Bibliometrics ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Medicine, Chinese Traditional

Objective To explore the medication closed-loop management of huangshi central hospital based on electronic medical records.Methods Diversified pharmaceutical information platform was constructed.The full coverage of all aspects of medication information,such as ordering/prescribing,transcribing,distributing,preparing,dispensing,administering,documenting,and monitoring was realized.Results The medication management and use had no information gap,and bias could be controlled to form a closed-loop management.Conclusion Application of the new information technology in the field of pharmaceutical care can improve work efficiency,reduce medication errors,broaden the vision of clinical pharmacists and scope of work,and improve the overall level of pharmaceutical care.

AIM: To investigate the effect of VEGF gene transfer on matrix metalloproteinases(MMPs) and tissue inhibitor of metalloproteinases(TIMPs) expression after vascular balloon injury. METHODS: 90 New Zealand white rabbits were divided into 3 groups randomly: group Ⅰ(balloon injury group), groupⅡ (pAdtrackCMV group) and group Ⅲ(pAdtrackCMV-VEGF165 group). Hypercholesterol diet was given for 7 days before experiment and continued to receive until the animals were killed. Each group were divided into five subgroups according to the sacrifice time. Blood samples and iliac arteries were harvested for further analysis. RESULTS: In group Ⅰ and Ⅱ, MMP2 and TIMP1,2 expressions were detected during the whole process ,while in group III ,MMP1,2,9 and TIMP1,2 could be detected from 3 days after gene transfer and reached the highest level at 1 week and could not be detected at 8 week. CONCLUSIONS: Imbalance expression of MMPs and TIMPs occurred after vascular injury and this may be the reason of pathological remodeling. Local phAdtrackCMV-VEGF165 transfer could specifically change the expression of MMPs and facilitate the positive remodeling process after vascular injury.

Objective To clone human Sjogren's syndrome antigen A(SSA)for expressing of antigen SSA-52kD and establishing a new clinical detecting method.Methods According to the human SSA-52kD cDNA sequence reported in GenBank,primers of human SSA-52kD cDNA were designed and synthesized.Human SSA-52kD cDNA was amplified from RNA of cultured Hela cell by reverse transcriptase polymerase chain reaction(RT-PCR).The production of amplification was ligated to PET-30a vector and then transformed into the competent bacteria DH5?to construct the recombinant plasmid PET-30a-SSA-52kD.The recombinant plasmid was digested with Bgl Ⅱ and Hind Ⅲ,and positive clones were sequenced.Results The Human SSA-52kD cDNA fragment containing 1447bp was amplified by RT-PCR.Restriction endonuclease mapping using Bgl II and Hind III showed that the target gene was inserted into the recombinant plasmid.The complete coding sequence of Human SSA-52kD was consistent with that of GenBank through DNA sequencing.Conclusions The full length of human SSA-52kD cDNA was successfully cloned and the recombinant plasmid PET-30a-SSA-52kD was constructed.

Clostridium difficile infection(CDI)is a major cause of hospital-acquired gastrointestinal infections in children.Current treatment for pediatric CDI primarily involves antibiotics;however,some children experience recurrence after antibiotic treatment,and those with initial recurrence remain at risk for further recurrences following subsequent antibiotic therapy.In such cases,careful consideration of treatment options is necessary.Fecal microbiota transplantation has been shown to be effective for recurrent CDI and has a high safety profile.This article reviews the latest research on the pathogenesis,risk factors,diagnosis,and treatment of pediatric CDI domestically and internationally,with a particular focus on fecal microbiota transplantation therapy.

Objective To analyze the distribution of various genotypes of human cytomegalovirus glycoprotein N ( HCMV gN) in patients with HIV infection; to investigate the effects of HCMV-HIV co-in-fection on disease progression and the relationships between HCMV gN genotypes and disease progression. Methods Patients with active HCMV infection were screened out from 359 patients with HIV infection by using the pp65 antigenemia assay.The genes encoding HCMV gN ( UL73 ) were amplified by nested PCR ( nPCR) .The amplicons were digested by restriction enzymes including MboⅠ, ScaⅠ and SalⅠ.Then, the restricted fragment length polymorphisms were further analyzed on 4%agarose gel.The relationships be-tween HCMV genotypes and the morbidity and mortality of acquired immune deficiency syndrome ( AIDS ) were investigated via a prospective study.Results Among the 359 patients with HIV infection, 28 subjects were positive for the HCMV pp65 antigenemia assay.The HCMV gN genotypes in 20 patients with active HCMV infection were distributed as: gN-3a (4/20, 20%), gN-1 (4/20, 20%), gN-4d (1/20, 5%), gN-4b (1/20, 5%) and mixed infection (10/20, 50%).Patients with HCMV-HIV co-infection were more likely to develop AIDS during the follow-up period (RR=9.78).Patients harboring HCMV gN-1 and gN-4 genotypes would seem likely to have 4.6 times of chance leading to AIDS-associated death than those harbo-ring other HCMV gN genotypes.Conclusion HCMV infection ( especially gN-1 and gN-4 genotypes) might accelerate the progression of HIV infection.

