OBJECTIVE:To evaluate the effects of pharmaceutical care in PIVAS of our hospital,and to improve the quality and level of pharmaceutical care. METHODS:Combined with the actual situation of our hospital,various measures which had been carried out in PIVAS of our hospital were analyzed retrospectively,and the effects of pharmaceutical care were also analyzed. RESULTS & CONCLUSIONS:Through strengthening safety awareness,formulating effective management system,continuous op-timization process to guarantee the quality of drug dispensing,and focusing on the ability to improve the quality of the team,an ef-fective improvement has gained in the quality of pharmaceutical care. The proportion of irrational medical order of anti-tumor intra-venous drug use has decreased from 0.62% in 2008 to 0.09% in 2012. 1 363 irrational medical orders have been checked out dur-ing Jul.-Dec. of 2014,accounting for 0.39% in total. The satisfactory degree of clinical staff has increased from 80.0% to 98.5%. PIVAS has a positive role in promoting pharmaceutical care.

OBJECTIVE:To study the influence of oscillator on the cleanliness of class 100 clean bench in PIVAS. METH-ODS:Using sedimentated bacteria and the number of dust particle as index,in common drug configuration room,antibiotics con-figuration room and risk drugs configuration room including biological safety cabinet and horizontal laminar flow,the cleanliness of class 100 clean bench were monitored when oscillator was set at clean bench and different positions in work and non-working state. RESULTS & CONCLUSIONS:In working and non-working state of oscillator,there was no difference in sedimentated bacteria and the number of dust particle which was in line with the requirements of 2010 edition of GMP,i.e. the application and location of oscillator didn't influence the cleanliness of class 100 clean bench. From a view of safety,it is suggested to place the oscillator in the left(or right)posterior wall of clean table when biological safety cabinets is used to dispense antibiotic and risk drugs.

Objective To verify the feasibility of eryoablation on rabbit brain tumor under interventional MRI guidance.Methods The procedures were performed under general anaesthesia.Twenty-two New Zealand white rabbit'S brains were inoculated with VX,tumor tissue through cranial holes. MR-guided cryoablation were conducted as preliminary experiment when diameter of brain tumor grew up to 0.8 cm in size.Cryoablation lasted two cycles of 5 minutes freezing, in 2 rabbits.and of 10 minutes freezing in another 2 rabbits.After procedure and MR scanning.rabbits were executed.Specimens of rabbit'S brain showed complete necrosis pathologically after cryoablation of cycles of 10 minutes freezing.The optimal parameters of eryoablation were defined.Except for the two rabbits that died of infection,the other 16 rabbits were divided into control group and therapeutic group.According to the optimal parameters of cryoablation,cryoablation of 10 minutes freezing were performed for rabbit brain tumors in therapeutic group.Venous injeetion of 20%mannitol and subcutaneous injection of dexamethasone were used for dehydration.None of rabbit brain tumors in the control group were treated.After cryoablation,MRI scanning Was performed immediately,7 days later,14 days later and 60 days later,to observe the ablative area and the pathologic changes.The survival time wag recorded.Resuits Brain tumors could be found in all New Zealand white rabbits after inoculation except two died of inflammation.The maximum diameter of brain tumors Was from 0.7 to 1.0 elEL The tumors showed slight low signal on T1WI and slight high signal on T2WI as well as comrast enhancement after injection of Gd-DTPA.Pathologically coagulative necrosis were observed after cryoablation immediately,7 days and 14 days later,and liquefactive necrosis was found 60 days later.The correlation between MRI and pathologic appearance of tmnors are consistent.The therapeutic area ranged from 1.0 to 1.5 em.,The maximium diameter of ice ball ranged from 1.5 to 2.0 cm Conclusion CiToablation for brain tumor iS a safe and feasible therapy.

Objective To evaluate the clinical feasibility of grading of ureteral stricture in renal allograft.Methods The clinical data of 9 case of ureteral stricture after renal transplantion from February 2015 to September 2015 were retrospectively analyzed and relative articles were reviewed to evaluate the significance of ureteral stricture grading.The diagnosis of ureteral stenosis was made by serum creatinine elevation,ultrasound of allograft kidneys and presence of stricture on a pyelogram.Grade 1 ureteral stenosis was defined as graft function deterioration with presence of hydronephrosis on ultrasound,but no obvious stricture identified on a pyelogranm.Grade 2 was defined as serum creatinine elevation,presence of hydronephrosis on ultrasound,and a focal (＜1 cm) distal ureteral stricture at the ureteral anastomotic site on a pyelogram.Grade 3 was defined as serum creatinine elevation,hydronephrosis on ultrasound,and a long segment (＞1 cm) distal ureteral stricture extending to proximal ureter or pelvis on pyelogram.Results One case,6 cases and 2 cases were classified to grade 1,2 (stricture length ＜1 cm) and 3 (＞1 cm),respectively.One case of grade 1,6 cases of grade 2 and 1 case of grade 3 were successfully dilated by balloon dilation catheter and endoureterotomy.One case of grade 3 was converted to open reconstructive surgery.Surgery success rate of grade 1 and 2 was 100％ (7/7) and 100％ (6/6) 6 and 9 months after surgery,respectively.Ureteral stenosis did not recur in one case of grade 1 and 6 cases of grade 2 during a follow-up period of 12 months after surgery.However,one case of grade 3 reoccurred 6 months after surgery,and reoperation was performed and there was no recurrence up to now (10 months).Conclusion Wuzhi tablet acted as an effective agent that makes rifampicin containing anti-tuberculosis chemotherapy possible and safe by stabilizing blood concentration of tacrolimus in post-renal transplant tuberculosis patients,which also reduced the dosage of tacrolimus as well as the risk of acute rejection greatly.

In this paper, We designed and accomplished a low frequency pulsed strong magnetic fields generator, which provides a pulsed magnetic field with the intensity range from 0.1-2.5 T and the adjusted time interval of pulse. This device is easy to operate and performs reliably. It can work steady for a long time and has been successful used in the experiments of biological effects of electromagnetics.
Electromagnetic Phenomena ; instrumentation ; Equipment Design ; Software Design

Objective To analyze the risk factors and pathogen distribution of ventilator-associated pneumonia (VAP) in patients following coronary artery bypass grafting (CABG).Methods The clinical data of 1414 patients undergoing CABG in Teda International Cardiovascular Hospital from June 2014 to June 2016 were retrospectively analyzed .The VAP developed following CABG in 42 patients ( VAP group ) and not occurred in 1372 patients ( non-VAP group) .Multivariate logistic regression was used to analyze the risk factors of VAP in patients after CABG , and the microbial culture and drug sensitivity test were performed in VAP patients.Results The incidence rate of VAP after CABG was 2.97％ (42/1414).Multivariate logistic regression analysis showed that history of smoking ( OR =2.216, 95％ CI 1.018 -4.825, P <0.05), mechanical ventilation time >48 h (OR=7.457, 95％ CI 3.443-16.161, P<0.01), LVEF<40％(OR=3.524 , 95％ CI 1.203-10.325, P<0.05) and postoperative acute kidney injury (OR=16.239, 95％ CI 7.551 -34.924, P <0.01) were independent risk factors for VAP in patients after CABG.A total of 42 pathogen strains were detected in 42 patients with VAP, including 37 strains of Gram-negative bacteria, 2 strains of Gram-positive bacteria, and 3 strains of fungus.Gram-negative bacteria mainly were Klebsiella pneumoniae subspecies ( n =23, 54.76％) and Burkholderia cepacia ( n =6, 14.27％);the Gram-positive bacteria were Staphylococcus aureus ( n =2, 4.76％);the fungus was Candida albicans ( n =3, 7.14％).Klebsiella pneumoniae was sensitive to many antibiotics;and the resistance rate to amikacin , aztreonam , meropenem , and levofloxacin was <10％, the resistance rate to ceftazidime and piperacillin was <25％. Burkholderia cepacia was naturally resistant to amikacin , ampicillin, aztreonam, cefazolin, gentamicin and sulfamethoxazole .Conclusion The incidence of VAP was higher in patients after CABG , and the involved pathogens were mainly Gram-negative bacteria .Clinically , it is necessary to take necessary measures to prevent and treat VAP in order to improve the prognosis of patients undergoing CABG .

