Objective: To monitor vancomycin plasma concentration results by clinical pharmacists in order to participate in individualized medication adjustment.Methods: Clinical pharmacist monitored the blood concentration of vancomycin in special patients, and then designed the individualized medication according to the monitoring results and clinical manifestations of patients.Results: Through the individualized medication adjustment, clinical pharmacist enhanced the efficacy and reduced the incidence of adverse reactions, and improved the level of clinical rational drug use as well.Conclusion: Clinical pharmacist can provide better service for clinics through the practice of individualized precision pharmacy, and reasonable and safe pharmacy service can be provided for patients.

Objective To study the clinical effect of the treatment of patients with bronchial dilation in the treatment of patients with the combination.MethodsWenzhou Hospital of integrated traditional Chinese and Western Medicine in March 2013~July 2015 diagnosed and treated with bronchial dilation and infection of 72 cases of elderly patients, according to the random number table method is divided into the study group and the control group, each group of 36 people.Two groups were given conventional intervention of bronchial dilation.The control group in the conventional intervention based on the given first cell risperidone sulbactam sodium and ambroxol intravenous injection treatment.The study group in the control group on the basis of the implementation of the whole treatment plan based on bronchial alveolar lavage and local administration of rice.Compared with the two groups, the main symptoms and signs of the total improvement time, blood gas indicators before and after treatment.ResultsThe study group cough sputum, fever and chest X-ray shadow the significant remission time were significantly faster than that of the control group (P<0.05).After treatment, two groups above the index of blood gas analysis were group than before treatment significantly improved (P<0.05) study group on each index improved significantly better than the control group (P<0.05).ConclusionAged bronchiectasis infection patients given according to for etimicin plus bronchoalveolar lavage can be more significant to promote the improvement of patients with respiratory symptoms and signs, curb inflammation.At the same time, the index of blood gas and respiratory function in patients with more significant.

Objective To study the fibrous capsule structure and its change after expansion.Methods Twelve minipigs were chosen for establishing the animal models of conventional intermittent tissue expansion (CITE) and continuous pressure tissue expansion (CPTE). The capsule samples were taken for measurement and histological examination.Results The thickness and the contraction rates of capsules in CPTE group were significantly less than those of CITE group. The capsule consisted of four layers, in which a large amount of collagen and elastic fibers existed and some small arteries, veins and capillaries were well developed. After expanded flaps were transplanted, capsules contained in flaps were partially degenerated except elastic fiber layer and fibrolaminar layer, but capsules on the wound bed almost all degenerated. Conclusion The results suggest that capsules have contractive and blood supply abilities. Capsulectomy is able to decrease flap contraction. Large expanded flaps are better to have the capsule reserved. No efforts shall be done to the capsules on wound beds.

Objective To investigate the cell dynamic changes of conventional intermittent tissue expansion (CITE) and continuous pressure controlled tissue expansion (CPTE). Methods Domestic pigs were chosen for CITE and CPTE models. Immunohistochemical technique was used to detect proliferative cells, DNA fragments in situ labeling for apoptotic cells, and H E stain for total fibroblast counting. Results Proliferative index of basal cell increased during expansion. The peak value of 78.5% reached at the ninth day in the CITE group versus 84.2 % at fourth day in the CPTE group. Proliferation index in both groups decreased after expansion. Fibroblast proliferation, apoptosis and total fibroblast density increased slowly in both groups during and after expansion. At the sixth day, total fibroblast densities in CITE group (38.1 cells/H) and in CPTE group (40.9 cells/H) were significantly increased, compared with 34.93 cells/H in the normal skin. There were obvious proliferation and apoptosis phenomena in epidermal cells and skin adnexa. Conclusion Tissue expansion has both effects of proliferation and apoptosis on cell dynamics. Continuous tissue expansion can induce tissues growing much effectively.

