OBJECTIVE:To explore clinical pharmacists participating in anti-infection therapy in intensive care unit(ICU).METHODS:The typical cases of clinical pharmacists participating in anti-infection treatment in ICU were analyzed.RESULTS&CONCLUSION:Clinical pharmacists developed pharmaceutical care for anti-infection treatment in ICU and helped physicians to design individualized dosage regimen.It can improve the safety and effectiveness of antimcrobials in ICU patients and reflect the role of clinical pharmacists in rational use of drug.

Objective To investigate the diagnosis value of soluble B7-H4(sB7-H4) in rheumatoid arthritis (RA) .Methods By using the ELISA sandwich method ,the serum levels of soluble B7-H4 ,anti-cyclic citrullinated peptide(anti-CCP) antibody and glu-cose 6-phosphate isomerase(GPI) were detected in 67 cases of RA ,72 cases of osteoarthritis(OA) and 75 cases of healthy people . The immunoturbidimetric method was adopted to determine the serum rheumatoid factor (RF) .Then the diagnostic value of sB7-H4 in RA was compared and analyzed .Results The serum level of soluble B7-H4 in the RA group was significantly higher than that in the control group and the OA group with statistically significant difference between them (P<0 .01) .The sensitivity of sB7-H4 in diagnosing RA was higher than that of RF ,anti-CCP antibody and GPI ,but the specificity was lower than that of anti-CCP antibody and GPI .There was better correlation between sB7-H4 with RF and anti-CCP antibody .The combination detecting of sB7-H4 ,RF , anti-CCP antibody and GPI could increase the diagnostic rate of RA .Conclusion B7-H4 has better clinical application prospects in diagnosing RA .

Objective To compare in vitro fertilization and embryo transfer( IVF-ET ) outcome of gonadotropin-releasing hormone( GnRH ) antagonist protocol and GnRH agonist long protocol in patients with polycystic ovary syndrome ( PCOS)and to provide reference for rational selection of ovulation stimulation protocol for PCOS patients. Methods One hundred and four patients with PCOS who underwent IVF-ET were randomly divided into two groups. In the study group,41 patients were subjected to the GnRH antagonist protocol;In the control group,63 patients were subjected to a long protocol of GnRH agonist. Doses and duration of gonadotropin therapy,the thickness of endometrium and the profile of hormone level on the day of HCG administration,the number of retrieved oocytes,the ratio of fertilization,the ratio of cleavage,the ratio of the good quantity embryos,implantation rate of embryo,pregnancy rate,the cycle cancellation rate and the incidence rate of ovarian hyperstimulation syndrome( OHSS)were recorded. Results The IVF-ET outcome of the two groups was similar with respects to the number of oocytes,the ratio of fertilization,the ratio of cleavage,implantation rate of embryo and the pregnancy rate( P﹥0. 05). Significant differences were found(P﹤0. 05)between the two groups regarding to the doses and duration of gonadotropin therapy,the levels of serum E2 and LH on the day of HCG administration,and the cycle cancellation rate. The incidence rate of OHSS was not significantly different ( 2. 44% vs. 12. 70%) between the two groups. Conclusion The duration of gonadotropins administration,the cycle cancellation rate,incidence of OHSS and the financial burdern are reduced in patients treated with GnRH antagonist. The growth of follicle,the ratio of fertilization,the ratio of cleavage,implantation rate of embryo and the pregnancy rate are not different between the two methods. The GnRH antagonist protocol is optimal for patients with PCOS.

OBJECTIVE To study the drug-resistance of commonly encountered pathogens and the manifestations of irrational use of antibiotics,in order to provide the gist for clinical therapy.METHODS The retrospective analysis on the drug-resistance of commonly encountered pathogens that isolated from clinical samples and records of(irrational) use of antibiotics from Jan 2004 to Jon 2005 were carried out.RESULTS Among 870 isolates,the first five kinds of pathogens were Pseudomonas aeruginosa(17.47%),Klebsiella pneumoniae(9.66%),Acinetobacter baumannii(8.85%),Escherichia coli(7.36%)and Candida albicans(11.95%).They had resistance to the commonly used(antibiotics) in various degrees.In 4 462 records,there were 659 records of irrational use of (antibiotics),occupied 14.77%.CONCLUSIONS It is important that to strengthen the management of antibiotics(usage) and institutions in hospitals,to inform doctor the drug-resistance trend,based on the result of drug(sensitivity) test,in order to use antibiotics more rationally and reduce the appearance of drug-resistant bacteria.

