OBJECTIVE:To explore the role of clinical pharmacists in the treatment of critical patients at perinatal stage. METHODS:During the treatment process of 4 critical patients at perinatal stage,according to the patients'special pathophysiolog-ic status (such as urea cycle disorder,dyslipidemia,severe infection,can not recover circulating blood volume rapidly,etc.), weighing the order of priority,based on relevant guidelines and literatures,clinical pharmacists provided individual medication ad-vices in respects of drug selection,medication timing,treatment course,drug combination and dosage adjustment,such as using cefuroxime,reduced glutathione,ursodesoxycholic acid,etc.,stopping drugs timely or adjusting antibiotics therapy plan. They al-so provided pharmaceutical care as lab index determination and ADR monitoring. RESULTS:Physicians adopted clinical pharma-cists'advices,and then 4 critical patients were all recovered. CONCLUSIONS:During the treatment course of critical patients at perinatal stage,clinical pharmacists should select safe and effective drugs as much as possible and adjust therapy plan in time ac-cording to clinical symptoms. When the security runs counter to effectiveness,clinical pharmacists should fully weigh the advantag-es and disadvantages and guarantee the maximum safety of pregnant or delivery women and fetuses.

Objective To understand the status quo of the prevention and treatment of hepatitis B in rural area ,to analyze the shortages in prevention and treatment strategy ,to explore the corresponding prevention countermeasures and to provide the scientif‐ic basis .Methods The inhabitants were randomly sampled from 6 natural villages in the rural area of Zhangjiakou as the research subjects .The venous blood HBsAg and HBsAb were detected .The respondents were divided into 2 groups according to the distance of residence place from cities and towns .The distribution differences of HBsAg and HBsAb were compared among different age groups for analyzing the influence of age and public health conditions on the HBV control effects .Results The HBsAg positive rate averaged 5 .92% and the HbsAb positive rate averaged 33 .73% ,with the age increase ,the HBsAg positive rate showed the increas‐ing trend and the anti‐HBsAb showed the decreasing trend ;the anti‐HBsAb positive rate in the inhabitants aged under 15 years near town was higher than those far from town .Conclusion It is needed to increase the input and support intensity to the rural areas in the aspects of finance and manpower ,improve the public health conditions of the rural area with the planned immunity as the main thing ,enlarge the hepatitis B vaccine inoculation range ,strengthen the publicity of HBV harm ,prevention and treatment knowledge , increase the neonatal hepatitis B vaccine inoculation rate and the 24 h timely inoculation rate of hepatitis B vaccine ,accomplish the immune blocking in pregnant women with HBsAg positive ,and preventing the HBV communication during feeding process in in‐fants .

Objective To investigate the clinical value of miRNA-34a,miRNA-34c,and miRNA-135a in the early diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD).Methods The patients were collected in the outpatient and inpatient of Neurology during Aug 2014 to May 2016.The levels of miRNA-34a,miRNA-34c,an dmiRNA-135a were detected with quantitative real-time polymerase chain reaction (qRT-PCR).Results AD patients had higher level of miRNA-34a than the controls.The levels of miRNA-34c were higher in MCI and AD patients,while lower levels of miRNA-135a compared to the controls.Conclusions The miRNA 34a and miRNA-135a were likely to became the biomarker in early diagnosis of MCI and AD.

Quantum dots (QDs) are nanometer-sized luminescent semiconductor nanocrystals. Their unique optical properties, such as high brightness, long-term stability, simultaneous detection of multiple signals and tunable emission spectra, make them appealing as potential diagnostic and therapeutic systems in oncology. Preparing the functional QDs by modifying bio-molecules such as antibody will have potential value for cancer diagnosis and treatment. This paper summarized the recent progress of promising application of QDs in cancer diagnosis and therapy, from identifying molecular targets, to drug delivery and therapy; from limitations of toxicity issues related to QDs in living organisms to multifunctional design and development. Finally, the promising applications of QDs are also discussed.
Animals ; Diagnostic Imaging ; trends ; Drug Delivery Systems ; trends ; Humans ; Nanomedicine ; methods ; Nanoparticles ; therapeutic use ; Neoplasms ; diagnosis ; therapy ; Quantum Dots

