OBJECTIVE:To discuss the approach to launch pharmaceutical care in hospital preparation room.METHODS:The contents of launching pharmaceutical care in the preparation room of our hospital were analyzed and summarized retrospectively.RESULTS & CONCLUSION:A shifting toward technical service is on the way by launching pharmaceutical care in hospital preparation room.

Objective Clinical parenteral nutrition( PN) support still lacks in standards on some degree .This paper was to analyze the clinical application of PN support in our hospital in order to provide the basis for clinical rational drug use . Methods Random weighting method was applied to collect 5% hospitalized patients′information from each patient unit each month from April 2012 to March 2013 in Nanjing Gerneral Hospital of Nanjing Military Region .NRS-2002 nutrition risk screening was applied to eval-uate whether the patient needed PN support .Statistical analysis were carried out on patients supported with parenteral nutrition from department distribution, PN detailed components and distribution intervals of aII in one admixture non-protein calorie and nitrogen ra-tio. Results According to the survey, 393 patients had received PN support, including 217 cases′NRS score <3 and 176 cases′NRS score ≥3.General surgery department ranked the first in the cases of usingall in oneadmixture support.Among 133 cases receiving all in one admixture support, the course of 37 cases(27.82%) <7 d.The aII in one admixture non-protein calorie and ni-trogen ratio(100~150∶1) only took up 28.57%. Conclusion Although PN has got wide application in clinical departments, the rationality of prescription should be strengthened .Pharmacists should help doctors set up appropriate prescription from the aspect of pharmacy.

OBJECTIVE: To monitor clinical rational use of drugs,analyze the problems involved and to put forward reasonable suggestions.METHODS: Using the platform of medical information communication established based on the "Military Medical Project No.1" local area network and "Hospital Information Management System",the electronic medical records of the inpatients,ward round records,treatment plans and the relative laboratory test reports from October 2006 to March 2007 were retrieved online.The involved problems were discussed with clinical physicians through the network.RESULTS: The problems in the clinical drug use manifested as repeated medication,improper administration,overdoses and adverse interactions of combined drugs.The irrational prophylactic administration of antibiotics in the surgical department was characterized by improper choice of drugs and prolonged course of treatment etc.CONCLUSION: Great importance should be attached to drug interactions,and the indications for drug combination and course of treatment should be kept under tightly control so as to reduce adverse reactions and delay the onset of drug resistance.

OBJECTIVE:To study the ex vivo adsorption of montmorillonite powder to ofloxacin.METHODS:Different dosages of ofloxacin and montmorillonite powder were mixed with artificial gastric juice and artificial intestinal juice,respec?tively,which were filtrated after warmed at(37?0.5)℃in water bath for1hour,the content changes of ofloxacin were de?termined by ultraviolet spectrometry.RESULTS:The adsorption rates of montmorillonite powder to ofloxacin in artificial gastric juice and in artificial intestinal juice were(99.76?0.01)%and(99.55?0.02)%,respectively.CONCLUSIONS:Montmorillonite powder has strong adsorption to ofloxacin in both artificial gastric juice and artificial intestinal juice,there?fore,which should not be administered simultaneously in the clinic.

This paper develops an intelligent NO delivery system cooperating with the ventilator to make NO inhaled safely, reliably, conveniently and economically, which is based on correlation between the parameter setup of the ventilator and the concentration of NO. The circuit control system consists of a mass flow controller and a CPU mainly. A mixing unit is designed to mix NO with the gas from the ventilator uniformly. Clinical experiments show that the NO from the intelligent delivery system can decrease PH and increase SaO2 with the concentration of generated NO2 less than 5ppm.

