Whooping cough(pertussis)is a highly contagious respiratory disease,which mainly affects infants and young children.Vaccination is an effective measure to prevent pertussis infection.Due to the fewer side effects,acellular pertussis vaccines(aPVs)have replaced whole-cell pertussis vaccine(wPVs)in many countries.Despite vaccination coverage is high,the short immunity induced by aPVs is considered to be significant reason for the re-emergence of pertussis.For improving pertussis vaccine,genetically detoxified vaccine and live attenuated vaccine have showed obvious clinical results and other strategies including using novel adjuvants in aPVs,increasing antigen or packaging aPVs with nanoparticles also have good prospects.This paper reviews the antigen composition and protective effects of aPVs,vaccination programs in different countries,potential candidate components of pertussis vaccine and new strategies for prevention of pertussis.

Objective:To study the pharmaceutical care for patients with severe infection in ICU performed by clinical pharmacists. Methods:Clinical pharmacists participated in the medication treatment process of one case of patient with pulmonary infection after glioma resection. According to the medical history, clinical symptoms and lab results, the pharmaceutical care was given in the respects of anti-infection therapy, analgesia/ sedation, anti-platelet therapy, drug interactions,drug precautions and adverse drug reactions. Results:The compliance,therapeutic effect and medication safety of the patient were all improved by giving clinical pharmaceutical care. The vital signs of the patient were stable,the anti-infection therapy achieved satisfactory therapeutic effects,and then the patient transferred from ICU and continued to be treated with rehabilitation therapy. Conclusion:Clinical pharmacists in medical team can assist physicians on the basis of the status of patients with reasonable and effective individualized medication and provide professional and efficient pharmaceutical care with high quality.

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Male ; Middle Aged ; NF-kappa B ; metabolism ; Neovascularization, Pathologic ; pathology ; Tryptases ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

Objective: To study the entry points of pharmaceutical care performed by clinical pharmacists for patients in ICU.Methods: Clinical pharmacists participated in the medication treatment process of one case of patient with torsade de pointes by providing individualized pharmaceutical service, including antiarrhythmic drug selection, anti-infection therapy adjustment and electrolyte disorder rectification.Results: The therapeutic effect and medication safety of the patient were both improved by giving clinical pharmaceutical care.The vital signs of the patient were stable, and then the patient transferred from ICU and continued to be treated with rehabilitation therapy.Conclusion: Clinical pharmacists can play an active role in the rescue of ICU patients by the pharmaceutical thinking and provide efficient pharmaceutical care with high quality.

Objective To evaluate the impact on long-term survival using elective transcatheter arterial chemoembolization (TACE) before liver transplantation (LT) to treat patients with hepatocellular carcinoma (HCC).Methods A medical literature search was conducted up to October 2011 to identify comparative studies which evaluated survival rates,recurrence rates,and disease free survival.Pooled odds ratios (OR) and 95 ％ confidence intervals (95 ％ CI) were calculated using either the fixed or random effect model.Results 571 patients were included into this meta-analysis:326 patients were treated with elective TACE before LT and 245 patients were not treated before LT.A comparison between the elective pretransplantation TACE group and the LT only group showed the odds risks (95％CI) of 1-,3-,5-years overall survival rate were 1.90 (0.09-3.33),1.19 (0.67-2.14),1.23(0.63-2.39),respectively.The odds risks (95％CI) of 1,3,5-years disease free survival rates were 1.36 (0.65-2.83),0.91 (0.48-1.75),1.16 (0.76-1.79),respectively.The odds risk (95％CI of recurrence was 1.60 (0.65-3.89).Conclusion Pretransplatation TACE improved 1-year overall survival,but it did not improve the 3 and 5 years overall survival,disease-free survival and recurrence rates.

Objective:To explore the effect of lipoic acid (LA) on chronic oxidative stress,cytokines and inflammatory gene expression with mice fed with high fat diet (HFD) and whether LA supplementation could prevent development of chronic inflammation.Methods:C57BL/6 mice were randomly assigned to three groups.The control group were administrated with an ordinary diet.The two experimental groups were fed with a high fat diet or high fat plus 0.1% LA.Antioxidants defense index such as SOD,CAT,GSH-Px and MDA were examined after 10 week.Cytokines such as IFN-?,IL-4,IL-6,TNF-? and IL-10 were examined after 10 week,respectively.Gene expression related to oxidative stress and inflammation were confirmed by QRT-PCR.Results:HFD led to potently weaken antioxidant defenses in mice.HFD significantly increased levels of IFN-?,IL-6 and TNF-?,and decreased levels of IL-4 and IL-10 in mice plasma.QRT-PCR results showed an up-regulation of inflammation related genes and a down-regulation antioxidant-related genes.Conclusion:LA is a possibly effective supplementation with HFD,both to prevent from the development of long-term oxidative stress and to attenuate chronic inflammation.

