Objective To analyze the behavior of patients with serious adverse drug reactions and look for risk factors leading to serious adverse drug reactions .Methods Patient medication behavior evaluation method was established,which was used in cases of serious adverse reaction caused by stains in recent three years in Beijing Chuiyangliu Hospital .Clinical pharmacists participated in field survey .Medication behavior of patients was analyzed from three aspects of knowledge ,attitude and ability .Results Three patients had serious adverse reactions occurred in recent 3 years,drugs were suspected of simvastatin and atorvastatin .The score of medication knowledge was lower than 20%.The score of health attitude was lower than 20%.The score of taking ability was lower than 20%. Conclusion In the investigation of serious adverse reaction ,pharmacists found the risk behavior of patients with daily medication is an important cause of patients with serious adverse reaction .Pharmacists should strengthen the drug education and publicity ,especially in patients with risk factors of medication behavior such as knowledge ,attitude and ability in their daily work .

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 To evaluate the safety and efficacy of mechanical thrombectomy in treating in-stent restenosis of lower extremity arteriosclerosis obliterans. Methods From May 2015 to Sep 2016, the clinical data of 9 cases of lower extremity arteriosclerosis obliterans who were with in-stent restenosis(3 were stent graft)were retrospectively collected, and of which 7 were males and 2 were females with a mean age of (75.4 ± 6.3)years old. All the cases were treated by mechanical thrombectomy of Rotarex catheter. All the patients were diagnosed via low-extremity artery CTA, and treated by means of the Rotarex catheter, combined with angioplasty and stent if necessary. All patients received antiplatelet therapy. Doppler ultrasonography was taken during the followed-up. Results All the 9 cases were successed in technology, without complications in hospital. All patients received Rotarex mechanical thrombectomy. Six of which used balloon and 1 stent implanted. The ABI increased from 0.29 ± 0.07 to 0.88 ± 0.07 after treatment, the difference was statistically significant(t=28.875,P<0.05). All the patients were followed up for 3—18 (median time, 11.5)months. No death and symptoms recurrence appeared during the follow-up. Conclusions Mechanical thrombectomy using Rotarex catheter is a safe and effective treatment for in-stent restenosis in lower extremity arterial diseases.

Objective To study effect and mechanism of fungus polysaccharide PSM-a of Polyporus sp.M05 on S180 bearing mice. Methods MTT method was used to detect the inhibiting role of PSM-a on S180 cells proliferation in vitro. S180 mice model was established,and was administered by gavage. Tumor volume was detected, and the ratio of tumor to mile weight and inhibiting tumor rate. The activity of NK and LAK cells on the target cells was analyzed by MTT colorimetric assay ;HE stain was used to detect the necrosis of tumor cells. Results PSM-a could inhibit S180 cells grouth in vitro. PSM-a could decrease the tumor weight and increase the ratio of tumor volume and mice weight; Tumor inhibiting rate reached 80% and above when treated with 250 μg/nml PSM-a. PSM-a could increase the activity of NK and LAK cells, and necrosis happened. Conclusion PSM-a could significantly inhibit the growth of S180 cells, and the mechanism bnay be related with the increased killing activity of immunne cells to tumor cells.

Objective:To understand the status of HIV-2 infection and the epidemiological characteristics of HIV-2 infected individuals in Hunan province.Methods:The stock blood samples with HIV-2 indicative bands in the original records of 15 AIDS confirmation laboratories in Hunan province from 2003 to 2020 were collected. The samples were tested by Mikrogen GmbH (HIV 1+ 2) antibody comfirmatory kit (Germany). And meanwhile the epidemiological data of the first HIV test and the epidemiological follow-up records of the cases who could be contacted were collected.Results:A total of 378 samples with HIV-2 indicative bands were collected, involving 363 individuals. Serological test result showed that 326 cases (89.81%) were HIV-1 antibody positive, 18 cases (4.96%) were HIV-2 antibody positive, 12 cases (3.31%) were HIV antibody positive but could not be typed, 6 cases (1.65%) were HIV antibody uncertain and 1 case (0.28%) was negative for HIV-1/2 antibody. There were 15 cases from Xiangtan city and the other 3 cases from Changsha city among the 18 HIV-2 antibody positive individuals. The result of epidemiological investigation showed that there were 12 males (66.67%) and 6 females (33.33%), with a male-to-female ratio of 2∶1. The average age of the first detection was (56.94±12.52) years, in the males the age ranged from 33 to 76 years and in the females the age ranged from 44 to 66 years. The male age span was larger than that of the female. There were 10 married cases (55.56%) including one couple, 6 divorced or widowed cases (33.33%), 2 cases (11.11%) with unknown marital status. There were 13 cases from hospital monitoring (72.22%), 2 cases each from prison detention and blood screening in volunteer donors (22.22%), and 1 case from spouse screening (5.56%). These samples were tested for the first time in 2005, 2009, 2013, 2014, 2018, and 2020, with 1 case each, 6 cases in 2016, 2 cases in 2017, and 4 cases in 2019. By the end of 2020, 9 cases were alive and 9 cases were dead or missing. Three cases have accepted antiviral treatment. Of the 7 cases that could be followed up, all admitted heterosexual transmission, 6 cases denied any history of traveling abroad, and 1 case denied any history of foreign sexual intercourse.Conclusions:HIV-2 epidemic has lasted for a long time in Hunan province, local infection is not an occasional case, and there is a possibility of long-term clustering epidemic spread. This suggests that the country should strengthen the surveillance, detection, diagnosis and treatment of HIV-2 research and pay attention to the risk of HIV-2 transmission.

Objective To investigate the safety and clinical value of using ExoSeal vascular closure device (VCD) in interventional management via antegrade femoral access.Methods Clinical and imaging data of 303 patients (316 affected limbs) who were received interventional procedure via antegrade femoral access closure were retrospectively analyzed.ExoSeal VCD (VCD group,n=127) and manual compression (MC group,n =176) were performed to make femoral artery puncture point hemostasis.The time of hemostasis,actual immobilization time,technical success rate and vascular related complications were recorded and compared between the two groups.Results In VCD group and MC group,the time of hemostasis were (3.68 ± 2.40) min and (18.32 ± 4.54) min,the actual immobilization time were (3.45±5.30) h and (10.44±14.68) h,the technical success rates were 98.52％ (133/135) and 93.92％ (170/181),and the complication rates were 2.22％ (3/135) and 8.84％ (16/181),respectively.There were statistically significant differences between two groups (all P＜0.05).In VCD group,there were 2 cases of subcutaneous hematomas,and 1 case of retroperitoneal hematoma.In MC group,there were 15 cases of subcutaneous hematomas and 1 case of acute thrombosis in the puncture side limb.Conclusion Regarding hemostasis of puncture site in interventional management via antegrade femoral access,the use of ExoSeal VCD is safe and effective.

Objective To investigate the management of Graves' disease in Jiangsu province. Methods According to the 2011 management of GD survey from American Thyroid Association and the 2013 survey from European Thyroid Association, a questionnaire was designed for this survey to acquire the diagnosis, treatment, and follow-up of Graves' disease among endocrinologists from 35 tertiary hospitals in Jiangsu province. Results A total of 476 valid questionnaires were collected. For patients with symptoms of hyperthyroidism, a large majority of respondents monitored serum FT3 , FT4 , TSH, thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody, and finding of thyroid ultrasound, accounted for 95. 6％, 95. 0％, 95. 4％, 95. 8％, 90. 3％, 90. 5％, and 93. 9％physicians, respectively. 91.2％ of physicians preferred anti-thyroid drugs as the first-line treatment, and 92. 6％ of them gave priority to the use of methimazole. For the duration of anti-thyroid drugs therapy, 41.2％of endocrinologists chose 24 months, while 20％ chose 18 months. When patients have moderate and active ophthalmopathy, most respondents with medium or senior professional titles preferred anti-thyroid drugs, while most resident physicians chose radioactive iodine plus corticosteroids. When pregnancy was confirmed in the patients of Graves' disease, 88％ of respondents preferred propylthiouracil during the first trimester of pregnancy, and 58. 4％ of them would continue propylthiouracil into the second trimester. Conclusions The mastering of basic perception of Graves' disease knowledge is satisfactory among the endocrinologists. But by comparing to the American and European survey results and related guidelines, there are still some differences in diagnosis and treatment. Therefore, physicians should notice those differences and make improvement on standardized treatment for patients to raise the response ratio while reducing the recurrent events.

Objective To explore the prognostic values of telomerase reverse transcriptase promoter (TERTp) mutation and 1p/19q co-deletion in newly-diagnosed O6-methylguanine-DNA methyltransferase (MGMT) promoter un-methylated/isocitrate dehydrogenase (IDH) wild-type glioblastoma multiform (GBM). Methods A total of 82 patients pathologically newly-diagnosed MGMT promoter un-methylated/IDH wild-type GBM, admitted to our hospitals from March 2016 to November 2018, were included in this study. TERTp mutations (TERTp wild-type and TERTp mutation [C228 mutation and C250 mutation]) in GBM specimens were detected by PCR sequencing, 1p/19q co-deletion in GBM specimens was detected by fluorescence in situ hybridization (FISH), and clinical data, adverse reactions and prognoses of patients with different molecular typing were compared. Results There were 33 patients in the TERTp wild type group with mean age of 48 years, and 49 patients in the TERTp mutation group with mean age of 59 years; the difference of age was significant (P<0.05); there were no statistical differences in gender distribution, Karnofsky performance status (KPS) scores, tumor sites and surgical resection degrees between the two groups (P>0.05). There were 8 patients with 1p/19q co-deletion and 74 patients without 1p/19q co-deletion; no significant differences in above clinical parameters were noted between the two groups. There were no statistically significant differences in the incidences of bone marrow suppression, digestive tract response and fatigue, disease progression rate, or survival rate between patients from TERTp wild type group and TERTp mutation group, and between patients with 1p/19q co-deletion and patients without 1p/19q co-deletion (P>0.05). No significant differences in above clinical parameters, disease progression rate, and survival rate were noted between patients with C228 mutation and C250 mutation (P>0.05). Conclusion TERTp typing and 1p/19q co-deletion status do not have prognostic value in newly-diagnosed MGMT un-methylated/IDH wild-type GBM patients; patients with TERTp mutations have older age than wild-type patients; patients with C250 mutation trend to have higher survival rate than those with C228 mutation.