OBJECTIVE:To explore the intervention effects by clinical pharmacist on the use of antibacterials during periopera-tive period of hysteroscopic surgery. METHODS:250 medical records of hysteroscopic surgery were collected from July to Septem-ber in 2014(before intervention)and from October to December in 2014(after intervention). The rationality of antibacterials dur-ing perioperative period was retrospectively analyzed before and after intervention. RESULTS:After intervention by clinical pharma-cists,the antibacterial use density decreased from 47.02 DDDs/(100 persons·day)to 23.30 DDDs/(100 persons·day),and the rate of perioperative use of antibacterial decreased from 82.40% to 57.20%,with significant difference(P<0.01). The rationality of medication indicators for perioperative application of antibacterials for hysteroscope increased from 56.80%to 82.52%;the rational-ity of medication duration increased from 49.51% to 79.02%,with significant difference(P<0.05). CONCLUSIONS:Clinical pharmacist's intervention is effective and feasible to perioperative application of antibacterials for hysteroscopic surgery. It could ef-fectively promote the rational use of antibacterials.

The etiology and pathogenesis of intrahepatic cholestasis are complex,and those are not still very clear in current.Studies suggest that genetic factors play an important role in the pathogenesis of the disease.Some familial cholestasis have been confirmed by gene mutation causing.Bile secretion process regulated by a number of bile relation gene at the molecular level.Farnesoid X receptor (FXR) gene is related to intrahepatic bile secretion process.Bile secretion is indirect control by FXR which formats a complex network,becoming more attention to researcher in recent years.

Arrhythmias, Cardiac ; etiology ; Birth Weight ; Electrocardiography ; Female ; Humans ; Hypocalcemia ; complications ; Infant, Newborn ; Male

Objective To compare the accuracy of Marsh model and Schnider model for propofol target?controlled infusion ( TCI) system. Methods Eighty patients, aged 20-60 yr, of American Society of Anesthesiologists physical status ⅠorⅡ, with body mass index of 17?5-28?0 kg∕m2 , scheduled for e?lective gynecological operation under general anesthesia, were equally and randomly divided into either Marsh model group ( group M) or Schnider model group ( group S) using a random number table. The target plasma concentration was set at 3 μg∕ml in both groups. During TCI and at different time points after the end of TCI, the blood samples were collected for determination of blood propofol concentrations by high per?formance liquid chromatography with fluorescence detector. The difference between measured and predicted concentrations (△C) at each time point was calculated. The median performance error ( MDPE) , median absolute performance error ( MDAPE) , and wobble of propofol TCI system were calculated in each group. Results In M and S groups, the MDPE was 9. 90% and 14?00%, respectively; the MDAPE was 11?43% and 14?49%, respectively;the wobble was 7?77% and 7?79%, respectively. There was no sig?nificant difference in △C at each time point during TCI between group M and group S (P>0?05). After TCI was stopped, △C at each time point was significantly lower in group M than in group S ( P<0?05) . Conclusion Marsh model provides higher accuracy than Schnider model for propofol TCI system in the pa?tients undergoing gynecological operation.

The function of hepatic stellate cell (HSC)in liver fibrosis has been well recognized.In recent years,the role of HSC in the liver tumor microenvironment have been paid increasing attention.Platelet derived growth factor (PDGF) is the most important mitogen of hepatic stellate cell,and plays an important role in the activation of hepatic stellate cell.Hepatic stellate cell is not only the target cells of PDGF,but also PDGF-secreting cells.Thus a bi-directional cycle mode of PDGF activating hepatic stellate cell has been established.The signaling pathways of HSC activation include MAPK,PI-3K,Ca2+ and JAK pathways.To explore PDGF activating hepatic stellate cell in liver tumor microenvironment and to find the new methods of targeting PDGF and hepatic stellate cell,may help us find a new direction for the treatment of hepatocellular carcinoma.

Objective To compared the effect of combined teaching method of lecture,case analysis and GasMan@software (LAG) and traditional teaching method (LBL) in inhalation anesthesia practice course.Method 78 anesthesiological undergraduates were randomly assigned to G group (n=39) or Control group (n=39).According to the requirements of clinical anesthesiology in the syllabus,G group used classroom lectures,case analysis and GasMan@software (LAG) teaching method,while Control group used lecture based learning (LBL) teaching method.The students took anonymous quiz and filled teaching effect evaluation form after practice course.Then the exam results were compared between groups to evaluate the teaching effect.SPSS 19.0 was applied to do statistical analysis and t test and x2 test were used.Results Compared to the Control group,G group got better results in objective questions like choosing,judgment,case analysis and average ranks (P=0.000),and there was no significant difference in the identification section (P=0.087),while G group also got better results in subjective questions like learning interests,study efficiency,memorize,logical thoughts,ability of analysis,solving problems and cooperation (P＜0.05).Conclusion Compared to traditional teaching method,the combined use of lecture,case analysis and GasMan@software make students immersive,develop their clinical thinking ability,and improve the teaching effect of inhalation anesthesia practice course significantly.

In recent years,along with the deepening study of bone marrow mesenchymal stem cells (BMSCs),the repair effect of BMSCs in various tissue injury have been gradually revealed.And in recent years,except the ability of differentiate to the target cells,its paracrine effect,for example,a variety of cyto-kines secreted by BMSCs,also plays an important role in the process of repairing.

