Objective To investigate the expression of FOXO3a and MMP 9 in colorectal cancer tissues and their relationship . Methods Tissue microarray and immunohistochemical SP methods were used to detect the expression of FOXO 3a and MMP 9 in 78 cases of colorectal cancer tissues and 69 cases of corresponding normal intestinal mucosa tissues ,then analyze the relation be-tween their expression and the clinicopathologic parameters of the patients ,and the relation between the expression of FOXO3a and MMP 9 .Results (1)The positive expression rate of FOXO3a in 78 cases of colorectal cancer tissues and 69 cases of normal intesti-nal mucosa tissues are 57 .69% (45/78)and 95 .65% (66/69) ,the positive expression rate of MMP 9 in 78 cases of colorectal cancer tissues and 69 cases of normal intestinal mucosa tissues are 85 .90% (67/78) and 15 .94% (11/69) ,and the difference is significant (P=0 .000) .(2)The decreased expression of FOXO3a and the increased expression of MMP 9 in colorectal cancer are significantly correlated with the depth of tumor invasion ,tumor histological differentiation ,metastasis of lymph node and TNM stage (P<0 .05) ,but there is no significant relationship with patients′age ,gender and tumor size (P>0 .05) .(3)There was a negative corre-lation between the expression of FOXO3a and MMP 9 (r=0 .272 ,P<0 .05) .Conclusion The decreased expression of FOXO3a and the increased expression of MMP 9 may be closely related with carcinogenesis ,invasion and metastasis of colorectal cancer ,and their combination may be an important indicator to evaluate the malignant degree and prognosis of the colorectal cancer .

OBJECTIVE: To probe the role of clinical pharmacists in drug use of patients with severe pneumonia. METHODS: Clinical pharmacists participated in the treatment for a patient with ESBLs producing Klebsiella pneumoniae severe pneumonia. The patient was given cefoperazone tazobactam combined with moxifloxacin and ganciclovir initially. Clinical pharmacists suggested stopping cefoperazone tazobactam and moxifloxacin and additionally using meropenem according to the elevation of hemogram infection indexes; suggested stopping ganciclovir and continuously using meropenem according to the results of sputum culture; suggested providing cefoperazone sulbactam de-escalation sequential therapy for ESBLs producing Klebsiella pneumoniae and stopping cefoperazone sulbactam and azithromycin according to clinical symptoms of the patient. RESULTS: The physicians adopted the suggestions of clinical pharmacists. After treatment, body temperature and lab indexes of the patient recovered to normal; the result of sputum culture turned to negative. Chest CT showed that the infection focus was obviously absorbed compared to before. After discharged from hospital and followed up, the patient was found to have a good prognosis. CONCLUSIONS: Through actively participating in drug therapy, based on lab indexes and results of sputum culture, clinical pharmacists provide pharmaceutical care and adjust medication plan to improve treatment rate of patients with severe pneumonia and the safety and effectiveness of drug treatment, be of great significance to promote the rational use of antibiotics.

Objective:To evaluate the effect of special teaching on anti-bacterial drugs that applied the problem-based learning combined with case-based learning.Method:s A total of 100 pharmaceutical students who participated in internships in Qujing First People's Hospital of Yunnan Province from 2018 to 2019 were included. According to the career plan after graduation, the students were divided into experimental group (to be engaged in clinical pharmacy) and control group (to be engaged in drug dispensing). There were 50 people in the experimental group, who received the problem-based learning combined with case-based learning teaching mode on the basis of traditional theoretical teaching (basic theoretical knowledge teaching). There were 50 people in the control group, who received only the traditional teaching mode. After the internship, the quality of teaching was assessed through examinations and questionnaires.Result:s There were no significant differences in the overall scores and individual scores of the objective questions ( P>0.05). The overall scores and individual scores of the case analysis of the experimental group were significantly higher than those of the control group ( P<0.05). The enthusiasm and initiative, and ability of clinical thinking, innovative practice, communication, team work of the experimental group were significantly better than those of the control group ( P<0.01). Conclusion:The problem-based learning combined with case-based learning teaching method is superior to the traditional theoretical teaching mode, which can significantly improve the teaching quality of antimicrobials for pharmacy interns. It is worth being promoted in teaching.

