OBJECTIVE:To offer guidance for pharmacy work and provide references for rational use of traditional Chinese medicines. METHODS: 3 425 outpatient prescriptions of traditional Chinese medicines in our hospital in 2006 were randomly collected for the analysis of the drug use pattern by tabulation method. RESULTS & CONCLUSION: The use of traditional Chinese medicines prescribed in our hospital was rational on the whole, but the prescriptions of traditional Chinese medicines for diseases of respiratory system were on the high side, and the diagnoses in the prescriptions were more like the diagnoses of west medicines but lacked the characteristics of traditional Chinese medicine, so that the international classification coding of disease was not suitable for traditional Chinese medicine. Medication frequency of traditional Chinese medicines serves as guidance for the dispensary of traditional Chinese medicine. The hospital information system is far from perfect.

Objective To investigate the distribution and susceptibility of carbapenem resistant citrobacter freundii for rational antimicrobial therapy.Methods The C.freumdii were collected between January 2011 and December 2014 from inpatients.The minimum inhibitory concentration (MIC) were detected by an automated analyzer (VITEK 2) to analyze the characteristic of tested bacteria.Results (1) Of the 21 strains of carbapenemresistant citrobacter freundii,95％ were collected from urine,among which most of the strains were isolated from the Department of Transplantology (66.7％) and Urology (19％);(2) Antimicrobials Susceptibility test showed that Citmbacter freund were highly resistant to Cephalosporins and relevant beta-lactamase inhibitors.Even carbapenem were highly resistant.Imipenem had a resistance rate of 90％ (95％ confidence interval:70 to 99),Meropenem 85.7％ (95％ confidence interval:64 to 97),The drug resistance rate to Amikacin was only 4.8％,followed by Nitrofuran toin (10.5％) and Fosfomycin (15％).Conclusions Carbapenem resistant citrobacter freundii,which often causes urinary tract infection in our hospital,was characterized by multi-drug resistant (MDR).Monitoring of the Citrobaeter freundii should be strengthened to control the prevalence of drug resistance.

BACKGROUND: It has been recognized that the traditional herbal treatment and daoyin exercises(physical and breathing exercise) can relieve the symptoms such as tiredness of cancer patients and strengthen the tolerance to chemical drugs. But the criterion of quantitative evaluation for the effect should be scientific.OBJECTIVE: To evaluate the influence of Chinese herb for strengthening the body resistance and daoyin exercises on the survival state of lung cancer patients with the evaluation scale of life quality.DESIGN: Non-randomized and concurrent controlled trial.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Clinical Cancer Research Center, Guangzhou Medical College;Zhaoqing First People's Hospital.PARTICIPANTS: Totally 60 inpatients of the Department of Integrated Traditional Chinese and Western Medicine of Clinical Cancer Research Center of Guangzhou Medical College were enrolled from October 1997 to March 2001 in the study. All of them were volunteers. There were 41 males and 19 females, 30 patients in the treatment group and 30 in the control group.METHODS: The treatment group was given chemical therapy, at the same time, the herbal treatment and daoyin exercises. The control group was given chemical therapy only. The same chemical therapy was applied to both groups. The appointed doctor familiar with the evaluation table of quality of life was responsible for evaluating the quality of life of the patients in the two groups before and after treatment and the observation of their accomplishment of chemical therapy. The evaluation table of quality of life of Chinese lung cancer patients was used in the evaluation. The table included 5 factors: the physiological state caused by lung cancer, social/family state, relation of altitude towards doctor and disease, emotional state, and functional state. The statistical analysis was done to see the accomplishment of chemical therapy of two groups.chemical therapy of the two groups.RESULTS: According to the intention-to-treat analysis, 60 patients all completed the whole process of study. The comparison of the score before physiological state after treatment was obviously lower than that before treatment[ (14. 1 ± 3.2), (31.7 ±2.9) scores, P ＜ 0.01] and of control state was obviously higher than that before treatment[(25.2±3.1),(12.2 ±2.3)scores, P ＜0.01] and of control group[(19.1 ±2.2) scores,after treatment was obviously higher than that before treatment[ (37.4 ± 5.2),(24.2 ±3.5) scores, P ＜0. 01 ]and of control group[ (29. 1 ±3.4)scores, P before treatment[ (43.8 ± 5.6), (28.5 ± 4. 7) scores, P ＜ 0. 01 ] and of tional state after treatment was obviously higher than that of before treatment [(26.3±2.3), (17.3±3.3) scores, P ＜ 0.01] and of control group [ (20. 3 ± 1.1) scores, P ＜ 0. 05] . The accomplishment rate of chemical control group, 26 patients accomplished 1 course(87%, 26/30) and 18rate of 2 courses of chemical therapy of treatment group was obviously higher than that of control group ( P ＜ 0.05 ).CONCLUSION: The herbal treatment combined with daoyin exercises can improve the tolerance of lung cancer patients for chemical therapy and relieve the symptoms, thus improving their quality of life.

