OBJECTIVE:To investigate the role of clinical pharmacists in pediatric severe infection treatment,and to provide reference for rational drug use in clinic. METHODS:Based on related typical cases,the breakthrough points of clinical pharmacists providing pharmaceutical care in pediatric severe infection treatment plan were introduced. RESULTS:Clinical pharmacists formu-lated multi-drug resistance pathogenic antibacterial plan according to the results of pathogenic microbiological examination,use pharmacokinetics/pharmacodynamics,excluded interference to pediatric anti-infection treatment from ADR,and guideline and eco-nomical factors of patients. CONCLUSIONS:Clinical pharmacists adopt professional knowledge of pharmacy to provide pharmaceu-tical care in pediatric severe infection treatment and play professional assisted role so as to guarantee safe,effective and economical treatment.

Biotechnology is one of the important areas of life science, consequently the ethical problems were caused by its researches and applications. The article analyzed the ethical problems related to the development of biotechnology and put forwards some countermeasures in order to keep it developing constantly and steady.

Objective:Defensins from human neutrophils exhibit a broad antimicrobial activity.The transfection of the gene fused by human neutrophil peptide 1(HNP1) with the J chain into other cells may induce the in vitro expression of HNP1 to play antimicrobial roles.The authors analyzed the influencing factors on the expressed proteins of HNP1 and the J chain gene in COS-7 cells.Methods: Western blot was used to analyze the technical factors influencing the HNP1 protein expression.Results: Recombinant J-HNP1 was expressed in the cells successfully.Conclusion: The expression of J-HNP1 can be detected inside and outside the cells by Western blot.

Objective To investigate the effect of postoperative analgesia with oxycodone on T cell function after operative of cesarean section with chronic hepatitis B.Methods Sixty cesarean sec-tion women with chronic hepatitis B undergoing CS,aged 22-35,were randomly divided into two groups:oxycodone group (group O)and morphine group (group M).The changes of immune cells (Th1,Th2)and liver function were recorded after the analgesia (immediate,postoperative 24 h,48 h,72 h).The total number of pressing analgesia pump and the cumulative amount of PCA were re-corded.Results The Th1 of group O was higher than that of group M at 24 h,48 h after operation (P <0.05),while there was no significant difference of Th1 and Th2 in group M.The total patient-controlled pressing times and accumulated amount of PCA of group O were significantly lower than those in group M (P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Oxycodone can activate T cell function in postoperative analge-sia,while morphine causes the inhibition of Th1 cells.

Objective To investigate the effect of different subtypes of fractionated doses on multidrug resistance in ovarian cancer cells.Methods The human ovarian cancer cell lines SKOV3 and its drug-resistant subtype SKVCR were divided into four groups i.e., sham-irradiated, single dose (10 Gy),fractionated dose (2 Gy × 5 ) and multi-fractionated dose (1 Gy × 2 × 5).Cell sensitivity to vincristine(VCR),etoposide ( VP-16),pirarubicin (THP) and cisplatin (DDP) was measured by MTT assay.Western blot was applied to detect the expression of P-gp after irradiation.Results The doubling time of SKVCR was about 1.8-fold of that of SKOV3 cells.P-gp was expressed in SKVCR but not in SKOV3.IC50 values of SKVCR were higher than those of SKOV3.To SKOV3 cells,single dose irradiation decreased cell sensitivity to THP and DDP and fractionated irradiation decreased cell sensitivity to VCR,THP and VP-16.Multi-fractionated irradiation decreased cell sensitivity to VP-16.In SKVCR cells,all these irradiation treatments increased cell sensitivity to VCR and VP-16 but not to DDP.In addition,single and fractionated irradiation decreased P-gp expression in SKVCR cells.Conclusions Single,fractionated and multi-fractionated radiation induced chemotherapy resistance in SKOV3 cells,while reversed drug resistance to VCR and VP-16 in SKVCR cells.

