Objective To investigate the clinical significance of serum sialic acid (SA) in the diagnosis and treatment of IgA type multiple myeloma (MM). Methods The level of serum SA in 50 healthy subjects and 70 patients with MM were determined. Results In MM group, there were 25 cases of IgA type, 51 cases of other than IgA type (40 cases of IgG type, 7 cases of light chain type MM, 4 cases of non-secreting type MM). In healthy subjects, patients with IgA, IgG, light chain, non-secreting types and other than IgA type, the serum SA levels were (570.33 ± 67.72) mg/ L, (1289.24 ± 325.42) mg/ L, (585.88 ± 159.12) mg/L, (600.77 ± 126.90) mg/L, (590.50 ± 100.86) mg/L, and (588.39 ± 150.90) mg/L. The serum SA level of IgA type patients was higher than those of healthy subjects and other types (all P<0.01), and there was no significant difference among the other groups (all P> 0.05). The serum SA level of IgA type patients had positive correlations with serum IgA, globulin, bone marrow smear myeloma cell population and ESR (r values were 0.699, 0.753, 0.504, and 0.732, all P< 0.05); the serum SA level of IgA type patients had negative correlations with serum albumin, IgG, hemoglobin and platelet (r values were -0.712, -0.505, -0.629, and -0.596, all P< 0.05). The serum SA level of IgA type patients had no correlation with leukocyte, serum creatinine, serum IgM, lactic dehydrogenase, serum calcium, C-reactive protein and β2-microglobulin (all P>0.05). The level of serum SA in IgA type patients decreased with the improvement of the condition, and increased with the severity of the disease. Conclusions In MM patients, serum SA level in IgA type is high. The serum SA is an index for reflecting the tumor load capacity, and can evaluate the therapeutic efficiency of IgA type MM patients.

OBJECTIVE:To investigate the problems commonly occurred in outpatient prescriptions and to evaluate pharmacists’ role in the checking and intervention of prescriptions.METHODS:Questionable prescriptions recorded by outpatient pharmacists in their routine prescription checking from June,2004 to October, 2004 were classified and statistically analyzed. RESULTS:On average,the questionable prescriptions accounted for 0.35% of all the prescriptions dispensed by pharmacists. Of the questionable prescriptions,usage problems accounted for 43.0%,dosage accounted for 39.4%,volume dose accounted for 9.7%,frequency accounted for 2.7%.The results in prescribed frequency were significantly different before and after pharmacists intervention(P

Objective To investigate the changes of cardiac structure and function in type 2 diabetes mellitus (T2DM), analyze the related risk factors of heart failure, and improve the awareness of the effect of diabetes on the heart. Methods Randomly selected 170 cases of T2DM patients As the object of study, 170 cases of non diabetic patients as con-trol group, according to whether complicated with heart failure were divided into heart failure patients and non heart failure patients.Comparison of each group left ventricular posterior wall thickness, left ventricular end diastolic diameter, left ven-tricular end systolic diameter, left ventricular ejection fraction, E/A ratio Differences, analysis of the related risk factors of heart failure by logistic regressive.Results T2DM group left ventricular posterior wall thickness, left ventricular end diastolic diameter and left ventricular end systolic diameter increased , Left ventricular ejection fraction decreased, E/A ratio de-creased, were statistically significant difference compared with the control group (p <0.05).These differences are mainly come from non heart failure patients.Logistic regression showed that factors in patients with diabetes duration, HbA1c, com-pliance and complications of hypertension, coronary heart disease, is a risk factor for heart failure complicated with T2DM (all p<0.01).These may be the risk factor for diabetic patients with heart failure.Conclusion Diabetes can cause cardiac remodeling, systolic and diastolic dysfunction maybe some T2DM patients.They did not show symptoms of heart failure in the clinical, but their Cardiac structure and function are abnormal.We should pay attention to the cardiac function examination and early evaluation, prevention of risk factors, to avoid the occurrence of heart failure.

Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.

Objective To observe the effects of target-controlled infusion ofpropofol on hemodynamics during anesthesia induction in intracranial aneurysms interventional treatment.Methods Ninety patients in intracranial aneurysms interventional treatment were divided into three groups by random digits table method with 30 cases each:control group (group C),plasma drug concentration in target controlled infusion group (group P) and effect of chamber drug concentration in target controlled infusion group (group E).The induction of anesthesia:patients in group C were single intravenous injected with propofol of 2 mg/kg; patients in group P were set target plasma concentration of propofol with 4 μ g/ml.Patients in group E were set the effect target concentration of propofol with 4 μ g/ml.Three groups were set the concentration of remifentanil 4 ng/ml with plasma controlled infusion,and cisatracurium was injected with 0.2 mg/kg.Electrocardiogram,mean arterial pressure (MAP),heart rate (HR),end-tidal pressure of carbon dioxide,bispectral index,pulse oxygen saturation were continuously monitored.Before the time of induction (T0),immediately before intubation (T1),after intubation 1 min (T2),3 min (T3),5 min (T4),10 min (T5),arterial pressure and HR were recorded and the number of using vasoactive drugs were recorded.Results The level of MAP and HR among three groups at T0 had no significant difference (P ＞ 0.05).The level ofMAP and HR in three groups at T1 was significantly lower than that at T0.(P ＜ 0.05).The level of MAP and HR in group P was lower than that in group E and group C,and there was significant difference (P ＜ 0.05).The incidence of using vasoactive agen in group P was significantly lower than that in group C [6.7％(2/30) vs.40.0％ (12/30)],and there was significant difference (P ＜0.01).Conclusion Hemodynamics is relatively stable during anesthesia induction using plasma target controlled infusion with propofol in patients undergoing interventional therapy for intracranial aneurysm.

