Chronic Disease ; Heart Failure ; therapy ; Humans ; Systole ; United States

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Heart Failure ; therapy ; Humans ; Stem Cell Transplantation

Objective: To discuss the importance of pharmaceutical care in anti-infective treatment for one patient with severe pneumonia and renal insufficiency performed by clinical pharmacists. Methods: Clinical pharmacist participated in evaluating and changing the anti-infective treatment regimen, adjusted the drug dosage according to the renal function reasonably to avoid adverse drug reactions and completed the medication education and health education for the patient. Results:The infection was controlled effective-ly, gasp was controlled effectively and blood pressure was steady. Conclusion:Clinical pharmacists should monitor the whole treatment process,evaluate the drug regimen comprehensively and reduce adverse drug reaction to the maximum limit during the pharmaceutical care.

Objective To investigate the expression of Skp2 and P27kip1 and their relationship with the clinicopathologic characters in basal cell carcinoma(BCC). To explore their expression between with the types of BCC of skin, especially in morpheaform BCC group. Methods Immunohistochemical SP technique was used to examine the expression of Skp2 and P27kip1 in 50 cases of BCC and 30 cases of normal tissues of skin.The expression level was analyzed combined with clinicopathological features of age, sex and types of tumor.Results Skp2 positive products located in cytoplasm or nucleus. P27kip1 positive products located in nucleus.The high expression of Skp2 and the low expression of P27kip1 were observed in BCC, there was statistical significance between the tumor group and the control group (P ＜ 0. 05 ) . The expression of Skp2 and P27kip1 were correlated with clinical types of BCC ( P ＜ 0. 05 ), while which were not correlated with age and sex ( P ＞0.05 ). In BCC tissue, Skp2 expression was negatively correlated with P27kip1 ( - 0.624; P ＜ 0.05), there was no correlated with each other in morpheaform BCC group ( P ＞ 0. 05 ). Conclusion The expression of Skp2 and P27kip1 in BCC are significant differences to normal skin tissues, and they are correlated with each other.They may play an important role in carcinogenesis and the development of BCC, and also make targets to treat it. Compared to nodular and superficial BCC group, the expression of Skp2 are higher in morpheaform BCC group, and the expression of P27kip1 is lower. They may play an important role in the types of the BCC and useful factors to predict the types of the tumor, also determine surgical margin for BCC cases.

Inflammatory bowel diseases (IBD) possibly lie in a dysregulated response of the intestinal mucosal immune system towards intestinal microflora under a combined action of genetic and environmental factors.Mucosal dendritic cells are assumed to play key roles in regulating immune responses in the antigen-riched intestinal environment, either by initiating immune responses or by maintaining tolerance. Defects in this regulation are supposed to lead to IBD. This paper reviews the recent research advances in the relationship between IBD and dendritic cells.

Objective Through the analysis of endocrinology outpatient data of Jiangsu provincial hospital,the law and the pathogenesis of TCM for type 2 diabetes was discussed.Methods The data of patients who were diagnosed of type 2 diabetes in Jiangsu provincial hospital outpatient in January 2014-October 2014 were collected,which including the oral medicine,establishment of a database,statistical analysis of single herb drugs appear frequency and its clinical efficacy.Results We collected a total of 583 prescriptions which contain 281 kinds of medcicines.Among these medicines,107 medicines were used more than 30 times,with the most frequently used medicines were poria,root of herbaceous peony and Astragalus.The clinical efficacy of these 107 medicines belonged to 10 kinds,medinces with the tonics and antipyretic functions occupied highest proportion(frequency of 30.4％,22.2％),followed by promoting blood circulation,diuretics for eliminating dampness,and promoting qi flow.Conclusions The pathogenesis of type 2 diabetes was mainly deficieny of both yin and fluid,and dryness heat inside,accompanied by blood stasis,phlegm,Qi stagnation.Therefore the treatment should be nourishing yin and clearing away heat,besides invigorating blood circulation and eliminating stasis,removing dampness and promoting diuresis,and disperse the depressed liver Qi.

Chronic Disease ; Guidelines as Topic ; Heart Failure ; History, 21st Century ; Humans

Objective To investigate the early diagnostic value of high‐sensitivity C‐reactive protein(hs‐CRP) ,D‐dimer and cTnI in ACS .Methods All the 83 blood samples of patients with chest pain in the emergency department of our hospital were enrolled in the study ,and 30 healthy people were recruited as the control group .According to the final clinical diagnosis ,29 patients were grouped into non‐ischemic chest pain(NICP) group and 54 patients were grouped into ACS group .Venous blood samples were col‐lected and the concentrations of serum hs‐CRP ,cTnI ,plasma D‐dimer were measured .The diagnostic value of the 3 indicators and their combined test for ACS was evaluated by using the receiver operating characteristic(ROC) curve and Youden index .Results The levels of hs‐CRP ,cTnI and D‐dimer in ACS group were significantly higher than those of the control group and the NICP group (P<0 .05) .The levels of hs‐CRP and D‐dimer in ACS group were significantly higher than those of the NICP group(P<0 .05) . ROC showed that the area under urve of hs‐CRP ,D‐dimer and cTnI were 0 .564 ,0 .631 and 0 .639 respectively .The sensitivity ,spe‐cificity and accuracy of the combined detection of hs‐CRP ,cTnI and D‐dimer were 88 .1% ,58 .7% ,53 .2% respectively . Conclusion To some extent ,the levels of hs‐CRP ,cTnI and D‐dimer all could be used as indicators in the diagnosis of ACS .But combined detection of hs‐CRP ,cTnI and D‐dimer could improve the sensitivity and specificity ,and had value to guide clinical diagno‐sis of ACS in the early stage .

The therapeutic efficacy of large bone defects with traditional methods, such as autograft or allograft and biomaterial filling, is not favorable and hinders the widely clinical application. Bone tissue engineering has provided a promising way to solve this problem, and has become one of the hotspots nowadays. However, the key technology of vascularization has not been solved ideally yet. Obviously, the routine treatment has become a challenge in repairing large bone defect. In order to find a clinically applicable bone tissue engineering approach, we put forward and established a microcirculation system of osteogenesis inducted by perfusion in vivo. The "regulable osteoinduction microcirculation/microenvironment system in vivo (ROIMS)" has characteristics as follows: the culture conditions are controlled. For example, the release of a variety of growth factors can be controlled stably and quantitatively at bone defect site. Early nutrition and revascularization in the center of tissue-engineered bone can be effectively solved; some shortcomings resulted from construction of tissue-engineered bone in vivo, including secondary injury, high level technical requirements, and complex operation, can be avoided; vascularization and osteogenesis can be constructed simultaneously; simple safe and efficient operation. ROIMS perfectly combines in vitro construction and in vivo construction of tissue-engineered bone. Thereby, we can expect that this new type of technology of tissue engineered bone will be used in clinic in a near future and finally repair large segmental bone defects in clinic.

OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis