OBJECTIVE To establish a comprehensive platform for regional pharmaceutical care among Jiangxi provincial pediatric alliance to realize the management of pediatric hierarchical diagnosis and treatment, and improve the quality of pharmaceutical care. METHODS A unified diagnosis and treatment information standard and a knowledge base of children's rational drug use rules were established among the medical institutions of Jiangxi provincial pediatric alliance. On this basis, the medical records and drug use information of patients in various medical institutions in the region were uploaded to the chain in a structured manner in real time, and a comprehensive platform for regional pharmaceutical care was built. RESULTS The comprehensive platform for regional pharmaceutical care built based on blockchain technology could share medical resources and information among medical institutions, realize rational drug use management, remote prescription review, individualized drug use guidance, popular science education, government supervision, etc., and improve the quality of pharmaceutical care. CONCLUSION The comprehensive platform for regional pharmaceutical care among Jiangxi provincial pediatric alliance can help allocate high-quality medical resources (drug safety knowledge base and pediatric pharmacists) for primary medical institutions. Further more, it lays the foundation for government supervision at the same time ensuring children’s medication safety, which has great practical significance.

Objective To investigate whether Andrographolide(AG)can alleviate intestinal injury in sepsis by ac-tivating the SLC7A11/GPX4 axis in ferroptosis.Methods Forty rats were randomly divided into sham group(sham group),sepsis group(CLP group),AG low,medium and high dose groups(5,10 and 20 mg/kg).HE staining was used to observe the pathological changes of Intestinal tract.ELISA method was used to determine Inter-leukin 6(IL-6),tumour necrosis factor α(TNF-α),intestinal fatty acid binding protein(I-FABP),D-lactate content.The mechanism of ferroptosis was explored with AG high dose group(AG20 group),forty rats were ran-domly divided into sham group,CLP group,ferroptosis inhibitor(Fer-1)group,AG20+Fer-1 group.HE staining and transmission electron microscopy were used to observe the pathological changes of Intestinal tract.The kits were used to determine oxidative stress MDA,GSH levels and Fe3+content.Western blot was used to detect the protein levels of solute carrier family 7 member 11(SLC7A11),glutathione peroxidase 4(GPX4),and ferritin heavy poly-peptide 1(FTH-1).Results Compared with the sham group,the CLP group showed severe morphological damage to the small intestine,with significantly higher levels of inflammation,I-FABP and D-lactate(all P＜0.05),the AG group reversed these changes in a concentration-dependent manner(all P＜0.05).Compared with the CLP group,the AG20 and Fer-1 groups showed improved pathological damage to the small intestine,with lower levels of MDA and Fe3+and higher levels of GSH,SLC7A11,GPX4 and FTH-1 protein expression increased(all P＜0.05),and pathological injury and oxidative stress were reduced in the AG20+Fer-1 group,and SLC7A11,GPX4 and FTH-1 protein expression increased more significantly(all P＜0.05).Conclusion The mechanism by which AG attenuates intestinal injury in sepsis may be related to SLC7A11/GPX4 axis activation in ferroptosis.

Objective : To investigate whether NaHS，a hydrogen sulfide donor，can improve myocardial injury in sepsis by inhibiting oxidative stress and activating the Xc －/ GPX4 signaling pathway in ferroptosis． Methods : Lipopolysacc-haride(LPS) induced H9c2 in rat cardiomyocytes to form an in vitro model of myocardial injury in sep- sis，which was divided into Control group，LPS group and LPS + NaHS group．The kits were applied to detect the changes of cardiomyocyte viability，Fe2 + ，LDH and CK-MB，determine the levels of oxidative stress indexes GSH and MDA，detect the changes of cellular ROS and mitochondrial membrane potential levels by fluorescent probes， and detect the expression levels of ferroptosis regulatory proteins SLC7A11 and GPX4 by Western blot. Results: Compared with the Control group，H9c2 cell viability decreased，Fe2 + concentration increased ，GSH ，MDA and ROS levels increased，mitochondrial JC-1 monomer increased ，expression levels of ferroptosis regulatory proteins SLC7A11 and GPX4 decreased，and cell damage increased after LPS stimulation (P＜0. 05) ．Compared with the LPS group，NaHS attenuated LPS-induced H9c2 cell injury and elevated Fe2 + concentration，decreased the level of LPS-induced oxidative stress in H9c2 cells ，and increased the expression levels of ferroptosis regulatory proteins SLC7A11 and GPX4 (P＜0. 05 ) ． Conclusion The mechanism by which NaHS attenuates myocardial injury in sepsis may be related to the inhibition of oxidative stress and activation of the Xc －/ GPX4 signaling pathway in fer- roptosis.

Objective:To discuss the surgical approach and the clinical effect of laparoscopic enucleation for hepatic hemangioma(HH).Methods:Forty HH patients admitted in the Third Affiliated Hospital of Soochow University between Aug 2018 and Dec 2019 were analyzed. The technical knowhow involved is to make a good explosure of the pseudocapsular HH from underneath. Herewith a process of HH enucleatoin started.Results:All the 40 patients undergone total laparoscopic hepatectomy successfully.The operative time was (90.3±32.3)min, the intraoperative blood loss was (50±500)ml, the time of hepatic block was (12.5±35.4) min. The volume of postoperative drainage was 10-150 ml on the first postoperative day, and was gradually reduced to <30 ml on the third day after the operation. All patients were up and about from post-op day 2. The length of stay after operation was (5.5±2.7)d. There were significant differences in ALT、AST、TBIL and prealbumin in 1 and 3 days after surgery (seperately, t=-5.481, -4.182, -2.235, 9.722, all P<0.05), before back to normal on day 7 (seperately t=0.167, -1.392, 1.000, -2.531, all P>0.05). Liver function recovered to normal in 7 days after surgery. Conclusion:New approach breaks the traditional stripping method and makes the procedure simple, safe, lessly disturb the liver function.

Objective To investigate the effect of preventive antidepressants application on the prognosis of and serum brain derived neurotrophic factor(BDNF) level in acute cerebral infarction(ACI).Methods One hundred and forty-one patients with ACI were prospectively and randomly selected.Seventy-two cases in the intervention group was added with sertraline for 12 weeks on the basis of the routine therapy,while 69 cases in the control group only used the routine therapy.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the nervous function impairment degree and daily living ability.The Hamilton Depression Rating Scale-17 was used to evaluate the emotion after stroke.The cognition function was evaluated by the Mini-Mental State Examination (MMSE).The BDNF level was detected by using the double antibody sandwich enzyme-linked immunosorbent assay.Results The NIHSS and HAMD scores after 3-month treatment were (1.77±0.58)points and (5.43±1.77)points in the intervention group,and (4.06±0.79)points and(10.27±3.78)points in the control group,which were significantly decreased compared with before treatment(P＜0.05);the BI value in the intervention group and control group were (96.24±4.58) and (77.64±6.96),which weresignificantly increased compared with before treatment (P＜0.05),and serum BDNF levels were (8.38±0.74)ng/mL and (5.72 ±0.67)ng/mL respectively,which were significantly increased compared with before treatment,moreover the change in the intervention group was more obvious than that in the control group (P＜0.05).The MMSE score had no statistical difference between the two groups (P＞0.05).The PSD occurrence rate was 10.0％ in the intervention group,which was significantly decreased compared with 53.6％ in the control group (P＜0.05).Conclusion Preventive antidepressants application in the patients with ACI can increase the serum BDNF level,improves the prognosis and is worth promotion and application.

Objective To probe the effect of perioperative therapeutic regime on breast reconstruction after surgery in breast cancer patients.Methods We retrospectively reviewed the clinical data of 145 consecutive breast cancer patients with 162 reconstructions.Results 127 of 145 patients got an excellent or good appearance (87.6％),and 42 cases had complications occurring in 162 operations (25.9％).After a median follow-up of 38.4 months,recurrences were found in 9 patients,3 cases died,and the disease free survival rate was 93.1％.Multivariate analysis showed that radiation therapy,without nipple-sparing and one-stage prosthesis implant were independent risk factors for negative postoperative aesthetic outcome;Delayed reconstruction and implant reconstruction were found to be protective factors for the postoperative complications.Conclusions Although the survival rate appears to be scarcely affected,different treatment modalities in reconstruction strategy bring different clinical results and outcomes.The perioperative decision-making of reconstruction strategy should be based on oncological safety,postoperative complications,aesthetic outcomes and subsequent therapies.

Objective:To explore the role of TNFSF14 and its receptors LTβR and HVEM in the pathogenesis of virus hepatitis.Methods:Marine fulminant viral hepatitis model was established by infecting mice with MHV-3.Liver tissue destruction in LIGHT KO and WT mice were analyzed by HE staining and ALT levels in serum by automatic biochemical analyzer .The mRNA levels of HVEM and LTβR in the liver and spleen tissues in the indicated time points ( 0 h, 12 h, 24 h, 48 h, 72 h ) were detected by quantitative-PCR.The expression of HVEM and LTβR on PBMC in patients with severe hepatitis were measured by flow cytometry.Results:In the MHV-3-induced murine fulminant hepatitis model ,liver injury in LIGHT KO mice was obviously decreased than that of WT mice,and ALT levels was also significantly lower than that of WT mice (P<0.01).The mRNA of HVEM and LTβR in the spleen were increased significantly after 48 h postinfection with MHV-3 ( P<0.05 );The level of LTβR mRNA in liver was significantly up-regulated in 12 h postinfection with MHV-3(P<0.01).Compared to healthy volunteers,the expression of both HVEM and LTβR on PBMC in patients with severe hepatitis was remarkably enhanced .Conclusion: TNFSF14 and its receptors LTβR and HVEM play a critical role in the pathogenesis of viral fulminant hepatitis .

Objective To explore the ability of copeptin to predict infarction severity and prognosis after 3 months in patients with acute cerebral infarction .Methods One hundred and thirty‐eight consecutive patients were included with an acute cerebral in‐farction and admitted to the hospital within 72 h .Plasma copeptin levels were measured by double antibody enzyme linked immu‐nosorbent assay and neurological impairment were evaluated by the national institutes of health stroke scale score (NIHSS) after hospitalization .The patients were divided into mild ,moderate and severe groups according to NIHSS score .At the same time ,60 healthy adults were selected as control group .Unfavorable outcome was defined as a modified rankin scale score>2 .The correlation of plasma copeptin levels with 3 month unfavorable outcome was analyzed .Results Upon admission ,plasma copeptin level in pa‐tients was statistically significantly higher than that in healthy controls (P<0 .01) ,the highest was found in severe subgroup (P<0 .05) .Multivariate logistic regression analysis revealed that copeptin was independently associated with unfavorable outcome within 3 months (OR=4 .403 ,95% CI:1 .120-8 .328 ,P<0 .05) .Conclusion Copeptin levels contribute to mirror the initial infarction se‐verity and even bear an association with poor outcome of patients with cerebral infarction within 3 months .

Objective To study the impact of psychological care and health education on patients with digestive tract cancer and abnormal emotion receiving chemotherapy. Methods A retrospective analysis was carried outin 245 patients with malignant digestive tract cancer from July 2005 to July 2009 treated in our hospital, 147 cases of these patients received psychological care and health education besides conventional therapy were set as the intervention group, 98 cases given only basic nursing care were set as the control group. The clinical efficacy was analyzed in the two groups before and after chemotherapy using anxiety and depression indexes as indicators. Results After chemotherapy, SAS and SDS scores were significantly lower, while the survival time was significantly higher in the intervention group than those of the control group. Conclusions Psychological care and health education can reduce abnormal emotion in patients with malignant digestive tract cancer receiving chemotherapy and prolonged their survival time.

OBJECTIVETo explore the preventive effect of lanthanum chloride on enteral bacterial translocation in scalded rats.

METHODSNinety Sprague-Dawley (SD) rats were employed in the study and randomly divided into three groups, i.e. normal control (A), burn control (B) and treatment (C) groups. Plasmid PUC19 labelled by JM109 was transfected to Escherichia coli (E. coli), so that restriction endonuclease finger - print image spectrum analysis could be applied to the tracing and quantification of the translocation of E. coli from intestine to mesenteric lymph nodes (MLNs) and blood. The intestinal tissue contents of endotoxin (ET), nitric oxide (NO), nitric oxide synthase (NOS), malondialdehyde (MDA) and superoxide dismutase (SOD) were determined.

RESULTSIt was identified that the bacteria in MLNs and blood exhibited the same gene map with those from gastric gavage in B and C groups. But the bacterial quantity in MLNs in C group on 3 postburn day (PBD) was much lower than that in B group (P < 0.05). The intestinal MDA content in C group on 1 and 3 PBDs was obviously higher than that in B group (P < 0.05).

CONCLUSIONBacteria (E. coli) could be translocated from gut to MLNs and blood, which could be evidently alleviated by lanthanum chloride by means of its bactericidal property, inhibition of NOS activity, so that NO production decreased, and its ability to increase SOD activity leading to less production of MDA.

Animals ; Burns ; drug therapy ; microbiology ; Endotoxins ; blood ; metabolism ; Escherichia coli ; drug effects ; growth & development ; metabolism ; Escherichia coli Infections ; blood ; microbiology ; prevention & control ; Female ; Intestines ; drug effects ; metabolism ; microbiology ; Lanthanum ; pharmacology ; Lymph Nodes ; drug effects ; microbiology ; Male ; Malondialdehyde ; blood ; metabolism ; Mesentery ; drug effects ; microbiology ; Nitric Oxide ; blood ; metabolism ; Nitric Oxide Synthase ; blood ; metabolism ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; blood ; metabolism