OBJECTIVE: To explore an approach and method for the pharmaceutical care for COPD patients. METHODS: According to characteristics of clinical pharmacy in China, the approaches and methods of pharmaceutical care for COPD patients were established by referring to approaches for pharmaceutical care issued by Joint Accreditation Commission of Health Care Organizations. RESULTS&CONCLUSION:Pharmaceutical care could apparently improve drug use more safely, effectively and economically as well as prognosis for patients.

Objective To investigate the T cell clonality in patients with systemic lupus erythematosus (SLE) . Methods T cell clonality in peripheral blood lymphocytes from six patients with active SLE was analyzed using reverse transcriptase- polymerase chain reaction (RT- PCR) and GeneScan technique. Results T cell receptor (TCR) Vβ PCR products from two patients were derived from polyclonal T cells, however, TCR Vβ9, Vβ2, VβI, Vβ2 pioducts from the other four patients were derived from oligoclonal T cells respectively.ConclusionT cells from patients with SLE demonstrated a striking oligoclnality and their clonal expansion may be a specific response driven by autoantigens.

Objective To retrospectively analyze management of chronic lateral ankle instability and evaluate its clinical results. Methods There were 74 patients including 43 males and 31 females at age range of 15-63 years (mean 39 years). All patients had at least half year of disease history, more than twice repeated strains and over six weeks of conservative management. Of all, 41 patients were trea-ted with surgical operations including modified Brostrom in 12 patients, Myerson in eight and Chrisman-Snook in 21. The aasoeiated pathological problems should be treated at the same time, ie, tenedesis for the peroneal tendon subluxations in six patients, Achilles tendon lengthening in nine, lateral shift of cal-caneal osteotomies in eight and clearance and holes-making for the osteochondral lesions in 13. Results Of all, functional instability was alleviated in 21 patients through conservative treatment before surgery. Of 53 patients with either functional or mechanical instability, 10 patients showed symptomatic relief, two refused surgical operation and the remained 41 patients were treated surgically. Thirty-nine patients trea-ted surgically and 28 treated conservatively were followed up for 6-91 months. The Roos Functional Out-come Score was used for validating the results. The average value of the ankle functional outcome was 86.24 and 97.34 respectively following operation and conservative management. Conclusions The full examination is needed to remove any possible pathological factors for the patients with chronic lateral ankle instability. The surgical operation can obtain satisfactory functional recovery of the ankle if the conserva-tive management is failed.

Objective To investigate the relationship between β3 - adrenergic receptor(β3 - AR)gene poly-morphism and the susceptibility of occurrence in children obesity. Methods The database of PubMed,Web of Science,Springer Link,Medlink,SinoMed,Wanfang,VIP and CNKI were systematically browsed online. The study re-ports regarding β3 - AR associated with children obesity from January 1995 to February 2014 were included in the re-search. The data were extracted,evaluated and heterogeneity tested by using software RevMan 5. 1. Results A total of 162 related literature were retrieved,and 9 of them were eligible with 1 494 obese children and 1 623 normal children were included. Allele T compared with C,the differences between the study group and the control group were statistical-ly significant(P < 0. 05),the findings from the same TC + CC compared to TT and TC compared with TT + CC were similar. Japanese research findings were similar to those of China,but the differences between the study group and the control group had no statistical significance(P ﹥ 0. 05)in Hungary. The sensitivity analysis in each study was stable and the funnel graphics were basically symmetric. The results of sensitivity analysis and publication bias diagnostics demonstrated the reliability and stability of the Meta analysis. Conclusions TC + CC/ TT,TC/ TT + CC genotype and allele T/ C are related to the occurrence of childhood obesity in China,Japan,but there is no significant correlation with childhood obesity in Hungary. There are regional difference between β3 - AR gene polymorphism and genetic susceptibility to children obesity.

Objective To investigate the relationship of apolipoprotein E (ApoE) gene polymorphism and the suscepti-bility of childhood obesity Methods The database of PubMed, OVID, Science online, BMJ, Springer Link, Medlink, China Journal Full-text and Wanfang were systematically searched. The studies regarding ApoE polymorphism associated with child-hood obesity from March 1996 to March 2013 were included in the research. The data were extracted, evaluated and hetero-geneity tested using software Rev Man 5.0. Results A total of 84 related literature were retrieved, and 9 of them were eligible with 767 obese children and 867 normal children included. According to the heterogeneity test results, the relationship between ApoE gene allele,ε2,ε3,ε4 and childhood obesity occurs was analyzed by means of ifxed or random effect model. The results indicated that, comparing to children with normal body mass, the OR value and 95%CI of ApoE allele geneε2,ε3,ε4 in obese children were 1.10 (0.85, 1.43), 0.66 (0.55, 0.80), and 1.82 (1.31, 2.52) respectively. The differences ofε3 andε4 between normal and obese children were signiifcant (P<0.001) but notε2 (P=0.45). The sensitivity analysis in each study was stable and the funnel graphics were basically symmetric. Conclusions ApoE gene polymorphism is closely related to childhood obesity withε3 allele as a protective factor whileε4 allele as a risk factor.

Objective To evaluate the relationship between vitamin D receptor(VDR) (rs731236)single nucleotide polymorphisms and genetic susceptibility to overweight/obesity in school-age children of Han and Kazakh in Xinjiang Uygur Autonomous Region.Methods The VDR gene rs731236 genotypes were detected by using polymerase chain reaction-restriction fragment length polymorphism method in 250 overweight/obesity school-age children(127Han,123 Kazakh) and 255 healthy controls(131 Han,124 Kazakh) as well.Results (1)There were statistically significant differences in the frequencies of rs731236 genotypes and alleles between the healthy controls of Han and Kazakh (x2 =9.904,P =0.005;x2 =9.312,P =0.002).(2)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and the alleles between the overweight/obesity cases and healthy controls of Kazakh (x2 =3.891,P =0.049 ; x2 =5.871,P =0.015).But the difference in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls of Han were not statistically significant (x2 =0.064,P =0.800 ; x2 =0.190,P =0.663).(3)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of male school-age children of Kazakh (x2 =5.25,P =0.02;x2 =4.57,P =0.03),but the differences in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls were not statistically significant in female school-age children of Kazakh (x2 =0.06,P =0.80 ; x2 =1.40,P =0.24).There was no statistically significant difference in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of female school-age children of Han (x2 =0.04,P =0.84 ; x2 =0.04,P =0.84),and there was no statistically significant difference in male school-age children of Han(x2 =0.05,P=0.82;x2 =0.18,P=0.67).Conclusions VDR gene(rs731236)polymorphism bears ethnic diffe-rence.The polymorphisms of VDR gene polymorphism rs731236 are not associated with the susceptibility to overweight/obesity in school-age children of Han,while it is associated with the susceptibility to overweight/obesity school-age children in Kazakh,especially in male school-age children.

Objective To research the therapeutic effect of dihydroarteminsinin/piperaquine phosphate(duo-cotecxin)on rats with Pneumocystis pneumonia(PCP),and explain its potential mechanism.Methods The PCP rat model was established through the subcutaneous injection with cortisone acetate twice a week for 6 weeks.The model rats were orally treated with duo-cotecxin at a dose of 40 mg/kg once a day for 3 days,and with cotecxin at a dose of 60 mg/kg once a day for 6 days,respectively.The therapy control group was treated orally with SMZco(sulfamethoxazol 250 mg/kg +Trimethoprim 50 mg/kg),positive control group and normal group were established,respectively.The drug efficacy was based on rat survival rate,increase rate of body weight,lung weight/body weight ratio,mean numbers of the cysts per field in the lung print smear,and the changes of CD4+ T cells,CD8+ T cells,NO,IFN-? and TNF-? in the blood.Results The survival rates and the body weight of rats treated with duo-cotecxin and cotecxin were higher and heavier than those of the positive control group respectively,which approached to those of the group treated with SMZco.The lung weight/body weight ratio,and mean cyst number per field of lung print smear of the rats treated with duo-cotecxin and cotecxin were lower than those of the positive control group,respectively.NO and TNF-? in the blood of the rats treated with duo-cotecxin and cotecxin were lower than those of the positive control group,respectively(P

