OBJECTIVE:To explore the role of clinical pharmacists participating in the prevention and treatment of sotalol-in-duced QT prolongation in aged patient with heart failure. METHODS:Clinical pharmacists participated in the treatment for a aged patient with heart failure,and assisted physicians to identify and assess the risk of sotalol-induced QT prolongation. According to the clinical symptoms and laboratory indexes,it was suggested to continue to use sotalol for antiarrhythmic,adjust the hepatoprotec-tive drug,given pharmaceutical care of ECG,electrolyte level monitoring,drug education and so on. RESULTS:Physicians adopt-ed the suggestions of clinical pharmacists to relive the illness without malignant arrhythmia and discharged after 11 d. CONCLU-SIONS:The patient with heart failure should be dominated by improving cardiac function and maintaining hemodynamic stability;combined with related guidelines and documentation,clinical pharmacists can assist physicians to identify the drug that induced QT prolongation,asses the risk of torsades de pointes ventricular tachycardia and other bad consequences,develop and optimize the regimen and strengthen pharmaceutical care to ensure the safe and effective treatment.

Management of hospital water supply facilities is key to its logistics management.This paper cited the domestic water supply facilities management as an example, and summed up practical experiences in both JCI certification and review along with the hospital′s fine management of water facilities.On such basis, it described such aspects as the establishment of management system, operation standards and work flow, implementation of preventive maintenance, renovation, emergency protection, inspection supervision, file management and staff training.These efforts provide reference for how to establish the fine management mode of water supply facilities.

ObjectiveTo study the efficacy and safety of early endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy (EST) for patients with acute biliary pancreatitis.Methods420 patients who were admitted to our hospital for management of acute biliary pancreatitis were divided into early endoscopic therapy group (n=218 patients) and conservative therapy group (n=202 patients).The durations for complete disappearance of abdominal pain,decrease in serum and urine amylase levels to normal,liver function recovery time,white blood cell recovery time,and the mean duration and costs of hospitalizations were analyzed.ResultsIn the ERCP group,all patients received EST.The stones in 172 patients with choledocholithiasis were removed with dormia baskets or balloon catheters.In 20 patients with severe acute biliary pancreatitis,endoscopic pancreatic duct stents were inserted for drainage.The durations of complete disappearance of abdominal pain,decrease of serum and urine amylase values to normal,white blood cell recovery time,liver function recovery time,cost of hospitalization and duration of hospitalization were significantly shorter in the early ERCP group than the control group.The mortalities in the ERCP and the control groups were 8.0％ and 22.2％,respectively.Conclusions Early endoscopic management for patients with acute biliary pancreatitis was not only safe and efficacious,but the management helped to identify the underlying causes of pancreatitis and reduced the duration of hospital stay and expenses.

ObjectiveTo evaluate left ventricle partial and global diastolic function in patients with silentmyocardial ischemia (SMI) by Doppler tissue imaging (DTI) combined with dobutamine stress echocardiography(DSE).Methods30 cases of silent myocardial ischemia(SMI) and 30 cases of normal control underwent dobu-tamine stressechocardiography(DSE). DTI was acquired at baseline and stress, and waveforms in mitral valve clos- ing, and the base and mid segments of left ventricle were used to measure diastolic early velocity(Ve), diastolic latelyvelocity(Va) ,and E deceleration time(Te). ResultsⅤ in control group increased accompanied with the increasingdose of dobutamine, Ve/Va decreased a little but not significantly. Ⅴ in the group with silent myocardial ischemia(SMI) increased at 10μg·kg-1·min-1 ,but decreased at 40μg·kg-1·min-1 compared with 10μg·kg-1·min-1 ,T inboth control and DSE group decreased at 40μg/kg accompanied with 10μg·kg-1·min-1, T in both control and DSEgroup decreased accompanied with the increasing dose of dobutamine, and there were significant differences betweenthe groups(P < 0.05). ConclusionDTI-DSE could quantificadvely detect the partial and global diastolic function ofleft ventricle.

