Objective:To evaluate the anti-infective therapy in a patient with multi-site infections after brain surgery and explore the role of clinical pharmacist in the treatment. Methods:With the applications of PK/PD characteristics of drugs and the coping strategies of resistant , vancomycin combined with fosfomycin were used to treat the intracranial infection caused by methicillin-resistant Staphylococcus epidermidis with vancomycin MIC of 2 mg·L-1 , and the dynamic adjustment of antibiotics was applied to treat the pulmonary infection caused by two kinds of pathogens including MDR bacteria. Results:The intracranial infection was successfully controlled, the pulmonary infection was also under control, and the overall condition of the patient was significantly improved. Conclusion: In the medical team, clinical pharmacists should make full use of their advantages in drug characteristics to carry out clinical pharmaceutical care.

Objective: To investigate the outcome and inlfuencing factors of graft vessels including saphenous vein graft (SVG) and left internal mammary artery graft (LIMAG) in patients after coronary artery bypass grafting (CABG). Methods: A total of 92 patients with post-CABG symptom recurrence from 2010 to 2015 were analyzed by angiography and clinical features for their native coronary vessel and graft vessel. There were 83 male and 9 female patients with the mean age of (62.6±10.8) years. The outcomes of graft vessel were assessed; correlation study was conducted between SVG, LIMAG lesions and traditional atherosclerosis risk factors like age, gender, hypertension, hyperlipidemia, diabetic mellitus, smoking, family history of coronary artery disease (CAD) with other clinical factors such as the time of angina recurrence, thetime from coronary angiography (CAG) to CABG, type of SVG (sequential graft or individual graft), the features of native target vessel lesions prior grafting. Results: The average time from CABG to symptom recurrence was (35.10±24.7) months. There were 146 grafts including 52 LIMAG and 94 SVG (60 individual and 34 sequential grafts), the patency rate of LIMAG was higher than SVG (63.5% vs 44.7%),P=0.030. SVG lesion was positively related to symptom recurrence (OR=1.119, 95% CI 1.002-1.249,P=0.046) and trended to female gender (P=0.065), while not related to other clinical factors; LIMGA lesion was not related to any clinical factors. The patency rate of sequential SVG was higher than individual SVG (58.9% vs. 36.7%,P=0.038). The native target vessel lesion (deifned by pre-operative occlusion/stenosis) was similar between individual SVG group (24/14) and no-lesion SVG group (17/5),P=0.388; while the native target vessel lesion in LIMAG group (7/12) was lower than no-lesion LIMAG group (23/10),P=0.04. Conclusion: Post-CABG lesion was not obviously related to traditional risk factors of CAD, post-SVG lesion was positively related to the time of post-CABG angina recurrence. SVG mid-and long-term patency in sequential graft vessel was higher than that in individual graft vessel. Pre-CABG native coronary blood lfow would affect the outcome of individual LIMAG but not SVG.

Objective To review and discuss the changes of diagnostic techniques and therapeutic modalities of pheochromocytoma during the past fifty years. Methods The clinical data of 362 patients (196 men and 166 women; age range,7-75 years;mean age,38 years) with pheochromocytoma from January 1955 to July 2004 were retrospectively analyzed.The disease course ranged from 20 d to 20 years with a mean of 3.9 years.According to the premedication,the past 50-year period was divided into 3 stages;and the diagnostic techniques,premedication, anesthetic skills,surgical procedures and perioperative death rate were compared among the 3 stages. Results There were 60 patients in the first stage (1955-1975) and their diagnoses were made on urine VMA and retroperitoneal air-contrast imaging.They had no premedication except for tranquilizers.The therapeutic modality was open surgery of resecting tumors under peridural anesthesia.The perioperative mortality was 8.3% (5/60).The second stage (1976-1994) included 105 patients and they were diagnosed mainly by 24-h urine catecholamine, ultrasonography and CT.Phenoxybenzamine was taken as the regular premedication and open surgery general anesthesia was used; the mortality decreased significantly to 1.0% (1/105).The third stage (1995-2004) consisted of 197 cases.In addition to 24-h urine catecholamine,ultrasonography and CT, 131I-MIBG scan was used as the specific diagnostic technique for pheochromocytoma widely.The premedication was phenoxybenzamine and urapidil.The microcirculation imaging analysis was used to judge the volume expansion preparation. Laparoscopic resection of the tumor under general anesthesia was adopted as the regular means.The perioperative mortality was 0.5% (1/197). Conclusions The diagnostic techniques for pheochromocytoma have become enriched and mature.The premedication has been standardized and included more medicines.The microinvasive surgery has become the current method for resecting tumors,and the perioperative mortality has become significantly decreased.