The prevention and treatment of COVID-19 in China is now at a key stage. The tasks faced by the medical organs are fighting against the COVID-19 while providing the medical services orderly. As a Specialist medical institution nationwide, ophthalmic hospitals are resuming receiving patients and performing operations gradually, including precision interruption of the epidemic, prevention of the secondary virus transmission, and avoidance of nosocomial cross infection among health care providers are required. We explored a multifaceted management for the prevention and control of epidemic, with a special focus on the individual protection for patients and medical staffs. A preliminary positive effect can be observed as a result. The main measures taken cover two aspects. On the one hand, 2019-nCoV ribonucleic acid (RNA) detection and hematological indices inspection including C-reactive protein (CRP) and serum amyloid A (SAA) are listed as routine tests of preoperative screening for ocular surgical patients. These tests are required to be completed upon the admission to avoid the possibility of accepting any asymptomatic infected individual and to reduce the risk of nosocomial cross infection. On the other hand, the 2019-nCoV RNA detection is also provided to high-risk employees who visited affected area recently. This assists in obtaining guarantee in both safety and quality of medical services provided, but also helps in lessening the mental and spiritual stress for medical staffs. It is expected that these measures can contribute to the work of our peers of ophthalmology in the prevention and control of COVID-19 and to the safe environment where the medical services are provided, and provide a reference for other outbreak of virus-causing disease.

Objective:To screen the potential biomarkers for the diagnosis and differential diagnosis of immune-mediated demyelinating diseases by tandem mass tags (TMT) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology.Methods:Twenty patients with demyelinating diseases (demyelinating group) and 10 patients with noninflammatory neurological diseases (NND group) from Beijing Tiantan Hospital affiliated to Capital Medical University from January 2020 to January 2021 were enrolled in this study. The demyelinating group included 10 patients with Guillain-Barre syndrome (GBS subgroup) and 10 patients with multiple sclerosis (MS subgroup). TMT proteomics was used to screen out the different protein expression patterns between the demyelinating group and the NND group and between the GBS subgroup and the MS subgroup (difference>2 or<0.5 and with statistical significance), and String database was used to perform gene ontology (GO) analysis and Kyoto encyclopedia of gene and genomes (KEGG) analysis on the pathways involved in the differently expressed proteins between the groups. In addition, 80 demyelinating patients (demyelinating diseases validation group) and 40 healthy subjects (healthy control group) were selected for retrospective analysis of general lipid indexes. The demyelinating diseases validation group included 40 GBS patients (GBS validation group) and 40 MS patients (MS validation group). Receiver operating characteristic (ROC) curve was obtained to evaluate the value of general lipid indexes for the diagnosis of demyelinating diseases and the differential diagnosis between GBS and MS groups.Results:A total of 362 proteins were detected by TMT proteomics. There were 101 differentially expressed proteins between the demyelinating group and the NND group, and 45 differentially expressed proteins between the GBS group and the MS group. Compared with the NND group, GO enrichment analysis showed that the top five enrichment pathways in the demyelinating group were macrophage colony stimulating factor and receptor complex, negative regulation of cholesterol input, negative regulation of very low density lipoprotein particle clearance, triglyceride-rich lipoprotein particle remodeling, and cholesterol reverse transport. Compared with MS group, the top five enriched pathways in GBS group were high-density lipoprotein particle receptor binding, negative regulation of very low density lipoprotein particle remodeling, negative regulation of cholesterol input, negative regulation of very low density lipoprotein particle clearance, and medium density lipoprotein particle. KEGG enrichment analysis results showed that differentially expressed proteins in the demyelinating group and the NND group were enriched in 8 pathways, including phosphatidylinositide 3-kinases-protein kinase B signaling pathway, complement and coagulation cascade reaction, extracellular matrix and its receptor interaction, Staphylococcus aureus infection, cholesterol metabolism, RAS signaling pathway, phagosome, and mitogen-activated protein kinase signaling pathway. Differentially expressed proteins in GBS group and MS group were enriched in 9 pathways: cholesterol metabolism, complement and coagulation cascade, platelet activation, peroxisome proliferators-activated receptors signaling pathway, vitamin digestion and absorption, novel coronavirus infection, fat digestion and absorption, axon guidance, and neutrophil extracellular trap formation pathway. The levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) were significantly higher, while high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1) levels were significantly lower in the demyelinating disease validation group than in the healthy control group (all P<0.05 or 0.01). Area under the curve (AUC) of TG, TC, HDL-C, LDL-C, apoA1 and apoB alone or in combination for the diagnosis of immune-mediated demyelinating diseases was 0.746, 0.643, 0.798, 0.703, 0.806, 0.708 and 0.868, respectively. The AUC of HDL-C, apoA1, LDL-C and apoB for differential diagnosis between GBS and MS was 0.692, 0.653, 0.632, 0.695 and 0.718, respectively. Conclusions:There are differences in cerebrospinal fluid proteomics between patients with immune-mediated demyelinating disease and patients with NND, GBS and MS, and the differentially expressed protein patterns mainly exist in the pathways related to lipid metabolism. Lipid related indicators may be used as biomarkers for the diagnosis and differential diagnosis of immune-mediated demyelinating disease.