OBJECTIVE:To evaluate the effect of clinical pharmacist intervention on the application of antibiotics in patients with respiratory infection from our hospital. METHODS:Each 500 patients were selected from respiratory department of our hospi-tal during Jan. to Jun. in 2016 and Jul. to Dec. in 2016. The patients were divided into pre-intervention group and post-intervention group. The application of antibiotics,the occurrence of ADR and anti-infective effects were compared before and after clinical phar-macist intervention,and the rationality of antibiotics use was evaluated. RESULTS:After intervention,the utilization rate of antibi-otics decreased from 92.60％ to 74.20％;the proportion of single drug therapy and triple and more drugs therapy were decreased significantly,with statistical significance(P<0.05). The incidence of ADR reduced from 14.20％ to 5.80％;the rate of infection control increased from 95.03％ before intervention to 97.04％;antibiotics cost decreased significantly,with statistical significance (P<0.05). The incidence of irrational drug use,nonstandard dosage,irrational drug combination and no etiological support as well as total irrational rate decreased from 7.40％,3.60％,5.80％,7.80％,20.60％ to 4.00％,1.40％,2.00％,4.20％,9.60％,with statistical significance(P<0.05). There was no statistical significance in the proportion of double drug therapy or emergency and se-vere rescue rate (P>0.05). CONCLUSIONS:The intervention implemented by clinical pharmacists effectively reduce the utiliza-tion rate of antibiotics and the incidence of ADR,improve the rate of infection control,reduce antibiotics cost and the occurrence of irrational drug use. However,there are still some problems in respiratory department of our hospital,such as irrational drug use, nonstandard dosage,irrational drug combination and no etiological support,etc. Continuous follow-up intervention is needed.

The idiopathic macular hole ( lMH ) is research priority associated with the regenerate quickly of vitrectomy. The unaided visual acuity and the best corrected visual acuity is partial for the visual acuity of the patient with lMH. The mechanism and clinical significance of modern visual function measurements associated with lMH, including contrast sensitivity, visual field, multifocal electroretinogram, and stereoscopic vision, have been introduced. These measurements could be of great value in early diagnosis of lMH, assessment of surgical indication and evaluation of visual performance after vitrectomy. They would also be helpful to the analysis of postoperative impaired visual function and its management. Having an adequate understanding of the contents and significance of visual function is helpful to the improvement of lMH surgery techniques and postoperative visual acuity.

Objective:To investigate the clinical efficacy and safety of antiplatelet combined with anticoagulation therapy for restenosis prophylaxis after stent placement in diabetic patients with leg atherosclerosis obliterans(LASO). Methods:83 diabetic LASO patients with stent placement were collected and randomly divided into the treatment group(42 cases)and the control group (41 cases)with 49 sick limbs in each. The control group was treated with clopidogrel(75mg,for 1 year)plus bayaspirin(100 mg),while the treatment group was treated with low molecular heparin(withdrawal when INR = 2. 0- 3. 0)plus warfarin(for 6 months)additionally. All cases were followed up for 12 months and the efficacy and safety were compared and evaluated. Results:After therapy,there were no differences in FPG,GHbA1C,TC and LDL-C at each time point between the two groups(P >0. 05). Compared with that in the control group,MLD in the treatment group was improved obviously(P < 0. 05)in the 12th month after the surgery,while restenosis rate and level of D-D in plasma were declined significantly(P < 0. 05). And there was no difference in bleeding rate between the two groups(P > 0. 05). Conclusion:Compared with antiplatelet therapy,antiplatelet combined with anticoagulation therapy for restenosis prophylaxis after stent placement in diabetic LASO patients is more effective and safer,which is worthy of clinical promotion.

Objective To observe the clinical effect and safety of propranololand imiquimod therapy for infantile hemangiomas of proliferative phase.Methods A total of 53 infantile patients with hemangiomas of proliferative phase that were treated in our department were collected.According to patient's condition,the patients were classified into treatment group and observation group.The treatment group consisted of 34 patients received propranolol and imiquimod treatment,and 19 cases belonged to the observation group.The changes of tumor were compared between the treatment group and the observation group.Pre-therapeutic and post-therapeutic heart rate,blood pressure,blood glucose were monitored in the treatment group,so were in post-treatment.Results After 6 months,the effective rate was 97.1％ (33/34) in treatment group,and the effective rate was 57.9％ (11/19)in observation group.There was significant difference between treatment group and observation group in effective rate (P＜0.05),and so did blood pressure and heart rate after medication in the treatment group,but not in blood glucose,heart rate six hours after medication (P＞0.05).Conclusions Propranolol and imiquimod therapy has a certain inhibitory effect on infantile hemangiomas of proliferative phase.Propranolol and imiquimod are safe in patients with infantile hemangioma,and adverse reactions are mild.

Objective To analyze the clinical characteristics of intestinal infection caused by Aeromonas and their drug suscepti-bility .Methods The data of 52 patients infected with Aeromonas were analyzed retrospectively .Aeromonas strains were identified with Vitek Ⅱ Compact .Drug susceptibility was determined by disk diffusion methods .Cefoxitin combined with ceftazidime ,aztreo-nam ,cefotaxime and ceftriaxone were used to detect inducible expression of AmpC β-lactamase .Results Abdominal pain ,watery di-arrhea ,tenesmus occurred in 75 .0% ,48 .1% ,and 38 .0% of the patients ,respectively .White blood cell tests were positive in 50 .0%patients′stools .52 strains of Aeromonas were isolated ,including 38 strains of Aeromonas hydrophila ,13 strains of Aeromonas so-bria ,and 1 strain of Aeromonas veronii .All strains were sensitive to carbapenems ,the second ,third generation of cephalosporins , monobactam ,fluoroquinolone ,aminoglycosides .The susceptibility rates to chloramphenicol ,trimethoprim-sulfamethoxazole ,cefox-itin ,cefazolin ,and amoxicillin/clavulanic acid were 94 .2% ,92 .3% ,76 .9% ,51 .9% and 23 .1% ,respectively .75 .0% isolates exhibi-ted inducible expression of AmpC β-lactamas .Conclusion Diarrhea caused by A eromonas has different clinical manifestations .Ceph-alosporins ,monobactam ,fluoroquinolone ,aminoglycosides are available for empirical therapy of diarrhea caused by A eromonas .But the third generation of cephalosporins should be cautiously used because of high prevalence of inducible AmpC β-lactamase in A ero-monas .

Aim To study the effects of Bauhinia championii flavones ( BCF ) on adjusting autophagy a-gainst myocardial ischemia reperfusion injury. Meth-ods 120 SD rats were randomly divided into control, model, 3-MA (15 mg·kg-1 ) and BCF (10, 20 mg ·kg-1) groups (n=8). 30min. ischemia, ischemia/reperfusion 1h. or 3h, while myocardial ischemia reperfusion model was established by ligating left ante-rior descending coronary artery. The contents of crea-tine kinase-MB ( CK-MB) , inducible nitric oxide syn-thase ( iNOS ) and total antioxidative capacity ( T-AOC ) in serum were determined according to the ultra-violet spectrophotometer colorimetric method. The pro-tein expression of LC3-Ⅱ, Beclin-1 and mTOR was observed by Western blot. Results Compared with model group, BCF dose-dependently improved T-AOC, decreased CK-MB and iNOS ( P < 0. 05 ) . Meanwhile, BCF down-regulated the protein expression of LC3-Ⅱand Beclin-1 , and up-regulated mTOR pro-tein expression ( P < 0. 05 ) . Compared with 3-MA group, BCF reduced the contents of CK-MB and iN-OS, increased the level of T-AOC. It raised LC3-Ⅱand Beclin-1 protein expression at 30min. of ischemia, and then declined the protein expression of LC3-Ⅱand Beclin-1 . BCF descended the protein expression of mTOR all over the time ( P <0. 05 ) . Conclusion Autophagy occurs in ischemia then improves in ische-mia/reperfusion period. BCF could promote the occur-ring of autophagy at 30min. of ischemia in the short term and inhibit the excessive expression of autophagy with the increase of time in reperfusion period. BCF pretreatment reduce myocardial ischemia/reperfusion injury may by promoting the occurrence of autophagy during ischemia period and inhibit them in reperfusion.

