Objective:To analyze the prophylactic use of antibiotics during the perioperative period of typeⅠincision operation in a cancer hospital in order to promote the safe, effective and rational use of antibiotics. Methods:The rationality of 480 cases of typeⅠincision operation from January to December in 2013 and from January to December in 2014 was evaluated respectively, and the analy-sis and comparison were performed on the prophylactic use of antibiotics. Results: Through the pharmaceutical intervention including the special evaluation carried out by clinical pharmacists, the use of antibiotics gradually reached the rational level. Conclusion: The participation of clinical pharmacists in the use management of antibiotics in typeⅠincision operation can improve the rationality of the drugs used in clinic.

The blood concentrations of the pharmacodynamic substances of traditional Chinese medicines (TCMs) are usually very low. How can they exert pharmacological actions, in which forms (original form, metabolite or the both) do they exert the actions. To answer these questions, we proposed a new concept ofEffective Formsof pharmacodynamic substances of TCMs and a hypothesis of additive effect of multiple constituents of TCMs. The hypothesis includes that the aggregate or summation of Effective Forms of pharmacodynamic substances of TCMs is the core material base of the effi-cacy of TCMs, and the additive effect of the blood concentrations of different Effective Forms is one part of the action mechanism. The additive effect of the different Effective Forms of a TCMs means an additive effect of numerous con-stituents or/and metabolites on a same target, and therefore the efficacy brought by the addition of the concentrations of all these compounds, which different from the synergy effect of multi-constituents on multi-targets. Studies on the disposition of TCMs showed that a constituent can be biotransformed to many metabolites (up to more than 50 metabolites);different constituents can produce the same metabolites;many metabolites (up to 10 compounds for each metabolite) are isomers or homologues; some constituents can be converted to each other in vivo; and some metabolites are bioactive. These com-pounds having the similar structure are likely to have the same pharmacological effects on the same target, which could provide experimental evidences for the concept ofEffective Formsand the hypothesis ofAdditive Effect. We suggest that the Effective Forms and Additive Effects of the pharmacodynamic substances of TCMs should be extensively investi-gated in the future, and the results of such researches will help us further understand the pharmacodynamic substances and action mechanism of TCMs, and give a new explanation 'Toxicities Scattering Effect' for 'Why the toxicities of TCMs are low', and propose a new strategy for quality control of TCMs.

Objective To investigate the correlation between exhaled nitric oxide and lung function (FEV1)in asthmatic children.Methods Fifty three stable asthmatic children aged 5 to 14 years old were recruited from ShengJing Hospital of China Medical University.According to whether the patients were treated with inhaled corticosteroid(ICS)therapy regularly,they were divided into two groups:steroid group and non-steroid group,then fraction of exhaled nitric oxide(FeNO)and lung function were measured.Results In non-steroid group,the levels of FeNO(mean 40.450±25.428 part by billion)were significantly higher than those in the steroid group(mean 19.879±13.845 part by billion),and they were statistically significant.(P = 0.003).The mean FEVI in non-steroid group was(95.152±8.993)%,and the mean FEVI in non-steroid group was(91.350±11.690)%,and there were no significant differences between two groups (P =0.189).Significantly negative correlation was found between FeNO and FEV1 in steroid group(r =-0.465,P = 0.039),but there was no significant correlation between them in steroid group(r = 0.058,P =0.747).Conclusion The levels of FeNO were higher in non-steroid group than those of the steroid group in the stable asthmatic children.FeNO is a good biomarker to evaluate the airway inflammation of asthmatic children.

Objective To study the genomic molecular organization and genotype of human astro-virus infected infants in Shanghai of China. Methods Based on the published genomic sequence of HAstV (GenBank), the whole genome of one isolate human astrovirus was sequenced by specific primers. The PCR-products were cloned to pMD18-T vector and sequenced, phylogenetic tree was constructed by the Neighbor-Joining method with MEGA 4 software. Results The genome of HAstV-SH is 6807 hp, contains three ORFs: ORF1a and 1b encode the non-structural protein (from 83 nt to 4372 nt), ORF2 encodes the structural protein (from 4364 nt to 6727 nt). Compared with the ORF2 gene of those eight astrovirus sero-types in GenBank, revealed that the highest homology is with genotype 1 (97%). Homology with other gen-otypes ranged between 63% and 70%. Conclusion HAstV-SH belonged to genotype 1 and closely clus-tered with a strain of Japan (AB009985).

