Objective: To monitor vancomycin plasma concentration results by clinical pharmacists in order to participate in individualized medication adjustment.Methods: Clinical pharmacist monitored the blood concentration of vancomycin in special patients, and then designed the individualized medication according to the monitoring results and clinical manifestations of patients.Results: Through the individualized medication adjustment, clinical pharmacist enhanced the efficacy and reduced the incidence of adverse reactions, and improved the level of clinical rational drug use as well.Conclusion: Clinical pharmacist can provide better service for clinics through the practice of individualized precision pharmacy, and reasonable and safe pharmacy service can be provided for patients.

Eighty two patients aged 60 or over with stable angina pectoris were randomized to control group ( n = 42, receiving conventional western medicine) and treatment group ( n = 40, receiving 1.5 g Songlingxuemaikang capsules three times a day in addition to western medicine) .The treatment was lasted for 12 weeks, angina classification of CCS, hs-CRP, blood pressure levels and SF-36 (36-item short form)of the patients were evaluated before and after the treatment.The degrees of angina pectoris in angina classification of CCS, hs-CRP and blood pressure levels decreased, and the quality of life was improved in both groups; but more markedly in treatment group than those in control group (P ＜ 0.05 ).Songlingxuemaikang capsule combined with conventional western medicine can effectively relieve the symptoms of ischemic chest pain in elderly patients with stable angina pectoris, which is associated with blood pressure reduction and life quality improvement.

Objective In order to evaluate the therapeutic effect, to screen effective drugs for AIDS, and to find out the changes of patient's condition, it is necessary to develop an objective method to quantitate the levels of viral load of the patients before and after treatment.Method Differential PCR(D PCR) was used to co amplify the target HIV 1 gag gene and reference template ? globin gene, so as to determine the level of HIV replication quantitatively. The levels of HIV DNA in the peripheral blood mononuclear cells of 8 patients with AIDS were determined quantitatively.Results The levels of the provirus of the 8 patients ranged from 0 508 2 210 copies/?g DNA, there were differences in the levels of replication and integration. Conclusion It is the authors′ opinion that this method is easy to control with an advantage of reliability, quickness and reproducibility, It is suitable to measure clinical specimens, and provides an objective evidence for the evaluation of responses to therapeutic intervention.

Objective To generate the spaO-ompA fusion gene of Salmonella paratyphi A and its prokaryotic expression system,and to determine the immunoprotection of the recombinant expression product rSpaO-OmpA.Methods A flexible peptide sequence was used to link spaO and ompA genes and a prokaryotic expression system of spaO-ompA fusion gene was subsequently generated.SDS-PAGE and Bio-Rad Agarose Image Analyzer were applied to examine the expression as well as the yield of the target recombinant protein rSpaO-OmpA.The antigenicity and immunoreactivity of rSpaO-OmpA were determined using immunodiffusion test,Western Blot assay and micro-Widal's test.By a mouse infection model,the immunoprotection of rSpaO-OmpA against the lethal challenge of S.paratyphi A was determined.In the animal protective test,the recombinant expressed SpaO (rSpaO) and OmpA ( rOmpA ) were used as the controls.Results The generated spaO-ompA fusion gene had 100％ nucleotide and amino acid sequence identities compared to the single spaO or ompA gene.The constructed prokaryotic expression system IPTG E.coli BL21DE3pET42a-spaO-ompA expressed the recombinant protein rSpaO-OmpA.rSpaO-OmpA combined with the antiserum against wholecell of S.paratyphi A to present positive hybridization signal and induced specific antibody in the immunized rabbits.Immunization with 100 or 200 μg rSpaO-OmpA contributed 66.7％ (8/12) or 83.3％ (10/12) immunoprotective rates in mice when the animals were attacked with S.paratyphi A.The immunoprotective rates produced by rSpaO-OmpA were significantly higher than that of equal rSpaO or rOmpA( P＜0.05 ).The sera from rSpaO-OmpA immunized mice presented 1∶5-1∶40 agglutination titers to the H antigens of different S.paratyphi species,and 1∶1-1∶16 immunodiffusion titers to rSpaO,rOmpA and rSpaO-OmpA proteins,respectively.Conclusion The artificially fusion antigen,rSpaO-OmpA,has more powerful immunogenicity and immunoprotection that the equal rSpaO or rOmpA.