By using the method of chondrocytes in monolayer culture in vitro we observed the effect of free radicals generated by the xanthine oxidase and xanthine on DNA, matrix proteoglycan (PG), collagen synthesis and ultrastructure of human embryo chondrocytes. Our results showed that the synthesis of DNA, PG and collagen of the chondrocytes were obviously inhibited and the membranes and subcellular organelles of the chondrocytes were damaged strongly. On the bases of these results we suggest that oxygen free radicals from poymorphonuclear leukocytes and phagocytes would be the important factors of cartilage injury in arthritis.

AIM: To compare the efficiency and safety of torsional phacoemulsification with or without intelligent phacoemulsification ( IP ) software in hard nucleus cataract extraction.
METHODS: Ninety two eyes with Ⅳ - Ⅴ grades cataracts were enrolled in this randomized prospective study. Operated eyes were divided into two groups -those operated without IP software ( non- IP group, n =43) and those operated using IP software (IP group, n =49 ). The two groups were compared in terms of ultrasound time (UST) and cumulative dissipated energy (CDE). Post- operative outcome measures included the corneal edema and best-corrected visual acuity (BCVA) at 1,7d and 3mo postoperatively, corneal endothelial cell density and percentage of hexagonal cell at 7d and 3mo postoperatively.
RESULTS: UST was measured as 52. 51±9. 64s in non-IP Group and 48. 79±7. 13s in IP Group (P = 0. 030). CDE was 15. 78±3. 73% in non-IP Group and 14. 29±2. 77% in IP Group ( P = 0. 026). At the first postoperative day, the rate of BCVA>0. 1 in non-IP Group was 56%, and the rate in IP Group was 79% (P= 0. 066). Corneal edema in non-IP Group was 2. 98±0. 77 scores, and in IP Group it was 2. 61±0. 64 scores (P = 0. 021). At the postoperative 7 and 30d, the BCVA and corneal edema were no differences between two groups. At the postoperative 7d, corneal endothelial cell density in non- IP Group were 2497. 95 ±211. 48 / mm2 , less than 2586. 26±154. 71 / mm 2 in IP Group (P= 0. 029);percentage of hexagonal cell in IP group was 48. 33±8. 69%,higher than 44. 19±9. 48% of non-IP group(P= 0. 030).CONCLUSION: In hard nucleus cataract extraction, the IP software can combine the advantages of the two kinds of ultrasonic modes, which is more effective with lower ultrasound energy and less injury for the corneal endothclium, and is helpful for the recovery of vision at early stage after surgeries.

[ABSTRACT]AIM:Toobservethelong-termeffectsoftaurine,Danxuetong(Salviamiltiorrhizacombinedwith Xueshuantong ) and breviscapine on contralateral testis with unilateral testicular torsion in prepubertal rats , and to compare their protective effect on testis with ischemia reperfusion injury .METHODS: Four-week-old healthy male SD rats ( n=64) were randomly divided into 8 groups:sham operation group, saline group, single-dose and successive taurine groups, single-dose and successive Danxuetong groups , and single-dose and successive breviscapine groups .The animal model of left testicular torsion reduction (720°for 2 h) was established.After 6 weeks of surgery, the right testes and epididymides from the rats were collected immediately to detect the total antioxidant capacity (T-AOC), the activity of superoxide dis-mutase (SOD), the activity of nitric oxide synthase (NOS) and the content of malondialdehyde (MDA).The sperm de-formity, sperm viability and sperm concentration were measured , and the pathological examination of the testicular tissues was performed.RESULTS:Compared with saline group, the activity of SOD, T-AOC, sperm viability and sperm concen-tration were increased , while MDA content and sperm deformity were decreased in 3 successive groups .SOD activity and sperm viability ( except single-dose breviscapine group ) were increased , but MDA content and sperm deformity were de-creased in 3 single-dose groups .T-AOC activity and sperm concentration were increased in single-dose taurine group .The saline group showed interstitial edema and degeneration of seminiferous tubules , and the rest groups showed a significant improvement in histological morphology .CONCLUSION:The contralateral testis in prepubertal rats was damaged after u-nilateral testicular torsion , and taurine , Danxuetong and breviscapine have long-term protective effect on the tissues under ischemia-reperfusion injury .The protective effect of Danxuetong is better than breviscapine , and taurine is the best of them.The effect of single-dose group is better than the successive application .

Animals ; Apoptosis ; drug effects ; Ginsenosides ; pharmacology ; Myocardial Reperfusion Injury ; pathology ; Myocytes, Cardiac ; cytology ; Rats ; Rats, Wistar