on-set of patients.

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for sever acute pancreatitis induced by hy-perlipidemia(HL-SAP)patient. METHODS:Clinical pharmacists participated in the therapy for a pregnant patient with HL-SAP af-ter cesarean section,assisted physicians to optimize therapy plan through analyzing the disease condition according clinical guide and relevant literatures. Clinical pharmacists suggested to decrease atorvastatin 20 mg,qd to 10 mg,qd in order to avoid the risk of rhabdomyolysis and liver injury. When patient’s hemogram kept stable and infection had been controlled,clinical pharmacists suggested antibiotics de-escalation treatment:Levofloxacin injection 0.5 g,ivgtt,qd+Metronidazole injection 0.5 g,ivgtt,q12 h in-stead of meropenem. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient was recovered and transfer to gastroenterology department 15 d later. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care for HL-SAP patient after cesarean section,and assist physicians to formulate therapy plan so as to reduce the incidence of ADR effectively and guaran-tee the safe and effective use of drugs.

Objective: To build the relationship model of job burnout, insecurity psychology, and insecurity behavior for miners. Methods: The valid random samples included 1229 miners from national and private coal mines, who were investigated with the revised Job-Burnout Inventory for Miners, Insecurity Psychology Inventory, and Insecurity Behavior Inventory. The data was analyzed through SPSS15.0 and AMOS7.0. Results: The three dimensions of job burnout had significant direct effect on insecurity behavior [β =0.008, 0.047, 0.019) .The three dimensions of job burnout had significant direct effect on psychological paralysis (β =0.031, 0.203, 0.374) and helplessness on security (β =0.206, 0.374, 0.472) . Emotional exhaustion and disengagement from work had significant effect on temporary psychology (β =0. 192, 0.411) and antagonistic psychology (β =0.079, 0.596) . Four dimensions of insecurity psychology had significant effect on insecurity behavior (β = 0.092, 0.023, 0.093, 0.097) and it was a mediator in the model. Conclusion: Miners'job burnout have significant direct effects on insecurity behavior, but also have indirect effects through the insecurity psychology mediator.