Objective To evaluate the platelet function in the patients with recurrent spontaneous abortion (RSA) ,to explore the correlations between Hcy and folic acid(FA)with mean platelet volume(MPV) and platelet distribution width(PDW) ,and to evalu-ate the application value of above indicators in predicting RSA .Methods Twenty-eight cases of RSA ,40 cases of healthy pregnancy and 50 healthy child-bearing women(control group) in our hospital were selected .The detection indicators included peripheral blood Hcy ,FA ,PLT ,MPV and PDW .Results The PLT and FA levels in the patients group were significantly lower compared with the normal pregnancy group and control group(P<0 .01) ,while the Hcy ,PDW and MPV were increased(P<0 .05);the various indica-tors had no statistically significant difference between the normal pregnancy group and control group (P>0 .05) .Blood Hcy was negatively correlated with PLT and FA ;Hcy and FA were negatively correlated in the normal pregnancy group ,other indicators had no obvious correlation(P>0 .05) .Conclusion The Hcy metabolism abnormality ,platelet parameter changes and their interactions may be related to RSA .The combined detection of Hcy ,FA and platelet parameters has a certain clinical significance to early diag-nosis and treatment of RSA .

OBJECTIVE:To explore the approaches for clinical pharmacists to participate in the treatment for lung cancer. METHODS:Based on the work of oncology department,the content and method of clinical pharmacist participating in clinical drug therapy were introduced in the terms of rationality,drug interaction,pain treatment,etc. RESULTS:Clinical pharmacists could participate in the treatment for lung cancer through paying attention to rationality of antitumor drug and ancillary drug use, drug interaction and pharmaceutical care for pain treatment,conducting special lecture for medical staff,and developing clinical study. CONCLUSION:Clinical pharmacists can provide various pharmaceutical care to promote safe and rational drug use.

Objective:To discuss the clinical assessment value of comprehensive echocardiographic parameters in detecting the left ventricular diastolic function in patients with hypertension. Methods: 60 hypertensive patients (30 cases without left ventricular hypertrophy (non-LVH), 30 cases with left ventricular hypertrophy(LVH) were divided into hypertension group, and 60 healthy subjects were in control group. All of the subjects were underwent M type, color ultrasound and tissue Doppler imaging (TDI). And to compare their comprehensive echocardiographic parameters.Results: Compared with the healthy control group, the IVSd, LVPWd, LVMI, LAD and LVD of hypertension group were significantly enlargement; the s', e', E peak and LVEDP of hypertension group also significantly increased, while a' and A peak were significantly reduced; compared with non-LVH, e', E peak and LVEDP of LVH group were significantly increased, and a' and A peak were significantly reduced, and these differences were statistically significant (t=-4.39,t=-4.39,t=5.47,t=-8.02, t=6.20,t=18.95, t=16.12;P<0.01).Conclusion: The comprehensive echocardiographic parameters can evaluate the extent of damage for left ventricular diastolic function of patients with hypertension, and they can be as the assessment standard of left ventricular hypertrophy. In clinical practice, TDI can be used as a new means in the evaluation of ventricular diastolic function.

Objective To observe the effect of Exendin-4 on the apoptosis of cardiomyocyte induced by H2O2,and approach the relationship between GLP-1 signal pathway and the injury of cardiomyocyte.Methods Cardiomyocytes were isolated and cultured,and were divided into 5 groups.Intercelluar ROS (reactive oxygen species) was measured,and cell apoptosis rate was evaluated by Flow cytometry in different groups.Also expressions of apoptosis-associated proteins (caspase-3) and PI3 K/AKT were evaluated by western blot.Results Compared with H2O2 group,Ex-4 co-incubation decreased the production of intercelluar ROS levels,also improved the cardiomyocyte apoptosis.At the same time,Ex-4 resulted in the alterations in expressions of the caspase-3 and p-AKT/AKT proteins.However,these effects of Exendin-4 were counteracted significantly by the co-incubation of LY294002.Conclusion The interventions of GLP-1 signal pathway can improve cardiomyocyte apoptosis induced by H2O2 incubation,and the mechanisms might partly attribute to the PI3K/AKT system.