Objective To investigate the effects of remote limb ischemic preconditioning (RLIP) on the lung injury in patients undergoing abdominal aortic aneurysm repair.Methods Sixty-two ASA Ⅱ or Ⅲ patients of both sexes,aged 54-72 yr,with body mass index 21-36 kg/m2,undergoing elective abdominal aortic aneurysm repair,were randomly divided to 2 groups ( n =31 each):control group (group C) and RLIP group.RLIP consisted of two 5-min cycles of left upper limb ischemia induced by a blood pressure cuff placed on the left upper arm and inflated to 200 mm Hg,with an intervening 5 min of reperfusion,during which time the cuff was deflated.RLIP was performed after anesthesia induction and before the start of surgery.Arterial and venous blood samples were taken at 10 min after intubation (T0),and 30 min and 4,8,12 and 24 h after aortic unclamping (T1-5) for blood gas analysis and determination of the concentrations of serum interleukin (IL)-6,tumor necrosis factor (TNF)-α,and plasma malondialdehyde (MDA) and superoxide dismutase (SOD) activity.The alveolar-arterial oxygen pressure difference (PA-aO2 ) and respiratory index (RI) were calculated.The peak airway pressure (Ppeak),plat airway pressure (Pplat) and positive end expiratory pressure (PEEP) were recorded at the same time points mentioned above to calculate dynamic lung compliance (Cd) and static lung compliance (Cs).The incidence of hypoxemia,extubation time and duration of stay in intensive care unit (IGU) were also recorded.Results Compared with group C,PA-aO2,RI and the concentration of IL-6 were significantly decreased at T3-5,Cs,Cd and SOD activity were significantly increased at T2-5,and the concentrations of TNF-α and MDA were significantly decreased at T2-5 in group RLIP ( P ＜ 0.05).Compared with group C,the incidence of hypoxemia was significantly decreased,and extubation time and duration of stay in ICU were significantly shortened in group RLIP ( P ＜ 0.05).Conclusion RLIP can reduce the lung injury through inhibition of the inflammatory response and lipid peroxidation in patients undergoing abdominal aortic aneurysm repair.

Objective To analyze the etiology of pseudoachalasia.Methods Patients who were diagnosed as having pseudoachalasia in Endoscopy Center of The Affiliated Zhongshan Hospital of Fudan University from September 2010 to June 2015 were retrospectively analysed.Results A total of 12 patients were enrolled in this study,6 males and 6 females.The median age,median disease duration and median Eckcardt score was 54.5(24.0～71.0) years old,2.5(0.2～ 10.0) years and 4(3～9),respectively.Seven cases were caused by malignant tumors,2 had benign tumors,and 3 peptic stricture.Conclusion The most common cause of pseudoachalasia is malignant tumors.Accurate diagnosis relies on the comprehensive medical history and complete examinations.

