Objective:To share the experience of clinical cooperation of physicians and clinical pharmacists in the treatment of one case of rodenticide poisoning. Methods: One case of rodenticide poisoning was early diagnosed by physicians according to the con-sciousness disorder and coagulation dysfunction. Clinical pharmacists participated in the drug treatment actively through providing vita-min K1 at the dose of 30 mg·d-1 as the treatment dose and monitoring the effectiveness. Toxicology analysis was recommended, and 718 ng·ml-1 bromadiolone was found out in the blood samples. According to the long half-life of bromadiolone, the initial duration of treatment was set at 2-3 months, while follow-up plan and final duration of treatment were defined based on coagulation parameters and poison concentration monitoring results. Results:The patient recovered rapidly after hospitalization due to the cooperation of physicians and clinical pharmacists through quickly correcting diagnosis of physicians and actively participating in medication of clinical pharma-cists. After the 3-month treatment, the coagulation parameters of the patient were normal and the patient was discharged with follow-up. Conclusion:The collaboration of physicians and clinical pharmacists leads to the optimal regimen with early, full dose and long course of vitamin K1 therapy.

OBJECTIVE:To systematically review the efficacy and safety of pituitrin combined with phentolamine versus pitui-trin alone in the treatment of bronchiectasis hemoptysis(BH),and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang and VIP database,the randomized controlled trails(RCT)about pituitrin combined with phentolamine(test group)versus pituitrin alone(control group)in the treatment of BH were collected,and afterdata extract and quality evaluation ,Meta-analysis was performed by using Rev Man 5.2.3 statistics soft-ware. RESULTS:A total of 43 RCTs were included,involving 3 094 patients. Results of Meta-analysis showed the significant effi-cacy [RR=1.50,95%CI(1.38,1.62),P<0.001] and effective rate [RR=1.25,95%CI(1.20,1.30),P<0.001] in test group were sig-nificantly higher than control group,inefficacy [RR=0.29,95%CI(0.23,0.36),P<0.001], hemoptysis stopped or remission time [MD=-2.00,95%CI(-2.43,-1.57),P<0.001],incidence of headache [RR=0.36,95%CI(0.22,0.59),P<0.001],incidence of chest tightness [RR=0.41,95%CI(0.26,0.63),P<0.001],incidence of abdominal pain [RR=0.26,95%CI(0.16,0.43),P<0.001] and incidence of elevated blood pressure [RR=0.28,95%CI(0.14,0.56),P<0.001] in test group were significantly lower than control group,there were significant differences in 2 groups. CONCLUSIONS:Pituitrin combined with phentolamine has better efficacy and safety than pituitrin alone in the treatment of BH. Due to the limit of methodological quality and sample size,it re-mains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.

Objective:To screen and identify the potential targets of carthamin against sepsis by studying the characteristics of carthamin.Methods:The pharmacological parameters and molecular characteristics of carthamin were analyzed with the aid of Traditional Chinese Medicine Systems Pharmacology (TCMSP). The targets of carthamin were screened by SwissTargetprediction (a website providing compound target prediction) and Drug Repositioning and Adverse drug Reaction via Chemical-Protein Interactome (DRAR-CPI). The anti-sepsis targets were selected from the three databases of Online Mendelian Inheritance in Man (OMIM), Comparative Toxicogenomics Database (CTD) and Therapeutic Targets Database (TTD). The targets of carthamin screened by the two websites and disease targets selected from the three databases were matched to screen the targets of carthamin against sepsis. The anti-sepsis potential targets of carthamin were identified by molecular docking software.Results:The oral bioavailability of carthamin was 41.15%, the drug-likeness was 0.24, and the rotational bond number was 1, which indicated that carthamin was well absorbed by oral administration and showed good drug formation. A total of 115 potential targets of carthamin were screened by SwissTargetprediction and DRAR-CPI; 149 disease targets were found from OMIM, CTD and TTD databases; 115 target proteins of carthamin screened by the two websites were matched with the disease targets , and 10 target proteins were found to be both molecular targets and disease targets. The 10 target proteins were coagulation factor Ⅸ (F9), adenosine A1 receptor (ADORA1), nitric oxide synthase 2 (NOS2), mitogen activity protein kinase 1 (MAPK1), cathepsin G (CTSG), neutrophil elastase (ELANE), protein C (PROC), lipocalin 2 (LCN2), glucose-6-phosphate dehydrogenase (G6PD) and prostaglandin endoperoxidase 2 (PTGS2). Molecular docking software analysis showed that carthamin had the ability to bind to the above 10 target proteins, which were potential targets of carthamin against sepsis. Carthamin could interact with the key amino acid residues of the targeted proteins, so as to play the corresponding efficacy.Conclusion:Carthamin combines with the targets could reduce the tissues and organs damage of sepsis by regulating CTSG, ELANE and LCN2, reduce inflammatory response of sepsis by regulating ADORA1, PTGS2, NOS2, MAPK1 and mediating PROC and F9 to inhibit clotting, and improve oxidative stress, reduce the incidence of sepsis by regulating G6PD, finally, prevented and treated sepsis.