Objective To investigate the alteration of C/EBP α,C/EBP β and endoplasmic reticulum stress (ERS) related molecules (IRE1α and sXBP1) expression in pancreatic tissues in rats with hypertriglyceridemia related acute pancreatitis.Methods Ninety six Sprague Dawley (SD) rats were divided into 4 groups:control group,hypertriglyceridemia (HTG) group (n =24,fed with high fat diet for 2 weeks),AP group (n =24),HTG + AP group (n =24),and AP was induced by peritoneal injection of cerulein.The rats were sacrificed at 3,6,9,24 h after AP induction,respectively.The pathological changes of the pancreatic tissues were observed and scored by HE staining.Plasma levels of IL-1β,IL-6 and TNF-α were measured by ELISA.The expression of IRE1α,sXBP1,C/EBPoα,C/EBPβ mRNA were analyzed by real time PCR.The expressions of IRE1α,sXBP1,NF-kB,C/EBPα and C/EBPβ protein were determined by Western Blot.The expressions of C/EBPα and C/EBPβ proteins were also determined by immunohitochemistry.Results After two weeks of high fat diet,serum levels of triglyceride(TG) and total cholesterol (TC) in HTG group,HTG + AP group were much higher than those of the control group,and the difference was statistically significant (P ＜ 0.05).The pancreatic tissue injury was more severe in HTG + AP group,particularly at 9 h (P ＜ 0.05).And plasma IL-1β,IL-6 and TNF-α levels were also much higher in HTG + AP group when compared with that of AP group,the differences were all significant at 9 h (P=0.011;P=0.034;P =0.027).After AP induction,IRE1,sXBP1,C/EBP and C/EBPβ mRNA began to be up-regulated at 3 h,and IRE1 mRNA reached the highest level at 24 h,sXBP1 mRNA at 9 h,while C/EBP and C/EBPβ mRNA reached the highest level at 6 h.Compared with AP group,IRE1,sXBP1,C/EBP and C/EBPβ mRNA levels were much higher in HTG + AP group.In addition,as to IRE1 and sXBP1 mRNA,the difference was significant at 3,6,9,24 h,and C/EBP mRNA at 6,9,24 h,C/EBPβ mRNA at 6 and 9 h (P ＜ 0.05).After AP induction,IRE1α,sXBP1 and NF-kB proteins in the pancreatic tissue began to be up-regulated at 3 h,and all reached the highest level at 9 h.IRE1α,sXBP1 and NF-kB proteins were up-regulated more obviously in HTG + AP group,and the up-regulation in HTG + AP group was higher than that in AP group,and the high expressions of C/EBPα and C/EBPβ proteins could only be detected at 6 and 9 h in the HTG + AP group,while there was no expression detected in AP group.Conclusions C/EBPα,C/EBPβ,IRE1α and sXBP1 may be involved in the pathogenesis of HTG related AP,and IRE1α/sXBP1 pathway and C/EBPoα,C/EBPβ may mediate the pathologic injury and inflammation process of HTG related AP.

Objective To prepare a conjugate vaccine by linking Haemophilus influenzae type b (Hib)polysaccharide to PsaA protein carrier and evaluate the immunogenicity and efficacy of the conjugate vaccine. Methods A recombinant protein rPsaA,expressed by using the genetic engineering technology, was used as a protein carrier to prepare conjugate vaccine together with Hib polysaccharide. Ten mice at age of 3 weeks were immunized with the conjugate vaccine,while another 10 age-matched mice were immunized with Hib-tetanus toxoid(Hib-TT)vaccine which was produced formerly as a control. The mice treated with equal volume of PBS were set up as the negative control. The IgG antibodies in serum samples against PsaA and Hib polysaccharide were detected in two weeks after the final immunization. A suspension of Pneumococ-cus was injected into the middle ears of mice from experiment and control group. Histopathological analysis was performed to measure the clearance of bacteria in the middle ears and the severity of infection on days 3 and 7 after bacterial challenge. Results The rPsaA protein was prepared by the genetic engineering tech-nology and purified successfully with anion-exchange column. The Hib polysaccharide-PsaA protein conju-gate vaccine was prepared through a series of amide condensation reactions. The detection of IgG antibodies against PsaA protein and Hib polysaccharide in the immunized mice demonstrated that there was no signifi-cant difference with the titer of IgG against Hib polysaccharide between the mice immunized with the Hib-PsaA conjugate vaccine and those immunized with the Hib-TT vaccine. Less Pneumococcus strains were de-tected in the middle ears of mice immunized with the conjugate vaccine than those mice immunized with the Hib-TT vaccine three days after challenge. The mice from control group showed severe inflammation in the middle ears than those from experiment group. The Hib polysaccharide-PsaA protein conjugate vaccine im-proved protection against Pneumococcus infections as compared with the Hib-TT vaccine. Conclusion The rPsaA protein could be produced by genetic engineering technology and purified by anion-exchange column. The Hib polysaccharide was successfully conjugated with the rPsaA protein through amide condensation reac-tion. Both anti-PsaA and anti-Hib immune responses were induced in young mice by the injection of Hib pol-ysaccharide-PsaA protein conjugate vaccine. Apart from providing protection against Hib infection,the con-jugate vaccine might also be used for the prevention of acute otitis media caused by Pneumococcus infection.

Objective To analyze the effects of feeding with non-nutritional sucking and simultaneous transoral tube feeding on the quality of life of very low birth weight infants. Methods A total of 84 cases of very low birth weight infants from January 2017 to December 2017 in NICU of children′s hospital of Soochow University were randomly divided into the observation group and the control group, 42 cases in each group. Children in the observation group were fed with non-nutritional sucking and simultaneous transoral tube feeding and those in the control group were fed by transoral tube alone. The clinical manifestations of front, middle and after feeding and before refeeding of the two groups were observed. Results The breathing and heart rate along with percutaneous oxygen concentration during and after eating of the two groups had no statistically significant differences (all P>0.05). the sucking appetite, the frequency of the oral movement, the expression of the facial musclar tension, the state of quiet sleep, complications of feeding intolerance such as stomach retention with vomiting, abdominal distension, fecal occult blood and necrotizing enterocolitis during and after feeding and before refeeding of the observation group were 83.33% (35/42), 85.71% (36/42), 92.86% (39/42), 95.24% (40/42), 4.76% (2/42), the control group was 54.76% (23/42), 61.90% (26/42), 64.29% (27/42), 69.05% (29/42), 21.43% (9/42), the difference was statistically significant (χ2=5.126-10.182, P<0.05). The feeding volumes and mean relative growth rate during hospitalization, the time of extracting gastric tube, the average hospital stay of the observation group were (3.10 ± 1.23) ml, (20.00 ± 2.50) g, (19.06 ± 2.23) d, (41.50±4.23) d, and it had more advantages than the control group (1.50±1.15) ml, (13±1.33) g, (36.45± 4.31) d, (52.03 ± 4.21) d, the difference was statistically significant (t=6.16- 23.22, P<0.01). Conclusions Feeding with non-nutritional sucking and simultaneous transoral tube feeding for very low birth weight infants is safe and effective, it can reduce complications and promote feeding tolerance and achieve the desired growth target and shorten the hospital stay, and finally improve the quality of life.

ObjectiveTo assess the diagnostic value of preoperative lymphoscintigraphy for lateral lymph node metastasis in low rectal cancer. MethodsFrom May 1999 to March 2001, pelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid was performed on 32 patients with proven colorectal cancer one day prior to operation. Among these patients were 27 rectal cancers, 3 sigmoid cancers and 2 colon cancers. Fifteen cases of rectal cancer with the tumor located at or below the peritoneal reflection received extended lymphadenectomy with lateral dissection (D3 lymphadenectomy). The result of lymphoscintigrams was correlated with histologic lateral node examination. Results The image ratio of pararectal nodes, obturator nodes, and internal iliac aorti lymph trains was 69%, 91%, and 100% respectively. In 15 patients receiving D3 lymphadenectomy, 10 had negative lymphoscintigrams whereas 5 had positive image, and the lateral pathology positive rate was 13%(2/15). Analysis of these results revealed the sensitivity (100%), specificity (77%) and accuracy (80%) of this diagnostic method. ConclusionPelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid could demonstrate the lateral lymph node drainage of low rectal cancer, and the correlation with postoperative histologic lateral node examination was high enough to enable surgeons to adopt an individualized surgical approach.

OBJECTIVETo study the early X-ray and CT findings of patients with severe acute respiratory syndrome (SARS).

METHODSChest radiography and CT were performed in 28 patients with SARS within one to three days after onset of the disease. CT examinations included conventional spiral CT and high-resolution CT (HRCT). The radiographic and CT findings of these patients were analyzed retrospectively.

RESULTSAbnormal CT findings were noted in all the patients, but abnormal chest radiographic findings in 17 cases (60.7%, 17/28). CT showed single small focal patchy opacities in 23 patients (82.1%, 23/28), including oval ground-glass opacities in 20 patients, lobular distribution ground-glass opacities in 2 and small patchy consolidation in one. Multi-focal ground-glass opacities were found in 2 patients and extensive opacities in three. In the 28 patients, a total of 31 lesions were found in the upper (7, 22.6%), middle (3, 9.7%), and lower lobes (21, 67.7%). The diameter of the lesions ranged from 20 to 35 mm.

CONCLUSIONThe dominant feature of early SARS patients is focal patchy opacity in the lung, and oval small ground-glass opacities are the common morphological findings on CT.

Adult ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed