0.05), FⅧ, c: 28.9?8.7 vs 43.9?11.4 per cent (P

Objective:To provide ideas for the participation of clinical pharmacists in clinical individualized medication.Methods:Clinical pharmacists participated in the clinical consultation for one senior patient with acute cholangitis treated with biapenem.Results:The consultation comments and suggestions proposed by clinical pharmacists were accepted by clinics,which played an important role in assisting doctors in the rational drug use and significantly improved the medical treatment.Conclusion:Clinical pharmacists should participate in individualized medication and help clinicians optimize drug therapy,which can improve the safety and efficacy of medication.

Blood Gas Analysis ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Intensive Care Units, Neonatal ; Male ; Respiration, Artificial

Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Trichloroacetic Acid ; urine

AIM: To investigate effect of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer.
METHODS: A total of 83 cases ( 83 eyes ) with severe fungal corneal ulcer treated in our hospital from Jan. 2013 to Jan. 2016 were selected. Among them, 36 cases ( 36 eyes) were treated with drug therapy, and 47 patients(47 eyes ) were treated with autogenous conjunctival flap transplantation, two group did fungal culture and identification, observed the two groups treatment effect.RESULTS:The effective rate of surgical treatment group was 89%, significantly higher than that of drug treatment group, the difference was statistically significant ( P <0.05 ); The effective rate of surgical treatment of filamentous bacteria was 92%, which was significantly higher than that of drug treatment, the difference was statistically significant(P<0. 05). The effective rates of surgical treatment and drug treatment of yeast were 80%and 78%, the difference was not statistically significant( P<0. 05).
CONCLUSION: Autologous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer has good curative effect. The operation is simple, worthy of recommendation method. Filamentous bacterial corneal ulcer without good drug therapy effect, surgical treatment should be performed in a timely manner to improve the curative effect.

Objective To study the changes of TNF-??NO in lung of immature rabbits with meconium aspiration and the relationship with right ventricular pressure. Methods (1)We established mild and severe immature rabbits model of meconium aspiration by endotracheal intubation imbuing meconium 0.6 ml/kg and 4 ml/kg. (2)We measured the right ventricular pressure by right ventricular puncture. (3)level of TNF-? in lung was measured by radioimmunoassay and that of NO was detected by Cr deoxidation. Results Meconium caused pulmonary inflammatory response which was reflected in the increase of cell counts in BALF, peaking at 24 h after instillation [WBC counts (6.06? 0.15 ) ?10 8/L,PMN counts (0.484?0.009)?10 8/L] and recovered by 72 h[(1.93?0.08)?10 8/L,(0 082?0 007)?10 8]. (2)The level of TNF-? in lung of mild group (1.41?0 15) ng/ml increased significantly comparing with control group (0 48?0.07) ng/ml, level of NO (31.9?2.4) ng/ml decreased significantly. Peaked at 16~24 h and recovered to normal by 72 h. the changes of severe group [TNF-?(1.85?0.17) ng/ml, NO(26.4?2.4) ng/ml] were significantly different from those in mild group. (3) At mild group,the right ventricular pressure began to increase at 16 h ( 19.28 ? 0.10 ) mm Hg, peaked at 24 h (26.78?0.14) mm Hg and returned to normal level by 72 h ( 14.18 ? 0.04) mm Hg. The pressure of severe group ( 32.70 ? 0.14 ) mm Hg was significantly higher than that of control and mild group. Conclusions (1)After immature rabbits aspirating meconium, there were remarkable pulmonary inflammatory responses. (2)The level of TNF-? in lung increased, and was correlated with right ventricular pressure,which revealed that MAS with PPHN could be associated with inflammatory response. (3)The level of NO decreased after meconium aspiration, and was lower at severe group. The level of NO was negatively correlated with right ventricular pressure, which indicated that the severe meconium aspiration was companied with severe damage of endotheliocyte which promoted and exacerbated PPHN.

Objective To explore the risk factors and outcomes associated with pulmonary hemorrhage in very low and extremely low birth weight infants.Methods Retrospective analysis were performed to predict risk factors for pulmonary hemorrhage in very low and extremely low birth weight infants (birth weight less than 1200g) admitted to NICU of Shengjing Hospital from Jan.2010 to Dec.2015.Infants at similar birth weight without pulmonary hemorrhage were as controls.We compared the characteristics of both maternal and infants.Multivariable Logistic regression models were derived to predict pulmonary hemorrhage.Short outcomes of the infants were assessed.Results Of the 435 neonates,71 developed pulmonary hemorrhage (pulmonary hemorrhage group),364 were as controls (control group).Gestational age[(28.2±1.7)week],birth weight[(936±192)g] in pulmonary hemorrhage group were significantly lower than those in control group[(29.5±2.1)week,(1033±134)g,t=4.776,5.145,P<0.01].Neonatal respiratory distress syndrome(RDS)(76.1%),pulmonary surfactant (PS)use(PS use≥2 courses)[76.1%(9.9%)],patent ductus arteriosus (PDA)(66.2%)were significantly higher than those in control group[41.2%,30.8%(4.1%),38.7%;χ2=33.457,28.970(4.074),32.798,P<0.05].Antenatal corticosteroids utility ratio (21.1%)was lower than that in the control group (41.2%;t=10.177,P< 0.001).Multiple factors Logistic stepwise regression analysis showed that RDS (OR=3.739,95%CI 1.383-10.113,P<0.05 ),PDA (OR=2.206,95%CI 1.205-4.093,P<0.05),and 5 minutes Apgar score <7(OR=2.851,95%CI 1.191-6.828) were independent risk factors of pulmonary hemorrhage,and higher birth weight (OR=0.998,95%CI 0.996-1.000,P<0.05) and the use of antenatal corticosteroids (OR=0.432,95%CI 0.224-0.834,P<0.05) were the protection factors in pulmonary hemorrhage.In pulmonary hemorrhage group,the incidence of intracranial hemorrhage,retinopathy of prematurity and severe bronchopulmonary dysplasia(16.9%,12.7% and 18.3%) were significantly higher than those in control group (5.8%,4.4% and 2.2%;χ2=36.824,7.520 and 33.568,P<0.01);Compared to control group,the mortality in pulmonary hemorrhage group was higher (49.3% vs.14.0%;χ2=46.634,P<0.01).Conclusion Pulmonary hemorrhage in very low and extremely low birth weight infants is associated with multiple factors.Prevention of premature birth and prenatal corticosteroids treatment can help prevent the occurrence of pulmonary hemorrhage.The incidences of poor outcomes are higher in newborns with pulmonary hemorrhage.

Objective To explore the changes of index of heart function and major cardiovascular events (nonfatal myocardial infarction, stroke, and cardiovascular death) to H-type hypertension patients with left ventricular hypertrophy caused by Tianma Gouteng Decoction.Methods 126 H-type hypertension patients with left ventricular hypertrophy from January 2014 to May 2014 in our hospital were divided into observation group and control group,63 cases in each group.Control group was treated with conventional western medicine, observation group was treated with Tianma Gouteng Decoction on the basis of control group.The levels of plasma homocysteine (Hcy), left ventricular ejection fraction (LVEF),the E/A, and the incidence of major cardiovascular events were recorded and compared between the two groups.Results Compared with pre-treatment, the levels of Hcy in the two groups were significantly decreased(P<0.05), and the effect of observation group was better (P<0.05).After the treatment, the E/A and LVEF of the two groups were significantly improved (P<0.05); the E/A ratio and LVEF in observation group were significantly higher than those in control group (P<0.05).The incidence of major cardiovascular events in observation group was significantly lower than that in control group (6.35%VS 19.05%,P<0.05).Conclusion Tianma Gouteng Decoction can significantly reduce the Hcy of patients who get H-type hypertension, improve diastolic and systolic function and lower the occurrence of major cardiovascular events.

Objective To study the differences in clinical characteristics and etiology in bronchopneumonia and lobar pneumonia,and provide the basis for the clinical diagnosis and treatment.Methods A retrospective study was performed on 100 children with lobar pneumonia and 200 children with bronchopneumonia from Dec.2005 to Dec.2007.Antibodies of mycoplasma(MP) and chlamydia(CP) were detected with quantitative enzyme linked immunosorbent assay of serum samples which were collected on addmission.On the second day morning,axenic sputum samples of laryngeapharyngis at pars were collected with onetime asepsis aspiration sputum tube by negative pressure for bacterial culture,and the common seven viruses were detected with direct immunofluorescence,and MP DNA,CP DNA were detected.The results and the clinical data and the characters of sternum were analyzed.Results Lobar pneumonia was more in the elder children,and the features were fever and cough in clinic,absence in physical sign of bellow,and inflammation of one pulmonary lobe in X-ray.Sixty-one percent of childhood lobar pneumonia had MP infection in laboratory examination.But bronchopneumonia was found more in infants and young children,whose features were cough,dyspnea and catarrhus in clinics,wheezy phlegm and stridor in physical sign of bellow,pulmonic shadow of spot and lamellar in X-ray.Bacteria were the most common pathogen in bronchopneumonia.Conclusions Lobar pneumonia was different from bronchopneumonia in age and clinic features and sternum characters of patients,and much more different in etiology.Bacterial infection was important in bronchopneumonia.But in lobar pneumonia,MP infection occupied 61.0%,which was different from traditionaletiology.Moreover,the MP infection rate in infant and young children tend to increase obviously.

Objective Monkey B virus(BV), also known as Cercopithecine herpesvirus 1,is an important zoonotic pathogen.According to the national standard, antibodies are detected using BV as an antigen.However, the preparation of BV antigen is very stricted due to biosafety issues.Therefore, in this study, we used alternative antigens to detect the BV antibody by serological assay and verified their specifity and sensitivity.Methods A total of 135 blood samples from rhesus monkeys were tested by two ELISA method (BV and HVP2) and enzyme immunosorbent assay (EIA)method.The positive and suspicious samples were verified by immuno-fluorescence assay (IFA), Western blot and immunoblotting technique using HSV-1 gC1 purified glycoprotein as an antigen.Results The positive rates of HVP2-ELISA, BV-ELISA and HSV-1-EIA were 32.6%, 37.8% and 34.8%, respectively.Consistant result of the three detection method accounted for 91.1% (123/135), and the positive result were confirmed by IFA And WB.There were 12 suspicious samples,in which 33.3% (4/12) were verified to be positive.Conclusions Compared with BV antigen, the sensitivity and specificity of the alternative antigen HSV-1 are moe close than HVP2.Positive and suspicious samples should be verified by several method to avoid missed detection.