Objective:To analyze one case of drug-induced liver injury to provide reference for clinical pharmacists participating in the clinical practice. Methods: Through the participation in the diagnosis and therapy of one patient with drug-induced liver injury, clinical pharmacists found the correlation between the suspected drugs and the disease, which provided basis for the clinical diagnosis and therapy. Results:Clinical pharmacists actively assisted physicians by providing reasonable defining characteristics and drug therapy scheme for the patient free from drug interactions and adverse reactions. The function of the patient recovered after the treatment. Con-clusion:Clinical pharmacists participating in clinical practice can make use of pharmacy knowledge to search causes of diseases and optimize therapeutic scheme.

Objective Improve the efficiency of radiology doctors on reading bone age films by sharing Tanner-Whitehouse(TW2)bone algorithm on the network. Methods The bone age algorithm web was Programmed with a Java script implementation of Tanner-Whitehouse Method and putted on a Web server based on HTTP service. The program allows to select a stage (from a set of 8 stages) for every bone (from a set of 20 bones), and also allows doctors to input some specific data such as birthday, sex. Based on TW2 reported values, selected and input data, the program computes the bone age. We assessed the bone ages on 50 left hand and wrist X-ray films of Chinese children aged 2-18 (1000 bones totally) with computer-aided method and manual method. The grading agreement of bone development and the time spent for bone age assessment were compared (U test) between the two methods. Results Computer-aided method is easy to use, better than manual method in accuracy of bone development grading, and it also has a friendly interface. For the 1000 bones assessed by TW2, the rate of the same maturity classification was 83.8%(838/1000), the rate of one-level maturity difference (+ 1 and - 1) was 14. 9% (149/1000), the rate of two-level maturity difference (+2 and -2) was 1.3% (13/1000). For the 1000 bones assessed by manual method, the rate of the same maturity classification was 65.7% (657/1000), the rate of one-level maturity difference (+ 1 and -1) was 27. 2% (272/1000), the rate of two-level maturity difference (+ 2 and -2) was 7.1% (71/1000). TW2 bone algorithm was significantly better than manual method (U =9.31595 ,P <0.01). The average time of assessing bone age by the two methods was 3-5 min and 15-20 min, and the TW2 method saved time for radiologists doctor. Conclusion Sharing TW2 bone age algorithm through the network can be quick and easy.

Objective To observe the difference in therapeutic efficacy between acupuncture with distant acupoints selection and proximal acupoints selection in treating acute headache.Method Sixty patients with acute headache were randomized into group A and group B, 30 cases in each group. Group A was intervened by acupuncture with distant acupoints selection, while group B was by acupoints with topical acupoints selection. The Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) from McGill Pain Questionnaire (MPQ) were observed before and after intervention, and the clinical efficacies were compared between the two groups. Result After treatment, the VAS and PPI scores were significantly different from that before treatment in both groups (P<0.01). The changes of VAS and PPI scores in group A after intervention were significantly different from that in group B (P<0.01). The total effective rate was 90.0% in group A versus 73.3% in group B, and the difference was statistically significant (P<0.01). Conclusion Acupuncture with distant acupoints selection can produce a better therapeutic efficacy than acupuncture with topical acupoints selection.

Objective To retrospectively analyze the clinical features of elderly-onset systemic lupus erythematosus (SLE).Methods A total of 916 patients were enrolled in this retrospective study,and their clinical data were collected by the same methods in the past ten years (1999 2009) in fifteen hospitals in Jiangsu Province.Patients were divided into two groups based on the age of onset disease:control group and elderly group.The relationships between clinical features,immunology index and disease activity were analyzed in different age group.Results Among 916 SLE patients,24 patients were selected in the elderly onset SLE group,and 892 patients were considered as the control group.The ratio of male/female,mortality rate,the number of complications were higher in elderly onset SLE group than those in the control group (all P ＜ 0.05),and discoid rash,thrombocytopenia,elevated C-reactive protein (CRP) level,abnormality of serum albumin were found more common in elderly onset SLE group than in control group (all P＜0.05).The incidences of Malar rash and photosensitivity,antinuclear antibodies (ANA) positivity rate,anti-Sm antibodies positivity rate were lower in elderly onset SLE group than in control group (all P＜0.05).The time of final diagnosis,mean time of onset to death,positive family history,oral ulcers,arthritis,serositis,nervous involvement,musculoskeletal disorder,renal involvement,elevated serum creatinine (Scr) level,leucopenia,hemolytic anemia,elevated proteinurine,Erythrocyte Sedimentation Rate (ESR) levels,anti-dsDNA antibodies positivity rate,decreased complement C3 level,SLEDAl score had no significant differences between the two groups.Conclusions There were many differences in the clinical features between the elderly onset SLE patients and the controls,and the mortality rate is higher in the elderly onset SLE patients,which should be pay more attention to in clinical medcine.