Objective To report the clinical effect of repair of significant tongue defect after tongue cancer radical resection using anterolateral thigh perforator free flap with CTA three-dimensional reconstruction technique assistance.Methods From January,2012 to November,2015,13 cases were performed using anterolateral thigh perforator free flap in the repair of significant tongue defect after tongue cancer radical resection.Preoperation CT scan of the free flap donor site was done to obtain the three-dimensional images of arterial blood area by Digital Three-dimensional Reconstruction CT Technique to determine the origin of the anterolateral thigh flaps,direction,classification,length,diameter and the position of pedicle perforator.According to the condition of the defect of the tongue,flap of area from10 cm×9 cm to 8 cm×6 cm was design,the flap arteries and veins were anastomosed with the external maxillary artery or the superior thyroid artery,anterior vein,internal jugular vein or external jugular vein respectively.The shape and recovery of function of the reconstructed tongue were observed regularly after operation.Results All the flaps in the 13 cases survived,in the postoperative 4 to 18 months followed up,the appearance of the reconstructed tongue was close to the normal one,the patients were satisfied with the mastication and feeding function.Conclusion CTA three-dimensional reconstruction technique assisted anterolateral thigh perforator free flap technique is useful in obtaining good clinical effect,and it is one of the most best methods for repairing significant tongue defect after tongue cancer radical resection.

Objective:To investigate the clinical value of the free fibula flap transplantation in repair of the defect of tibia and soft tissue with the help of augmented reality (AR) technology.Methods:From May, 2017 to May, 2019, 9 patients with tibial and soft tissue defects were treated. Before operation, CTA scan was performed on both shanks to obtain DICOM data of tibial bone defect. Images of the designed fibular flap and its blood supply model were imported into Sina software through computer virtual surgery assistant technology. With the AR technology, information of virtual fibula flap were projected onto the body surface at the donor site, and the operation was carried out under the precise positioning. In this group, the free fibular flap was harvested with an area of 6.0 cm×4.0 cm-12.0 cm×6.0 cm and the length of fibula was 6.0-13.5 cm. The free fibula flap were used to repair the tibial defect with 5.0-12.0 cm in length and soft tissue defect area at 5.0 cm×3.0 cm-10.0 cm×4.5 cm. Patients were followed-up to observe the survival of fibular flap and the functional recovery of the repaired lower limb, and evaluate the clinical effect.Results:All the fibular flaps survived without vascular crisis and without serious complications occurred at both of donor and recipient sites. After 8-12 months of follow-up, the flap was soft in texture and good in blood supply. The appearance of the repair site was not bloated. Callus began to form at the junction of fibula and tibia at 3-5 months and healed well in 8-12 months. No bone resorption, nonunion, loosening or falling off of screws were found. There was no pain in the shank of the recipient area. Patients could stand and walk freely, and the weight-bearing function was close to normal. According to Enneking system, the average score was 27 points; 7 cases were excellent and 2 cases were good.Conclusion:Application of AR technology in the repair of tibial bone defect with fibular flap transplantation has good clinical effect and has certain practical value.

OBJECTIVE To investigate the management situation of cross infection in outpatient service of stomatology in hospital and clinic in Zhanjiang city and conduct effective measure to control hospital infection.METHODS In our investigation,we selected 105 hospitals and private clinics to inspect their management situation of cross (infection) via dental(instrument).RESULTS The management in the hospitals of the city was quite qualified but the some private dental clinics were terrible.The main problems were as follows: no effective disinfection for dental instrument and the bad environment in procedure room,especially the worse sterilization situation of the dental handpieces.Most of the doctors in private clinics were short of knowledge in the sterilization for dental(instruments.) CONCLUSIONS There is no time to delay for the health administration department to normalize the management of the private dental clinics.It is essential to train the medical staffs,and implement measures for dental instrument disinfection management in private dental clinics.