Objective To evaluate the utility of CD4+ TCR tetramers‐based flow cytometric analysis and cell climbing slice assay in detecting antigen‐specific CD14+ monocytes in the blood of tuberculosis (TB) patients .Methods CD4+ TCR tetramers were used to detect tetramer‐positive CD14+ monocytes in the peripheral blood (PBL ) samples of inpatients with advanced pulmonary TB (PTB) by flow cytometric analysis .The PBL samples obtained from non‐TB patients and umbilical cords were used as controls .These tetramers were also used to examine tetramer‐bound CD14+ monocytes and Mycobacterium tuberculosis (MTB) antigen‐specific and tetramer‐bound cells by cell climbing slice in situ staining .Results The median percentage of tetramer‐bound CD14+ monocytes in PBL samples from PTB patients ,non‐TB patients and umbilical cords were 1 .32% , 0 .50% and 0 .26% respectively by using CD4+ Vα21‐J39/Vβ29‐D1‐J2 tetramer , while the medians were 1 .05% , 0 .49% and 0 .19% respectively by using CD4+ Vα21‐J39/Vβ29‐D2‐J2 tetramer . The percentage of tetramer‐bound CD14+ monocytes in PTB patients group was significantly higher than the other two control groups .In cell climbing slice in situ staining ,tetramer‐bound CD14+ monocytes ,and MTB antigen‐specific and tetramer‐bound cells were positive in PTB tissue compared with negative in control tissues . Conclusions CD4+ TCR tetramers‐based flow cytometric analysis and cell climbing slice assay could be used to sensitively detect M TB antigen‐specific CD14+ monocytes in the blood of TB patients ,and more accurately evaluate the changing profile and clinical significance of these cells in TB patients .

Aim To investigate the neuroprotective effect of salidroside in MCAO rats. Methods The rats were subjected to middle cerebral artery occlusion with suture-occluded method, and the neurologic injury and infarct size of rats were evaluated. According to the gene chip detected, the protein expressions of caspase-3 , cleaved caspase-3 were determined and the mRNA expressions of IL-6, Vgf, Hba-a2, Hbb-b1, Hbb, CD44, Pnpla2, Slc6a5 and Slc5a7 were tested. Re-sults Compared with MCAO group, salidroside signif-icantly improved the neurological deficit, reduced the infarct sizes, inhibited the expressions of cleaved caspase-3 protein and IL-6 mRNA, promoted the ex-pressions of Vgf, Hba-a2, Hbb-b1, Hbb, and reduced the expressions of CD44 , Pnpla2 , Slc6 a5 and Slc5 a7 . Conclusions Salidroside can reduce the neurological deficit and infarct size, and protect rats against focal cerebral ischemia-reperfusion injury, which may be ac-complished by increasing the expressions of Vgf, Hba-a2, Hbb-b1, and Hbb, and decreasing the expressions of cleaved caspase-3 , IL-6 , CD44 , Pnpla2 , Slc6 a5 and Slc5 a7 .

Objective To establish a method for the determination of berberine and salvianolic acid B in Fuyankang En- ema.Methods The chromatograhie separation was performed on a Kromasil C_(18) column (250 mm?4.6 mm,5?m) with a gradient elution of acetonitrile-0.04 mol/L potassium dihydrogen phosphate solution containing 0.1% phosphoric acid.The flow rate was 1.0 mL/min and column temperature was set at 30℃.The detection wavelength was 230 nm.Results There was a good linearity in the range of 0.0924～2.3100?g (r=0.999 9) for berbeine,and 0.1000～2.5000?g (r=0.999 9) for salvianolic acid B.The average recoveries of berberine at high,middle and low concentra- tions were 100.40 %,99.51% and 99.15 % respectively with RSD being 0.59 %,0.67 %and 1.02 % (n=3) re- spectively.The average recoveries for salvianolic acid B were 101.52 %,99.32 % and 98.68 % respectively with RSD being 0.60 %,0.92 % and 1.00 % (n=3),respectively.Conclusions This method is convenient,specific and re- producible for the determination of berbeine and salvianolic acid B in Fuyankang Enema by HPLC.

Objective To compare the influence of different extraction technology on the pharmacodynamic actions of drug pair of Rhizoma Atractylodis Macrocephalae and Radix Paeoniae Alba.Methods The influences of water extraction,alcohol extraction,and SFE-CO2 extraction on pharmacodynamic actions of drug pair of Rhizoma Atractylodis Macrocephalae and Radix Paeoniae Alba were evaluated by mice intestine propulsive motility test,rats repelling acute gastric mucosa damage test,mice twisting test and hot-plate test.Results The paired drugs extracted by SFE-CO2 combining with water extraction or alcohol extraction had better pharmacological actions.Conclusion This study provides a scientific basis for optimizing the extraction technology of drug pair of Rhizoma Atractylodis Macrocephalae and Radix Paeoniae Alba.

Objective To investigate the effects of continuous end-eiastoloc volume index(CEDVI) adjusted by right venteicular ejection fraction(RVEF) in using for volume resuscitation of critically ill patients.Methods 51 critically ill patients who Swan-Ganz volume pulmonary artery catheters were inserted in via right internal jugular or subclavian vein underwent fluid therapy.Fluid was infused according to the relationship of RVEF and CEDVI.And the relationship of RVEF and CEDVI was that when RVEF was 0.2,0.3,0.35,0.4 and 0.5,respectively,CEDVI is 200～400ml/m~2,150～180ml/m~2,125～150ml/m~2,100～120ml/m~2,50～60ml/m~2 respectively.When RVEF is