Objective To analyze the characteristics and distribution of TCM syndromes of advanced gastric cancer;To provide reference for the standardization and clinical research of TCM syndromes of advanced gastric cancer.Methods The four diagnosis information with advanced gastric cancer was retrospectively collected at Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2010 to December 2020.And the investigation results were analyzed by combining principal component analysis and clustering analysis,so as to explore the distribution pattern of TCM syndromes of advanced gastric cancer.Results Totally 164 patients were included,involving 601 case-times.10 principal components were obtained through principal component analysis on 29 items of four diagnosis information.The four diagnosis information with factor coefficient>0.4 were selected and allocated to the 10 principal components.Then,based on the results of principal component analysis,clustering analysis was conducted to obtain the distribution proportion of the three types of TCM syndromes.According to the syndrome differentiation by professional clinicians,the results were followed by the frequency distribution as cold coagulation and blood stasis(356,59.28%),stomach yin deficiency(145,24.17%)and phlegm-heat accumulation(100,16.55%).Conclusion There are three basic TCM syndromes of advanced gastric cancer,which are cold coagulation and blood stasis,stomach yin deficiency and phlegm-heat accumulation.Cold coagulation and blood stasis occupies the largest proportion,and the treatment should be based on warming the middle to dissipate cold and promoting blood circulation to remove blood stasis.

Autologous fat grafting (AFG) is a new postoperative plastic technique for breast cancer. The safety of this technique in oncology is a controversial issue in academic circles. In some basic experiments, it was found that adipocytes could promote the proliferation of surrounding cancer cells through autocrine and paracrine. However, clinical trial data show that this procedure does not increase the risk of postoperative recurrence or metastasis of breast cancer. Nowadays, there are variety of researches on the safety of this technique, but many limitations are found in these trials. Therefore, to accurately assess the relevance of these studies to any realistic clinical risk, it is necessary to include large sample of clinical studies. In this paper, the data of basic experiments and clinical trials in recent ten years were collected, and the safety of oncology was further analyzed and discussed, which will provide reference for clinical decision-making of postoperative breast reconstruction.

Objective:To explore the nursing effect of clinical nursing pathway in emergency care of severe pneumonia and its effect on lung function.Methods:A total of 90 patients with severe pneumonia in Lianyungang First People ′s Hospital of Jiangsu Province from June 2017 to July 2019 were selected as subjects. The randomized patients were divided into control group ( n=45 cases) and observation group ( n=45 cases). The control group received routine nursing. The observation group was combined with the clinical nursing pathway on the basis of the control group. Both groups were treated for 1 month. The symptom improvement time, lung function level and nursing satisfaction were compared. Results:The improvement time of wheezing (3.45 ± 1.06) d, the improvement time of antipyretic fever (3.48 ± 1.08) d, and the improvement time of lung rales (4.31 ± 0.49) d in the observation group were shorter than those in the control group [(7.01 ± 1.42) d, (4.56 ± 1.32) d, (6.62 ± 0.79) d] ( t value was 9.642, 7.375, 6.189, P <0.05); maximum voluntary minute ventilation (MVV) of the observation group in 1 month after nursing , Vital capacity (VC) and 1s forced expiratory volume (FEV1) levels were higher than before nursing ( P <0.05); MVV (71.42 ± 18.75) L, VC (72.41 ± 17.74)% and FEV1 were observed in the observation group 1 month after nursing (67.36 ± 18.48) L, all higher than (62.38 ± 16.69) L, (60.18 ± 15.69)% and (59.15 ± 17.13) L of the control group ( t value was 6.393, 5.544, 7.491, P <0.05); observation group after-care, nursing method, content, form of nursing, nursing service attitude, and nursing effect satisfaction were 97.78% (44/45), 95.56% (43/45), 97.78% (44/45), 93.33% (42/45 ), 95.56% (43/45), which were higher than 80.00% (36/45), 90.48% (38/45), 82.22% (37/45), 77.78% (35/45), 80.00% of the control group (36/45), with statistically significance ( χ2 value was 5.412-9.581, P <0.05). Conclusions:The clinical nursing pathway is effective for emergency nursing of patients with severe pneumonia. It can shorten the time of symptom disappearance, improve the lung function level and satisfaction of nursing, and it is worthy of popularization and application.

