OBJECTIVE:To explore the intervention effects by clinical pharmacist on the use of antibacterials during periopera-tive period of hysteroscopic surgery. METHODS:250 medical records of hysteroscopic surgery were collected from July to Septem-ber in 2014(before intervention)and from October to December in 2014(after intervention). The rationality of antibacterials dur-ing perioperative period was retrospectively analyzed before and after intervention. RESULTS:After intervention by clinical pharma-cists,the antibacterial use density decreased from 47.02 DDDs/(100 persons·day)to 23.30 DDDs/(100 persons·day),and the rate of perioperative use of antibacterial decreased from 82.40% to 57.20%,with significant difference(P<0.01). The rationality of medication indicators for perioperative application of antibacterials for hysteroscope increased from 56.80%to 82.52%;the rational-ity of medication duration increased from 49.51% to 79.02%,with significant difference(P<0.05). CONCLUSIONS:Clinical pharmacist's intervention is effective and feasible to perioperative application of antibacterials for hysteroscopic surgery. It could ef-fectively promote the rational use of antibacterials.

Objective To explore the pharmacokinetics and tissue distribution in rats with a single dose by orally administra‐tion of moxifloxacin .Methods Totally 60 rats were equally divided into 10 groups with orally administration moxifloxacin for 50 mg/kg .The lungs ,uterus ,ovaries (tube) ,kidney ,ureter and bladder tissues were collected at different time points (before give med‐icine and after 0 .25 ,0 .50 ,1 .00 ,2 .00 ,3 .00 ,4 .00 ,6 .00 ,8 .00 ,12 .00 ,24 .00 h) .The concentrations of moxifloxacin in tissues were determined by the established HPLC method and the pharmacokinetic parameters were calculated by 3p97 .Results The established HPLC methods had good specificities ,and the linear range was between 0 .001 6-50 .000 0μg/mL for tissue sample .T1/2βof moxi‐floxacin were (13 .65 ± 3 .56) ,(12 .64 ± 2 .86) ,(13 .27 ± 3 .51) ,(13 .47 ± 3 .29) ,(14 .78 ± 2 .64) ,(11 .56 ± 1 .58)h in lung ,uterus , ureterine adnexa ,kidney ,ureter and bladder ;Cmax of moxifloxac in various tissues were (15 .61 ± 3 .58) ,(12 .48 ± 4 .57) ,(16 .18 ± 4 .21) ,(12 .65 ± 3 .17) ,(26 .68 ± 7 .42) ,(1 .13 ± 0 .58)μg/mL ;Tmax of moxifloxac in above tissues were (3 .15 ± 1 .24) ,(2 .66 ± 1 .74) ,(2 .97 ± 1 .65) ,(2 .58 ± 1 .36) ,(3 .47 ± 1 .84) ,(2 .46 ± 1 .87)h;AUC0 -t of moxifloxac in above tissues were (87 .2 ± 5 .41) , (70 .89 ± 4 .56) ,(92 .41 ± 7 .65) ,(88 .26 ± 6 .94) ,(170 .59 ± 21 .48) ,(14 .57 ± 5 .47)μg · h-1 · mL -1 .Conclusion Moxifloxacin had a higher concentration in ureterine adnexa and ureter by orally administration with single dose ,and it can maintain for a long time .

ObjectiveTo evaluate central compartment lymph node metastasis in cN0 papillary thyroid carcinoma(PTC) patients. MethodsThe clinical data of 166 cN0 PTC patients was retrospectively analyzed. ResultsThe central compartment lymph node metastasis rate of age ＜ 45 years group was higher than the group of age≥45 years(39％ vs.22％,P ＜0.05).Tumor size ＞0.5 cm tends to metastasize more often than tumor size ≤0.5 cm(P ＜0.05) ; there was significantly difference in central compartment lymph node metastasis rate between upper pole tumor ( 25％,12/48 ) and middle ( 45％,13/29 ) or lower pole (43％,31/72),P ＜ 0.01. ConclusionscN0 PTC patients with tumor located in middle pole or lower pole,tumor size ＞ 0.5 cm or age ＜ 45 years are at higher risks for central compartment lymph node metastasis.

Oncogene Pim-1 has a close relationship with the occurrence and development of several tumours.It is involved in a number of signal transduction pathways and regulates the expression of the downstream biological factors or acts synergistically with other oncogenes.Pim-1 plays an important role in the clinical diagnosis,treatment and prognosis of some tumors,and provides a new potential target in the chemotherapy of tumors.Recently,Pim-1-targeting treatment strategy has be a research hotspot and it would be used for cancer clinical treatment hopefully.