Objective To investigate the efficacy and safety of ultrasound-guided polyglycol in patients with scar pregnancy. Methods Thirty-six patients with scarring treated in Third People's Hospital of Hangzhou from November 2014 to November 2016 were selected as subjects. All patients underwent ultrasound-guided polyglycol administration. The results were analyzed and analyzed. The results were analyzed. Gonadotropin (β-HCG) returned to normal time and the occurrence of adverse symptoms. Results The average recovery time, treatment cost, average recovery time and adverse reaction rate of blood β-HCG in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). Conclusion The effect of ultrasound on the injection of polyphenols in patients with scar pregnancy is safe, feasible and easy to be accepted by patients and their families. It has clinical significance.

Objective To investigate the nursing for preventing deep venous thrombosis after mini-incision for total hip arthroplasty in old patients. Methods 53 old patients who accepted total mini-incision hip arthroplasty from July, 2005 to June, 2006 were analyzed retrospectively. Results Affected limb swelling were found in 8 patients 2 d to 2 weeks after operation. They all were cured after anticoagulation treatment, no pulmonary embolism occurred.Conclusion Nursing intervention can prevent deep venous thrombosis after mini-incision for total hip arthroplasty.

ObjectiveTo explore the damage of blood vessels in carbon monoxide poisoning patients by hyperbaric oxygen, especially for damage of vein, to understand the factors aggravating inflammatory response, thus work out the homologous protective measures.MethodsFrom January 2006 to January 2008, 80 patients of carbon monoxide poisoning were selected as the observation group. Another 80 patients with other diseases were set as the control group. Two groups both accepted hyperbaric oxygen treatment. The time of angioplerosis was compared between the two groups, besides, pain reaction of the observation group was also observed.ResultsThe time of angioplerosis was significantly different between the two groups, pain sensibility intensified in the observation group compared with that before treatment.ConclusionsHyperbaric therapy is closely related with vascular inflammatory reaction of carbon monoxide poisoning patients. Protective measures should be established in order to prevent further damage of vessel, relieve pain of patients and ensure smooth progress of the treatment.

Objective To analyze the correlation between the tubular gastric width and the anti gastroesophageal reflux after esophageal cancer operation,and to provide reference for the choice of surgical methods in treatment of esophageal cancer.Methods Selected 60 patients who received radical surgery for esophageal carcinoma combined with gastric tube reconstruction surgery in our hospital from January 2015 to October 2015,and divided them into two groups according to the way of stomach tube anastomosis (cervical anastomosis,thoracic anastomosis) and different width of gastric tube (greater than or equal to or less than 3 cm).Namely:cervical anastomosis + greater than or equal to 3 cm group(14 cases),cervical anastomosis + less than 3 cm group(15 cases),thoracic anastomosis + greater than or equal to 3 cm group(15 cases) and thoracic anastomosis + less than 3 cm group(16 cases).All patients recieved esophageal pH monitoring for 3 days continuously from the 11 th day after operation.The monitoring indicators include:number of reflux,accumulation time of pH ＜ 4,whether there were clinical symptoms (heartburn,chest pain,pharyngeal foreign body sensation,cough,asthma,etc.) after surgery,and the frequency and time of these clinical symptoms appeared.All the patients were given endoscopic examination at the 14th days postoperatively.Observed the esophageal mucosa of patients and conducted histopathological grading of gastric mucosal inflammation.And then made a correlation analysis of gastric tube width and esophageal mucosal inflammation grade among all the patients with reflux symptoms.Results The cumulative time and number of reflux,incidence rate of clinical symptoms,and pH values less than 4 were significantly different(P ＜ 0.05).The cumulative time and number of reflux,incidence rate of clinical symptoms,and pH values less than 4 in the cervical anastomosis + less than 3 cm group were significantly lower than that in the other 3 groups(P ＜ 0.05),with statistical significance between different groups of endoscopic esophageal mucosa inflammation grade difference (P ＜ 0.05).Esophageal mucosal inflammation grading in patients of the cervical anastomosis + less than 3 cm group was the lightest.It showed a linear correlation between the gastric tube width and esophageal mucosal inflammation grading in patients with reflux symptoms.Conclusion Postoperative gastroesophageal reflux is closely related to stomach esophagus width after resection of esophageal carcinoma with tubular stomach reconstruction of stomach esophagus,because it is unable to control gastric tube width to the appropriate range.And it should be strengthened in patients with reflux related indicators for monitoring,so as to take measures to prevent gastroesophageal reflux as soon as possible to improve the prognosis of patients with quality.