Objective To investigate the status of living relative kidney transplantation, and the clinical effects and social significances of kidney transplantation between spouses. Methods We retrospectively collected the clinical data of the department of kidney transplant of the First Affiliated Hospital of Zhengzhou University, from January 2011 to December 2013. The spouse group as group 1, the age and sex of doners were taken into account,the siblings with the similar age of the same period were enrolled in group 2. Then the postoperative recoveries of the two groups were compared. Considering the current social status, particularly the shortage of donor kidneys, the clinical, social and family significances of kidney transplantation between spouses were analyzed. Results Twelve cases of spouses in group 1, 8 cases of siblings in group 2 , the differences of donor and recipient age of the two groups were 0.33 ± 0.98 years and 2.29 ± 7.23 years, respectively. The human major histocompatibility complex antigens (HLA) was less than three in group 1, and was greater than or equal to three in group 2. The changes of serum creatinine and urea nitrogen were analyzed. No significant differences of serum creatinine and downward trend of blood urea nitrogen were observed between two groups (P = 0.84, P = 0.79). Conclusion The kidney transplantation between spouses has good clinical efficacy and great social significance, improving the status of the shortage of donor kidney and contributing to family harmony. The renal transplantation between spouses has obvious advantages and need further promotion.

OBJECTIVE:To establish the HPLC characteristic chromatogram of pheretima,and compare the differences of the main ingredient contents of Guangdong pheretima and Shanghai pheretima and the chromatogram differences among pheretima and 3 other animal drugs. METHODS:Pheretima HPLC characteristic chromatogram method was adopted to determine the characteris-tic chromatograms of 16 Guangdong pheretima,8 Shanghai pheretima,3 eupolyphaga,3 hirudo and 3 catharsius. Similarity evalua-tion and t test were used to analyze the differences of chromatogram data of 5 animal drugs. RESULTS:The established HPLC char-acteristic chromatogram method firstly identified 11 common characteristic peaks,including 6 nucleosides,4 nucleobase and 1 ami-no acid;and it could be used for the identification of pheretima from eupolyphaga,hirudo and catharsius;the differences of main ingredient contents in the characteristic chromatogram of Guangdong pheretima and Shanghai pheretima were firstly studied. The contents of xanthine and adenosine in Guangdong pheretima were higher than Shanghai pheretima,while the contents of uridine, guanosine and 2′-deoxy guanosine in Shanghai pheretima were higher than Guangdong pheretima. A new index S,calculated by these 5 constituents,was successfully applied to distinguish the 2 kinds of pheretima. CONCLUSIONS:The characteristic chro-matogram can be used for the identification of pheretima,and can provide reference for the pharmacodynamic differences study of Guangdong pheretima and Shanghai pheretima.

Objective To determine association between tongue carcinoma and polymorphism of urokinase-type plasminogen activator (PLAU) gene.Methods PLAU genotypes of 97 patients with tongue carcinoma and 91 health controls were examined by the PCR-RFLP method.Statistical analyses included a chi-square test for homogeneity and logistic regression analysis.Results The polymorphism in PLAU gene was rs2227564 C/T.Logistic analyses indicated that compared with CT and TT genotypes,CC genotype was risk factor for development of tongue carcinoma (adjusted OR =1.281,95 ％ CI 1.098-2.577,P =0.037).Conclusion PLAU polymorphism may be associated with development of tongue carcinoma.