ObjectiveTo analyze the characteristics of dysphagia in children with cerebral palsy and explore the relation with the gross motor function classification.MethodsThe children with cerebral palsy in our rehabilitation center from June 2009 to June 2010 were assessed by Dysphagia Disorders Survey(DDS), Oral Motor Assessment and Gross Motor Function Classification System (GMFCS) to explore the relationship between the dysphagia disorders and different gross motor levels.ResultsOf all 105 children with cerebral palsy, 21.9% were mild dysphagia, and 34.3% were moderate to severe dysphagia, resulting in a prevalence of dysphagia of 56.2%. DDS and oral motor scores were changed by GMFCS levels. The correlation coefficient were 0.767 and -0.504 between DDS, oral motor scores and GMFCS, 0.55 and 0.27 between dysphagia, oral motor disorder and the gross motor functions, respectively(P<0.01).ConclusionDysphagia was positively related to severity of motor impairment. Children in GMFCS levels Ⅳ～Ⅴ almost with problems in the pharyngeal and esophageal phases, apparently on the DDS, should be referred for appropriate clinical evaluation of swallowing function.

Objective To observe the clinical effect of propofol combined with sufentanil in laparoscopic ovarian cyst resection.Methods 80 cases who underwent laparoscopic ovarian cyst resection were chosen,they were divided into the observation group and control group with 40 patients in each group according to the random number table method.The observation group was anaesthetized with propofol combined with sufentanil,while the control group was anaesthetized with propofol combined with fentanyl,the recovery status,operation time,intraoperative bleeding volume,recovery time of gastrointestinal function and postoperative complications in the two groups were compared. Results The recovered spontaneous breathing time,recovery time,extubation time of the observation group were (8.4 ±2.3)min,(10.51 ±3.3)min,(12.7 ±2.3)min,which of the control group were (10.11 ±2.2)min, (12.3 ±2.6)min,(15.3 ±3.5)min,there was statistically significant difference between the two groups (t =3.378, 2.710,3.926,all P <0.05);The operation time,operation amount of bleeding,gastrointestinal function recovery time of the observation group were (44.7 ±5.4)min,(19.5 ±3.5)mL,(18.3 ±2.4)h,which of the control group were (67.5 ±7.8)min,(42.7 ±2.8)mL,(42.4 ±3.2)h,there were significant differences between the two groups(t =15.200,32.736,38.105,all P <0.05).Postoperative analgesia,postoperative awareness,emergence delirium inci-dence rates of the observation group were 25%,0%,7.5%,which were significantly lower than 57.5%,12.5%, 37.5% of the control group,the differences were statistically significant(χ2 =8.717,5.333,10.323,all P <0.05). Conclusion The propofol combined with sufentanil in laparoscopic ovarian cyst resection has more significant effect, which can shorten the operation time,promote the postoperative recovery,reduce complications,worthy to be widely used in clinical practice.

Objective To explore the folate receptor mediated (FRD) check and multi-function acetic acid white solution liquid based cervical cytology (TCT) application value in cervical cancer screening.Methods A total of 602 cases of patients was tested with FRD multi-function acetic acid white solution check,and TCT and cervical biopsy pathology examination.With the used of histopathological results as the gold standard,FRD multi-function acetic acid white analysis was compared with the TCT screening inspection results.Results For a total 602 patients with TCT screening,the positive rate was 21.8％ (131/602),including 36 cases of CIN Ⅰ level,41 cases of CIN Ⅱ level,24 cases of CIN Ⅲ level,and 30 cases of cervical invasive carcinoma.For the FRD multifunction white acetate solution screening,its positive rate was 23.8％ (143/602).No statistically significant difference was found between TCT and FRD screening (P ＞ 0.05).The missed diagnosis rate of FRD multi-function white acetate solution screening was 2.6％ in inflammation,and 21.1％ in cervical invasive cancer,and 3.8 ％ in CIN.The missed diagnosis rate of TCT screening was 7.2％ in inflammation,5.3％ in CIN Ⅰ,4.9％ in CIN Ⅱ,and 58.6％ in CIN Ⅲ]; whereas,its detection coincidence rate was 100％ in squamous cells carcinoma (SCC) and adenocarcinoma (AC).FRD multi-function acetic acid white solution screening had a sensitivity 80.92％,specificity 92.14％,positive predictive value 74.13％,and negative predictive value 95.59％.TCT examination had a sensitivity 90.84％,specificity 90.23％,positive predictive value 72.12％,and negative predictive value 97.25％.No significant difference was found between FRD and TCT methods (P ＞ 0.05).Conclusions FRD and TCT methods were both efficient in screening and evaluation for cervical lesions and cervical cancer.Because FRD method is limited in the deep tube for examination of cervical lesions; it cannot completely replace the TCT examination.However,FRD method is reliable,economic,and simple operation; it is suitable for primary hospitals census of cervical cancer

