Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

Biopsy ; Histological Techniques ; instrumentation ; methods ; Humans ; Indicators and Reagents ; Paraffin Embedding ; Ultrasonics

Objective: To explore the relationship between septal myocardial metabolism and left ventricular mechanical synchronization in patients with dilated cardiomyopathy (DCM) and left bundle branch block (LBBB) by gated 18F-FDG myocardial metabolic imaging.
Methods: A total of 20 consecutive patients diagnosed for DCM with LBBB from 2010-10 to 2013-05 were enrolled, there were 11 male and 9 female at the mean age of (54±11) years. All patients received gated 18F-FDG myocardial metabolic PET imaging. TrueD software was used to determine the maximal standardized 18F-FDG uptake value (S-SUVmax) and the average standardized uptake value (S-SUVavg). QGS software was applied to conduct left ventricular phase analysis and to detect the cardiac function, left ventricular bandwidth (BW), standard deviation of bandwidth (SD), left ventricular end-diastolic volume (LVEDV), LVESV and LVEF. The relationship between 18F-FDG uptake in septal myocardium with the indexes of phase analysis and the indexes of cardiac function was analyzed.
Results: S-SUVmax and S-SUVavg were respectively negatively related to BW (r=-0.44, P<0.05 and r=-0.48, P<0.05);they were also respectively negatively related to SD (r=-0.57, P<0.01 and r=-0.51, P<0.05). While S-SUVmax and S-SUVavg were not really related to LVEDV, LVESV and LVEF, all P>0.05.
Conclusion: In patients of DCM with LBBB, reduced septal myocardial metabolism was closely related to left ventricular mechanical synchronization, gated 18F-FDG myocardial metabolic PET imaging may simultaneously detect both functions, which was important for prognostic evaluation and therapeutic monitoring in clinical practice;phase analysis.

Objective To explore humor experience and its relationship with theory of mind in patients with schizophrenia. Methods sixty?one schizophrenic patients without treatment and sixty?three healthy subjects were assessed with the Humor Picture Test ( HPT) ,Humor Video Test ( HVT) and the Theory?of?Mind Picture?Se?quencing Task ( ToM?PST) . Results Compared with healthy subject in HPT,schizophrenic patients showed sig?nificantly higher non?humor picture rating score (24.41 ± 8.82 vs 28.41 ± 11.56, P<0.05),and less humor picture rating score (45.65 ± 11.49 vs 34.41 ± 13.06, P<0.05). Compared with healthy subject in HVT,schizophrenic patients also showed significantly less humor video rating score (3.56 ± 0.57 vs 2.46 ± 0.79, P<0.01) and the number of standard humorous moments (3.68 ± 1.19 vs 2.42 ± 1.40, P<0.01) and the sensitivity of standard hu?morous moments?d’(humor) score (1.11 ± 0.46 vs 0.47 ± 0.42, P<0.01). Schizophrenic patients had significant?ly less total score (39.89 ± 12.33 vs 58.76 ± 0.64, P<0.01) of ToM?PST compared to normal control. Correlation analysis showed a negative correlation between d’ ( humor) score and the Positive and Negative Syndrome Scale ( PANSS) total score ( r=-0.380, P<0.01) for the patients. There was significantly negative correlation between non?humor picture rating score and ToM?PST total score ( r=-0.316, P<0.05) ,and positive correlation between d’ (humor) score and ToM?PST total score ( r=0.400, P<0.01) in schizophrenic patient. After controlling for the PANSS total score,the correlation between d’(humor) score and ToM?PST total score remained significant. Conclusion Schizophrenic patients have poor humor experience,which is related to the impairments of theory of mind.Humor experience deficit may share a common neuropsychological base with the impairment of theory of mind.

OBJECTIVEThis study assessed cardiac function changes post embryonic stem cells (ESCs) perfusion at different concentrations in the isolated apolipoprotein-E gene deficiency (apo E-/-) and wild type (WT) hearts.

METHODSapo E-/- and WT mice hearts were isolated and retrogradely perfused (Langendorff model) and ESCs were infused with different concentrations (Low dose group: 1.0 x 10(6) cells, high dose group: 2.5 x 10(6) cells). Hemodynamic parameters including coronary flow (CF), heart rate (HR), dp/dtmax, dp/dtmin, left ventricular end diastolic pressure (LVEDP), were recorded after stabilization period and at before, 5 min, 15 min and 30 min after cell perfusions. The number of cells in the transudate was counted.

RESULTSCardiac function parameters were similar before cell perfusion in apo E-/- and WT hearts. Cardiac function was significantly impaired after low dose cell perfusion in apo E-/- hearts while remained unchanged in WT hearts with the exception of lowered HR. Cardiac function was also significantly impaired after high dose cell perfusion in both apo E-/- and WT hearts, especially in apo E-/- murine hearts. Most of the cells perfused into the heart were expelled after 30 min (63.2% - 77.0%).

CONCLUSIONESCs perfusion into an isolated heart, especially in the atherosclerosis-prone hearts, in the Langed off model impaired cardiac function in a concentration-dependent manner.

Animals ; Apolipoproteins E ; deficiency ; genetics ; Disease Models, Animal ; Heart ; physiopathology ; In Vitro Techniques ; Mice ; Mice, Knockout ; Myocardial Reperfusion Injury ; etiology ; Stem Cells

Objective:To investigate the mediating roles of perceived social support and relative deprivation in the relationships between life events and Internet addiction among Chinese college students.Methods:Totally 413 college students (200 males and 213 females,aged 16-21 years),completed the Relative Deprivation Questionnaire,Adolescent Self-Rating Life Events Check List,Perceived Social Support Scale and Chinese Internet Addiction Scale Revised to measure the level of relative deprivation,life events,perceived social support and Internet addiction.The Bollen-Stine of structural equation modeling and Bootstrap were used to test the mediating effect of perceived social support and relative deprivation on the relationship between life events and Internet addiction.Results:The scores of PSSS were negatively correlated with the scores of ASLEC,RDQ,and CIAS-R (r=0.11-0.36,Ps ＜0.05).The scores of ASLEC,RDQ,and CIAS-R were positively correlated with each other (r=0.14-0.23,Ps ＜ 0.01).Path analyses showed that the ASLEC scores were not associated with the CIAS-R scores directly (β =0.11,P ＞0.05),but indirectly through the mediating roles of the scores of PSSS and RDQ and the chain mediating effect of them among Chinese college students.The structural equation model could be accepted by Bollen-Stine Bootstrap (P ＜0.01).The confidence interval from Bootstrap output of the mediating effects of the scores of PSSS and RDQ and the chain mediating effect of them were (0.010,0.103),(0.002,0.032) and (0.005,0.061) respectively.Conclusion:It suggests that life events could not directly affect Internet addiction,but indirectly lead to Internet addiction through reducing perceived social support and increasing relative deprivation.

OBJECTIVEAcute lung injury is a severe complication after cardiac surgery performed with cardiopulmonary bypass in infant patients. Pulmonary surfactant has been successfully used in treating neonatal respiratory distress syndrome for many years. This study focused on exploring the clinical efficacy of exogenous pulmonary surfactant in treating infant patients with acute lung injury after cardiac surgery with the use of extracorporeal circulation.

METHODTwenty-three infants with ventricular septal defect (VSD) were enrolled in the study. None of the patients needed oxygen treatment nor ventilation before heart surgery. VSD repair operation was done under cardiopulmonary bypass, and acute lung injury was found postoperatively. Ten infant patients in the treatment group were given pulmonary surfactant by tracheal instillation during mechanical ventilating postoperatively. Thirteen patients in control group were randomly selected in the same period in hospital, and acute lung injury was diagnosed without pulmonary surfactant treatment after cardiopulmonary bypass. Blood samples were obtained from all the patients, and blood gas analysis was performed every 6 hours. Demographics (body weigh, age, gender, VSD diameter) and clinical characteristics (CPB time, oxygenation index, mean airway pressure, pH and PCO2) of all the patients were collected, and statistical analysis was done to compare the data between treatment and control group.

RESULTIn the first 24 hours after heart surgery, compared with the control group, a more increased oxygenation index (from 89.36 ± 12.69 to 285 ± 16.51) was observed in treatment group, and it was from 93.71 ± 11.82 to 133 ± 19.62 in the control group. There was a significant difference in oxygenation index between the two groups (P < 0.05). At the same time, the MAP (from 17.5 ± 3.18 to 10.4 ± 3.37) of the patients in comparison with the control group (from 18.2 ± 2.63 to 13.8 ± 2.55), a more significantly decreased MAP was observed in the treatment group (P < 0.05). There was no significant difference in pH and PCO2 between the two groups. The ventilation time in cardiac care unit was shorter in treatment group (17.43 ± 9.12) h compared with the control group [(30.97 ± 14.85) h, P < 0.05]. ICU stay time of treatment group (3.90 ± 1.34) d was shorter than that of control group [(6.18 ± 1.90) d, P < 0.05].Two infants of the control group died, but none in treatment group died.

CONCLUSIONIn this study, a satisfactory curative effect was observed for the treatment of acute lung injury with PS intratracheal instillation after heart surgery under cardiopulmonary bypass in infant patients. It can reduce the duration of mechanical ventilation and cardiac care unit stay and improve prognosis. In addition, this study was a pilot study and the limited sample size was probably the cause of insufficient statistical power. Further study of larger scale is needed.

Acute Lung Injury ; etiology ; therapy ; Cardiopulmonary Bypass ; adverse effects ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pilot Projects ; Postoperative Complications ; therapy ; Pulmonary Surfactants ; therapeutic use

Objective To investigate the application of cervical diffusion tensor imaging (DTI) in the diagnosis of amyotrophic lateral sclerosis (ALS). Methods Cervical DTI and conventional magnetic resonance imaging (MRI) was performed in 28 ALS patients rated with ALS functional rating scale (ALSFRS) and 20 healthy control subjects to obtain the mean diffusivity (MD) and fractional anisotropy (FA) histograms of the cervical spinal cord. Correlation analysis between DTI of the cervical spinal cord and the ALSFRS scores of the ALS patients was conducted. Results Compared with the control subjects, the ALS patients had significantly lowered mean FA and reduced cross-sectional area of the cervical spinal cord (P<0.05), but the MD value did not differ significantly between the two groups (P>0.05). A close correlation was found between the mean FA of the cervical spinal cord and the ALSFRS score (r=0.730,P=0.000), but not between the MD value and the ALSFRS score in the ALS patients. Conclusion Patients with ALS have significantly lowered mean FA, which may serve as an indicator for the diagnosis orALS. Together with the ALSFRS score, cervical DTI can better characterize the progression of ALS.

OBJECTIVETo investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation.

METHODSFrom January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI).

RESULTSAll patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000).

CONCLUSIONRecurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the advantage including less invasion and quickly recovery.

Adult ; Aged ; Bone Screws ; Feasibility Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Spinal Fusion

OBJECTIVETo investigate the clinicopathological characteristics of large cell calcifying Sertoli cell tumor (LCCSCT) of the testis.

METHODSWe studied a case of LCCSCT by light microscopy, Western blotting and immunohistochemistry, reviewed relevant literature, and analyzed the clinical, morphological and immunohistochemical features, treatment and prognosis of the tumor.

RESULTSThe patient was a 25 years old man. Pathohistologically, the tumor was characterized by a mass of polygonal tumor cells in a tubular and trabecular growth pattern, with abundant acidophilic cytoplasm, enlarged vesicular nuclei, and extensive calcified debris in stroma. The tumor cells were positive for inhibin, S-100, vimentin and alcian blue, but negative for PLAP, SMA, CK, AFP and periodic acid-Schiff (PAS) reaction.

CONCLUSIONLCCSCT is a rare testicular sex cord stromal tumor. Its diagnosis is based on immunohistochemical staining, and it is to be differentiated from other lesions of the testis, including seminoma, Leydig cell tumor, Sertoli cell node, and androgen insensitivity syndrome. For the treatment of LCCSCT, surgical resection often has a good prognosis.

Adult ; Humans ; Male ; Sertoli Cell Tumor ; pathology ; Sex Cord-Gonadal Stromal Tumors ; pathology ; Testicular Neoplasms ; pathology ; Testis ; pathology