Objective:To investigate the expressions of P53and nm23 proteins in cancer tissue of patients with oral squamous cell carcinoma.Methods:There were 57 males and 43 females,ranging in age from 35 to 75 years old.The clinical stages were T1 10,T2 29,T3 56 and T4 5;pathologic classifications were high differentiation in 74,medial and low differentiation in 26;lymph node metastasis in 56,no metastasis in 44.The expressions of P53 and nm23 proteins were detected by immunohistochemical technique.Results:The expressions rates of P53and nm23 proteins were 58.0%(58/100) and 40.0%(40/100) respectively (P＜0.05)in cancer tissue of patients with oral squamous cell carcinoma.The expressions rates of P53and nm23 were 71.5%(40/56)and 28.6%(16/56)in group of patients with node lymph node metastasis;40.9%(18/44)and 54.5%(24/44) in group of patients with negative metastasis respectively.Conclusion:Lymph node metastasis might be correlated with high level expression of P53 protein and low level expression of nm23 protein in patients of oral squamous cell carcinoma.

OBJECTIVE:To provide reference for the clinical rational application and preventing the adverse reactions of hy-droxyethyl starch(HES). METHODS:The HES application of inpatients in a hospital in Jul. 2014 were retrospectively analyzed, the usage and dosage,indications,and the changes of renal functions and blood coagulation function before and after HES treat-ment were detected,and the application rationality was evaluated. RESULTS:The usage of HES in the hospital was hydroxyethyl starch 200/0.5 and Sodium chloride injection,which was the second generation of HES. In the 347 patients,295 patients had moni-tored the renal functions before the HES treatment,the result was normal;and 21 patients had monitored the renal functions after HES treatment,the result was normal. Meanwhile,326 patients had monitored the blood coagulation functions before and after HES treatment,the results were normal. HES was not used for the patient of severe sepsis,renal dysfunctions and coagulopathy in this hospital. CONCLUSIONS:The application of HES can induce renal damage and coagulation disorder,so relevant indicators should be closely monitored before and after treatment to prevent the incidence of adverse reactions;further more,clinicians should strictly handle indications,usage and dosage and precautions during the clinical application;in addition,it is suggested to replace the second generation of HES by the third generation,which is more safer.

Objective To explore the clinical value of using pectoralis major myocutaneous flap in surgery with various adverse factors for advanced oropharyngeal cancer.Methods 15 patients who presented with advanced oropharyngeal cancer were performed for radical surgery,and pectoralis major myocutaneous flaps were applied for immediate reconstruction of surgical defect.In all cases,various adverse factors(advanced age,diabetes,cardiovascular disease,radiation damage,etc.)were existed.The effect of reconstruction was observed.Results All surgeries were successful,and all patients tided over perioperative period.The average time of operation was 5 hours with a range of 4 to 6 hours.The average time cost for flap preparation was 40 minutes with a range of 40 to 55 minutes.The completely survival rate of flaps was 93%.Partial skin necrosis occurred in 1 case(7%);and submandibular fistula occurred in another one(7%).Two patients(13%)developed wound infection.All of them were healed by symptom-atic treatment.Conclusion For the patients with advanced oropharyngeal cancer and various adverse factors of sur-gery,pectoralis major myocutaneous flap can be used as salvage measure in reconstruction of surgical defect,which is more secure than free flap.

AIM:To observe the expression of chemokine fractalkine,and its receptor,CX3CR1,in kidneys of lupus-prone BXSB mice,and their changes after treatment with prednisone. The role of fractalkine and CX3CR1 in the pathogenesis of lupus nephritis was also discussed. METHODS:Twelve 12-week-old male BXSB mice were randomly divided into two groups,the prednisone treatment group (BXSB-prednisone group,n=6) and the experimental control group (BXSB group,n=6). Six male C57BL/6J mice at the same weeks of age served as a normal control group (C57BL/6J group). Both the C57BL/6J and the BXSB group of mice received a daily intragastric administration of 0.5 mL normal saline. The BXSB-prednisone group of mice was given a daily intragastric administration of prednisone (0.18 mg/20 g BW) dissolved in 0.5 mL normal saline. All treatments lasted for 10 weeks. The mRNA and protein expressions of fractalkine and CX3CR1 in kidneys of mice were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analysis respectively. The changes of laboratory index and the kidney histopathology of mice were also investigated. RESULTS:The mRNA and protein expressions of fractalkine and CX3CR1 in kidneys of BXSB mice were significantly higher than those in C57BL/6J mice. The expressions of fractalkine and CX3CR1 in BXSB-prednisone group of mice were much lower than those in BXSB group of mice,accompanied by the lower serum IgG,IgM and anti-dsDNA antibody levels as well as blood urea nitrogen,serum creatinine and urine protein. The glomerular immune complex deposition and the kidney histopathology were also significantly improved in BXSB-prednisone group of mice. CONCLUSION:These results indicate that fractalkine and CX3CR1 participate in the pathogenesis of lupus nephritis in BXSB mice,and the effect of glucocorticoids treatment may be attributed,in part,to its ability to inhibit the expression of fractalkine in kidney.

