OBJECTIVE To discuss the participation of clinical pharmacists in rational drug use management by informatization clinical pathway under diagnosis related groups(DRGs) background by taking glycyrrhizic acid injection as an example. METHODS Based on the PDCA cycle theory, the evaluation scheme was established to find the problems in the use of glycyrrhizic acid injection in Jinhua Municipal Central Hospital, and the necessity of glycyrrhizic acid injection in the pathway was determined according to the needs of diagnosis and treatment, and the elimination and maintenance were carried out. The rational rate of drug use and the changes of monitoring indexes were compared before and after intervention in the same period(Q2 2021 vs Q2 2022). RESULTS Compared with the same period in 2021, the rational use rate of glycyrrhizic acid injection increased to a certain extent in the second quarter of 2022, and the utilization rate, the number of intravenous administration per capita per day, the intensity of use and the average drug cost per case all decreased. CONCLUSION Under the background of DRGs, the participation of clinical pharmacists in rational drug use by informatization clinical pathway can reduce the irrational use of glycyrrhizic acid injection and reduce the hospital monitoring index.

Objective To understand the clinical characteristics and susceptible factors of neonatal nosocomial infection in primary hospital,and discuss the control measures in order to effectively reduce the neonatal nosocomial infection rate.Methods A retrospective analysis about clinical characteristics and susceptible factors of neonatal nosocomial infection was carried out from October 2010 to September 2012.Results Premature rupture of fetal membranes,premature infant,low birth weight,invasive operation were high risk factors for nosocomial infection.Infection most often occurred in respiratory tract,skin and soft tissue.Conclusions Neonatal nosocomial infection is influenced by many factors,in which the awareness of prevention and control among the medical staff,the aseptic operation,hand hygiene compliance,the ward disinfection management level and education during the pregnancy are crucial,which are the key link in the control of neonatal nosocomial infection.

Objective To analyze the application value of side way lymph node cleaned up in the low order rectal cancer operation. Methods 45 cases were randomly divided into two groups:first group was 30 cases, they were used the side way lymph node cleaned up of the rectal cancer broadens the curing once and for all skill;second group was 15 cases,they were used traditional rectal cancer curing once and for all skill. Results 7 cases of 1 group happen the side way lymph nodes transfer,the rate of transform was 23. 33% ,that low disintegration gland cancer and mucus gland cancer happen the rate of the side way lymph nodes transfer was beyond one-fold much than hight and middle disintegration gland cancer( P＜0. 05 ) ,the divergence is obvious. The operation time and amount losing blood of two group is not obvious, but first group's 3 years living rate was more higher than second group. Conclusion To the low order rectal cancer case sufferer that the side way lymph node cleaned up, may cut down the pelvic cavity recurs,obviously improve the living quality,lift the living rate,it has clinical practice value.

OBJECTIVE:To explore the effects of tamsulosin on proliferation and apoptosis in prostatic cancer PC-3 cells. METHODS:After treated with 0 (blank control group),12.5,25 and 50 μmol/L tamsulosin (tamsulosin low,medium and high-concentration groups)for 48 h,the viability of PC-3 cells was detected by MTT method. Hoechst 33258 staining was used to detect cell apoptosis rate. Western blot was used to determine the expression level of Bax and Bcl-2 protein,and the phosphoryla-tion level of protein kinase B(Akt),mammalian target rapamycin(mTOR),ribosomal S6 protein kinase(p70S6K)and 4E bind-ing protein 1(4E-BP1). RESULTS:Compared with blank control group,PC-3 cells viability and the phosphorylation level of Akt, p70S6K and 4E-BP1 decreased in tamsulosin low,medium and high-concentration groups,while expression level of Bax protein in-creased (P<0.05 or P<0.01);the apoptosis rate of PC-3 cells was increased in tamsulosin medium and high-concentration groups,while the expression level of Bcl-2 and phosphorylation level of mTOR were decreased(P<0.01),in concentration-depen-dent manner. CONCLUSIONS:Tamsulosin can inhibit PC-3 cells proliferation and induce cell apoptosis via blocking Akt/mTOR signal pathway.

Objective To study the safety and effectiveness finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe benign prostatic hyperplasia (BPH). Methods A total of 110 consecutives from January to December 2015 were divided randomly into control and observation groups and each of 55 cases; the patients in control group received finasteride combined with transurethral prostatectomy (TURP) and they in observation group adopted finasteride combined with 1470 nm semiconductor laser vaporization and resection, then to compare the differences of surgical success rate,complications rate,mean operation time,blood bloss during and after operation, indwelling catheter time,prostate volume before and after operation; the follow-up time was 12.0 months, the differences of international prostate symptom score (I-PSS), Quality of life score (QOL), peak flow rate (Qmax) peak flow rate (Qmax) and post-void residual (PVR). Results The surgical success rate in the two groups were no statistical difference, the complications rate in observation group was significantly lower (P<0.05). The mean operation time and indwelling catheter time in the two groups were no statistical difference, while the total blood bloss and prostate volume after operation in observation group were both less, and the difference of prostate volume was more (P<0.05). The I-PSS and PVR were lower, QOL and Qmax higher in the two groups after operation, what'more, there were more improvements in observation group (P<0.05). Conclusion It is more prior to finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe BPH on the Safety and effectiveness than TURP.

