Objective:To improve the recognition of bleeding risk in the anticoagulant process by analyzing one case of senior patient with deep vein thrombosis occurred severe bleeding during the anticoagulant therapy.Methods:The possible causes of hemorrhage were analyzed after the brief introduction of medical history,lab test report and treatment process of the patient.Results:The reasons of hemorrhage might be as follows:① the combination of warfarin and dalteparin induced the adverse drug reaction;② albumin decreased during the treatment process resulting in the effect enhancement of warfarin;③ the clearance of warfarin decreased resulting from the low creatinine clearance of the elderly patient.Conclusion:Clinical anticoagulant practice should be more careful in senior patients.The frequency of related laboratory tests should be increased in order to find potential risks timely.

Objective: To optimize the extraction process of Yunpitongbian decoction.Methods: With the extraction yield and the contents of hesperidin and atractylenolide Ⅲ as the comprehensive evaluation indices, and based on the results of single factor tests, Box-Behnken response surface methodology was used to optimize the extraction process with the extraction duration, extraction times and liquid-solid ratio as the independent variables.Results: The optimum processing conditions were as follows: extracted three times with 15-fold amount of solvent and extraction time of 66 min.The measured value of comprehensive score was 1.198 40, which was close to the predicted value of 1.204 78.Conclusion: The optimized extraction process of Yunpitongbian decoction is simple and feasible with good predictability.

Objective:To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharma-cists for chemotherapy-induced Ⅳ degree myelosuppression. Methods: One advanced lung adenocarcinoma patient suffering from IV degree myolosuppression after being treated with pemetrexed combined with nedaplatin was selected as the example, and the chemother-apy regimen, the cause and treatment of IV degree myolosuppression and the pharmaceutical service could be carried out were ana-lyzed. Results: With the help of clinical pharmacists, the patient conquered chemotherapy-induced myelosuppression, and clinical pharmacists enhanced the awareness of pharmaceutical care and played a positive role in the safe and effective drug use. Conclusion:The participation of clinical pharmacists in clinical pharmaceutical care through providing pharmaceutical service is beneficial to safer and more effective drug therapy.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Hep G2 Cells ; Humans ; Interleukin-6 ; metabolism ; Liver Neoplasms ; metabolism ; pathology

OBJECTIVE: To explore the application value of postmortem multi-slice spiral computed tomography (MSCT) by observing and analyzing the injury features in the traffic accident victims. METHODS: Ten traffic accident victims were scanned with whole body MSCT. The systemic autopsy was subsequently performed to compare with the results of MSCT. The advantages and disadvantages of autopsy and MSCT for obtaining the information of traffic accident injuries were then analyzed. RESULTS: MSCT could reveal 3D shape of fractures clearly and detect air accumulation in different positions of the body, which showed the obvious advantages compared with autopsy. However, the resolution of MSCT was limited compared to the detection of organ and soft tissue injuries. CONCLUSION A combination of MSCT and autopsy is the best way for determining the manner and the cause of death in traffic fatality victims.
Accidents, Traffic ; Autopsy ; Fractures, Bone ; Humans ; Soft Tissue Injuries ; Tomography, Spiral Computed

Objective To investigate CT findings,of the non-epithelial benign tumors of the larynx and their value in diagnosis and treatment.Methods Thirty-nine patients with non-epithelial benign tumors of larynx were examined with CT before treatment.Results Twenty-two cases with hemangioma displayed phebolithes in 9 cases,plain CT in 8 cases showed isodensity with respect to muscle near them and enhanced CT in 14 cases showed moderate to marked enhancement(9 cases)and no contrast enhancement(5 cases). Among 6 cases of neurogenic tumor,neurilemmoma(5 cases)presented as low to intermediate density on plain CT scan(1 case)and enhancement with homogeneous or inhomogeneous after enhanced CT,another case of neurofibroma presented as low density with homogeneous on plain CT imaging.Chondroma(3 cases) showed enhancement with inhomogeneous on enhanced CT scan.Pleomophic adenoma(3 cases)showed moderate to marked enhancement and one of the three cases presented as marked cystic degeneration. Lipoma(2 cases)demonstrated low density with no contrast enhancement.Lymphangioma,leiomyoma and fibroma(each has 1 case)displayed no contrast enhancement(lymphangioma)and moderate to marked enhancement(leiomyoma and fibroma)on enhanced CT scans.Conclusion CT can definitely display the shape,range and density of the tumors in larynx and provide information for diagnosis and treatment.