0.05), but significant difference when compared the older-age group with the young & middle-age group(P

OBJECTIVE: To analyze the therapeutic drug monitoring results of valproic acid( anti- epileptic drug) . METH-ODS: The concentrations of valproic acid in 226 cases in our hospital were determined by fluorescence polarization immunoassay. RESULTS: The results showed that 47. 79% were within the normal referenced concentration range, with average concentration at( 66. 19? 12. 13) ? g? mL- 1, 46. 90% were below the lower limit and 5. 31% were above the upper limit. CONCLUS-ION: The monitoring results are far from satisfactory. It is advisable to adopt individualized administration so as to achieve the goal of treatment.

Objective To review advance of gabapentin in treatment of refractory chronic cough, and to provide evidence for its clinical usage and further study.The original articles referring to gabapentin’ s effect on sensory neuropathy such as refractory chronic cough, which were retrieved from CNKI, Wanfang Medical Network, as well as PubMed over the last 15 years, were reviewed.The safety, efficacy and its mechanism of gabapentin were sorted, generalized and analyzed.Gabapentin appears to be effective and safe in the treatment of sensory neuropathic disorder such as refractory chronic cough, and its effective treatment results may come ture through improving central sensitization, which indicates the drug has new clinical application value.Relevant clinical trials investigating its efficacy and safety profile in the treatment of cough are limited and further research are needed.

Objective To investigate the prognostic value of arterial blood lactate(Lac) and lactate clearance rate(LCR) for severe neonatal asphyxia.Methods One hundred and fifteen cases of severe neo natal asphyxia admitted in NICU of our hospital from January 2011 to October 2014 were retrospectively analyzed.Lac and LCR values were measured at multiple time points and were compared between those died (27 cases,the death group) and those survived (88 cases, the survival group).The correlation between prognosis and Lac as well asLCR was investigated.Receiver operating characteristic(ROC) curves were drawn to evaluate the prognostic value of Lac and LCR at different time points.Results No significant differences in initial lactate levels and neonatal critical illness score (NCIS) were detected between the two groups (P ＞0.05), while Lac and LCR values at 1 h,2 h,and 6 h showed significant differences between the two groups (P ＜ 0.05).The low-LCR group showed a higher rate of multiple organ dysfunction syndrome and mortality rates than the high-LCR group (44.64％ vs.15.25 ％, P =0.001;32.14％ vs.15.25 ％, P =0.033, respectively).Post-treatment Lac level was positively correlated with prognosis, while LCR at 1 h,2 h, and 6 h were negatively correlated with prognosis.Areas under curve of Lac ROC at 1 h,2 h, and 6 h were 0.625,0.719,and 0.835 respectively, while areas under curve of LCR ROC at 1 h, 2 h, and 6 h were 0.676,0.784, and 0.898 respectively.Conclusion Low LCR for severe neonatal asphyxia predicts poor prognosis.Lac level and LCR at 6 h after emergency treatment is a prognostic indicator for severe neonatal asphyxia.

OBJECTIVE:To explore the new method for clinical pharmacists training,and provide reference for improving the quality of clinical pharmacists training. METHODS:Based on the full-awareness of Definition and characteristics of stage-progres-sive learning(SPL)and problem-based learning(PBL)teaching method,SPL-PBL teaching method was used in the teaching of the-oretical and clinical practice in the process of students training in clinical pharmacist training base. The teaching course of theoreti-cal knowledge was mainly SPL in first half and PBL in another half. While in the clinical practice teaching of ward rounds,check-ing doctor's advice,participation in the development of treatment programs and case discussion,PBL was mainly used interspersed by SPL;SPL was mainly in inquiry,pharmaceutical care and medication education interspersed by PBL. RESULTS:SPL-PBL teaching method had not only effectively aroused the enthusiasm of the students'learning,enhanced the sense of responsibility and improved their clinical professional knowledge and practice ability,but also strengthened the cultivation of students communication ability,document retrieval ability,writing communication ability and self-learning ability(four abilities) to make students more quickly into the role and improve their subjective initiative. CONCLUSIONS:Practice has proved that the SPL-PBL teaching meth-od not only gives consideratin to the inndividual differences among studengts,but also mobilizes the enthusiam,and not only gives consideration to the teaching about basic theoretical knowledge,but also strengthens the training for clinical thingkig andfour abili-ties,wich can be used for the clinical pharmacists training. Meanwhile,SPL has expanded the aplication surface of PBL beacuse that SPL has reduced the requirements of PBL for overall qulity. However,it needs to be improved because of the short time appli-cation.