Objective To investigate the therapeutic effect of mitoxantrone on prostate cancer and the effect of relieving pain of patients.MethodsRetrospective analysis of clinical data of patients with bone pain in April 2010 to May 2016 year in our hospital for treatment of prostate cancer, according to their treatment divided into control group and observation group, the control group was 40 cases given docetaxel treatment, the observation group was 30 cases treated with mitoxantrone.Compared the pain relief, sleep quality, tumor markers and the incidence of adverse reactions of the two groups.ResultsAfter treatment, the observation group pain control rate was 96.67%, significantly higher than the control group, the difference was statistically significant (P<0.05);the observation group sleep quality was significantly better than the control group, the difference was statistically significant (P<0.05);the observation group cPSA and CEA were lower than those of control group, the difference was statistically significant (P<0.05).Two groups of patients with bone marrow suppression, nausea and vomiting, rash and liquid retention rate had no significant difference (χ2=0.648, P=0.421).ConclusionMitoxantrone has better therapeutic effect on prostate cancer, can significantly relieve the situation and quality of sleep in patients with bone pain.

Objective To investigate the effect of the treatment of prostatitis and NIH-CPSI score and clinical therapeutic effect of prostate cancer treated with prostaglandin E and alpha blockers.MethodsThe clinical data of patients with prostatitis treated in The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from March 2015 to August 2016 in were retrospectively analyzed.The patients were divided into control group and observation group.The control group was treated with the treatment of the first aid, while the observation group was treated with the combination of the first and the second.The therapeutic effects of the two groups were observed and compared between the two groups before and after treatment NIH-CPSI score, prostate fluid routine, cytokine levels and adverse reactions.ResultsIn the observation group, the treatment efficiency was 97.78%, significantly higher than the control group (85%), the difference was statistically significant (χ2=4.575, P=0.032);Two groups of patients before treatment NIH-CPSI score no difference, after treatment, the observation group of pain or discomfort, voiding symptoms, quality of life and total score were lower than the control group(P<0.05);Two groups of patients before treatment, no difference in the prostatic fluid, after treatment, the observation group was higher than the control group, the number of white blood cells was lower than the control group(P<0.05);There was no difference in the levels of cytokines before and after treatment in the two groups.After treatment, the levels of TNF-α, IL-6 in the observation group were lower than those in the control group(P<0.05).There were no obvious adverse reactions such as liver and kidney injury during the treatment of two groups of patients.ConclusionThe treatment of prostatitis combined with alpha blocker has good therapeutic effect, can significantly improve the clinical symptoms, and has good application value.

Objective To summarize our experience in microsurgical treatment of dumbbell tumors. Methods The clinical features,surgical approaches,operative techniques and surgical results of 21 cases of dumbbell tumors were analyzed retrospectively.Four surgical approaches were adopted according to the size and location of tumors,including,posterior midline approach(in 7 cases),modified far lateral approach(in 5 cases),posterior midline supplied by anterior cervical approach(in 2 cases)and paramidline approach(in 7 cases). Results In this series,10 cases of tumors were situated in the cervical,6 in thoracic,4 in lumbar and 1 in sacral segment of the spine.Total removal were achieved in 95% (20/21),and subtotal removal in 5%(1/21).Postoperative pathological diagnosis revealed 15 neurinomas,5 spinal meningiomas and 1 metastatic adenocarcinoma.14 cases of meningiomas and 1 metastatic adenocarcinoma were followed up for 1 to 48 months.11 of the 14 patients recovered completely,with 3 of them living daily life independently,4 maintainly radical hypoesthesia,and one having decubital ulcer unhealed.No postoperative malformation and dysfunction of the disposed spine occurred in these patients.Magnetic resonance imaging scans in 11 of the 14 follow-up cases revealed no tumor recurrence,of which inhanced MRI scans were performed in 8 cases. Conclusions dumbbell tumors should be treated by one-stage operation.Microsurgical technique could improve the rate of total removal,and decrease postoperative complications.

With the progress of the medical imaging technology,imaging medicine plays an essential role in medical treatment practice,primarily including the imaging equipment and personnel cultivation。This paper presents some opinions on how to combine imaging technology with personnel and bring modern imaging medicine into full play. Imaging medicine progress is also changing our thought on the diagnosis and treatment,and we should accept new technology and adopt new idea,so as to bring many patients new hope.

Diabetes mellitus has become the third threaten diseases second only to cardiovascular disease and tumor.Many re-searches demonstrated that the microRNAs(miRNAs)in blood related to the occurrence and development of diabetes melli-tus.Because of the non-invasion and repeatability of circulating miRNAs,the circulating miRNAs have a broad application prospect of diagnosis and prognosis evaluation for various types of diabetes.This overview arms to introduce the source and characters of circulating miRNA,and also the progress of circulating miRNA related to diabetes mellitus,so as to lay a foun-dation for further research.