ObjectiveTo investigate the initial symptoms, onset time and predisposing factors of acute cerebral haemorrhage in order to more effectively prevent cerebral haemorrhage. Methods 728 cases with acute cerebral haemorrhage were collected in recent 8 years. The initial symptoms,onset time and predisposing factors of all the patients were investigated. ResultsAcute cerebral haemorrhage in 582 caces (79.9%) occurred at time between 6am and 18pm and 146 cases (20%) at night. The main predisposing causes of acute cerebral haemorrhage were the playing of chess, cards and mahjong (16.1%), quarrels (12.8%), overwork (11.7%), alcoholism (7.2%) and so on. The most common initial symptom was hemianesthesia, accounting for 16.2%, others were vertigo (13.0%), headache ( 11.4%), amaurosis fugax ( 9.3%), speech ambiguity ( 8.6%) and transitory visual disturbance (7.9%).ConclusionsThe preventive measures of cerebral haemorrhage should be focused on daytime, especially in the morning. Sixteen locations where the cerebral haemorrhage is prone to happen should be paid more attention to by the patients with hypertension and the medical staff. Thirteen symptoms,such as hemianesthesia and vertigo,are the aurae of cerebral haemorrhage.

In order to explore the role of acetylcholine in the pathogenesis of Parkinson's disease (PD), the changes in the concentration of acetylcholine (Ach) in the striatum, the apoptosis of substantia nigra cells, the ultrastructure and the changes of Nissl cells in rats during the morbidity of PD, and the corresponding behaviors in rats with PD were observed. Rat PD model was established by using the modified Thomas method. Eighty-one rats were randomly divided into normal control, sham operation and PD groups and their behavior features were observed at post-operative day (POD) 7, 14 and 21 as three subgroups (n=9 each). The concentration of Ach in the striatum was determined by using high-performance liquid chromatography. The apoptosis of substantia nigra cells was assayed by using TUNEL method. The ultrastructural changes in the substantia nigra were observed under the electron microscopy, and the survival of neurons in the substantia nigra area was examined by using Nissl staining. In PD group at POD 7 to 21, the damage in the substantia nigra area was gradually aggravated, the concentration of Ach, apoptosis rate and turns of rotation were gradually increased, and the number of Nissl cells was gradually reduced over the time as compared with the normal control and sham operation groups (all P<0.05). It was concluded that there exist dynamic changes in Ach concentration, ethology and apoptosis of the substantia nigra cells during the morbidity of PD, suggesting the contribution of apoptosis to the morbidity of PD, and critical role of Ach in the pathogenesis of PD.

ObjectiveTo evaluate the pregnancy outcomes in female kidney transplant recipients and the long-term follow-up for the health of the offspring. MethodsClinical data from April 1978 to April 2011 of 15 female renal transplant recipients who were pregnant more than 5 months and their offspring were retrospectively analyzed. ResultsThe 15 recipients were taking CsA or Tac based immunosuppressive regimens.Twelve had successful pregnancies with stable and functioning grafts ; 1 paitent died of pulmonary infection and cardiac failure with functioning graft after the delivery of a healthy male infant; 2 experienced chronic rejection proven by biopsy at week 21 and 23 respectively,the pregnancies were therefore terminated and the grafts were lost even after rescue.All 13 newborns were smoothly delivered by cesarean section,they had an average gestational age of 35.2 ± 4.0 weeks,and a mean birth weight of 2510 ± 68 g,Apgar scale for each infant was 10,respectively.There were no birth defects,structural malformations,nor learning disabilities in 13 newborns,and their mothers all chose to bottle-feed.Thirteen children had normal intelligence,physical and mental development.Seven children experienced repeated respiratory tract infections during 0- 2 years,and 1 was diagnosed with attention deficit hyperactivity disorder.The oldest offspring is 21 years old and the youngest is 3 years old. ConclusionsFemale renal kidney recipients could achieve successful pregnancies and deliveries 3 years post transplantation with strict criteria.Their offspring were healthy during follow-up.