OBJECTIVE:To investigate the methods and breakthrough point of clinical pharmacist participating in the consulta-tion for Acinetobacter baumannii infection cases,in order to improve the level of clinical rational drug use. METHODS:The con-sultation records of 39 A. baumannii infection cases in neurology department of our hospital during 2013-2014 were analyzed retro-spectively. The patients’general condition,site of infection,bacterial culture and drug sensitivity test were analyzed statistically as well as drug regimen before and after consultation,disease condition,lab indexes and nutritional status. RESULTS:A. baumannii were found in sputum culture of all patients,among which there were 11 cases of multiple resistant bacteria(28.2%),13 cases of pan resistant bacteria (33.3%),8 cases of drug resistant A. baumannii (20.5%) and 7 cases of non-multiple resistant bacteria (17.9%). The most widely used drug was minocycline (average dose of 0.2 g/d),followed by cefoperazone-sulbactam (average dose of 9 g/d),ceftazidime (average dose of 6 g/d), etimicin (average dose of 0.27 g/d),amikacin (average dose of 0.4 g/d). The antibacterial daily doses were higher than before. 3 patients were recommended to use fosfomycin. Before consultation,2 pa-tients didn’t received antibiotics (5.1%),and there were 13 cases of single drug (33.4%),22 cases of two-drug combination (56.4%)and 2 cases of three-drug combination(5.1%). After consultation,none of patients didn’t received antibiotics(0),and there were 7 cases of single drug (17.9%),26 cases of two-drug combination (66.7%) and 6 cases of three-drug combination (15.4%). After the consultation,body temperature,symptom and infection indexes of patients got better. Clinical pharmacists ad-justed nutrition program of 12 patients (30.8%) and expecterant program of 9 patients (23.1%). Compared with before consulta-tion,oubumin level of 11 patients (28.2%) and prealbumin level of 20 patients (51.3%) were all increased. CONCLUSIONS:Clinical pharmacist should formulate reasonable therapeutic regimen and reduce irrational drug use according to infection and physi-cal condition. They should provide anti-infective regimen,at the same time,pay attention to the adjustment of expectorant regimen and nutrition support program.

Objective To explore influence of comfort care on life quality of breast cancer patients undergoing chemotherapy. Methods Hospitalized breast cancer patients(80 eases) after modified radical mastectomy were selected by convenience sampling method.They were randomly divided into the intervention group and the control group.The control group received conventional care.The intervention group was given comfort care based upon conventional care.The quality of life questionnaire-core 30 (QLQ-C30) by European organization for research and treatment of eancer(EORTC),hospital anxiety and depression scale (HADS) and self-designed questionnaire of satisfaction degree with nursing job were adopted for evaluation of the two groups. Results There was no significant difference in the life quality of patients between two groups before intervention (P＞0.05),but statistical difference was seen after intervention (P＜0.05).The incidence rate of depression and anxiety after the intervention in the intervention group was significantly lower than that of the control group (P＜0.05) and the satisfaction degree with nursing job was significantly higher (P＜0.05). Conclusions Comfort nursing intervention can improve the quality of nursing service,reduce anxiety and depression,improve the life quality of patients.

Objective To establish a simple animal model and the cytotoxic T cell(CTL) detecting system for the studies of the effects of CTL on HCV infection. Methods The CTL activity in BLAB/c mice immunized by polypeptides in the core region of HCV was detected with lactic dehydrogenase (LDH) by using SP2/O cells as the target cells. Results CTL activity in BLAB/c mice immunized by polypeptides in the core region of HCV could be detected with LDH. The activity could be enhanced by CPA10(5～23 aa) but inhibited by CPA9(39～74 aa). Conclusion CTL activity in BLAB/c mice can be detected stably by LDH.

