OBJECTIVE:To investigate the value of genetic testing in clopidogrel individualized antiplatelet therapy for acute coronary syndrome(ACS)patients after percutaneous coronary intervention(PCI). METHODS:Clinical pharmacists participated in therapy for 3 ACS patients after PCI,and analyzed risk factors of stent thrombosis as the degree of lesion complexity,length and number of stents,complication,smoking history,etc. Clinical pharmacists suggested conducting clopidogrel genetic testing (CYP2C19,PON1,ACBC1),and suggested replacing antiplatelet agents,maintaining original plan and strengthening monitoring according to the results of genetic testing. RESULTS:The physicians adopted the suggestions of clinical pharmacists. After optimiz-ing antiplatelet therapy according to the results of genetic testing and clinical factors,3 patients were stable and discharged from hospital with drugs. CONCLUSIONS:Genetic testing can provide evidence for the formulation of individualized antiplatelet thera-py in ACS patients after PCI,and can be regarded as one of the breakthrough points for clinical pharmacists to carry out pharmaceu-tical care. In conducting genetic testing,clinical pharmacists should evaluate the risk of thrombosis in ACS patients and select the appropriate population for testing. At the same time,the clinical factors as medication compliance,stent thrombosis risk,therapeu-tic efficacy,ADR,and evidence-based pharmaceutical evidence should be comprehensively evaluated on the basis of genetic test-ing,and antiplatelet therapy plan should be optimized so as to guarantee the safety and effectiveness of drug use.

Correspondence between man and nature theory is the core of TCM chronomedicine, and also plays an important role in ancient Chinese philosophy. The theory believes that distinguishing the rhythm is the foundation of treatment; complying with nature is the core of treatment; taking advantage of wane and wax is the method of treatment. This article combined the physiological and pathological characteristics of children to review the prevention and treatment of pediatric diseases based on chronomedicine, with a purpose to provide inspirations for clinical treatment.

OBJECTIVE To survey the antibiotic usage and its rationality in clinical.METHODS From Jan 2009 to May of 2009,950 medical records were selected to conduct a retrospective investigation.RESULTS The incidence of antibiotic usage was 88.2%,71.6% cases were intended for active treatment,28.4% for preventive regimen.72% cases in internal medicine were for active treatment whereas 94% were for surgical prophylaxis.In terms of the antibiotic use,single drug accounted for 56.2%,two-drug 38.9% and three-drug 4.9%.Inspection rate of drug treatment was 69.7% and hospital infection rates was 2.1%.CONCLUSIONS To improve antibiotic administration,systematic efforts are required to keep the medical staff updated of antibiotic principles so as to improve clinical rational use of antibiotics.

Objective To compare the clinical effects of modified single open-door laminoplasty combined with segmental lateral screw fixation with conventional single open-door combined with continuous screw fixation in the treatment of multilevel cervical spondylotic myelopathy (MCSM).Methods Retrospective analysis was used to analyze the fifty-five cases of MCSM who underwent posterior operation in Lianyungang Hospital Affiliated to Xuzhou Medical University from March 2009 to January 2017.Among them,26 cases in the modified group were treated by modified single open-door laminoplasty combined with segmental lateral screw fixation;29 cases in the traditional group were treated by conventional single open-door combined with continuous screw fixation.JOA score collected before the operation and at the last time of the follow-up,the cervical spine mobility,cervical curvature,cervical axial symptom,C5 nerve root palsy and the incidence rate of screw fracture in both groups were compared.Operation time and the intraoperative blood loss were recorded.Results 55 cases were all followed up.The cervical spine mobility at the last time of the follow-up in the modified group was significantly higher than that of the traditional group ((39.63°±5.98°) vs.(36.14°±6.05°),P=0.036).The cervical curvature in the modified group was higher than that of the traditional group ((19.83°±5.61°) vs.(16.02°±7.05°),P=0.030).The operation time and intraoperative blood loss in the modified group were significantly lower than those of the traditional group ((116.3±13.2) min vs.(128.7±14.3) min,(186.7±39.8) ml vs.(228.7±42.5) ml,P=0.002,0.000).In the modified group,the proportion of patients with postoperative cervical axial symptom was 15.38%,the rate of C5 nerve root palsy cases was 8.69%,compared with 48.27% and 34.48%,respectively in the control group,the difference between the two groups was statistically significant (P=0.011,0.022).In the traditional group,2 cases of screw fracture were found at the last follow-up,while there was no such case in the modified group.Conclusion The modified cervical single open-door laminoplasty combined with segmental lateral screw fixation can obtain good effect of nerve decompression,maintain cervical mobility and cervical curvature,reduce the occurrence of postoperative cervical axial symptom,C5 never root palsy,screw fracture and other complications,is a safe and effective surgical method.

Electromagnetic Fields ; adverse effects ; Health Policy ; Humans

Animals ; Dogs ; Drug Evaluation, Preclinical ; methods ; Statistics as Topic

Comprehensive evaluation for colleges of stomatology is a complex systematic engineering, which is affected by the determination of index and weight. Based on the previous research results,this study establishes a comprehensive evaluation index for colleges of stomatology in China by applying Delphi method,carrying out two-round consultation to 45 experts,which includes 4 first layer indicators and 21 second layer indicators.

Pertussis is an severe infectious respiratory disease that continues to be a serious public health problem,which is caused by Bordetella Pertussis.Because it's highly infectivity,it is still an important etiological factor associated with persistent cough in adults and adolescents.With the introduction of mass vaccination in 1974,there has been a dramatic decrease in the morbidity and mortality.However,in recent years,increasing numbers of pertussis are reported in adolescents and adults in many countries where with high vaccination coverage.The thesis summarize and discuss the progress of pertussis cpidemiology and clinical characteristics.

Objective: To improve the diagnosis and treatment level of secretory otitis media (SOM) of children. Method :Clinical information of 80 children with SOM were colletcted and analysed. All of the 80 cases (144 ears)were treated by myringotomy with Grommet insertion. Among them, 30 cases by adenotonsillectomy. 10 cases by palatoplasty. Secretions of 54 ears were carded out by bacterial culture. Result:80 cases were followed up for 6 to 12 mothes. 120 ears of 144 were cured (83％) ,with hearing improved. The tympanograms and hearing threshold of pure tone were found to be normal. The Gram＇s positive and negative germs of bactevial culture were 20.7％ (6/29 samples ) and 24％ (6/25 samples ) respectively. Conclusion: Children with secretory otitis media should be treated as early as posible to improve the patients＇ hearing and develope their speech.

Abstract: Relapse and metastasis are the main causes responsible for failure of surgical operation in treating malignant tumors. This article introduces the present development in post-operation treatment of lung cancer, liver cancer and stomach cancer, showing that the synthetic treatment by stages combined with traditional Chinese medicine is the important way to prevent and treat the post-operation relapse and metastasis of tumors, and suggesting the optimized method for treatment.