Objective To investigate the trough and peak vancomycin plasma concentrations in steady-state following regular dosage and to improve dosing regimen based on pharmacokinetic modeling, providing reference for clinical practice in children.Methods we retrospectively analyzed pharmacokinetics of vancomycin in 50 cases admitted in our PICU who had been confirmed or suspected with gram-positive bacterial infections following regular dosage[40 mg /(kg?d)].Then we tried to optimize dosing regimens with Monte Carlo simulation to evaluate different dosing regimens of vancomycin in children.Results with regular dosage of vancomycin,mean trough concentrations of vancomycin were (1 1.02 ±4.44 )mg /L, trough concentrations higher than 15 mg /L accounted for only 12%.In the actual program,the extension of a single intravenous infusion to 3 hours after administration would result in 26% of trough concentrations dis-tributing in the range above 15 mg /L.If we increased daily dose to 50 mg /kg and 60 mg /kg with simulation, the trough concentration distribution frequency above 15 mg /L would increase from 12% to 32% and 40%. If minimum inhibitory concentration of vancomycin to pathogenic bacteria (Staphylococcus aureus )was 1 mg/L,the probabilities of target attainment for pharmacokinetic/pharmacodynamic evaluation were 51.73%, 76.54% and 87.5% for three dosages [40 mg/(kg?d),50 mg/(kg?d)and 60 mg/(kg?d)]of vancomycin, respectively.we suspected that dosage of 60 mg/(kg?d)was a good choice.with this dosage regimen,we could achieve a substantial increase in the probability of target attainment.Conclusion Following regular dosages, trough concentration distribution frequency from 15 to 20 mg /kg is low.The extension of a single intravenous infusion time can not achieve a good result.According to the result of pathogenic bacteria and anti-microbial susceptibility tests,increasing daily dosage of vancomycin to 60 mg /(kg?d)will help to improve the trough concentration and get more clinic achievements.

This study was aimed to summarize and analyze acupoint selection rule of acupuncture in the treatment of primary dysmenorrhea in recent years,and to guide acupoint selection and compatibility in clinical practice.Relevant literatures in recent years were retrieved from the China National Knowledge Infrastructure (CNKI) full-text database.And then,literatures involving acupuncture prescriptions were summarized.Data were integrated and input.Finally,the SPSS software was combined to analyze the data of acupoint selection in the acupuncture prescription to achieve the conclusion.The results showed that in the acupuncture treatment of primary dysmenorrhea,the main meridian selections were the Ren Meridian and the Spleen Meridian of Foot Taiyin.The generally used acupoints were SP6-Sanyinjiao,RN4-Guanyuan,SPS-Diji,and etc.The multi-point compatibility therapy was used.It was concluded that although the advantages of acupuncture in the treatment of primary dysmenorrhea are prominent,the pathogenesis is mainly related to the liver,spleen and kidney,which are recognized by most physicians.However,there are still large differences in acupoint compatibility and acupoint selection.Hence,there are still no unified,scientific and standardized diagnosis and treatment standards.Further exploration should be made to guide clinical practice.

Objective To introduce the mutated gene coding cysteine into the gene of dsFv VL of human antibody to N terminal fragment of lipopolysaccharide binding protein(LBP)and to express,purify the mutated dsFv VL in bacterium.Methods We reconstructed and sequenced the mutated gene of VL of human mAb Fab to LBP by Mega-primer PCR based on point mutagenesis method.Some codes of FWR1 of VL had been replaced by TGT in order to code cysteine.The DNA sequence of reconstructed VL was inserted into vector pET-28a(+),then VL was expressed by E.coli.BL21 star(DE3)and was purified by chromatography.Finally the activity of VL to bind NH-LBP was determined by ELISA.Results The results showed that the cysteine was introduced into the position 21 amino acid of VL to replace the threonine.The gene of VL was about 650 bp and relative molecular weight of VL was 28?103.VL could bind NH-LBP directly.Conclusion These have laid a foundation for producing the dsFv against NH-LBP.

Clinical teaching plays an important role in the education of medical graduate students.In the clinical teaching of the graduate students of burn and plastic surgery,we based it on clinical practice and guided the students in changing their modes of learning and thinking from examination-orientedness to problem solving,from simple vertical to clinical lateral thinking.We made sure that they all acquired innovative ideas and correct methods of clinical research by various academic activities,and cultivated their practical abilities and medical virtues by strict training and moral education.

Objective:To analyze the prognostic factors in patients with metastatic breast cancer (MBC). Methods:A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute&Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results: The median overall survival of the patients was 32 months (1 month to 132 months). Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months (4 months to 132 months), 32 months (7 months to 122 months), 29 months (1 month to 85 months), and 24 months (1 month to 98 months), respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion:Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.