Objective: To investigate the relationship between blood pressure, blood glucose or blood lipids and patients with cerebral infarction (CI) or intracerebral hemorrhage (ICH) in diff erent age or gender. Methods: hT e case-control study consecutively recruited patients with if rst-ever-in-a-lifetime CI (n=358) and ICH (n=230) and community-acquired pneumonia (n=165) as controls between January 2010 and December 2013 at the Second Xiangya Hospital of Central South University. hT epatients with CI or ICH were divided into the young group, the middle-aged group and the older group, and the risk factors were compared between the 3 groups. hTe patients with CI or ICH were respectively further divided into the male group and the female group. hTe blood pressure, glucose and lipids were measured. Results: Data from logistic regression models showed that CI was closely associated with high blood pressure, hypertension, diabetes mellitus (DM) or fasting plasma glucose (FPG) (P<0.05), and ICH was closely related to high blood pressure, hypertension, low density lipoprotein-cholesterol (LDL-C), FPG, serum creatinine (SCr) or alcohol drinking (P<0.05); hypertension was the main risk factor for stroke. hTe odds ratios for the young, the middle-aged and older group were 10.43, 4.74 and 7.39 respectively (P<0.05). Systolic blood pressure (OR=28.74) was the important risk factor for the young stroke, and the OR is 2.81 for the middle-aged stroke. Diastolic blood pressure (OR=2.96) and DM (OR=6.25) were the risk factor for the middle-aged stroke. LDL-C (OR=2.87) was a risk factor for the older stroke; the mean levels of diastolic blood pressure in males were signiifcantly increased compared with that in females with CI, while the mean levels of TC, HDL-C or LDL-C in females were signiifcantly higher than that in males with ICH (P<0.05). Conclusion: Hypertension, systolic blood pressure in particular, is the most common risk factor for young stroke patients. DM and hypertension are the risk factors for the middle-aged patients, while hypertension, DM, LDL-C and alcohol consuming are the risk factors for the aged patients.

Objective To observe the clinical efficacy of Yu’s meridian detection and treatment plus acupuncture in treating facial paralysis.Method Sixty patients with facial paralysis in acute stage were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by Yu’s meridian detection and treatment plus acupuncture, while the control group was by ordinary acupuncture. The House-Brackmann (H-B) scale and symptom-sign scores were observed before and after the treatment.Result The H-B scale scores were changed significantly in the two groups after the treatment (P<0.05). After the treatment, the H-B score of the treatment group was significantly different from that of the control group (P<0.05). The symptom-sign scores were significantly changed in both groups after the treatment (P<0.01). The symptom-sign score of the treatment group was significantly different from that of the control group after the treatment (P<0.05).Conclusion Yu’s meridian detection and treatment plus acupuncture is an effective method in treating facial paralysis.

Objective To explore the effect of continuous nursing based on WeChat public platform on the patients with high risk of pressure ulcers. Methods Selecting 165 pairs of high-risk patients and their caregivers from the emergency department of pressure ulcers in the General Hospital of Chinese People′s Armed Police Forces, and they were divided into control group and experimental group by paired random method. There were 83 pairs in control group, and 82 pairs in experimental group. The control group gave oral education according to the traditional model, and adopted the way of telephone follow-up for continuous nursing. While the experimental group let patients and their family members follow the Wechat public account that specially developed on Wechat platform and get continuous nursing in new models to come true networking health education and communicate with patients and their family members by multi-dimensional nurse. After 3 months intervening, compared patients′quality of life, the care behavior of caregivers and acquisition of knowledge of pressure scores, the incidence of pressure ulcers, degree of satisfaction of high-risk patients and caregivers between the two groups. Results The psychological function score, social function score and quality of life score was respectively ( 67.61 ± 1.67), (58.60 ± 1.52), (50.41 ± 2.70) points in experimental group, and (63.21 ± 1.30), (53.23 ± 1.92), (45.83 ± 2.59) points in control group, the comparative difference of the two groups was statistically significant( t=-4.638,-4.930,-2.749, P<0.05). There was no significant difference in the material life and body function score between two groups(P>0.05). The care behavior of caregivers score and pressure sores knowledge score was respectively (50.84 ± 1.92), (27.83 ± 1.48) points in experimental group, and (46.43 ± 2.40), (19.28 ± 1.31) points in control group, the comparative difference of the two groups was statistically significant (t=-3.192,-9.738, P<0.05 or 0.01). The incidence of pressure ulcers was 15.9%(13/82) in experimental group, significantly lower than that in control group (50.6%, 42/83), two groups was statistically significant (χ2=22.413, P<0.01). The satisfying degree and scores of patients or caregivers for follow-up form, nursing service attitude, follow-up content and the total score was respectively (24.83 ± 3.11), (24.10 ± 2.55), (25.03 ± 2.12), (76.23 ± 2.17) points in experimental group, and (18.34 ± 1.41), (17.41 ± 1.34), (19.85 ± 1.92), (63.25 ± 3.03) points in control group, the comparative difference between two groups had statistical significance (t=-7.797--4.061, all P<0.01). Conclusions Utilizing Wechat public platform continuity of care for patients at high risk of pressure ulcers can improve the patients quality of life, reduce the incidence of pressure ulcers, improve the efficient communication of nurses and patients, and enhance the degree of satisfaction of the patients. This method is convenient, shortcut, economic, practical and worthy for clinical use and promotion .