Objective To evaluate the value of 99Tcm-MDP uptake by left femoral neck for diagnosing osteopomsis.Methods A total of 58 cases (23 males,35 females,mean age:(66.15±8.45) years) with spondyloarthmpathies from May to December of 2012 were selected.Serum concentrations of type Ⅰ collagen telopeptide (sCTX-1) and bone ALP (BALP) were determined.All patients underwent dual-energy X-ray absorptiometry (DXA) to detect bone mineral density (BMD).According to the T scores,patients were divided into 2 groups:normal group (NG) (T＞-1.0) and osteoporosis group (OG) (T≤-2.5).99TcmMDP bone scan was further performed.The average radioactive ratio of the left femoral neck to the medial soft tissue of left femur (T/N) was measured.Data differences between the 2 groups were compared by twosample t test and Pearson correlation analysis.Results According to BMD,13 patients (7 males,6 females) were included in NG and 28 patients (10 males,18 females) were included in OG.The mean ages of OG and NG were significantly different ((68.82± 10.41) years vs (62.46± 11.77) years; t =3.560,P＜0.05).The BMD of left femoral neck in OG was significantly lower than that in NG ((0.67±0.08) g/cm2 vs (0.91±0.10) g/cm2 ; t=9.917,P＜0.01).Although BALP level of OG was significantly higher than that of NG ((35.92±11.58) U/L vs (22.38±6.34) U/L; t=-3.397,P＜0.05),no significant difference was observed on sCTX-1 between the 2 groups (t=-0.463,P＞0.05).T/N ratio of OG (11.63±6.22) was higher than that of NG (9.74±4.44) (t =-3.027,P＜ 0.05).There were significant correlations between the T/N ratio of the left femoral neck and the sCTX-1 and BALP concentrations (r=0.376,0.483,both P＜0.01).No correlations between the T/N ratio of the left femoral neck and age,BMI and BMD were observed (r=-2.031,-0.017,0.134,all P＞0.05).Conclusion The uptake ratio of the left femoral neck in 99Tcm-MDP bone scan could evaluate the metabolism of bone,and it is useful for the early diagnosis of osteoporosis.

Objective To investigate the preventative effect of perioperative intervention to lower extremity deep venous thrombosis (DVT) after gynecologic surgery. Methods The 1062 patients, who received gynecologic surgery during 2007 June to 2008 June, were derided into intervention and nonintervention groups randomizely. According to the risk factors of DVT, the patients in intervention group were divided into 4 subgroups: low, mid, high and extremely high rise Each group had its own preventive measures. If patients had spontaneous pain, tenderness and swelling, positivity of Neuhof or Homan syndrome, and extension of one low extremity superficial vein, the low extremity color Doppler ultrasound would be carried out immediately. The ultrasound would also be routinely carried out in the high and extremely high risk groups in intervention group after 2 and 7 days after surgery. A prospective study was carried out investigating incidence of DVT and coagulation function perioperation. The vein blood samples were taken at in a week before surgery and 48 hours post-operation. Results The incidence of DVT of intervention group was 1.10% (6/546), and in nonintervention group, the incidence was 3.29% (17/ 516). There was significant difference between two groups (P<0.05). The incidence of DVT in extremely high risk subgroup was 21.05% (4/19), which was significantly higher than that of low(0), mid(0) and high risk groups[2.13% (2/94), P<0.05]. D-dimer, antithrombin-Ⅲ(AT-Ⅲ) post-operation were all higher than that pre-operation in the two groups, but there was no significant difference (P>0.05). The indexes of coagulation system, such as blood platelet count, prothrombin time (PT), active partial throraboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor(PAI), were not significantly changed perioperation (P>0.05 in all pre-or post-operation indexes). Conclusions Perioperative intervention measurement according to different risk of DVT could cut down the incidence of DVT. DVT preventive intervention is suggested to high and extremely high risk people.