The coverage of large soft tissue defects in heel is a problem for surgical reconstruction. Various reconstructive materials are available depending on the location, size and depth of heel defect, but unique function of heel skin cannot be restored easily by means of reconstruction. We used prefabricated flap of the foot heel to cover heel defect in a child and obtained satisfactory clinical results.
Amputation ; Child ; Heel ; injuries ; surgery ; Humans ; Male ; Surgical Flaps

OBJECTIVETo investigate the clinical features in children with tuberous sclerosis complex (TSC)-associated cardiac rhabdomyomas (CRM).

METHODSThe clinical data of 15 children with TSC complicated by CRM were collected. The clinical features of the patients were analyzed, and TSC gene mutations were detected.

RESULTSEleven cases (73%) developed multiple CRM. The majority of the tumors were located in the left and right ventricles. Most tumors presented as a round-like hyperechogenic mass with a clear margin on echocardiography. Arrhythmias occurred in 3 patients and 2 patients experienced heart failure. Gene mutation tests were performed in 2 patients, and pathogenic mutations were detected in both patients, which were TSC1 mutation and TSC2 mutation, respectively. Three patients were followed up for 6 to 38 months, and their CRM shrank or regressed spontaneously.

CONCLUSIONSTSC-associated CRM is generally multiple. Heart failure and arrhythmias may occur in some patients. Echocardiography is important for diagnosis of CRM. TSC-associated CRM has an inclination to spontaneous regression. TSC can be diagnosed at a molecular genetic level by TSC gene mutation detection.

Child, Preschool ; Female ; Heart Neoplasms ; complications ; genetics ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Male ; Mutation ; Rhabdomyoma ; complications ; genetics ; Tuberous Sclerosis ; etiology ; Tumor Suppressor Proteins ; genetics

OBJECTIVETo evaluate the clinical application of microsurgical fascia latae flaps combined with rib and skin graft for reconstruction of the distal phalanx defect.

METHODSThe phalanx wounds were sutured together like syndactyly. The autologous rib was revised to repair the bone defect of distal phalanx. The fascia latae flap was used to cover the bone exposure with microvascular anastomoses and resurfaced by a meshed split-thickness skin graft.

RESULTS5 cases were treated successfully. The fascia latae flaps were all survived with only skin graft necrosis at the distal end in one case. It was healed spontaneously.

CONCLUSIONSThe fascia latae flap is nourished by the descending branch of the lateral circumflex femoral artery. The flaps has a good blood supply and can be easily obtained with a long vascular pedicle. The flap is ideal for the reconstruction of distal phalanx defect when combined with autologous rib implant and skin graft.

Adolescent ; Adult ; Fascia Lata ; transplantation ; Female ; Finger Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; transplantation ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

Objective To test the efficacy of cognitive behavioral self-help therapy (CBTI-SH) on patients with chronic insomnia vs.a zolpidem control condition.Methods A total of 60 adults with chronic insomnia and common comorbidities were recruited from our hospital from July 2011 to October 2012.Participants were randomly assigned to either intervention group (n=30),consisting of sleep hygiene plus four-week CBTI-SH with printed material and 2 telephone instruction-calls,or control group (n=30),consisting of sleep hygiene plus a four-week supervised zolpidem tapering therapy.The CBTI-SH included cognitive restruction,stimulus control therapy,sleep restriction therapy and relaxation therapy.The primary outcome was self-report symptom,based on sleep diaries (including Sleep Latency-SL,Total Sleep Time-TST,Time In Bed-TIB,Sleep Efficiency-SE,Wake after Sleep Onset-WASO),Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleeping Scale (ESS) which were evaluated at baseline and at the end of the 2th,4th,6th week treatment.Continuous variables were evaluated by repeated-measures multivariate analyses of variance (MANOVA).At the end of every two weeks,each participant was asked to assess treatment adherence to the six core recommendations of CBTI-SH or sleep hygiene.Results The multivariate analysis of variance showed a significant treatment group plus time interaction,and time main effects for PSQI,ESS,SL,SE,TST,TIB and WASO in the two groups (P＜0.05).The patients in the intervention group had significantly better outcomes than those in control group.Effect sizes (Cohen d)were 1.93,0.04,1.00,0.98,0.11,0.57 and 0.43,respectively.The intervention group reported higher average adherence scores in "use of the bed only for sleeping,not worrying in bed",and lower average scores in "adherence to TIB prescription,getting out of bed when unable to sleep",compared with those in the control group.Conclusion CBTI-SH is effective for treating chronic insomnia and daytime sleepiness as compared with supervised zolpidem tapering therapy,but the treatment adherence needs to be improved.