Objective: To investigate the role of clinical pharmacist in the treatment of patients with severe infections in urology department.Methods: An objective analysis of the important roles of clinical pharmacists was carried out by making and adjusting the anti-infective treatment plan of two patients in urology department.Results: During the participation in the treatment of two patients with severe infections in urology department, clinical pharmacists played important roles in the treatment of the diseases through observing the clinical symptoms,analyzing the conditions of the patients and giving the pharmaceutical opinions and suggestions, and finally the infections were controlled successfully.Conclusion: Clinical pharmacists should participate in the therapy strategy adjustment in urology department using their professional knowledge to play important roles in the management of anti-infection strategy for severe patients.

Objective To investigate the expression of Smac/DIABLO, XIAP mRNA in acute pancreatitis (AP) and the relationship with the severity in rats.Methods Fifty-four SD rats were randomly divided into three groups:sham-operation (SO) group, acute edematous pancreatitis (AEP) group and acute necrotizing pancreatitis (ANP) group.The models of AEP and ANP were induced by retrograde injection of 1％ and 3.5％ sodium deoxycholate into the pancreaticobiliary duct respectively.The specimens of pancreatic tissue at 3 h, 6 h, 12 h were collected, pathological changes of the pancreas were observed, apeptosis in pancreas were detected by TUNEL method and the expression of Smac/DIABLO, XIAP mRNA were analyzed by real-time PCR.Results Pathological changes of the pancreas confirmed the establishment of AEP and ANP.Apeptosis indexes in SO group, AEP group and ANP group were 0.67±0.82, 6.62 ±0.78 and 4.70 ±0.82, and the differences were significant (P< 0.05).The expression of Smac/DIABLO mRNA of AEP group increased with time, while the expression of ANP group decreased with time.Compared with SO group, Smac/DIABLO mRNA expressions at 6 h in AEP and ANP group were 2.41 ± 0.92 and 1.47± 0.53, and the differences were significant (P<0.05).By contrast, the expressions of XIAP mRNA in AEP group decreased with time,while the expressions in ANP group increased with time.The expressionsof XIAP mRNA at 6 h in AEP and ANP group were 5.51 ± 1.07 and 6.99 ± 1.00, and the differences were significant (P<0.05).Conclusions In acute pancreatitis, the expression of Smac/DIABLO mRNA was consistent with the apoptosis of pancreatic acinar cells, but not consistent with the severity of pancreatitis.The expression of XIAP mRNA was consistent with the severity of pancreatitis.Smac/DIABLO, XIAP mRNA is associated with regulation of apoptosis.

OBJECTIVE:To compare the effectiveness and safety of low-molecular-weight-heparin(LMWH)calcium and rivar-oxaban in preventing lower extremity deep venous thrombosis (DVT) in the elderly patients after surgery of replacement of frac-ture. METHODS:A total of 58 elderly patients underwent hip or artificial femoral head replacement were randomly divided into LMWH group (29 cases) and Rivaroxaban group (29 cases). All patients received basic prevention and physical prevention for DVT after surgery. Based on this,LMWH group was given Heparin calcium injection 4100 IU subcutaneously 10 h after surgery, for 10 d. Rivaroxabar group was given Rivaroxaban tablet 10 mg 10 h after surgery,once a day,for consecutive 10 d. The occur-rence of DVT and positive D-dimer were observed in 2 groups after surgery. The PT,APTT,TT,FIB and platelet counts abnormal-ity were also observed in 2 groups. RESULTS:There was no statistical significance in the incidence of DVT,the occarrence of pos-itive D-dimer,PT,APTT,TT,FIB and platelet counts abnormality 4,10 d after surgery between 2 groups(P>0.05). CONCLU-SIONS:LMWH and rivaroxaban both can be used for lower extremity DVT in the elderly patients after replacement of fracture sur-gery of and have similar therapeutic efficacy and safety.

Venous thromboembolism includes deep venous thrombosis and pulmonary embolism. It is a more common and preventable complication in neurology. The prevention of venous thromboembolism is an important component in the treatment of the patients with cerebral hemorrhage. The measures include mechanical prevention and drug prevention. The mechanical prevention measures include intermittent pneumatic compression devices and pressure gradient elastic stockings. Studies have suggested that anticoagulants also plays an important role in the prevention of venous thromboembolism. The comprehensive and systematic understanding of the prevention of venous thromboembolism wil help to guide the clinical therapy and improve the outcomes of patients after primary intracerebral hemorrhage.

Objective To explore the clinical effect of Jiangru Formula(Herbal formula for soothing the liver,clearing heat,activating blood and removing stasis)combined with TCM surgical treatment for plasmocyte mastitis.Methods Fifty five patients with plasmocyte mastitis were treated with Jiangru Formula orally and TCM surgical treatment to see the effect of this method.Results The total effective rate was 100%.The average treatment period was(28?13.61)days.The recurrence rate was 1.82%.Conclusion The combination of Jiangru Formula with TCM surgical treatment for plasmocyte mastitis is effective in shortening the treatment period,reducing the recurrence rate and keeping the shape of the breast.

Objective: To investigate the association between the family relationship of college students in Shanghai and the psychological stress response under the COVID-19 epidemic. Methods: Totally 904 college students from universities in Shanghai were investigated with questionnaire of FACESII-CV and IES-R. Results: The score of family relationship intimacy was(61.32±6.29), the score of family relationship adaptability was(43.30±5.83), the score of psychological stress was(30.77±7.33), the score of internal dimension，avoidance, high alertness were(11.63±2.53)(11.69±2.64)(7.45±2.33). About 77.5%(701) and 17.3%(156) of college students showed mild and moderate stress reactions. Three dimensional scores of psychological stress response and two dimensional scores of family relationship differed significantly by age, grade, family income and parental education(P<0.01). Moreover, family relationship intimacy and adaptability scores showed negative associations with intrusive symptoms, avoidance symptoms, and high alert symptom dimension scores(P<0.05). Conclusion College students showed mild psychological stress under the COVID 19 epidemic with intrusion and avoidance symptoms as the most common. The intimacy and adaptability of family relationships are negatively associated with psychological stress response of college students under the epidemic. High-quality family relationships can reduce the psychological impact and adverse effects of the new crown epidemic on college students.

Objective: To explore the clinical and echocardiography characteristics between noncompaction of ventricular myocardium (NVM) and dilated cardiomyopathy (DCM) combining hypertrabeculation in order to distinguish NVM from DCM.
Methods: Our research included 2 groups of patients: NVM group,n=31 and DCM combining hypertrabeculation group, n=50. The basic information as gender, age, family history, symptoms, ECG, plasma levels of BNP and echocardiography were recorded and examined in all patients; the size of cardiac chambers, myocardium, endocardium and hemodynamics were particularly focused. The trabeculation was analyzed by 17 segments method.
Results:①Compared with NVM group, the patients in DCM combining hypertrabeculation group had the worse cardiac classiifcation, higher plasma levels of BNP (P<0.05) and more obvious cardiac dilatation.②The patients in NVM group had the most trabeculation segments (9.82 ± 2.02) and the apical (17th segment) was involved, patients had the higher ratio of noncompacton/compaction (NC/C) as (2.84 ± 0.61), there were (4.12 ± 2.68) segments with NC/C > 2.③The patients in DCM combining hypertrabeculation group had the less trabeculation segments (5.56 ± 1.56) and the apical was seldom involved, patients had the lower ration of NC/C as (1.91± 0.42), there was at most 1 segment with NC/C > 2. All P<0.05.
Conclusion: Echocardiography is a simple, practical and noninvasive method to distinguish NVM from DCM. NVM could be diagnosed by obvious left ventricular apex involvement with NC/C >2 in at least 2 segments of free ventricular walls.

Objective:To assess the left ventricular (LV) systolic function in amateur marathoners by two-dimensional speckle tracking echocardiography.Methods:A total of 59 amateur marathon runners were recruited from January 2019 to June 2020 in Hangzhou and were divided into group A (>2-5 years) and group B (>5 years) based on their time of participating in marathon. Thirty-one healthy volunteers were enrolled from Affiliate Hospital of Hangzhou Normal University during the same period as a control group. Conventional echocardiography combined with two-dimensional speckle tracking imaging were applied to all the subjects to obtain interventricular septum diastolic thickness (IVSd), LV posterior wall thickness(PWd), LV end-diastolic diameter (LVEDd), relative wall thickness(RWT) and LV mass(LVM), LV end-diastolic volume(EDV), LV end-systolic volume(ESV) and stroke volume(SV), LV ejection fraction(LVEF), LV global longitudinal strain (GLS), and global circumferential strain (GCS). Pre-marathon, 1 hour and 4th day post-marathon echocardiography were performed in amateur marathon runners.Results:Compared with the control group, group A amateur marathon runners showed significant increases in IVSd, PWd, LVEDd, RWT and LVM(all P<0.05); In addition, the IVSd, PWd, LVEDd, RWT, LVM, EDV, ESV and SV in group B runners were further increased compared to those of group A runners (all P<0.01). The LVEF and pre-marathon GCS showed no statistically significant differences among the three groups (all P>0.05), while the pre-marathon GLS showed a statistically significant difference among the three groups ( P<0.01). Compared with group A runners, the pre-marathon, 1 hour and 4th day post-marathon GLS and 1 hour post-marathon GCS were significantly decreased in group B runners (all P<0.01); In intra-group comparison, 1 hour post-marathon GLS was significantly decreased in relative to pre-marathon and 4th day post-marathon GLS in both group A and B (all P<0.05). One hour post-marathon GCS was significantly decreased compared with pre-marathon GCS in group B ( P<0.05). Conclusions:Amateur runners who have participated in long time marathon have reduced LV longitudinal strains and transient post-marathon decreases in LV systolic function.

OBJECTIVETo investigate the effects of nano-lead exposure on learning and memory and iron homeostasis in the brain of the offspring rats on postnatal day 21 (PND21) and postnatal day 42 (PND42).

METHODSTwenty adult pregnant female Sprague-Dawley rats were randomly divided into control group and nano-lead group. Rats in the nano-lead group were orally administrated 10 mg/kg nano-lead, while rats in the control group were administrated an equal volume of normal saline until PND21. On PND21, the offspring rats were weaned and given the same treatment as the pregnant rats until 42 days after birth. The learning and memory ability of offspring rats on PND21 and PND42 was evaluated by Morris water maze test. The hippocampus and cortex s amples of offspring rats on PND21 and PND42 were collected to determine iron and lead levels in the hippocampus and cortex by inductively coupled plasma-mass spectrometry. The distributions of iron in the hippocampus and cortex were observed by Perl's iron staining. The expression levels of ferritin, ferroportin 1 (FPN1), hephaestin (HP), and ceruloplasmin (CP) were measured by enzyme-linked immunosorbent assay.

RESULTSAfter nano-lead exposure, the iron content in the cortex of offspring rats on PND21 and PND42 in the nano-lead group was significantly higher than those in the control group (32.63 ± 6.03 µg/g vs 27.04 ± 5.82 µg/g, P<0.05; 46.20 ±10.60 µg/g vs 36.61 ± 10.2µg/g, P<0.05). The iron content in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly higher than that in the control group (56.9 ± 4.37µg/g vs 37.71 ± 6.92µg/g, P<0.05). The Perl's staining showed massive iron deposition in the cortex and hippocampus in the nano-lead group. FPNl level in the cotfex of offspring rats on PND21 in the nano-lead group was significantly lower than that in the control group (3.64 ± 0.23 ng/g vs 4.99 ± 0.95 ng/g, P<0.05). FPN1 level in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly lower than that in the control group (2.28 ± 0.51 ng/g vs 3.69 ± 0.69 ng/g, P<0.05). The escape latencies of offspring rats on PND21 and PND42 in the nano-lead group were longer than those in the control group (15.54 ± 2.89 s vs 9.01 ± 4.66 s; 6.16 ± 1.42 s vs 4.26 ± 1.51 s). The numbers of platform crossings of offspring rats on PND21 and PND42 in the nano- lead group were significantly lower than those in the control group (7.77 ± 2.16 times vs 11.2 ± 1.61 times, P<0.05; 8.12 ± 1.51 times vs 13.0 ± 2.21 times, P<0.05).

ONCLUSIONn Nano-lead exposure can result in iron homeostasis disorders in the hippocampus and cortex of offspring rats and affect their learning and memory ability.

Animals ; Cerebral Cortex ; drug effects ; metabolism ; Female ; Hippocampus ; drug effects ; metabolism ; Homeostasis ; Iron ; metabolism ; Lead ; toxicity ; Learning ; drug effects ; Maternal Exposure ; adverse effects ; Memory ; drug effects ; Pregnancy ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To analyze the current situation and correlation between job burnout and mental health of college counselors in Shanghai City. METHODS: With stratified cluster random sampling method, 235 counselors were selected as study subjects. Their job burnout and mental health was investigated by using Burnout Inventory Educator's Survey and Kessler Psychological Distress Scale. RESULTS: The median score of the 3 dimensions of emotional exhaustion, deindividualization and low sense of achievement of counselors was 3.4, 3.2 and 1.6, respectively. In each dimension, the ratio of moderate level job burnout was 93.2%, 94.9% and 26.8%, respectively; the ratio of high level job burnout was 6.8%, 5.1% and 73.2%, respectively. The median score of mental health was 31.0, and the grade of general, poor and very poor mental health standard was 2.6%, 35.3% and 62.1%, respectively. The scores of emotional exhaustion and deindividualization were positively correlated with the scores of mental health status(Spearman correlation coefficients were 0.54 and 0.44, all P<0.01). The score of low achievement was negatively correlated with the score of mental health status(Spearman correlation coefficient=-0.39, P<0.01). The multiple linear regression analysis showed that the scores of emotional exhaustion and deindividualization had positive predictive value on mental health after excluding gender, spouse, age, length of service, educational level, position title, household registration, authorized strength, and university level(all P<0.01). Low achievement score had a negative predictive effect on mental health(P<0.01). CONCLUSION: The job burnout in college counselors in Shanghai City is at a moderately high level and their mental health is poor. The job burnout affects their mental health. Alleviating job burnout is beneficial to improve counselors′ mental health.