Objective:To explore the effects of macrophages after influenced by tuberculosis antigen Ag85 on the proliferation and apoptosis of Hodgkin lymphoma cells, and to discuss the possible role of tuberculosis infection in the progression of Hodgkin lymphoma.Methods:The indirect co-culture system between Hodgkin lymphoma cell line KM-H2 and human monocytic leukemia cell line THP-1 (simulated macrophage) was established by using Transwell nesting. KM-H2 cells were cultured as KM-H2 group alone, KM-H2 cells interfered with Ag85 were taken as KM-H2+Ag85 group, and KM-H2 cells co-cultured with THP-1 cells were taken as KM-H2+THP-1 group. The co-culture system of KM-H2 cells and THP-1 cells interfered by Ag85 was taken as KM-H2+THP-1+Ag85 group. The proliferation of KM-H2 cells in each group was detected by using CCK-8 assay, and the growth curve was drawn. The apoptosis of cells in each group was detected by using flow cytometry. The mRNA expression levels of p53, c-myc, bcl-2 and vascular endothelial growth factor receptor 3 (VEGFR3) in each group were detected by using quantitative real-time fluorescence polymerase chain reaction (qRT-PCR). The expressions of bax and bcl-2 proteins were detected by using Western blotting.Results:The cell proliferation ability of KM-H2+Ag85 group was higher than that of KM-H2 group (all P = 0.001) after 24 and 48 h culture, but the cell proliferation ability of KM-H2+THP-1 group was lower than that of KM-H2 group after 24 h, 48 h and 72 h culture (all P < 0.05). The cell proliferation ability of KM-H2+THP-1+Ag85 group was lower than that of KM-H2 group after 48 h and 72 h culture (all P < 0.05), but the cell proliferation ability of KM-H2+THP-1+Ag85 group was enhanced after 24 h and 48 h culture compared with KM-H2+THP-1 group, and there was no statistically significant difference between the two groups after 72 h culture ( P > 0.05). The apoptosis rate of KM-H2+Ag85 group was lower than that of KM-H2 group [(0.92±0.80)% vs. (6.02±1.63)%, P < 0.001], and the apoptosis rate of KM-H2+THP-1 group [(8.57±0.57)%] was higher than that of KM-H2 group ( P < 0.05). The apoptosis rate [(0.60±0.13)%] in KM-H2+THP-1+Ag85 group was lower than that in KM-H2+THP-1 group ( P < 0.001). The relative expression of bcl-2 and VEGFR3 mRNA in KM-H2+Ag85 group was higher than that in KM-H2 group ( P = 0.018, P = 0.017), while the relative expression of c-myc mRNA in KM-H2+Ag85 group was lower than that in KM-H2 group ( P = 0.016), and there was no statistically significant difference of p53 mRNA relative expression level between the both groups ( P > 0.05).The relative expression of p53 mRNA in KM-H2+THP-1+Ag85 group was lower than that in KM-H2+THP-1 group ( P = 0.048), while the relative expressions of bcl-2 and VEGFR3 mRNA in KM-H2+THP-1+Ag85 group were higher than those in KM-H2+ THP-1 group ( P = 0.016; P = 0.021). The expression of bax protein in KM-H2+Ag85 group was lower than that in KM-H2 group ( P = 0.019), and bcl-2 protein was more than that in KM-H2 group ( P = 0.001). The expression of bax protein in KM-H2+THP-1+Ag85 group was lower than that in KM-H2+THP-1 group ( P = 0.011), but there was no statistically significant difference in the expression of bcl-2 protein between the two groups ( P > 0.05). Conclusions:Tuberculosis antigen Ag85 may inhibit the apoptosis of Hodgkin lymphoma KM-H2 cells and enhance the proliferative activity by affecting the function of macrophages.

Interpreting configuration of ancient Chinese characters means to divide characters into several parts,and infer the meaning of characters from the meanings of each part,the relationship between parts and the context.This method,characterized by tracing the original source and visualizing the characters, can be used to explain the meaning of Huangdi Neijing(Huangdi's Internal Classic)text and its TCM terms vividly.It may contribute to a more accurate and profound understanding of the medical theory in Huangdi Neijing,and building a deep understanding of the thinking pattern of classification according to manifestation by ancient people.