Objective To explore the effect of hepatitis B virus (HBV) X protein (HBx) on autotaxin (ATX) expression and its significance. Methods The recombinant eukaryotic expression vector of HBx ,pcD-NA3.1(+)-HBx,and the recombinant luciferase reporter gene vector of ATX promoter,pGL3-ATX,were con-structed and used to co-transfect HepG2 cells to examine the effect of HBx on the activity of ATX promoter. The sta-ble cell expressing HBx,HepG2.HBx,was constructed,and Western blot(WB)was used to detect the effect of HBx on ATX expression. Results The luciferase activity of pcDNA3.1(+)-HBx and pGL3-ATX group was 1.47 times as that of the empty vector cDNA3.1(+)and pGL3-ATX group(P<0.000). WB detection showed that the expression of ATX protein was increased in HepG2.HBx cells,and 1.75 times as that of HepG2 cells(P<0.05). Conclusion HBx can activate ATX promoter and up-regulate ATX expression ,thus suggests that HBV infection might enhance ATX/LPA signaling.

Objective To analyze the changes of lymphocyte subsets in peripheral blood of patients with drug eruption . Methods 18 newly diagnosed patients were served as the drug eruption group ,and were subdivided into cephalosporin group (n=9) ,penicillin group(n=5) and Chinese medicine group(n=4) according to different sensitizing drugs .20 healthy people were taken as the control group .Flow cytometry were utilized to detect the percentages and absolute counts of T lymphocytes (CD3+ ,CD3+CD4+ and CD3+CD8+ ) ,B lymphocytes ,natural killer cell(NK) and natural killer T lymphocytes(NKT) in their peripheral blood . Results Differences of percentages of T lymphocytes (CD3+ ,CD3+ CD4+ ) ,B lymphocytes ,NKT cells between the drug eruption group and the control group showed statistical significant (P<0 .05) .Difference of percentages of CD3+ CD8+ lymphocytes of pa-tients between the drug eruption group and the control group demonstrated no statistical significant (P>0 .05) ,while that of abso-lute counts of T and B lymphocytes of patients was statistical significant between the drug eruption group and the control group (P<0 .05) .Conclusion The percentages of CD3+ ,CD3+CD4+ lymphocytes of patients with drug eruption decrease ,while those of NKT cells increase ,which may be related to the patients′immune regulation .

Objective To evaluate the accuracy of Sysmex XT-4000i automated hematology analyzer on neonatal leukocytes count and classification results.Methods 213 cases of neonatal blood specimens were analyzed respectively by Sysmex XT-4000i automated hematology analyzer and microscope counting and staining of two categories of methods.Results The instrument that immature granulocyte,primitive cell,shift to the left,three kind of tip in any one or more specimens have 112,accounted for 52.58% (112/213),and staining immature cell or shift to the left of the specimens was 91,accounted for 42.72% (91/213).The instrument to nucleated erythrocyte specimens were 109,accounting for 51.17% (109/213),and staining of nucleated erythrocyte were 66,accounting for 30.99% (66/213).Classify or classification of incomplete instrument failed to leukocytes were 11,ac-counting for 5.16% (11/213).When the specimens without nucleated erythrocytes interference or the number of nucleated eryth-rocytes is low [≤ 10/100 white blood cells(WBC)],Instruments on leukocyte count and manual counting results,there was not statistically significant differences between the two groups(P >0.05 ),when the sample number of nucleated erythrocytes (>10/100 WBC),When the specimens were nucleated erythrocyte number for a long time(>10/100 WBC),Instruments on leukocyte count and manual counting results,there was significant difference between the two groups(P <0.05).Correlation analysis on the instrument detection and manual dyeing classification of leukocytes,neutrophils,lymphocytes,monocytes,eosinophils,basophils, the correlation coefficient is respectively 0.95,0.93,0.78,0.86,0.14.Conclusion Some errors exist in Sysmex XT-4000i auto-mated hematology analyzer to count and classification of leukocytes.On neonatal blood tests should be carried out at the same time man-ual microscopy,and on the basis of nucleated erythrocytes were corrected,to ensure the clinical blood routine reporting results.