Objective To investigate the effect of mitogen-activated protein kinases (MAPKs) activation on the heat stressinduced apoptosis of pulmonary microvascular endothelial cells (PMVECs).Methods A mouse model of severe heat stroke was made and TUNEL and immunohistochemistry were employed to detect lung tissue damage.MACS separation was used for isolation of neonatal PMVECs,and TUNEL was utilized to detect the apoptosis of PMVECs.Western blotting was used for determining the MAPKs activation during heat stress recovery (0,2,6h).The monolayer permeability of endothelial cells was detected in terms of transmembrane resistance (TEER) and horseradish peroxidase (HRP).Cells were pretreated with MAPKs activation inhibitors to examine the effect of heat stress on the monolayer cell permeability and apoptosis.Results In mice with severe heat stroke,extensive apoptosis of PMVECs was found in their pulmonary tissues.TUNEL revealed that the number of apoptotic cells increased over time during heat stress recovery period and heat stress could activate MAPKs in PMVECs.Compared with heat stress group,in the cells pretreated with p38 or ERK activation inhibitor PD98059 and SB203580,the monolayer permeability and apoptosis increased while in cells pretreated withJNK inhibitor SP600125,the cellular permeability and apoptosis decreased.Conclusion In mice with severe heat stoke,PMVECs might experience apoptosis and p38 and ERK could inhibit apoptosis while JNK could promote apoptosis.

Objective To investigate the clinical efficacy of modified cistanche decoction combined with lactulose oral liquid in the treatment of patients with constipation -type irritable bowel syndrome ,and to observe its effect on improving the quality of life of patients.Methods From June 2013 to June 2016,the clinical diagnosis and treatment of 76 patients with constipation-predominant irritable bowel syndrome in the People's Hospital of Qingyuan County were retrospectively analyzed.Among them,lactulose oral liquid was used in the control group.On the basis of the control group,cistanche soup was given in the treatment group ,the control group and the treatment group had 38 cases.The clinical effects,adverse reactions were analyzed ,and before and after treatment ,TCM syndrome score and quality of life score were recorded.Results After treatment,the TCM syndrome scores of the treatment group were significantly lower than those of the control group (t＝2.87,3.17,2.68,3.75,4.27,3.83,5.02,4.40,2.48, P＝0.00,0.00,0.00,0.00,0.00,0.00,0.00,0.00,0.01),the quality of life dimensions scores of the treatment group were significantly higher than those of the control group (t＝3.10,3.44,3.36,3.58,4.51,3.32,2.95,2.89, P＝0.00,0.00,0.00,0.00,0.00,0.00,0.00,0.00).However,after treatment,the scores of TCM syndromes in both two groups were significantly lower than those before treatment ( control group:t ＝4.28,5.11,4.07,6.38,5.06, 2.11,7.32,4.38,20.22,P＝0.00,0.00,0.00,0.00,0.00,0.00,0.04,0.00,0.00;treatment group:t ＝7.81, 9.86,7.68,13.76,9.31,6.57,14.639.62,7.36,P＝0.00,0.00,0.00,0.00).The scores of all dimensions of life quality were significantly higher than those before treatment (control group:t＝2.85,3.59,2.58,2.60,4.01,4.88, 3.05,2.36,P＝0.00,0.00,0.01,0.01,0.00,0.00,0.00,0.02;treatment group:t＝5.57,6.72,6.60,6.40,7.74, 7.63,5.84,6.30,P＝0.00,0.00,0.00,0.00,0.00,0.00,0.00,0.00).The total effective rate of the treatment group was 86.84%,which was significantly higher than 65.79% of the control group(χ2＝7.13,P＝0.02).There were no significant adverse reactions during treatment.Conclusion Cistanche decoction combined with lactulose oral solution for constipation -irritable bowel syndrome patients has significant effect ,and can help to improve the quality of life of patients.

Objective:To observe the motor capacity of patients early after cardiac surgery using a cardiopulmonary exercise test.Methods:Patients who had performed a cardiopulmonary exercise test within 3 months after cardiac surgery were included in this retrospective study. Patients who took the test within 30 days of the operation formed a discharge group ( n=20), those within 30 to 60 days and 60 to 90 days formed the one month and two month groups ( n=10 for both). The discharge group was further divided into an aortic surgery group ( n=9), a bypass surgery group ( n=6) and a valve surgery group ( n=5) according to their procedure. The exercise capacity of each person was measured in terms of the changes in heart rate and systolic pressure from the resting to the anaerobic threshold stage. Anaerobic threshold, peak oxygen uptake and carbon dioxide ventilation equivalent were also recorded. Results:All of the patients completed the cardiopulmonary exercise test above the anaerobic threshold, and no adverse events such as exercise accidents occurred. At the anaerobic threshold the average heart rate of the discharge group was (8.8±7.1)bpm, significantly lower than the averages of the one month and two months groups: (17.0±5.9) and (18.3±10.5)bpm respectively. The average anaerobic thresholds and peak oxygen uptakes of the 1 month and 2 months groups were not significantly different, but they were all significantly higher than the discharge group′s averages. There were, however, no significant differences among the groups in the average changes in their systolic pressure and carbon dioxide ventilation equivalent. Moreover, the average anaerobic threshold and peak oxygen uptake of the aortic surgery group and the bypass surgery group were significantly lower than the valve surgery group′s averages.Conclusions:Postoperative motor ability after cardiac surgery improves significantly for at least 30 days. Patients who have received aortic or bypass surgery have significantly lower exercise capacity than those after valve surgery.

Primary liver cancer (liver cancer) is one of the main indications of liver transplantation. However, postoperative recurrence of liver cancer severely affects the long-term clinical efficacy of liver transplantation. Programmed cell death protein 1 (PD-1) is an immunosuppressive molecule. Activation of PD-1/programmed cell death protein-ligand 1 (PD-L1) signaling pathway plays a pivotal role in the immune tolerance of grafts. In recent years, immune checkpoint inhibitor(ICI), such as PD-1/PD-L1 inhibitor, has become one of the effective approaches to treat advanced liver cancer, whereas ICI can be applied in liver transplant recipients is highly controversial, and the efficacy and safety remain to be studied. In this article, the expression of PD-1/PD-L1 in liver allograft tissues, the mechanism of PD-1/PD-L1 inducing transplantation immune tolerance and clinical application of PD-1/PD-L1 inhibitor in liver transplantation for liver cancer were reviewed.

Objective:To analyze the medication rule of treating orthopedics in Tibetan Medicine by data mining, in order to summarize the characteristics and theory of ethnic minorities medicine for treating orthopedics and traumatology.Methods:By collecting the treatment methods of orthopedics and traumatologic diseases in books of Chinese Materia Medica·Tibetan Medicine Volume and Chinese Medical Encyclopedia·Tibetan Medicine to analyze the frequency, cluster and association rules of Tibetan Medicines by using Office Excel 2019, IBM SPSS Statistics 26.0 and IBM SPSS modeler 14.1 respectively. Results:Among the 202 Tibetan Medicine prescriptions of Orthopedic Department, 338 belongs to Chinese medicines. The top 3 Chinese medicines that are frequently appeared are Chebulae Fructus, Inula racemosa Hook.f, and Carthami Flos. The properties of those medicines are mainly cold, warm and cool, and the tastes are mainly pungent, bitter and sweet; the meridians mainly belong to liver, lung, stomach and spleen; The priscriptions mainly cover four kinds of diseases: trauma, arthralgia syndrome, lumbosacral tendon injury, chest and back tendon injury. The four kinds of cluster combinations were obtained. The core Chinese medicines were Chebulae Fructus, Terminaliae Belliricae Fructus, Phyllanthi Fructus, Cassiae Semen, Olibanum, Abelmoschus moschatus, and the common medicine pair were Chebulae Fructus- Terminaliae Belliricae Fructus, Abelmoschus moschatus- Cassiae Semen, Olibanum- Abelmoschus moschatus and so on. Conclusions:Tibetan Medicines treat orthopedics and traumatological diseases with antipyretic medicines as the main yellow water, followed by blood activating, Qi regulating and wind dampness removing medicines. With Sanguo Decoction and Sanhuang water of Tibetan medicine as the core, they are often combined with other antipyretic and blood cooling medicines and bone connecting medicines. Tibetan Medicine pays attention to the application of dry yellow water theory, which reflects the role of the core theory of Qingxie method and yellow water theory of Tibetan Medicine in the diagnosis and treatment of orthopedic and traumatologic diseases.

OBJECTIVEEndogenous hydrophobic bile acids may be a pathogenetic factor of biliary complications after orthotopic liver transplantation (OLT).This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA), when administered early after OLT, on serum liver tests and on the incidence of biliary complications.

METHODSA total of 112 adult patients undergoing OLT were randomly assigned to one of two groups for receipt of UDCA (13 to 15 mg/kg/d for 4 weeks, n=56) or a placebo (n=56). All patients underwent serum liver testing and measurement of serum bile acids during the 4 weeks following OLT.Patients with T-tube underwent measurement of biliary bile acids during the 4 weeks following OLT.Biliary complications, as well as patient and graft survival rates, were analyzed during the follow-up period (mean of 65.6 months).

RESULTSAt post-OLT days 7, 21 and 28, the UDCA-treated patients showed significantly lower levels of alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transpeptidase (all P less than 0.05).In addition, the UDCA-treated patients showed significantly lower incidence of biliary sludge and casts within the first year post-OLT (3.6% vs.14.3%; x2=3.953, P=0.047). However, there were no significant differences for the incidence of other biliary complications at post-OLT years 1, 3 and 5.The graft and patient survival rates were also similar between the two groups.

CONCLUSIONUDCA, when administered early after OLT, improves results from serum liver tests and decreases the incidence of biliary sludge and casts within the first postoperative year.

Alanine Transaminase ; Aspartate Aminotransferases ; Bile ; Bile Acids and Salts ; Biliary Tract Diseases ; drug therapy ; physiopathology ; Humans ; Liver ; physiopathology ; Liver Cirrhosis, Biliary ; Liver Function Tests ; Liver Transplantation ; Postoperative Complications ; physiopathology ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase