Objective:To explore the participation mode of clinical pharmacists in anti-infective therapy. Methods:Clinical phar-macists provided rational medication suggestions for anti-bacterial and antifungal therapy, and carried out pharmaceutical care for one patient with lung and intracranial infection after decompressive craniotomy for severe brain injury. Results: According to the sugges-tions of clinical pharmacists, fluconazole therapeutic regimen and amphotericin B therapeutic regimen was applied in turn respectively with the treatment course of 32d and 28d. During the treatment, the pharmacists also provided therapy advice on the infection induced by Staphylococcus epidermidis and Pseudomonas stutzeri, ADR warning and monitoring of fluconazole and amphotericin B, and adjust-ment of anti-infective therapy according to the results of antimicrobial susceptibility testing. The therapeutic effect was significant. Conclusion:The participation of clinical pharmacists in drug treatment can optimize medical therapy, which contributes to the coopera-tion between doctors and pharmacists.

Objective:To discuss the experience accumulation and thinking tralning of clinical pharmacist in the pharmaceutical consultation with SOAP model. Methods:Clinical pharmacist performed the condition evaluation for one patient with Acinetobacter bau-rnannii infection after esophagus cancer surgery and was invited to the consultation for three times. Clinical pharmacist also provided the references for the drug treatment and monitored the whole process. Clinical pharmacist actively followed and pald return visits for the prognosis of the patient for one month. Results: After identifying the pathogen, the experiential therapy was given and the condi-tions of the patient were improved. According to the changes of the conditions, the treatment was adjusted in time with the most suitable drugs for the conditions and infection degree. Finally, the infection was controlled effectively, and the patient was discharged after the 35-day postoperative treatment. Conclusion:During the consultation, clinical pharmacist should correctly judge the conditions of pa-tients, summarize and evaluate the earlier therapy results, and then choose suitable drugs according to the property of PK/PD. Clinical pharmacist also should track the therapy results to assess the conditions of patients and individualize the treatment.

Objective To analyze the application effect of standardized colostomy irrigation nursing in rectal cancer patients with Miles operation.Methods 126 rectal cancer patients underwent Miles operation were randomly divided into the observation group and the control group,63 cases in each group.The patients of the control group were treated with traditional colostomy natural defecation ostomy care model,and the patients of the observation group were given standardized colostomy irrigation nursing mode.Before and after nursing,the life quality function score,life quality score and individual total care expenses of the two groups were compared.Results Before nursing,the function score and quality of life event scale score between the two groups were compared,and the differences were not statistically significant(all P >0.05).After nursing,physical function[(97.84 ±3.83)points],cognitive function[(96.79 ± 8.77)points],emotional function[(94.57 ±8.76)points],role function[(96.57 ±1.57)points],social function [(92.77 ±6.17)points],nausea and vomiting[(0.56 ±0.23)points],insomnia[(2.64 ±1.78)points],pain [(1.48 ±0.63)points],fatigue[(5.13 ±2.47)points],loss of appetite[(1.76 ±0.83)points]of the observation group were significantly better than those of the control group [(90.22 ±3.79)points,(80.99 ±8.74)points, (83.26 ±13.83)points,(78.85 ±3.26)points,(83.67 ±3.45)points,(1.27 ±0.76)points,(12.25 ±3.61)points, (4.08 ±1.67)points,(6.76 ±2.98)points,(3.47 ±1.62)points],there were statistically significant differences between the two groups(t =11.22,10.13,5.48,38.87,10.22,7.10,18.95,11.56,3.34,7.46,all P <0.05).After nursing,the product cost[(1 488.78 ±102.49)yuan],nursing cost[(158.46 ±10.73)yuan],total cost[(1 638.79 ± 106.73)yuan]of the observation group were significantly lower than those of the control group [(2 070.17 ± 141.78)yuan,(311.17 ±99.32)yuan,(2 380.63 ±212.79)yuan],the differences were statistically significant (t =26.38,12.13,24.73,all P <0.05 ).Conclusion Standardized colostomy irrigation nursing can improve overall quality of life in patients of rectal cancer after Miles operation,reduce the economic and psychological burden,and its application effect is better.