Objective:To investigate the clinical features of diagnosis and treatment of renal parenchymal invasive urothelial carcinoma.Methods:The clinical data of 23 patients with renal parenchymal invasive urothelial carcinoma admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2014 to December 2020 were retrospectively analyzed. There were 12 males and 11 females. The mean age was (67.3±10.1) years old. Among them, 7 cases complained of painless hematuria and 9 cases were asymptomatic. Three cases underwent preoperative MRI examination, 19 patients underwent preoperative enhanced CT examination, and 1 patient underwent both MRI and enhanced CT examination. MRI examination showed renal lobulated and other T1 mixed with T2 signals, the boundary was not clear, and DWI showed obvious restricted diffusion. The tumor was located on the left side in 15 cases and on the right side in 8 cases. Preoperative diagnosis was made by fine needle aspiration biopsy in 1 patient, and specimens were obtained by flexible ureteroscope in 2 patients. No tumor was reported. The preoperative diagnosis of 22 patients was unclear and the nature of the tumor could not be determined. One patient was considered to have urothelial carcinoma by fine needle aspiration. All patients were treated by surgery, including 20 cases of laparoscopic radical nephrectomy and 3 cases of nephroureterectomy with bladder sleeve resection.Results:Postoperative pathological specimens showed yellow-white mass, high-grade invasive urothelial carcinoma invading renal parenchyma. Nine cases were T 3a stage, 14 cases were T 3b stage, and 5 cases were lymph node metastasis. The average postoperative follow-up time was (18.6±6.72)months, 2 patients were lost to follow-up, 8 patients died, and the overall mortality rate was 38.1%. Seven patients died of recurrence or metastasis. There were 3 cases of bladder recurrence and 5 cases of metastasis after operation. Conclusions:Renal parenchymal infiltrating urothelial carcinoma is difficult to diagnose in the early stage, with poor clinical biological behavior and poor overall prognosis. For patients diagnosed with renal parenchymal invasive urothelial carcinoma preoperatively, laparoscopic nephroureterectomy + bladder sleeve resection is recommended.

Objective:To explore the clinical application value of vector flow mapping (VFM) in assessment of early cardiac dysfunction in aortic stenosis (AS) patients with normal left ventricular ejection fraction (LVEF).Methods:The clinical study consisted of 37 patients with various degrees of AS (LVEF>50%) from October 2015 to February 2017 in Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, including 16 mild to moderate ones (AS1 group ) and 21 severe ones ( AS2 group ). A group of 35 age- and gender-matched healthy volunteers were selected as control group. Using Hitachi Aloka Prosound F75 color Doppler ultrasound diagnostic system, general two-dimensional parameters of left ventricular structure and function were measured. Furthermore, standard dynamic apical long axis view color Doppler flow images during 3 completed cardiac cycles were acquired for DAS-RS1 off-line workstation.Based on time-flow curve(T-F curve) of left ventricle, ECG, and the open-close of valves, the diastole period of left ventricle was divided into the isovolumic relaxation phase(P1), rapid filling phase(P2), slow filling phase(P3), atria contract phase (P4), and total diastolic phase(P0); the systole period was divided into isovolumetric contraction phase (P5), rapid ejecting phase(P6), slow ejecting phase(P7), and total systolic phase(P8). The left ventricular energy loss (EL) of three groups were acquired in all phases.Results:Left ventricular EL: ①Three peaks of EL appeared in P2, P4 and P6 respectively and total diastolic EL was almost equal to systolic. ②Compared with control group, the EL values of AS1 group increased in all phases, but only in P4, P7 and P0 with significant differences ( P<0.05). ③Compared with the other two groups, the EL values in AS2 group increased significantly in all phases of AS2 group ( P<0.01). Correlation analysis: ①For control group and AS group, there were both significant positive correlations between P0-EL, P8-EL and LVMI ( r=0.561, 0.585; 0.635, 0.652 respectively; P<0.01). ②There were both significant positive correlations between P2-EL and E, e′( r=0.623, 0.537; 0.576, 0.502 respectively; P<0.01), while P4-EL and A( r=0.482, 0.555, P<0.01). ③There were both significant positive correlations between P0-EL, P8-EL and E/e′( r=0.480, 0.459; 0.673, 0.590 respectively; P<0.01) and negative correlations between P0-EL, P8-EL and LVEF ( r=-0.537, -0.596; -0.569, -0.625 respectively; P<0.01). Conclusions:Quantitative evaluation of left ventricular EL by VFM technique is expected to provide a sensitive indicator for evaluating the cardiac structure and functional status in AS patients with normal LVEF.