Objective To investigate the effects of antisense oligodeoxynucleotide c-myc (c-myc ASODN) on the growth of rabbit lens epithelial cells (LECs) induced by galactose. Methods Based on the translation initiation region of the second extron of c-myc gene, oligonucleotides were synthesized and modified with phosphorothioate. Lens epithelial cells were treated with galactose and c-myc ASODN. The effects of c-myc ASODN on the growth of LECs, cultured in high concentration of galactose, were observed by cytometry and MTT. Results The results demonstrated that c-myc ASODN at the doses of 2.5-10.0 ?mol/L inhibited the growth of LECs induced by galactose in a dose-dependent manner. Conclusion These results indicate that c-myc ASODN can inhibit the growth of LEC induced by galactose.

Objective To explore the influence factors of health literacy in middle-aged and elderly people in Hunan province.Methods With multi-stage randomized cluster sampling, people aged 45 years and over were selected from both urban and rural areas of six geographical regions of Hunan province, using the China residents health literacy questionnaire developed by Chinese Health Education Center, by face to face survey to get data. The influence factors were analyzed retrospectively with univariate and ordinal regression analysis.Results The 1158 persons were investigated and the valid questionnaires were 1154, the effective recovery rate was 99.7%. Univariate analysis showed that there were significant differences in heath literacy among different degree of education, age, gender, marital status, income, region and occupation (all P＜0.05). The results of ordinal regression analysis Showed that the major influence factors were degree of education, income,age and occupation.Conclusions The people at low levels of education or income should be concerned about health education and health promotion strategies.

Aim According to various target sites of HLA-E mRNA,to design and synthesize 3 pieces of HLA-E siRNA chain,to compare quantitatively their efficiency of silencing gene in BEL-7402 with HLA-E(+)in order to select the dominant siRNA.Methods The hepatocarcinomal BEL-7402 cells,induced by 5×10~5 IU·L~(-1) IFN-γ,expressed HLA-E(+) and was pured by flow cytometry selecting as target cells for research.3 pieces of specific siRNA(A,B,C group)were designed and chemically synthesized,then the concentration of which(0.1 mmol·L~(-1))was respectively transfected through Lipofectamin 2000 into target cells.After 48 h,the gene silent effect on HLA-E gene in A,B and C groups was quantitatively observed by cytoimmunofluorence,flow cytometery,Western blot and real-time PCR,as well as on NK cytotoxicity to target cells tested by NK killing rate.Results Compared with those of control or non-specific siRNA group,HLA-E antigen,protein product,HLA-E mRNA and HLA-E molecule on cell surface were statistically down-regulated in A,B,and C group(P<0.01),whose were silenced more (above 90%) in B or C group than in A group (P<0.01).The NK killing rate in A,B and C groups was dominantly improved(P<0.01),which in B or C group was higher than in A group (P<0.01).Conclusion The targeted siRNA can specifically and high-efficiently silence HLA-E expression in hepatocarcinomal cells,and may keep them from immunoescape through non-classic HLAⅠ pathway to imply new strategy for hepatocarcinomal gene-immunotherapy.

Objective To investigate the clinical superiority of Chaiqin tiaogan capsule in the treatment of hepatitis B virus.Methods 126 cases of patients admitted to hospital from January 2014 to June 2015 were randomly divided into two groups, the control group (interferon and lamivudine) and the experimental group (interferon, lamivudine and Chaiqin tiaogan capsule), each group of 63 cases.The HBsAg and HBV-DNA negative rate, the changes of liver function and the incidence of adverse reactions in the experimental group were observed and compared.Results The HBsAg negative rate and the HBV-DNA negative rate after treatment three and six months in the control group were significantly higher than the experimental group ( P<0.05).The levels of ALT, AST and DBiL in the control group and the experimental group were significantly decreased, and the levels of ALT, AST and DBiL after treatment six months in the control group were significantly lower than the experimental group ( P <0.05 ) .There were no serious adverse reactions in the control group and experimental group, there was no significant difference between two groups.Conclusion Chaiqin tiaogan capsule can effectively inhibit HBV replication and improve liver function, it has good tolerability and safety applied to clinical.

Objective To explore the relationship between galactose-induced apoptosis of lens epithelial cells and cataractogenesis.Methods Galactose was injected retrobulbarly into Wistar rats.The opacity of lens was examined by slit lamp.The expression of C-MYC was measured by flow cytometer.The apoptosis of lens epithelial cells was observed by TUNEL techniques.Results More than 50 percent of lenses were in the Ⅱ stage of cataractogenesis on the(7 d) after galactose induction;Eighty-seven percent of lenses were in the Ⅳ-Ⅴ stage on the(14 d),and 100 percent of lenses were in the Ⅳ-Ⅴ stage on the(24 d).The rate of apoptotic cell on the(7 d) and on the(14 d) after galactose induction was respectively 5.6%～8.4% and 30.2%～41.8%,and 60% apoptotic cells were observed on the(24 d).The levels of C-MYC expression in lens epithelial cells induced by galactose on the(7 d) and(14 d) were higher than that of normal lenses,but the level of C-MYC expression backed to normal level on the(24 d).Conclusion It was suggested that there are some apoptosis of the lens epithelial cells during galactose-induced cataractogenesis and that the apoptosis of the lens epithelial cells might be caused by higher expression of C-MYC.

BACKGROUND:Under certain conditions, bone marrow mesenchymal stem cels can be differentiated into hepatocytes, which are an important source of liver cels. Moreover, multiple factors can be involved in this induced differentiation process. OBJECTIVE:To investigate the inducible effect of cholestatic serum on the differentiation of bone marrow mesenchymal stem cels into hepatocytes. METHODS:Cholestatic animal model was prepared in rats to extract cholestatic serum. Bone marrow mesenchymal stem cels isolated from rats were divided into three groups and cultured in serum-free hepatocyte medium, serum-free hepatocyte medium plus cholestatic serum, serum-free hepatocyte medium plus normal serum, respectively. RESULTS AND CONCLUSION:The positive expression of alpha fetoprotein and keratin 18 and mass concentration of albumin were significantly higher in the serum-free hepatocyte medium plus cholestatic serum group than the other two groups (P < 0.05). These findings indicate that cholestatic serum has a certain inducible role in the differentiation of bone marrow mesenchymal stem cels into hepatocytes.

Objective To observe the clinical efficacy of long-time needle retaining at scalp acupoints plus body acupuncture in treating motor dysfunction in the sub-acute stage of cerebral stroke.Method A hundred patients in sub-acute stage of cerebral infarction or hemorrhage scored 4-24 by the National Institute of Health Stroke Scale (NIHSS) were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by dry rehabilitation training, while the treatment group was additionally intervened by long-time needle retaining at scalp acupoints (6-8 h) plus body acupuncture. The neural functional deficit, motor function, and activities of daily life were estimated and compared respectively by using NIHSS, Fugl-Meyer Assessment Scale (FMA), and Barthel Index (BI).Result The NIHSS score was significantly changed in the treatment group after 1 treatment course (P<0.05). After 2 treatment courses, the NIHSS scores were significantly changed in both groups compared to that before treatment (P<0.05). The FMA and BI scores were remarkably changed in both groups respectively after 1 and 2 treatment courses compared to that before treatment (P<0.05). After 2 treatment courses, there were significant differences in comparing the NIHSS score and BI score between the two groups.Conclusion Long-time needle retaining at Scalp acupoints plus body acupuncture can improve the neural function deficit, motor function, and activities of daily life in sub-acute stage of cerebral stroke.