Objective To explore the mechanism of CTL dysfunction in HCV infected person, to provide a theoretical basis for further understanding the pathogenesis of hepatitis C and the development of HCV vaccines. Methods HCV nucleopolypeptides were selected and synthesized with the method of solid phase synthesis. BALB/c mice were immunized subcutaneously with HCV nucleopolypeptides, and CTL activity of mice was detected by LDH releasing test. Results CTL of mice could be inhibited by HCV nucleopolypeptides residues 39-74, 67-76, 71-80 and enhanced by HCV nucleopolypeptides residues 5 23,63 72,131 140. Conclusion The function of CTL can be suppressed and intensified by different HCV nucleopolypeptides.

Objective To investigate the pathogenesis of cytotoxic T cell (CTL) dysfunction in patients with HCV infection. Methods CTL detecting system was established. Two polypeptides which could enhance CTL function and two polypeptides which could inhibit CTL function were selected and cross-combined. BALB/c mice were immunized by subcutaneous injection of the combined polypeptides, and the CTL activity in mouse spleen cells was detected by LDH release test. Results CTL activity in BLAB/c mice immunized by polypeptides in the core region of HCV could be enhanced by CPA10 (5-23 aa) and inhibited by CPA9 (39-74 aa). CTL activity in the mice could be enhanced by polypeptides from the HCV core region, CPB2+CPB8, and CPB6+CPB8, respectively. There was no obvious difference between CPB2+CPB7, CPB6+CPB7 and the negative control. Two-factor analysis of variance showed that there was reciprocal action between the inhibitory and enhancing polypeptides from the HCV core region. Conclusion CTL activity in BLAB/c mice can be detected stably by LDH. There is an interactive effect between the inhibitory and enhancing polypeptides from the HCV core region.

Objective To comparative the expression of suppressors of cytokine signaling 3 (SOCS3) in placental tissues between premature delivery and term delivery,and to evaluate the significance of SOCS3 in premature-delivered placental tissues.Meth ods Retrospective analysis was made on 30 patients who had spontaneous premature delivery and 30 pregnant women with normal delivery from February 2013 to October 2013 in our hospital.Reverse transcription and polymerase chain reaction (RT-PCR) was used to detect the mRNA expressions of SOCS3,interferon-α(IFN-α),and interleukin-10 (IL-10).Western-blot was used to detect protein expression of SOCS3,and to analyze the balance of Th1/Th2.Results PCR detection showed that SOCS3-mRNA in the control group was significantly lower than that in the experimental group (P ＜ 0.01).Western-blot test showed that SOCS3 protein expression in the control group was significantly lower than that in the experimental group (P ＜ 0.01).The expression of SOCS3 gene was consistent with its protein expression.PCR detected the significant increase of IFN-α with the secretion of Th1 cytokine,significant decrease of IL-10 with secretion of Th2 cytokine (P ＜ 0.05),and the balance deviation of Th1/Th2 toward Th1.Conclusions SOCS3 is associated with premature delivery,which mechanism might be involved in regulation of the immune balance through janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathways.

Objective To assess the therapeutic effect of cerebral aneurysmal embolization with electro-detachable platinum coils(EDPC), and to discuss the timing of the embolization and points for attention during the procedure. Methods From February 1999 to July 2004, 60 intracranial aneurysms were treated with EDPC in 58 patients, of which 56 cases were subject to subarachnoid hemorrhage (SAH). 36 patients were Hunt & Hess Grade I, 12 Grade II and 8 Grade IV～V. Two of all 58 patients had no SAH. Two sorts of EDPC were used in this group: one is Guglielmi detachable coil from Boston Scientific Corporation and the other is Sapphire detachable coil from Micro Therapeutics Inc. All the sessions of embolization and each detachment of the EDPC were closely monitored both fluoroscopically and angiographically for the accurate and safe embolization of aneurysmal lumen. Results Of all 60 aneurysms, 58 were successfully treated with EDPC and 2 were failed to be embolized due to arterial spasm. The packing degree of aneurismal lumen was complete in 44 cases (75.9%) and incomplete in 12 cases (20.7%). The incidence of non-thrombotic complication was 6.9%. One patient had hemiplegia because of the hernia into the parent artery by EDPC. No death occurred in our group. 41 patients were followed-up during a period of 1～4 years and no SAH onset recurred after embolization. Conclusions Endovascular treatment of intracranial aneurysms with GDC is a better alternative. But the long-term effects should be verified by follow-up in the future.

Objective To investigate the clinical value of dual phase 18F-FDG PET/CT in the diagnosis of recurrent and metastatic bladder cancer after surgery. Methods The imaging data from 84 patients underwent the dual phase 18F-FDG PET/CT after surgery with known histories of bladder cancer were analyzed. Among the 84 patients, 16 had symptoms of recurrence, 24 had symptoms of metastasis and 44 didn′t have any symptom. The median interval time between the primary tumor resection and the PET/CT scan was 11.5 months (0.5 ~ 240 months). According to the PET/CT imaging procedures, all patients underwent whole body PET/CT scan at 60 minutes after IV injection of 18F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis by using oral 40 mg furosemide. The 18F-FDG PET/CT findings were compared with histopathologic examination results and (or) the clinical follow-up. All patients were followed up for more than six months. Results Results of detecting recurrence and metastasis of bladder cancer showed that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the dual phase FDG PET/CT imaging protocol were 91.7%(22/24), 95.0%(57/60), 94.0%(79/84), 88.0%(22/25), 96.6%(57/59) and 90.0%(27/30), 96.3%(52/54), 94.0%(79/84), 93.1%(27/29), 94.5%(52/55), respectively. Conclusion Dual phase FDG PET/CT can be used to detect the recurrence and metastasis with high accuracy, contributing to the restaging and follow-up in bladder cancer after surgery.

The objectives of this study are to prepare resveratrol loaded mixed micelles composed of poloxamer 403 and poloxamer 407, and optimize the formulation in order to achieve higher drug solubility and sustained drug release. Firstly, a thin-film hydration method was utilized to prepare the micelles. By using drug-loading, encapsulation yield and particle size of the micelles as criteria, influence of three variables, namely poloxamer 407 mass fraction, amount of water and feeding of resveratrol, on the quality of the micelles was optimized with a central composite design method. Steady fluorescence measurement was carried out to evaluate the critical micelle concentration of the carriers. Micelle stability upon dilution with simulated gastric fluid and simulated intestinal fluid was investigated. The in vitro release of resveratrol from the mixed micelles was monitored by dialysis method. It was observed that the particle size of the optimized micelle formulation was 24 nm, with drug-loading 11.78%, and encapsulation yield 82.51%. The mixed micelles increased the solubility of resveratrol for about 197 times. Moreover, the mixed micelles had a low critical micelle concentration of 0.05 mg · mL(-1) in water and no apparent changes in particle size and drug content were observed upon micelles dilution, indicating improved kinetic stability. Resveratrol was released from the micelles in a controlled manner for over 20 h, and the release process can be well described by Higuchi equation. Therefore, resveratrol-loaded poloxamer 403/407 mixed micelles could improve the solubility of resveratrol significantly and sustained drug release behavior can be achieved.

Objective: In acute pancreatitis, traditional treatment insists fasting on purpose to avoid activation of proteolytic enzymes and pancreatic enzyme secretion. The aim of our study was to evaluate the efficacy and feasibility of early oral feeding as compared to traditional fasting in patients with mild acute pancreatitis.Methods: Seventy-two patients were randomized to the two treatment groups, fasting or early oral feeding. The inclusion criteria were pancreas amylase≥3times above normal, onset of abdominal pain within 48h, acute physiological and chronic health evaluation-II score<8 and C-reactive protein(CRP)<150 mg/L. Measures were amylase, systemic inflammatory response, length of hospital stay. Results: The groups were comparable with respect to age, sex, etiology, APACHE II, time from onset of pain and amylase at admission. No significant differences were seen between the groups concerning levels of amylase, CRP, leukocytes, abdominal pain or number of gastrointestinal symptoms. The length of hospital stay time was significantly shorter in the oral feeding group (13 vs. 17 days; P<0.05).Conclusion: Early oral feeding would not exacerbate disease process. The differences between treatment groups for amylase or systemic inflammatory response were not obvious. In mild acute pancreatitis, early oral feeding was feasible and safe and may accelerate recovery.