BACKGROUND: It is difficult to in vitro isolate and culture the ovarian surface epithelium with high purity, strong vitality and stable biological characteristics. Tissue adherence and enzymatic digestion are commonly used for primary culture, but there are certain problems in cel col ection, cel viability and cel purity. OBJECTIVE: To establish a method for primary isolating, culturing and identifying human ovarian epithelium. METHODS: The ovarian surface epithelium was obtained with cel brush innovatively, and then the cells were isolated and purified with erythrocyte spal ation and differential adherence. The epidermal growth factor was added into the serum-free Dulbecco’s modified Eagle’s medium-F12 medium for cel culture. The cel morphology was observed under inverted microscope, and hematoxylin-eosin staining and immunocytochemical staining were used to identify the cells, then the growth curve was draw. RESULTS AND CONCLUSION: The ovarian surface epithelium became adherent after cultured for 24 hours, and reached fusion basical y after cultured for 6-12 days. The cells were polygonal or flat with strong transparency and refraction. The morphological characteristics of the cells were in line with those of the normal epithelial cells, and almost al the isolated cells could express the epithelial cells surface marker CK19. The cells could be passaged for 6-8 generations with wel growth and the cel growth curve was in “S” shape. The purity of the cells was more than 95%. The results suggest that cel brush method is simple to operate and can obtain a large amount of ovarian surface epithelium rapidly. The purity of the isolated cells can reach to 95% after treated with erythrocyte spal ation and differential adherence method and the cells are in stable growth.

Objective To explore effect of propofol or sevoflurane combined with dexmedetomidine on postoperative cognitive function , erythrocyte sedimentation rate and oxidative stress in patients with bone tumour .Methods 52 cases with bone tumor and requiring a surgery were selected and divided into sevoflurane group and propofol group randomly.The sevoflurane group were anesthetized with sevoflurane and dexmedetomidine.Propofol group were anesthetized with propofol and dexmedetomidine.The cognitive function score, recovery time, sedimentation value and oxidative stress level were compared after operation.ResuIts Compared with propofol group at the same time, the cognitive function score of patients in sevoflurane group at postoperative 6, 12, 24 h were higher (P<0.05) and restored to preoperative levels at postoperative 24 h (P<0.05) .The recovery time of spontaneous breathing, eyes open, remove endotracheal intubation and directional force in sevoflurane group were shorter than that in propofol group (P<0.05).Compared with propofol group at the same time, the erythrocyte sedimentation rate in sevoflurane group at postoperative 5, 10d were lower (P<0.05) and restored to preoperative levels at postoperative 10 d (P<0.05).Compared with propofol group postoperation, the superoxide dismutase (SOD) and methane dicarboxylic aldehyde (MDA) levels in sevoflurane group were lower, total antioxidant capacity (T-AOC) level was higher (P<0.05).ConcIusion Sevoflurane has a smaller effect on postoperative cognitive function than propofol in patients with bone tumor, combined with dexmedetomidine, which has an important significance to clinical surgery.

Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg·kg -1 ·h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate(HR)and mean arterial pres-sure(MAP)of the two groups were compared when entered into surgery room(T0 ),administered 5min(T1 ),after intubation(T2 ),surgical incision(T3 )and after extubation(T4 ),and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were (62.2 ± 1.1)times/min,(67.3 ±3.2)times/min,(69.2 ±2.3)times/min,(70.2 ±2.5)beats/min and(68.3 ±0.5)mmHg,(70.1 ±0.9)mmHg,(71.5 ±0.9)mmHg,(68.2 ±1.9)mmHg significantly lower than which of the control group (t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P <0.05),and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant(t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P <0.05);Compose score(4.2 ±1.3)points of the study group was significantly higher than (1.2 ±0.2)points of the control group,but the agitation score of the study group was(1.2 ±0.7)points,which was significantly lower than (2.9 ±1.5)points of the control group,the differences were statistically significant(t =9.38,8.379,all P <0.05).Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.