Objective: To study the mechanism of safflower injection(红花注射液) on preventing thrombosis after arteriovenous fistula operation in rabbits.Method: Twenty-four rabbits were randomly divided into three groups: safflower injection group,heparin group and control group(each n=8).Rabbit femoral arteryvein side-to-side anastomosis models were performed on both sides of the lower extremities and they were coincided.Safflower injection(5 mg/kg) or heparin injection(6 U/kg) was given from ear edge vein immediately after operation in the respective group,while normal saline(0.9%) was given with the same fashion in the control group,once per day for 14 days.On the 1 st,3 rd,7 th and 15 th day after operation,the nitric oxide(NO) in serum and endothelin(ET) in plasma were determined respectively.Results: The plasma ET contents were significantly lowered in safflower and heparin groups compared with that of control group(both P

Objective To investigate the relationship between the expression of trannsient receptor potential vanilloid 1 (TRPV1) and the severity of airway remodeling in elderly patients with chronic obstructive pulmonary disease(COPD).Methods According to airflow obstruction severity,totally 100 cases of elderly patients with COPD were divided into chronic obstructive pulmonary disease Global Initiative(gold) grade 1 in 23 cases,24 cases of grade GOLD2,GOLD3 27 cases,GOLD4 26 cases,respectively.The TRPV1 concentrations in induced sputum supernatant and serum from each level of elderly patients with COPD as well as in 50 cases of healthy old people were analyzed.Results TRPV1 concentrations in serum and induced sputum in the COPD group was significantly increased compared with the healthy elderly group[(9.94±2.91)μg/L vs.(3.68±0.46)μg/L,(3.29± 1.32)μg/L vs.(0.70 ± 0.30)μg/L] (P ＜ 0.01).The serum and induced sputum TRPV1 concentrations in the mutual pairwise comparison between the elderly COPD patients with all levels had statistical difference (P ＜ 0.01).Conclusion The expression of TRPV1 protein become increased with the severity of airway remodeling in elderly patients with chronic obstructive pulmonary disease.

To explore the therapeutic effect of micro-traumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistulae.Application of cutting seton (truss rubber bands) implemented the high part of fistulae and loose seton (ligation rubber band but non-fastened) for the low part of fistulae.133/136 patients undergoing micro-traumatic surgery were cured by one operation,2 cases had pseudo-healing and there was 1 recurrent case.And the curative rate was 97.8％.The microtraumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistula has such multiple advantages as small incision,minor trauma,lesser pain,faster healing and a shorter course of treatment.And it may preserve the proper anal function and the integrity of anal skin.And its clinical efficacy is satisfactory.

Objective To analyze the clinical characteristics of children tsutsugamushi infection in order to strengthen understanding,reduce the misdiagnosis rate,reduce the complications and improve the level of diagnosis and treatment.Methods To analyze retrospectively the clinical data and treatment outcome of 22 cases of children tsutsugamushi disease,including symptoms,physical signs and laboratory examination.Results All the cases with fever onset,high fever (＞ 39 ℃) was 72.7％ (16/22),all cases were typical eschars and ulcers,while 8 cases (36.4％,8/22)had lymphadenectasis.Merger multiple organ damage in 14 cases (63.6％,14/22),anemia in 11 cases (50.0％,11/22)and liver function abnormal in 4 cases (18.2％,4/22).All of 22 cases were treated with azithromycin.All cases after treatment with azithromycin heal,no recurrence.Conclusions The manifestation of tsutsugamushi disease is diversity,much complications,among which hematology and liver are the most common cases.Physical examination roundly might reduce missed diagnosis and misdiagnosis as greatly as possible.Azithromycin has good therapeutic effects on children tsutsgamushi disease.

Objective To investigate the effect of docetaxel combined capecitabine chemotherapy and psychological intervention after radical mastectomy. Methods 80 cases of radical mastectomy for breast cancer treated in our hospital from January 2015 to January 2017 were treated with docetaxel combined with capecitabine chemotherapy. According to different nursing methods, the patients were divided into 2 groups. The observation group was treated with psychological nursing, while the control group received routine nursing care. The anxiety and depression scores in two groups before and after nursing were observed and compared. Results There were no significant difference in the scores of anxiety and depression between the two groups before and after treatment. After the intervention group, patients in observation group were significantly improved, and better than the control group patients; The nursing satisfaction rate in the observation group was 97.5%,which was significantly higher than that in the control group (72.5%) (P<0.05). Conclusion After radical mastectomy of breast cancer with docetaxel combined with capecitabine chemotherapy and psychological clinical observation of dry pre found in breast cancer resection and chemotherapy as the basis, to patients with psychological intervention can improve the clinical situation of patients, promote their mental status improved, improve nursing satisfaction rate of patients, so it is worthy of reference.