Objective:To investigate the risk factors of central lymph node metastasis (CLNM) in cN0 paillary thyroicl microcarcinoma (PTMC) and to establish a nomogram model for predicting the probability of cN0 PTMC CLNM.Methods:The clinicopathological data of 192 patients with cN0 PTMC admitted to the Department of General Surgery of the Second Hospital of Lanzhou University from Aug. 2016 to Aug. 2020 were retrospectively analyzed. There were 41 males and 151 females, 50 with CLNM and 142 without CLNM. The patients were divided into 2 groups according to the presence or absence of pathologically confirmed CLNM. Patient’s age, gender, tumor diameter, multiple, with Hashimoto’s disease, with nodular goiter, with or without near the posterior dorsal membrane, aspect ratio >1, with or without extratumoral infiltration, with or without lymphadenopathy, TSH levels, and TG levels were statistically analyzed. Pearson chi-square test was used to analyze the count data of hypothesis test, and the R language software package was used for Logistic multivariate analysis. The entry conditions were screened by stepwise regression to establish a nomogram prediction model, and the Bootstrap method was used for model verification. P<0.05 was considered statistically significant. Results:Multivariate logistic analysis showed that extratumoral invasion ( P=0.032) , presence of lymphadenopathy ( P=0.010) , and TG>68 μg/L ( P=0.007) were risk factors for central lymph node metastasis. The optimal model was established by stepwise regression. The factors included tumor diameter ≥0.5 cm, nodular goiter, extratumoral invasion, lymphadenopathy and TG>68 μg/L (AIC: 212.27) . The nomogram model was established according to the above risk factors. The consistency index (c-index) was 0.711. The results of calibration graph drawing and internal and external validation demonstrated its good consistency and applicability. Conclusion:Extratumoral invasion, lymphadenopathy, and TG>68 μg/L are risk factors for cN0 PTMC CLNM, and the nomogram established in the study can effectively predict the CLNM rate in patients with cN0PTMC and contribute to clinicians’ diagnosis and treatment decisions.

Objective To analyze the prevalence of cardiovascular disease (CVD) risk factors among nurses with high job stress in a Kunming tertiary hospital. Method The health data from 46 nurses who had gotten a medical examination between August 1 and November 30,2013 in the first people's hospital retrospectively analyzed .Results 76%of 46 nurses enrolled in this study had inordinately CVD risk factors,the top prevalence of CVD risk factors was dyslipidemia (58.9%),followed by hyperviscosity (45.5%),electrocardiographic abnormality (30.8%),overweight (19.2%),and hypertension (9.2%) . Moreover,there was significant differences of CVD risk factors among different departments ( <0.05),which the overall prevalence rate being highest among nurses working in the operating room. Conclusion The nurses with high job stress from tertiary hospital have high risks of CVD,therefore intervention measures should be taken to reduce the risk of CVD.

Objective To investigate the diabetes self-management (DSM) ability and influencing factors in patients with type 2 diabetes in Kunming. Methods A face to face questionnaire survey was conducted on type 2 diabetes patients admitted in the 1st Affiliated Hospital of Kunming Medical University from November 2010 to April 2012. Diabetes self-management instrument ( DSMI) was used to test self-management behavior, and psychological status was assessed by Problem Areas in Diabetes (PAID-5).Results 300 patients participated in the survey.The participant population consisted of 120 males (41.8%) and 168 females (58.2%) .A total of 190 patients (68%) suffered from DM related psychological problems.The mean DSM score was 95.23±20.6, and mean scores for the domain of integration DM care into one’s life, self-regulations, interaction with health professionals,self-blood monitoring glucose,and adherence to recommended regimen were 28.11±6.15,25.22± 5.67,23.06±6.41,10.98±2.96,and 8.75±2.21,respectively. There was no significant difference in the mean score between males and females (P>0.05) .Patients with psychological problems had lower scores in five DSM dimensions than those without psychological problems (P<0.05) . The result of multiple regression showed higher level blood glucose was negatively associated with DSM score, whereas patients with higher income was associated with a higher DSM score (P<0.05) .Conclusions The DSM situation is not good among patients with type 2 diabetes in Kunming, and most of the patients suffer from psychological problem. It is necessary to enhance the effective health education among diabetic patients.