OBJECTIVE:To establish an LC-MS method for determination of picamilon in human plasma. METHODS:Picamilon and repaglinide(as internal standard)were separated on Agilent C18 column,using methanol-water(85 ∶ 15) as the mobile phase at a flow rate of 0.2 mL?min-1. Column temperature was set at 20 ℃. SIM was used for determination of picamilon in human plasma.Ion mass spectral(m/z) of 207.0→121.1 was selected for picamilon and 451.3→379.2 for repaglinide.RESULTS:The linear range was 50～10 000 ?g?L-1(r=0.999 1); the method recovery was within 99.14%～104.27%. The RSD of inter-day and intra-day validation were 2.12%～5.94% and 7.30%～8.44%,respectively. CONCLUSION:The method is sensitive and accurate for the determination of picamilon in human plasma and its pharmacokinetic study.

Measuring the innovation capacity and competitive strength of the department mainly depends on the quality and quantity of its independent intellectual property.Here we discussed intellectual property issues occurring in the different stages of the application,approval,implementation and concluding,including the theses written at the application stage,the novelty retrieval of patent documentation,periodic achievement protection during implementation,the association between the patent application and paper publication,etc.And the intellectual property ownership was expounded according to Contract Law of PR China.The strategy of intellectual property protection was put forward from the view points of the mechanism,regulation,and personnel.The helpful tips are expected to the scientific researcher and the administrative staff.

ObjectiveTo explore the hemodynamic characteristics of parotid glands before and after acid stimulation test in patients with Sjogren syndrome.MethodsTwenty female patients with Sjogren syndrome were enrolled as case group,and 20 healthy women were selected in the same period as control group.The blood flow spectrums of bilateral superficial temporal artery and intra-parotid small artery before and after acid stimulation were detected by color Doppler ultrasonography.Peak systolic velocity (PSV),end-diastolic minimum velocity(EDV) and resistance index( RI ) were obtained and analyzed.ResultsPSV and EDV of intra-parotid small artery in case group were significantly higher than those in control group before acid stimulation test,and RI was obviously lower than that in control group [ ( 16.01 ± 6.18 ) cm/s vs.( 14.00 ± 5.23 ) cm/s,( 5.96 ± 3.00 ) cm/s vs.( 3.54 ± 2.03 ) cm/s,0.64 ± 0.07 vs.0.76 ± 0.06 ] ( P ＜ 0.05 ).In control group,PSV and EDV of superficial temporal artery and intra-parotid small artery increased and RI reduced after acid stimulation test,which had significant differences before and after acid stimulation test (P ＜ 0.05).There was no statistical significance in the hemodynamic indexes of case group before and after acid stimulation test(P＞ 0.05 ).Conclusions The reactivity of parotid artery to acid stimulation test in patients with Sjogren syndrome reduce,especially the intra-parotid small artery.Color Doppler ultrasonography can contribute to show the hemodynamic changes of the parotid lesions efficiently.

Objective To discuss the intervention effect of four oral care model on compliance of atomizing inhalation and mouth and throat complications in outpatient infants and young children patients. Methods A total of 480 cases of children patients using budesonide inhalation for the treatment of respiratory tract infection were divided into the observation group(n=260)and the control group (n=220) according to the time sequence. The control group received conventional nursing, the observation group used quaternity oral care model in nursing care. The compliance and occurrence of complications in the mouth and throat were observed between the two groups. Results In the observation group with nebulae inhalation compliance was 79.2% (206/260), evidently higher than that in the control group the compliance of 58.6%(129/220) (χ2=23.97,P<0.01). The incidence of oral herpes and ulcers in the control group was 2.73%(6/220), and 0.77%(2/260) in the observation group, but no significant difference was seen (χ2=2.79, P>0.05). The incidence of thrushes was 3.64%(8/220) in the control group, and none occurred in the observation group, which showed significant difference (χ2=9.62, P<0.01). Conclusions Using quaternity oral care model in corticosteroid nebulae inhalation patientscan increase compliance and decreasecomplications of oral and throat of outpatient children.

Objective:To study the effect of shear stress on the expression of KLF2 and eNOS in venous endothelial cells under physiological and uremic conditions, and to explore the mechanism leading to dysfunction of venous endothelial cells.Methods:Under physiological conditions and uremia conditions, different shear stresses were simulated in the parallel plate flow cavity, and the shear stresses were applied to the venous endothelial cells of each group for 4, 12, and 24 hours. The expression of KLF2 and eNOS was detected by immunohistochemical fluorescent staining technique and real-time fluorescent quantitative PCR technique.Results:Under physiological conditions, KLF2 is obviously regulated by shear stresses. High-intensity shear stresses and physiological shear stresses will up-regulate the expression of KLF2, while low-intensity shear stresses and oscillating shear stresses will down-regulate the expression of KLF2. As the duration of action increases, the expression of KLF2 will also increase. In the state of uremia, the expression of KLF2 is significantly inhibited. Even if high shear stresses is applied, the level of KLF2 is not high-expressed as the physiological state. And under the action of low shear stresses and oscillating shear stresses, KLF2 expression is more significantly inhibited. KLF2 is mainly expressed in the nucleus. With the action of shear stresses, KLF2 is also expressed in the cytoplasm, while eNOS is mainly expressed in granular form in the cytoplasm and nucleus.Conclusions:After arteriovenous fistula operation, the expression of KLF2 and eNOS is inhibited under the action of multiple factors of uremia environment and oscillating shear stresses, which may be the main cause of the occurrence and development of venous endothelial cell dysfunction, intimal hyperplasia, and AVF failure.

Objective:To systematically evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) in acute kidney injury (AKI).Methods:All studies about the predictive effect of NLR on AKI were searched in the National Medical Library of the United States PubMed Database, the Embase database in the Netherlands, the Chinese Biology Medicine disc (CBMdisc) and the Chinese Evidence Based Medicine Cochrane Centre Database (CEBM/CCD). The data updated by October 2020, and regardless of language, region or whether blind method was used. Two authors independently extracted data and evaluated the quality of the studies. Data extracted from the studies were analyzed with RevMan 5.3 to assess the predictive value of NLR on AKI. A subgroup Meta-analysis was conducted to assess the predictive value of NLR on AKI according to different countries, different disease types (cardiovascular surgery, infectious diseases, other diseases including burns, cirrhosis, and emergency), and different sample sizes (≤ 300 cases and > 300 cases). The publication bias of included studies about the predictive effect of NLR on AKI were assessed by funnel plots.Results:A total of 11 studies were included in this Meta-analysis, including 4 997 patients, 1 308 patients in AKI group, and 3 689 patients in non-AKI group. The Meta-analysis results showed that: increased NLR had predictive value for the occurrence of AKI [mean difference ( MD) = 2.73, 95% confidence interval (95% CI) was 1.78-3.68, P < 0.000 01]. Subgroup analysis showed that increased NLR had predictive value for the occurrence of AKI in patients from Southeast Asia ( MD = 4.04, 95% CI was 1.09-6.99, P = 0.007) and Eurasia ( MD = 2.51, 95% CI was 1.12-3.90, P = 0.000 4). Increased NLR had predictive value for the occurrence of AKI in patients undergoing cardiovascular surgery ( MD = 0.77, 95% CI was 0.34-1.20, P = 0.000 4), infectious diseases ( MD = 4.74, 95% CI was 1.51-7.96, P = 0.004) and other diseases ( MD = 8.53, 95% CI was 6.26-10.80, P<0.000 01). Increased NLR had predictive value for the occurrence of AKI in studies with a sample size of ≤ 300 cases ( MD = 6.02, 95% CI was 4.90-7.14, P <0.000 01) and > 300 cases ( MD = 1.32, 95% CI was 0.61-2.03, P = 0.000 3). There was no significant publication bias in the included studies assessed by funnel plots. Conclusion:NLR is an important predictive tool for AKI.

Objective To explore the factors influencing the hyponatremia of hypertensive intracerebral hemorrhage.Methods One hundred and five patients with hypertensive intracere bral hemorrhage recorded 7 parameters in patients:age,gender,the use of furosemide,duration of using mannitol,the frequency of using mannitol every day,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.To get the obviously variability with the hyponatremia by single variable logistic regression analysis.To get the best equation by multivariable logistic regression analysis.Results The obviously variability with the hyponatremia is age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.Conclusion Hyponatremia has intimate relationship with age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.