OBJECTIVE:To investigate the effects of low molecular weight heparin calcium and rivaroxaban combined with atorvastatin on related indexes in patients with acute pulmonary embolism(APE). METHODS:The data of 72 APE patients were analyzed retrospectively. According to treatment plan,the patients were divided into group A(21 cases),group B(26 cases)and group C(25 cases). Group A was treated with intramuscular injection of Low molecular heparin calcium injection immediately after admission;2 days later,they were given Warfarin sodium tablets;7 days later,Low molecular heparin calcium injection was stopped while warfarin was still administrated,lasting for 3-6 months. Group B was given Low molecular heparin injection(same usage and dose as group A);2 days later,they were additionally treated with Rivaroxaban tablets;7 days later,Low molecular heparin calcium injection was stopped while rivaroxaban was still administrated,lasting for 3-6 months. Based on the treatment in group B,group C was treated with Atorvastatin calcium tablets 20 mg orally,once a day in the evening,lasting for 3-6 months. The time of dyspnea,chest pain and cyanosis disappearance were observed in 3 groups as well as the levels of HR,pa(O2),pa(CO2), CRP,D-dimer,TNF-α,IL-1,IL-6,ET-1 and NO before and after treatment. The occurrence of clinical outcome events and ADR were also observed. RESULTS:The time of dyspnea,chest pain and cyanosis disappearance in group A were longer than group B, and the group B was longer than the group A,with statistical significance(P<0.05). Before treatment,there was no statistical sig-nificance in the levels of HR,pa(O2),pa(CO2),CRP,IL-1,IL-6,TNF-α,D-D,ET-1 and NO among 3 groups(P>0.05). After treatment ,HR of 3 groups were all lower than before ,and they showed group Agroup B>group C,with statistical signif-icance(P<0.05). After treatment,CRP,IL-1,IL-6,TNF-α and D-D levels in 3 groups were significantly lower than before,and they showed group C>group A and group B,with statistical significance (P<0.05);but there was no statistical significance be-tween group A and B(P>0.05). ET-1 levels in 3 groups were significantly lower than before,and the levels showed group group group B>group A,with statistical significance (P<0.05). The incidence of clinical outcome events in group A was significantly higher than group C, the incidence of ADR in group B was significantly lower than that group A,with statistical significance(P<0.05). CONCLUSIONS:Low molecular weight heparin calcium and rivaroxaban combined with atorvastatin can significantly im-prove clinical symptoms and blood gas indexes,relieve vascular endothelial damage,reduce the levels of inflammatory cytokines and improve the prognosis of patients with APE,without increasing the incidence of ADR.

Objective To observe the effects of Zuogui Jiangtang Jieyu Formula (ZJJF) on the ability of learning and memory and the expressions of JNK, Bcl-2 and Bax in hippocampus in diabetic rats with depression; To explore the protective mechanism of hippocampal damage in diabetic rats with depression. Methods High-fat gavage combined with intravenous injection of STZ was used to establish the model of diabetic rats. 28 days of chronic stress was given continuously and diabetic rats complicated with depression were built successfully. Then rats were randomly divided into 6 groups, including normal, model, positive medicine, high-, medium-, and low-dose of ZJJF groups. After the last administration, Morris water maze was used to detect escape latency time;Western blot was used to disclose the protein expressions of JNK, Bcl-2 and Bax in rat hippocampaus;RT-PCR was used to test the gene expressions of JNK and Bcl-2 and Bax. Results Compared with the normal group, escape latency time in model rats was significant longer (P<0.01), the protein and gene expression of JNK and Bax in rat hippocampaus significantly increased, Bcl-2 was markedly decreased (P<0.05, P<0.01);Compared with the model group, escape latency time in positive medicine group and high-dose of ZJJF group was significant shorter (P<0.01), the protein and gene expressions of JNK and Bax significantly decreased, and Bcl-2 markedly increased (P<0.05, P<0.01). Conclusion ZJJF can significantly improve the ability of learning and memory in diabetic rats with depression, which might be associated with preventing neuronal apoptosis in hippocampus.

Objective To investigate the protective effects of purified effective component group in extract from Xiaoshuan Tongluo(CGXT)formula on chronic brain ischemia in rats.Methods CGXT 75,150,and 300 mg/kg or vehicle were ig administered daily for four weeks to rats with bilateral common carotid arteries ligation(BCCAL).From the day 24 to 28 after BCCAL,Morris water maze was performed to assess the learning and memory impairment of rats.Four weeks after BCCAL,brain gray and white matter damage were assessed.Results In Morris test,the mean escape latency of rats in the CGXT(150 and 300 mg/kg)groups was significantly shorter than that in the vehicle group.CGXT also attenuated the neuronal damage in hippocampus and cortex and reduced the pathological damage in the optic tract and corpus callosum.Conclusion CGXT could improve learning and memory impairment resulted from BCCAL in rats.These results provide the experimental basis for the clinical use of CGXT in stroke treatment and may help in investigation of multimodal therapy strategies in ischemic cerebrovascular diseases including stroke.