0.05).Three days after interventional therapy,the values of BF,BV,MTT,PS,MVD and VEGF of VX_2 tumors in interventional group were (7.5?2.4)ml? 100g~(-1)?min~(-1),(1.20?0.23)ml/100g,(3.29?0.57)s,(4.0?1.5)ml?100g~(-1)?min~(-1), 16.0?2.4/HP and 0.215?0.008 respectively.Compared with the values of pre-interventional therapy and the control group,there were significant differences among them(P0.7,P0.05)but had a significant negative correlation with average A value of VEGF(r=-0.78,P

OBJECTIVETo investigate the expression of Oct4, Sox2, Nanog, SMO, beta-Catenin and Wnt5b mRNA in four hepatocellular carcinoma cell lines of SMMC-7721, Bel-7402, HepG2, MHCC-97 and normal hepatocellular cell line of L02, and to compare the response of these cell lines to all-trans retinoic acid.

METHODSRT-PCR was used to detect expression of Oct4, Sox2, Nanog, SMO, beta-Catenin and Wnt5b mRNA in four hepatocellular carcinoma cell lines and normal hepatocellular cell line. Real time-PCR was used to quantify the expression of the genes.

RESULTSThere are different levels of expression of the stem cell-related gene in hepatocellular carcinoma cell lines and control cell line (P less than 0.05). There are significant differences in HepG2 and L-02 for the response to all-trans retinoic acid (P less than 0.05).

CONCLUSIONSThe stem cell-related genes are differentially expressed in different hepatocellular carcinoma cell lines.

Carcinoma, Hepatocellular ; metabolism ; pathology ; DNA Methylation ; Gene Expression Regulation, Neoplastic ; Hep G2 Cells ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Nanog Homeobox Protein ; Octamer Transcription Factor-3 ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Receptors, G-Protein-Coupled ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; SOXB1 Transcription Factors ; genetics ; metabolism ; Signal Transduction ; Smoothened Receptor ; Stem Cells ; drug effects ; metabolism ; Tretinoin ; pharmacology ; Wnt Proteins ; genetics ; metabolism ; beta Catenin ; genetics ; metabolism

The combination use of dexamethasone and calcium gluconate can be applied to hypersensitivity. Severe hypokalemia is a usual complication of dexamethasone and calcium gluconate therapy, which occurs frequently with therapeutic use. Fatal cases, accidental and intentional, occur frequently in forensic practice. The current case report presented a 43-year-old man with diabetes mellitus with infection, to whom dexamethasone and calcium gluconate were administered in the private clinic. With the development of such clinical symptoms of severe hypokalemia as quadriplegia, he was confirmed to have severe hypokalemia through a biochemical test before dying of arrhythmia. And also it presented pathophysiologic mechanism underlying severe hypokalemia as well as suggestions for clinical practice regarding combination use of dexamethasone and calcium gluconate.
Adult ; Anti-Inflammatory Agents/adverse effects* ; Calcium Gluconate/adverse effects* ; Dexamethasone/adverse effects* ; Diabetes Mellitus ; Fatal Outcome ; Humans ; Hypokalemia/chemically induced* ; Male

Postmortem chemistry is becoming more and more essential in routine forensic pathology and has made considerable progress over the past years. Biochemical analyses of vitreous humor, blood, urine and cerebrospinal fluid may provide important information in determining the cause of death or in elucidating forensic issues. Postmortem chemistry may be essential for the determination of cause of death when morphological methods (diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide many information in other forensic situations, including myocardial ischemia, sepsis, inflammation, infection, anaphylaxis and hormonal disturbances. The most recent relevant research advances on glucose metabolism, liver function, cardiac function, renal function, sepsis, inflammation, infection, anaphylaxis and hormonal aspect are hereby reviewed.
Anaphylaxis ; Autopsy/trends* ; Biomarkers/analysis* ; Body Fluids/chemistry* ; Death ; Diabetes Mellitus ; Forensic Pathology/methods* ; Humans ; Postmortem Changes ; Sepsis ; Vitreous Body