Objective To explore the relationship between the degree of intraplaque neovascularization in carotid artery and the level of serum homocysteine.Methods Contrast-enhanced ultrasound were performed on 72 carotid atherosclerotic plaques of 48 patients.Contrast-enhancement within the plaque was categorizde as grade 1 to grade 3.The level of serum homocysteine were detected in the fasting state during the same period.Results According to the degree of contrast enhancement(grade 1 to 3),patients were divided into 3 groups.The more new vessels in plaque,the higher the level of homocysteine.The levels of homocysteine in three groups increased in turn.There were distinct differences among the three groups(F =18.49,P ＜0.05),and there was significant difference between every two groups (P ＜0.05).The linear correlation analysis showed that the level of homocysteine was positively correlated with the degree of carotid plaque enhancement (r =0.66,P ＜ 0.01).Conclusions Contrastenhanced ultrasonography could semi-quantitate new vessles in plaque.There was positive correlation between the degree of intraplaque neovascularization with the level of serum homocysteine.Combine with the level of serum homocysteine based on intraplaque neovascularization detected by contrast-enhanced ultrasound,the plaque stability could be more accurately evaluated.

BACKGROUND:Uremia patients have different degree of anemia before kidney transplantation, preoperative, and perioperative anemia is harmful to intraoperative and postoperative recovery of the organism and renal function. OBJECTIVE:To observe the effects of perioperative anemia degree and total blood transfusion on non-living and living-relative donor kidney transplantation, and to summarize the perioperative drug treatment for anemia and perioperative principles of blood transfusion. METHODS: A retrospective study was done in 115 cases of non-living donor kidney transplantation (test group) and 92 cases of living-relative donor kidney transplantation (control group) from January 2012 to December 2013. Degree of anemia, total perioperative blood transfusion, electrolyte change within 12 hours of blood transfusion, and adverse events after blood transfusion were recorded and analyzed. RESULTS AND CONCLUSION:The incidence of anemia had no significant difference between the two groups (P > 0.05). Compared with the control group, the intraoperative and postoperative blood transfusion rate was higher in the test group (P < 0.05), and the preoperative red blood cel level, hemoglobin level, hematokrit, average hemoglobin level, average concentration of hemoglobin, and average amount of blood transfusions were significantly lower in the test group (P< 0.05). Fever (5.5%) was the main adverse event during the transfusion in the two groups, and there was no severe severe alergic reaction and electrolyte acid-base disturbance. These findings suggest that the perioperative degree of anemia is higher in patients undergoing non-living donor kidney transplantation and those undergoing living-relative donor kidney transplantation; preoperative drug treatment for anemia is crucial for correcting anemia status; intraoperative and/or postoperative blood transfusion treatment should be in strict accordance with the principles of perioperative blood transfusion.

Objective To dynamically monitor the changes of peripheral blood lymphocyte subsets of renal transplant recipients and investigate the relationship between lymphocyte subsets with infection and rejection.Methods The clinical data of allogenic kidney transplantation recipients and living relative donors in the Department of Kidney Transplantation of the First Affiliated Hospital of Zhengzhou University were prospectively collected from June 2015 to December 2016.The data of lymphocyte subsets and other related indexes were obtained from renal transplant recipients and relatives of the same period.Results Sixty-four cases of living-relative donors and 351 cases of renal transplant recipients were enrolled in this study,and the recipients were divided into 3 groups:infection group (67 cases),acute rejection group (46 cases),and stable group (238 cases),according to the diagnostic criteria.There was significant difference in the concentration distribution of lymphocytes between the stable group and the control group (P<0.05).The stable frequency distribution range of the stable group was as follows (cells/μL):Lym (1 000-1 500),T (<1 500),CD4+ (<1 000),CD8+ (<1 000),B (<300),NK (100-300),CD4+/CD8+ (0.5-1.0).The number of Lym,T,CD4+,CD8+,NK and B cells in the preoperative patients was less than that in the healthy population (P<0.05);The number of Lym,T,CD4+, CD8+,B and NK cells was gradually decreased in the postoperative infection group,which was less than that in the stable group (P<0.05).After treatment the indicators gradually restored to the level in the stable group level;the number of T,CD4+,CD8+,B cells was highly correlated with infection.The number of T and CD4+ cells,and CD4+/CD8+ ratio were significantly increased in acute rejection group as compared with the stable group,and gradually decreased after the rejection was reversed.The number of T,CD4+,CD8+ cells was highly correlated with rejection.Lymphocyte subsets had a predictive effect on infection and rejection of recipients,and CD4+ cell count and CD4+/CD8+ ratio were independent risk factors.Conclusion The monitoring of lymphocyte subsets has an important clinical value in the evaluation of immune status and individual treatment of renal recipients.