OBJECTIVE:To summarize the method and experience of clinical pharmacist participating in pharmaceutical care for a case of refractory class Ⅳ+Ⅴ lupus nephritis (LN). METHODS:Clinical pharmacists and physicians formulated individualized treatment together,i.e. prednisone 30 mg/d+MMF 0.5 g,q12 h+FK506 1 mg,q12 h;on the fifth day of treatment,the patient suf-fered from ardent fever and increase of blood pressure,and clinical pharmacist suggested using linezolid 0.6 g,ivdrip,q12 h+merope-nem1.0 g,ivdrip,q8 h to control pulmonary infection;using Amlodipine besylate tablet 5 mg,po,qd+one Valsartan hydrochlorothia-zide capsule, po,qd+Arotinolol hydrochlorid tablet 10 mg,po,bid to control blood pressure. RESULTS:Multi-target treatment for re-fractory class Ⅳ+Ⅴ lupus nephritis achieved efficacy:the patient got higher plasma albumin and lower 24 h urine protein quantity af-ter 14 days;the patient suffered from secondary pulmonary infection and high blood pressure;physicians adopted the pharmacist’s suggestion so that pulmonary infection and blood pressure had been controlled. CONCLUSIONS:To ensure the effectiveness and safe-ty of the multi-target treatment,clinical pharmacists should formulate individualized treatment,focus on the possible ADR and provide phamaceutical care in the field of blood pressure monitoring,infection control,etc. when participating in multi-target treatment.

This paper mainly discusses the development of animation courseware for medical statistics from the following aspects:courseware design,some related technologies in courseware making and the evaluation of courseware. The animation courseware for medical statistics can enhance self-regulated learning ability of students,from passive acceptance to initiative exploration,stimulate students'learning interest,raise their learning efficiency,and then enhance the quality of teaching.

OBJECTIVE:To provide reference for the perfecting of hospital information system (HIS) on drug control. METHODS: The problems encountered in using two drug control systems in our hospital were analyzed, and the constructive suggestions on its improvemen was put forward. RESULTS & CONCLUSIONS: The new HIS should be designed to overcome the weaknesses of the current HIS in code design, assignment of authority limit, drug application and dispensing, drug stocktaking so as to make full use of the merit of the computer management.

Bone Plates ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; methods

In vitro cellular adherence of murine neutrophils (Neu), macrophages (Mo) and eosinophils (Eos) to infective larvae (L3) of periodic Brugia malayi was promoted by immune serum (AIMS) or fresh normal mice serun (fNMS). Mo and Neu were more potent than Eos . in killing the L3. Eos could adhere to the L3 in the presence of AIMS or fNMS but a weak cy-totoxic effect was observed only when AIMS was used. The activity in AIMS could be removed with Staphylococcus aureus containing Protein-A (SPA) or anti-mice IgG antiserum suggesting that IgG might be in the observed cytotoxicity. Immunofluorescent staining revealed IgG binding to the surface of L3 after incubation with AIMS. Heat treatment of AIMS at 56℃ 30 min resulted in a reduced cytotoxic effect suggesting the role of complement in the reaction. EDTA but not EGTA abolished this activity indicating the operation of complement by alternate pathway. Scanning electron microscopic (SEM) studies comfirmed that the celluar adherence resulted in gross surface damage to the infective larvae.

Objective To investigate the entry points for clinical work of intensive care unit (ICU) pharmacists.Methods Through combination with daily work and referring the domestic and foreign literature,the characteristics of ICU medications were discussed to find out the entry point for clinical work of ICU pharmacists.Results ICU patients particularly need individualized pharmaceutical care because of the special pathophysiological characteristics and medicine use.Conclusion ICU pharmacists should provide pharmaceutical care based on Pharmacokinetics/pharmacodynamics knowledge and focus on the drug dosage adjustment,drug interactions and adverse event prevention.

Objective To evaluate the efficacy and safety of acupuncture as adjuvant treatment in the management of diabetic foot (DF).Methods We searched MEDLINE,Embase,CENTRAL,SinoMed,VIP,CNKI and WANFANG database.We also searched the bibliographies of retrieved articles and correlated proceedings and collected the literatures of DF of clinically randomized or quasi-randomized control trials of acupuncture as adjuvant treatment.After the data was extracted independently by 2 reviewers,we performed meta-analysis by using RevMan 5.1 software.Results Seven studies included 626 patients who met the inclusion criteria,and all employed clinical effects as evaluation indicator.Meta-analysis showed that acupuncture as adjuvant treatment could obviously improve the total effectiveness rate(RR =1.29,95％ CI:1.20,1.38,P ＜ 0.00001)and the recovery rate(RR =1.92,95％ CI:1.60,2.30,P ＜ 0.00001 ).No adverse reactions occured.Conclusions The limited current evidence shows that acupuncture as adjuvant treatment is safe and effective in the treatment of DF.Due to the poor quality of original studies,a prudent choice is suggested.Further studies with high quality and large samples according to CONSORT are also warrant.

Objective To study the expression of metabolism related genes in peripheral blood mononuclear cells in patients of non alcoholic fatty liver diseases (NAFLD)with cholelithiasis.Methods Patients who had BMI ≥ 27 were divided into obese ( n = 10),the NAFLD ( n = 7) and NAFLD with cholelithiasis (n= 16) groups.The subjects who had BM1<25 (n = 10) and cholelithiasis (n = 16) were served as controls.The expression of peroxisome proliferator-activated receptors (PPAR)α,sterol regulatory element-binding protein(SREBP)-lc and Leptin Rb in peripheral blood mononuclear cells were measured.Results The expressions of PPARα,SREBP-lc and Leptin Rb in peripheral blood mononuclear cells were different in five groups.The significant difference was found in expression of leptin Rb between NAFLD with cholelithiasis group and the obese group,NAFLD with cholelithiasis group and the cholelithiasis group,NAFLD with cholelithiasis group and NAFLD group,the obese group and controls (P values= 0.037,0.050,0.044and 0.038,respectively).The leptin Rb mRNA expression in NAFLD with choletethiasis group was the lowest.Conclusions The low expression of leptin Rb mRNA was found in NAFLD patients with cholelithiasis.Cholelithiasis may increase the extent of insulin resistance and cause NAFLD progression.

【Objective】In order to establish the foundation for transgenic mouse model,the human thalassemic gene(β654) was cloned and sequenced.【Methods】The human β654 gene was amplified by PCR,and cloned into the plasmid BGT51 in which the human β gene was cut out aforehand.The recombinant plasmid was certified by enzyme-digestion,reverse dot hybridization and sequencing.【Results】A recombinant plasmid was obtained,which contained the human β654 gene in the correct recombinant direction.Sequencing showed that the cloned insert was correct.【Conclusions】The recombinant plasmid constructed is useful for establishing a transgenic mouse.

Objective To study the basic pathogenic cause,clinical characteristics,treatment methods and prognosis of sub-acute infective endocarditis (IE) ,and to improve the diagnosis and treatment against it Methods The basic cardiac disease,clinical characteristics,pathogenic bacteria,ultrasound cardiogram, therapy and prognosis of 36 cases of sub-acute IE was retrospectively analyzed. Results Compared to previous reports, the proportion of rheumatic cardiac disease was a little lower, whereas the proportion of congenital cardiac disease and not-recorded cardiac diseases were a little higher.The main clinical characteristics showed as fever, heart failure, increasing in number of neutrophile granulocyte,blood sedimentation and anemia, The positive rate of blood culture was 58. 33% with the most common pathogenic bacterium of streptococcus viridans. Endocardial vegetation has been diagnosed in 63. 89% of patients through-thoracic echo-cardiography. The short-term fatality rate was 19. 44% . Conclusions There have been significant changes in the basic pathogenic causes,clinical characteristics and pathogenic bacteria of sub-acute IE as compared to the previous reports. The fatality rate remains high even after active treatment. Early surgical operation is recommended to those suitable patients.