Objective To investigate the effect of hyperoxia on the expressions of cysteinyl aspartate specific proteinase -3(Caspase -3)and proliferating cell nuclear antigen (PCNA)in bone marrow mesenchymal stem cells (BMSCs).Methods Primary BMSCs from SD rats were cultured in vitro,BMSCs grew to 70% -80% degrees of fu-sion and then were randomly divided into room air group and hyperoxia exposure group.Each group was divided into 5 sub -groups,and cultured for 0,3,6,1 2,and 24 h respectively.Morphology investigation with inverted phase contrast microscope was adopted.The expressions of Caspase -3 and PCNA protein levels were detected by Western blot. Results (1 )As time wenty by,compared with room air group,the gap between cells increased,some of the cells be-came circular,and cell detachment and floating appeared in the hyperoxia -exposure group (>1 2 h)compared with room air group.(2)As time went on,compared with the room air group,the expression levels of Caspase -3 protein in the hyperoxia -exposure group were increased,and the difference was significant after 6 hours of culture (0.27 ± 0.04 vs 0.1 4 ±0.02,t =5.03,P =0.007).(3)Compared with room air group,the PCNA levels of the hyperoxiaexpo-sure group(6 h)decreased,and the difference in PCNA protein expression levels was significant after 6 hours of culture (0.27 ±0.04 vs 0.38 ±0.04,t =3.37,P =0.028).Conclusions Hyperoxia exposure increases Caspase -3 expres-sion levels and decreases PCNA expression,which may affect the proliferation and apoptosis of BMSCs.

Objective To investigate the effects of the novel protein,TPds encoded by the 2.2 kb doubly spliced variant of hepatitis B virus(HBV)genome on the regulatory elements of HBV.Methods HBV promoters and enhancers were amplified by PCR and respectively cloned into the plasmid pGL3-basic to construct the recombinant firefly luciferase reporter vectors including pGL3-BCP(harboring basal core promoter),pGL3-CP1601(core promoter with enhancer Ⅱ),pGL3-XP(minimal X gene promoter),pGL3 XP1071(X gene promoter with enhancer Ⅰ),pGL3-SP1(promoter of large surface antigen)and pGL3-SP2 (promoter of middle surface antigen).The recombinant reporter plasmids were respectively co-transfected with either the pcDNA3.1/HisC-TPds(TPd8 expression plasmid)or pcDNA3.1/HisC(empty control)into Huh7 hepatocytes by FuGENE6 transfection reagent.Cells were lysed 48 h post transfection,the intracellulax luciferase activities were monitored and calculated by SPSS11.5 software.Results As compared with the empty control of pcDNA3.1/HisC.the intracellular luciferase activities were elevated when the Huh7 hepatocytes were co-transfected by pcDNA3.1/HisC-TPds with one of the recombinant reporter plasmids as pGL3-CP1601,pGL3-XP1071,pGL3-SP1,or pGL3-SP2,while no changes with pGL3-BCP or pGL3-XP.Conduslon TPds could transactivate the HBV regulatory elements a8 promoter SP1,SP2.and enhancer Ⅰ,Ⅱ,while no influences on basal core promoter and minimal X gene promoter.

Abstract： Objective　To analyze the characteristics and corresponding drug resistance of pathogenic bacterial spectrum in eight major infection sites of hospitalized patients, and to provide epidemiological data for the rational selection of antibiotics in clinical practice. Methods　A total of 396 bacterial strains isolated from clinical specimens of hospitalized patients in member institutions of the Hainan Provincial Bacterial Resistance Monitoring Network from September 1, 2020, to September 30, 2022, were included in this study. Data were screened and filtered from the database of MH120 Microbial Identification and Drug Sensitivity Analysis System based on the technical scheme of the National Bacterial Drug Resistance Surveillance Network and Science and Technology Basic Resources Investigation Project research plan in 2020. The testing data were integrated, summarized, and analyzed using EXCEL and WHONET 5.6 software, and statistical analysis was conducted using SPSS 26.0 software. Results　Among of 396 strains of bacteria, 78 (19.7%) were isolated from respiratory tract specimens, 74 (18.7%) from urinary tract specimens, 72 (18.2%) from blood specimens, 54 (13.6%) from abdominal cavity specimens, 48 (12.1%) from skin and soft tissue specimens 48 strains (12.1%), 30 (7.6%) from reproductive tract specimens, 22 (5.6%) from central nervous system specimens, 18 (4.5%) from digestive tract specimens. Gram-negative bacteria accounted for 69.4% of the isolates, while gram-positive bacteria accounted for 30.6%. The top five gram-negative bacteria isolated were Klebsiella pneumoniae (14.9%), Escherichia coli (14.4%), Pseudomonas aeruginosa (10.4%), Acinetobacter baumannii (5.3%), and Salmonella species (4.5%). The top five gram-positive bacteria were Staphylococcus aureus (11.1%), Streptococcus agalactis (7.8%), Enterococcus faecalis (3.0%), Enterococcus faecium (2.8%), and Streptococcus suis (1.8%). Respiratory failure and bloodstream infection were independent influencing factors of treatment response (P<0.01). The resistance rate of Escherichia coli to ampicillin was 81.4%, and the resistance rate of Staphylococcus aureus to gentamicin and levofloxacin were both below 7%. Conclusions　The pathogen spectra vary with different infection sites of patients, and rational selection of antibiotics based on drug susceptibility testing is crucial to shorten the treatment time of patients and avoid the unnecessary emergence of drug-resistant strains caused by drug abuse.