Objective:To explore the role of clinical pharmacists in the development of individualized drug treatment regimens for the osteosarcoma children with irregular body weight .Methods:Clinical pharmacists involved in the calculation of body weight surface area increased to that of adult for one case of osteosarcoma child during the chemotherapy , comparatively analyzed the suitable calcula-tion formula of surface area for the children in our country and helped clinicians make accurate dose of chemotherapy drugs .Mean-while, according to the pathological and physiological characteristics of the child , clinical pharmacist also provided advice on adjuvant drug use such as antiemetic regimen etc .Results:Physicians adopted the suggestions of clinical pharmacists and the chemotherapy was successfully completed .Overdose adverse reactions were avoided without the use of foreign general calculation formula of body surface area for the overweight child , and inadequate dose was also avoided for the conservative treatment , which could lower the risk of re-duced potential anticancer efficacy .Conclusion:Clinical pharmacists can help doctors perform safer and more effective drug treatment program and reduce adverse drug reactions in the treatment of special patients through participation in the development of individualized medication for cancer children to obtain maximum profit .

Objective To identify the biotype and analyze the epidemiological characteristics of twentyfour Brurella strains from the primary hospitals in Guangdong Province.Methods The twenty-four Brucella strains,collected from Oct.2009 to Oct.2015,were identified by routine biochemical methods,VITEK 2 COMPACT automatic microbial identification analyzer,16S rRNA gene sequencing and biology phenotype based on serological and bacteriophages lysis test.The etiology was analyzed based on clinical data,biotypes of the isolates and other clinical information.Results All of the twenty-four strains were Gram-negative coccobacilli,including two strains of Brucella suis biotype Ⅱ,four strains of Brucella melitensis biotype Ⅰ and eighteen strains of Brucella melitensis biotype Ⅲ.By GN card of VITEK 2 COMPACT automatic microbial identification analyzer,one strain was mistaken as Bordetella bronchiseptica and two strains were mistaken as Ochrobaetrum anthropi.The 16S rRNA gene sequencing showed they were high homology to Ochrobactrum intermedium and Ochrobaetrum anthropi,which completely excluded the possibility of Bordetella bronchiseptica.Tbe clinical data showed that all of the twenty-four patients were adults with an average age of 49.0 years old,men and women were twelve people respectively,with no significant gender differences and no occupational exposure,which presenting a wide and diverse range of nonspecific clinical signs and symptoms,but brucellosis was not aware of by the physician.Conclusion Brucella melitensis biotype Ⅲ is the main pathogen of brucellosis,with the characteristics of sporadic outbreak and occult infection in the primary hospitals in Guangdong Province.

OBJECTIVE To investigate the prevalence,antibiotic resistance and genotype of the extended-spectrum ?-lactamases(ESBLs)-producing clinical isolates of Klebsiella pneumoniae.METHODS A total of 104 isolates of K.pneumoniae were examined for the ESBLs production and the susceptibilities of the bacteria to 15 antimicrobial agents.PCR was performed to detect the genes encoding the ESBLs belonging to SHV and TEM families as well as CTX-M-1 and CTX-M-9 groups.RESULTS The ESBLs-producers of K.pneumoniae were 54.0% in the total of 104 isolates.Almost all of the ESBLs-producing isolates were resistant to the antibiotics commonly used,and only remained susceptible to carbapenems and the combination of cefoperazone with sulbactam.The genes of SHV,CTX-M-1 and TEM groups were detected in the ESBLs-producing isolates by 64.3%,46.4%,and 32.1%,respectively,and 35.7% and 8.9% of ESBLs-producing K.pneumoniae strains carried two and three genes.CONCLUSIONS The clinical isolates of K.pneumoniae in Tianjin Nankai Hospital are shown a high rate of ESBLs-producing and antibiotic resistance.SHV and CTX-M-1 groups of ESBLs are the dominant genotypes in the isolates of ESBLs-producing K.pneumoniae.

Objective To investigate the prevalence of nosocomial infections in Tianjin Children's Hospital and to provide database for monitoring and control of nosocomial infection.Methods The medical records of 6101 children admitted in the first half of 2005 and the laboratory results of isolated bacteria from clinical samples in 2005 were retrospectively investigated.Results The total nosocomial infection rate was 3.47%(212/6101),in which the surgical nosocomial infection rate was 2.66%(32/1204)and 2.95%(180/6101)infections were caused by non-surgical incisions.Respiratory tract was the most frequent infection site(119/212,56.1%).Several opportunistic pathogens were responsible for the major nosocomial infections,they were Escherichia coli,Coagulase negative staphylococcus,Enterococcus,Klebsiella pneumonia,Staphylococcus aureus and Pseudolnonas aeruginosa.Conclusion The pathogenic isolates for the infections show high resistance to most antibiotics.Monitor and control of the incidence of nosocomial infections and resistance to antibiotics should be enforced.

Objective To investigate antibiotic resistance and staphylococcal cassette chromosome mec(SCCmec)genotype of Staphylococcus aureus isolated from patients with nosocomial infections.Methods Antibiotic susceptibility pattern anti the gene mecA were examined in 89 Staphylococcus aureus isolates from patients with nosocomial infection in Tianjin Medical University Cancer Institute and Hospital.The SCCmec genotype in the mecA-positive strains were fuaher investigated with multiplex PCR.Results In 89 Staphylococcus aureus strains,21(23.6%)were phenotypic methicillin-resistant Staphylococcus aureus (MRSA)and 39(43.8%)were rnecA positive,the difierence was of statistical significance(χ2=8.146,P=0.004).MRSA strains showed multiple-antibiotic resistance but sensitive to vancomycin.Tvpe Ⅲ SCCmec carriers were the major epidemiological strains(26/39,66.7%).ConclusionMRSA strains isolated from Tianjin Medieal University Cancer Institute and Hospital are characterized by multi-drug resistance,and type Ⅲ is the dominant SCCmec earried by the MRSA strains.

Objective To investigate the drug resistance and genotype of methicillin-resistant Staphylococcus (MRS), and to study the epidemiology of drug resistance in Staphylococcus. Methods Drug susceptibility tests were performed for 138 Staphylococcus strains clinically isolated, and mecA gene was detected with PCR. For mecA positive strains, Staphylococcal cassette chromosome mec (SCCmec) gene was detected by two multiplex PCR assays. Results Seven (10.8%) out of 65 Staphylococcus aureus strains were methicillin-resistant Staphylococcus aureus (MRSA) strains, and 44 (60.3%) out of 73 coagulase negative Staphylococcus strains were methicillin-resistant coagulase negative Staphylococcus (MRCNS)strains. There was statistical significance on the difference of isolation rates (x2 = 37. 05, P ＜0.01). No vancomycin or nitrofurantoin resistant strain was found. There were 52 (52/138, 37.7%) mecA positive strains, including 16 SCCmec type Ⅰ strains, 1 type Ⅱ strain, 13 type Ⅲ strains, 9 type Ⅳ strains and 4 type Ⅴ strains. Conclusions Drug resistance in MRS is increasingly serious. MRCNS strains are more popular than MRSA in clinic, and SCCmec Ⅰ and Ⅲ may account for most infections.

Objective To compare several methods for the rapid detection of methicillin resistant StaphylOCOCCUS aureus(MRSA).Methods Forty-four Staphylococcus aureus isolates from Tianjin Medical University Cancer Institute and Hospital(TMUCIH)were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method,Oxacillin micro-broth dilution method,E tests and PBP2a Latex agglutinaltion assay.These above results were compared with PCR analysis.Results PCR analysis showed that 36 MRSA strains containing mecA was identified.Thirty-two MRSA strains were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method and Oxacillin micro-broth dilution method.Compared with PCR analysis,the sensitivity and specificity is 88.9%and 100%respectively.Thirty-three MRSA strains were identified by E test,with the sensitivity of 88.9%and specificity of 87.5%.Twenty-nine MRSA strains were identified by PBP2a latex agglutination assay with the sensitivity of 80.5%and specificity of 100%.Conclusions The turnaround time of PBP2a Latex agglutination assay could be reduced 24 h compared with other methods for detection of MRSA.This rapid,convenient and specific method could be applied in clinical laboratories for MRSA detection.