OBJECTIVE:To investigate the role of clinical pharmacist in pulmonary infection therapy for a patient with hyper-sensitivity to several kinds of antibiotics. METHODS:Through admission evaluation,clinical pharmacists participated in the formu-lation of pulmonary infection therapy regimen for a patient with hypersensitivity to several kinds of antibiotics. According to clinical efficacy and disease condition,clinical pharmacists adjusted therapy plan and provided individual pharmaceutical care. RESULTS:Physician adopted clinical pharmacist’s suggestions,and then the patient transferred to community hospital after pulmonary infec-tion had been controlled. CONCLUSIONS:Clinical pharmacists adopt admission assessment and classification management,posi-tion high risk patient,provide whole-course pharmaceutical care,and help physician to optimize and promote therapy plan,in or-der to guarantee the safety of drug use.

Objective Comparison the coincidence rate in the colloidal gold method and the passive agglu-tination method to detect mycoplasma pneumoniae (MP) infection, discuss the clinical value in rapid diagnosis of MP infection in the two methods. Methods Two-hundred patients with MP infection, including 100 cases in the the children group, and 100 cases in the adult group, were detected in MP-IgM antibody in serum with the colloidal gold method and the passive agglutination method. Results The positive rate of MP-IgM antibody with the passive agglutination method were slightly higher than that of the colloidal gold method in the children group (P > 0.05), While the positive rate of MP-IgM antibody with the passive agglutination method in the adult group were signifi-cantly higher than that of the colloidal gold method (P<0.05). When the antibody titer of MP-IgM antibody were 1:60, ≥1:320 in the children group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 95.40%, 95.30%;When the antibody titer of MP-IgM antibody were 1:80, 1:160,≥1:320 in the adult group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 0, 61.90%, 63.80%. Conclusions In the pediatric MP infection, for the high an-tibody titer of MP-IgM antibody, the positive coincidence rate with the colloidal gold method can reach clinical diag-nostic requirements. Clinical physicians according to the age and disease process of patients choose the appropriate method in order to realize the simple, rapid and accurate diagnosis of mycoplasma pneumoniae infection.

OBJECTIVE:To explore the clinical utilization of carbapenems in a hospital,analyze and evaluate its medication rationality. METHODS:All the 508 medical records of inpatients treated with carbapenems from Jul. 2012 to Jun. 2015 were retro-spectively investigated,the utilization and pathogenic examination of carbapenems were evaluated;by setting the carbapenems eval-uating standard,the medication rationality of carbapenems was evaluated and inappropriate cases were classified and analyzed statis-tically. RESULTS:The drug utilization indexed (DUI) of Imipenem and cilastatin sodium for injection and Meropenem for injec-tion were 0.80 and 1.32,respectively;the total rate of microbial inspection was 95.9%;according to the drug sensitive test result, the rate of drug selection was 62.8%;there were 54 cases(10.6%)of irrational use records,in which,irrational dosage(42.6%) and improper drug selection (31.4%) were the major problems. CONCLUSIONS:There are some inappropriate medication prob-lems in carbapenems utilization in the hospital. Developing the carbapenems utilization evaluation is helpful to discover typical medi-cation problems,which can provide reference for intervention and continuous improvement of rational drug use.

Adult ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma, Extranodal NK-T-Cell ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

AIM:To investigate whether the protective effect of adiponectin on glucose and lipid metabolism is achieved through down-regulating major histocompatibility complex classⅡ( MHCⅡ) in the adipose tissue.METHODS:Adiponectin knockout ( KO) mice and C57BL/6 ( WT) mice were fed with high-fat diet and standard diet for 24 weeks, re-spectively.The body weight, fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insu-lin resistance (HOMA-IR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol ( HDL-C) , hepatic histology, and classⅡtrans-activator ( CIITA) , histocompatibility 2 class II antigen E beta (H2-Eb1) and cluster of differentiation 74 (CD74) mRNA and MHC II protein levels in adipose tissue were measured at sacrifice.siRNA targeting MHC II and overexpression vector was used in 3T3-L1 cells to explore the effect of adiponectin on the protein level of MHCⅡ.RESULTS:The levels of body weight, FBG, FINS, HOMA-IR, TC, TG, LDL-C, hepatic steatosis, CIITA, H2-Eb1 and CD74 mRNA expression, and MHCⅡ protein expression in the KO mice were higher than those in the WT mice that fed with high-fat diet or standard diet.In 3T3-L1 cells, inhibition of adiponectin reversed MHC II protein level induced by specific siRNA.The expression of MHC II in adipocytes decreased after adiponectin was overexpressed.CONCLUSION: Adiponectin improves glucose and lipid metabolism through sup-pressing the expression of MHCⅡin the adipose tissue.