Objective: To study the role of hTERT and c myc, P53, ER, PR in endometrial carcinoma carcinogenesis. Methods: The expression of hTERT, c myc mRNA, P53 protein, ER and PR examined by in situ hybridization and immunohistochemistry in 14 cases of endometrial simple hyperplasia, 10 of complex hyperplasia, 8 of atypical hyperplasia and 52 with endometrial carcinoma. Results: (1) The positve rate of hTERT in simple, complex, atypical hyperlasia and carcinoma were 14.3% (2/14), 50.0% (4/8), 80.0% (8/10) and 92.3% (48/52), respectively. The prevalence and intensity of hTERT signal were greater in the carcinomas and atypical hyperplasia than those in simple or complex hyperplasia (P

OBJECTIVE: To explore the methods to detect and intervene children's late-onset hearing loss early which are suitable for basic-level hospitals. METHOD: Udiology and imaging diagnosis had been given to the children who passed the newborn hearing screening but showed auditory behavior disorders in the growth process, and individualized interventions were given according to the results of diagnosis. Seven children with high risk for hereditary deafness were sent to superior hospital and had molecular screening of common mutations of inherited deafness carried out, then corresponding prevention guidance and intervention were given to them. RESULT: Fifty-two cases with late-onset hearing loss or verbal disorders were detected by auditory behavior observations,including 4 cases of auditory neuropathy, 4 cases of unilateral sensorineural deafness, 27 cases of secretory otitis media. 13 cases of bilateral sensorineural deafness and 4 cases of autism. Seven newborns with high risk of hereditary deafness were sent to the Third Affiliated Hospital of Sun Yat-Sen University and received molecular screening of common mutations of inherited deafness. One case with GJB2 compound heterozygous mutations was detected and followed up to 4 years old, he was found bilateral moderate hearing loss and accepted the hearing aids at 2 years old. Mitochondrial DNA 1555 a > G heterogeneity mutation in 2 cases and GJB2 235 delC single heterozygous mutations in 3 cases, no mutation in 1 case, all these 6 cases have been followed-up until now, their hearing are normal. CONCLUSION Children's auditory behavior observations and the superior hospitals referral performing high risk individual screening for newborns with high risk for hereditary deafness can detect children's late-onset hearing loss in time, this model is suitable for basic-level hospitals.
Behavior Observation Techniques ; Child ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; DNA, Mitochondrial ; genetics ; Deafness ; diagnosis ; genetics ; Early Diagnosis ; Genetic Testing ; Hearing Tests ; Heterozygote ; Humans ; Infant, Newborn ; Male ; Mutation

OBJECTIVE:To systematically review the difference of phlebitis induced by Alprostadil injection with different ad-ministration routes,and to provide evidence-based reference for clinical rational use. METHODS:Retrieved from PubMed,EM-Base,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about phlebitis induced by Alprostadil injection with dif-ferent administration routes were collected. Meta-analysis was conducted by Rev Man 5.2 statistical software after literature screen-ing,data extraction and quality evaluation according to Cochrane System Evaluator's Manual 5.1.0. RESULTS:A total of 20 RCTs were included,involving 2562 patients. The results of Meta-analysis showed that the incidence of phlebitis induced by intravenous injection was significantly higher than that induced by intravenous dripping [OR=4.11,95%CI(1.59,10.67),P=0.004] and intrave-nous pump [OR=3.50,95%CI(1.50,8.16),P=0.004]. The incidence of phlebitis induced by general apparatus infusion was signifi-cantly higher than that induced by fine filtering infusion [OR=0.03,95%CI(0.01,0.08),P<0.001],with statistical significance. CONCLUSIONS:The incidence of phlebitis induced by low-concentration of Alprostadil injection or fine filtering infusion is low-er,and that of intravenous injection is higher.