OBJECTIVE:To study the impact of amoxicillin on dysmenorrhea model mice treated with paeoniflorin.METHODS:The enrolled mice were randomized to different groups and all were given diethylstilbestrol i.g.for 12 consecutive days.From day 5 to day 12,the model control(MC)group,positive control(PC)group and 3 PA groups(different dosage of paeoniflorin plus amoxicillin)were given amoxicillin i.g.On day 12,3 P(paeoniflorin)groups and 3 PA groups were respectively given different dosage of paeoniflorin i.g.All groups were respectively given oxytocin i.p 1 hour after medication.The incubation period(TIP,seconds)between oxytocin i.p.and the first time of body twisting and the number of the body twisting(NBT)in 15 minutes of the mice were recorded.RESULTS:Compare to NC(negative control)and MC groups,the TIP was significantly prolonged and the NBT in 15min were significantly decreased in 3 P groups(P0.05).CONCLUSION:The curative effect of paeoniflorin in treating dysmenorrheal model mouse was decreased by amoxicillin suggests that the 2 drugs were unsuitable to be used concomitantly.

A case of acute posterior dislocation of shoulder with fracture of greater tubercle of humerus was reported. The patient came to hospital complaining pain and limited motion of left shoulder caused by traffic accident. The diagnosis of posterior dislocation of the left shoulder and fracture of the greater tubercle was confirmed by medical history, physical examination and imaging. After the failure of manual reduction under anesthesia, MRI was conducted which revealed that the biceps brachii longus and supraspinatus and infraspinatus muscle were embedded between the head of humerus and glenoid scapula. Then open reduction and internal fixation was performed. The biceps brachii longus was cut off and then fixed in the inter nodal groove. After the rotator cuff was relieved from the impaction, the dislocation of the humeral head was successfully reduced and the fracture of the greater tubercle was reduced and fixed. According to the operation process, the possible trauma mechanism is discussed as follows: the displaced fracture of the greater tubercle destroyed the integrity of the lateral wall of the inter tubercular groove, and the biceps brachii longus slipped out of the inter tubercular groove and shifted to the medial side, which was embedded between the humeral head and the scapular glenoid, thus forcing the humeral head to fall posteriorly, and causing the fracture of the greater tubercle to move anteriorly and inferiorly. Attention should be paid to the possible acute dislocation of shoulder joint for the patients with high energy injury. The only way to avoid missed diagnosis is to combine with multi-directional X-ray or CT examination of shoulder. MRI should be used to determine whether there is tendon incarceration of rotator cuff and/or biceps brachii longus in patients with acute posterior dislocation of shoulder. Anatomic reduction of tubercle fracture is the key to recover the range of motion and muscle strength of shoulder joint.

Objective To explore the role of clinical pharmacists in pharmaceutical care for a pregnant patient with severe acute pancreatitis .Methods Clinical pharmacists participated in the treatments for one severe case of acute pancreatitis in preg-nancy .Based on the disease states and therapeutic results ,clinical pharmacists adjusted the drug regimen ,selected safer antibi-otics for pregnant patient and provided comprehensive pharmaceutical services for the patient .Results Clinical pharmacists provided individualized pharmaceutical care ,improved the clinical outcomes and reduced the adverse reactions .Conclusion Clinical pharmacists play an important role in improving the drug therapeutic outcome and monitoring the medication safety in specific group of patients .

ObjectiveTo investigate the clinical features and prognosis of culture-negative liver abscess (CNLA) versus culture-positive liver abscess (CPLA), and to provide a reference for early diagnosis and effective treatment. MethodsA retrospective analysis was performed for the clinical data of 371 patients with liver abscess who were admitted to The Second Affiliated Hospital of Air Force Medical University from 2005 to 2018, among whom 145 (39.1%) had positive results of pathogen test (CPLA group) and 226 (60.9%) had negative results (CNLA group). The two groups were compared in terms of clinical features, laboratory examination, imaging data, and prognosis. The t-test was used for comparison of normally distributed or approximately normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the CNLA group, the CPLA group had a significantly older age (t=-3.464, P=0.001) and a significantly higher proportion of patients with diabetes (χ2=17.362, P＜0.001) or cardiovascular disease (χ2=10.827, P=0.001), and compared with the CPLA group, the CNLA group had a significantly higher proportion of patients with AIDS (χ2=4.354, P=0.037). Compared with the CNLA group, the CPLA group had significantly greater increases in leukocyte count, percentage of neutrophils, alkaline phosphatase, gamma-glutamyl transpeptidase, and total bilirubin (U=20393, 19711, 18586, 19349, and 18496, all P＜0.05), a significantly greater reduction in albumin (t=3.348, P=0.001), and a significantly higher proportion of patients with a baseline APACHE Ⅱ score of ≥16 (χ2=9.550, P=0.002). Compared with the CNLA group, the CPLA group had a significantly higher proportion of tumors with a diameter of ＞5 cm (χ2=53.61, P＜0.001). In the CNLA group, 19.9% of the patients were treated with anti-infective therapy alone, while for both groups, anti-infective therapy combined with ultrasound- or CT-guided percutaneous drainage was the main treatment method. There were no significant differences in the length of hospital stay, recurrence rate, and mortality rate between the two groups (all P＞0.05). ConclusionCompared with CPLA patients, CNLA patients tend to have a younger age and are less likely to develop severe inflammatory response and liver insufficiency, with a smaller diameter of abscess which is less likely to be treated by percutaneous drainage, while there is no significant difference in prognosis between CPLA patients and CNLA patients.

Objective:To construct a comprehensive, systematic and quantifiable quality evaluation index system for blood purification care in ICU.Methods:The contents of the evaluation index system for blood purification care in ICU were determined by reviewing the literature, discussion of the research group and two rounds of Delphi expert consultation.Results:The response rate of the two rounds of experts was 100%. The authoritative coefficients of the two rounds of experts were 0.908 and 0.965 respectively. The coordination coefficient of the indicators of the second round of consultation results was 0.210-0.292, P<0.05 or 0.01. The quality evaluation index system for blood purification care included 3 first-class indicators, 16 second-class indicators, and 56 third-class indicators. Conclusions:The enthusiasm, authority, concentration of opinions and degree of coordination of the consulting experts are relatively high. The constructed evaluation system for the quality of blood purification care indicators can be used for reference in the implementation, training and quality control.

Objective: To explore the operative strategy of distal clavicle fracture involving coracoclavicular ligament. Methods: Data of 17 cases of distal clavicle fracture involving coracoclavicular ligament in our hospital from January 2013 to December 2018 were analyzed retrospectively. According to whether the coracoclavicular ligament was reconstructed or not, the patients were divided into two groups: non reconstruction group (10 cases), male (7 cases), female (3 cases), 19-60 years old (37.9±11.9). In the reconstruction group, 7 cases were male 5, female 2, 25-62 years old (44.9±13.0). Three dimensional CT was used to judge the ligament injury and X-ray was used to evaluate the fracture reduction and healing after operation. The time of fracture healing was compared between the two groups. The function of shoulder joint was evaluated by visual analog scale (VAS) and Constant score of shoulder joint. Results: The patients in both groups were followed up for (18.7±6.7) months (range, 9-27 months). At the latest follow-up, the time of fracture healing in the reconstruction group was 12.6±0.7 weeks (range, 12-14 weeks); VAS score was 3.0±1.3 and Constant-Murley score was 85±11. While those in the non reconstruction group were 23.7±7.9 (range, 16- 48 weeks), 3.1±1.8 and 77±10 respectively. The time of fracture healing was statistically significant (t=3.361, P=0.004). There was no significant difference in VAS score and Constant score (P> 0.05). In the non reconstruction group, there were 1 case of delayed union of fracture (healed 48 weeks after operation), 1 case of loosening of clavicular hook plate, 5 cases of acromioclavicular joint dislocation (Rockwood type II) after removal of internal fixation, and the overall complication rate was 70% (7/10). Reconstruction group: 1 case of acromial fracture, the overall complication rate was 14.3% (1/7). There was significant difference between the two groups (χ²=5.13, P=0.024). Conclusion Reconstruction of clavicular insertion of coracoclavicular ligament can effectively reduce the postoperative complications of distal clavicular fracture involving the coracoclavicular insertion. Attention should be paid to the repair and reconstruction of coracoclavicular ligament injury during fracture treatment.

Objective : To explore the role of Argonaute ( Ago) gene and RNA⁃Dependent RNA Polymerase (RDRP) gene of Aspergillus flavus in the growth and development about the RNAi mechanism . Methods : A. flavus Ago1 , Ago2 , RDRP1 , RDRP3 gene mutant strains were constructed by homologous recombination . The growth and development of the mutant strains were observed on potato dextrose agar(PDA) + uracil uridine (UU) medium inoculated with 3 μl 106 CFU/mL spores . 200 , 400 μg cell wall pressure agent conidored ( CR) , 0. 8 mol/L , 1 . 6 mol/L osmotic pressure agent NaCl , 2 mmol/L , 4 mmol/L oxidative pressure agent hydrogen peroxide (H2 O2 ) and 0. 01% , 0. 02% genomic damage agent methyl mesylate (MMS) were added to the Yeast extract Glucose Minimum (YGM) + UU medium to analyze the stress response of the mutant strains . Results : A. flavus mutant strains about ΔAgo1 , ΔAgo2 , ΔRDRP1 , ΔRDRP3 were successfully constructed and its growth and development were normal . The ΔAgo1 and ΔAgo2 strains reduced the stress effects on cell wall and osmotic pressure compared to the control . Ago1 gene deletion reduced the effect of H2 O2 , and conversely RDRP3 gene deletion increased the inhibition of H2 O2 . The Ago2 and RDRP1 strains reduced the effect on genetic damage agent . In addition , ΔRDRP1 increased the effect of osmotic stress . Conclusion The Ago1 , Ago2 , RDRP1 and RDRP3 genes of A. flavus are not in⁃ volved in the regulation of growth rate and asexual reproduction and can participate in the regulating of the host stress response to the environment .