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.

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

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.

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

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.

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

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 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.

ObjectiveTo observe the effect of early rehabilitation on poststroke anxiety and depression.Methods137 stroke patients with hemiplegia were divided into the rehabilitation group (70 cases) and control group (67 cases). All patients in both two groups were given routine clinical treatment, but the patients in the rehabilitation group were given regular early rehabilitation. All patients were evaluated with Bathel Index (BI), Fugl-Meyer Motor Scale (FMMS), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) before and 3 months after treatment.ResultsAfter 3 months treatment, the scores of HAMD, HAMA, BI and FMMS of patients in the rehabilitation group increased significantly compared with those before treatment ( P<0.05～0.01), and those in the control group ( P<0.05). The scores of BI and FMMS of patients in the control group after treatment also increased significantly compared with those before treatment ( P<0.05). The incidences of depression and anxiety of the rehabilitation group were 22.86% and 5.71%, those of the control group were 40.30% and 16.42%, there was a significant difference between two groups( P<0.05).ConclusionThe early rehabilitation can obviously decrease anxiety and depression of stroke patients with hemiplegia.

Objective To explore the value of dual energy CT imaging in the diagnosis of gouty tophus deposition.Methods Sixty-five cases of patients with gout treated in this hospital between December 2012 to December 2015 were selected.Another 65 cases of patients(rheumatoid arthritis,degenerative osteoarthritis and unexplained leg pain) were selected as control group.The re sults of dual energy CT imaging between two group were compared.Three experienced clinicians who didn't understand the imaging results were selected.They had a medical history and physical examination in patients with gout.The differences between clinical evaluation and imaging results were compared.Results Dual energy CT imaging showed that there were no tophi deposition in con trol group;the topi deposition in wrist joint,knee joint and ankle joint were 6.06％oo (33/34),100.00％ (22/22) and 96.49％ (55/57) in gout group.Dual energy CT imaging detected a total of 545 parts of tophus deposition.It was 4.36 times of the result of clinical evaluation(125 parts).Conclusion Dual energy CT imaging shows the advantages of simple noninvasive,high accuracy and low rate of misdiagnosis in diagnosing gout nodules.