Objective:To examine the potential influence factors of abdominal aortic aneurysm (AAA).Methods:A 1∶2 pair-matched, case-control study was conducted from July 2011 to December 2012 .A pair was composed of one AAA patient recruited from the Vascular Surgery Department , Chinese PLA General Hospital and two gender-and age-matched non-AAA subjects , one from the same hospital and the other from the community in Fangshan District in Beijing .Demographic data , medical history and the lifestyle of each subject were collected .Moreover , all the participants underwent abdominal ultra-sound or computed tomography ( CT ) and peripheral venous blood samples were obtained .Results:There were 155 case/control pairs .The multivariate conditional logistic regression model confirmed that suffering from hypertension conferred a 1.98-fold (95%CI 1.12-3.18) increased likelihood of AAA. Smoking was a strong independent risk factor of AAA , with odds ratios ( 95% confidence intervals ) of 5.23 (2.44-11.23).Dyslipidemia(OR=2.61,95%CI 1.45-4.70), a higher level of serum hs-CRP (OR=2.43,95%CI 1.37-4.31) and homocysteine (OR=2.73,95%CI 1.61-4.65) were all asso-ciated with AAA.Conclusion: Hypertension and smoking are the risk factors of AAA .Dyslipidemia, hsCRP and Hcy are associated with AAA .

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

Objective:To examine the effectiveness of revascularization of the deep femoral artery and its inflow vessels to treat critical limb ischemia in patients with thromboangiitis obliterans (TAO).Methods:The clinical data of 9 TAO patients with critical limb ischemia who underwent deep femoral artery and its inflow revascularization from January 2018 to October 2020 at Department of Vascular Surgery, the First Medical Center, People′s Liberation Army General Hospital were retrospectively analyzed.There were all males, aged from 26 to 50 years with onset time from 1 to 7 years.All patients had severe rest pain, and 4 had ischemic ulcers or gangrene.All patients had occlusion of the deep femoral artery origins and(or) its inflow tracts, including 2 ipsilateral common iliac artery occlusion, 4 ipsilateral external iliac artery occlusion, 7 common femoral artery occlusion, and 8 deep femoral artery origins, without the involvement of the contralateral common femoral artery or its inflow tracts.Surgical procedures included femoral endarterectomy with thrombectomy, merge suture, and bypass.Technical success rate, rest pain relief, ulcer healing, patency, amputation rate, and long-term prognosis were recorded.Results:The overall technical success rate was 9/9, including 8 femoral endarterectomies with thrombectomy (with 4 patch-angioplasty with the great saphenous vein, 1 merge suture, and 3 simple sutures), 4 femoral-femoral bypasses with artificial vessels, and 1 superficial femoral artery bypass with the great saphenous vein.Rest pain disappeared after the operation immediately.The follow-up time was 10 to 44 months.All patients survived.The semi-annual patency rate was 9/9, and the one-year patency rate was 6/8.Except for one patient with significantly reduced but unhealed dorsalis ulcer up to now due to continuous heavy tobacco exposure after surgery, all others had no rest pain occurred or recurrence of foot ulcers during the follow-up.Among the 8 patients, 3 cases with recent claudication had continuous moderate tobacco exposure (10 to 20 cigarettes per day or severe passive smoking).Conclusions:For patients with thromboangiitis obliterans involved in the deep femoral artery or its inflow vessels, revascularization should be the primary choice and a good long-term prognosis is promising.Postoperative tobacco exposure (including passive smoking) is of great impact on the prognosis of TAO patients, and smoking cessation education must be reemphasized and reinforced.