1.Analysis of Anticoagulant Treatment Adjustment Participated by Clinical Pharmacist for a Patient with Deep Vein Thrombosis of Lower Limbs
China Pharmacist 2017;20(6):1052-1054
Objective: To investigate the role of clinical pharmacist in anticoagulant therapy.Methods: Clinical pharmacist participated in the anticoagulant treatment adjustment for one patient with deep vein thrombosis (DVT) of lower limbs.Clinical pharmacist assessed the risk factors of DVT and the bleeding risk of anticoagulant therapy, provided suggestions in case of over-anticoagulation with warfarin, and offered medication education to the patient with unsatisfactory compliance.Results: Physician adopted the suggestions of clinical pharmacist, INR was within the rational range, and the patient was discharged with stable condition.Conclusion: The participation of clinical pharmacist in the anticoagulation with warfarin can reduce the risks of drug use and promote the efficacy and safety of medication effectively.
2.Application of 18 F-FDG PET-CT in TNM staging of non-small cell lung cancer and clinical significance
Journal of Jilin University(Medicine Edition) 2014;(6):1293-1296
Objective To compare the diagnostic results of 18 F-deoxyglucose positron emission tomographic-computed tomographic (18 F-FDG PET-CT)imaging ,CT and golden standards in TNM stating of non-small cell lung cancer (NSCLC), and to evaluate the diagnostic value of 18 F-FDG PET-CT imaging in TNM staging of NSCLC.Methods 18 F-FDG PET-CT was performed in the 65 patients with NSCLC who were diagnosed by pathology.Blind interpretation was used to dignose the TNM staging.The sensitivity(Se),specificity(Sp), positive predict value(PPV)and negative predict value(NPV),coincidence rate and Kappa analysis were performed to evaluate the values of PET-CT and CT in diagnosing TNM staging of NSCLC.Results Compared with golden standard,the diagnostic results of T staging among 65 NSCLC patients by CT and PET-CT were respectively as coincidence rate=72.31%,Kappa=0.46;coincidence rate=78.46%,Kappa=0.60;the diagnostic results of N staging among 58 NSCLC patients by CT and PET-CT were respectively as coincidence rate=74.14%,Kappa=0.50;coincidence rate = 87.94%,Kappa=0.78;the diagnostic results of lymph node metastasis by CT and PET-CT were respectively as Se=64.04%,Sp=77.53%,PPV=85.07%,NPV=51.88%,coincidence rate =68.54%,Kappa=0.37;Se=91.01%,Sp=83.15%,PPV=91.53%,NPV=82.22%,coincidence rate =88.39%,Kappa=0.74;the total detection rate and amount of metastasis by PET-CT were significantly higher than that by CT. Conclusion 18 F-FDG PET-CT has significant value on the diagnosis of the TNM staging of NSCLC.
3.Analysis on scores of epidemiologic exam and investigation on applications of course content in practice
Xiaojun WANG ; Xiujuan XU ; Jindong NI
Chinese Journal of Medical Education Research 2012;(11):1157-1160
Objective To provide references for epidemiology teaching reform by investigating scores of epidemiological exam and applications of epidemiologic course content in practice.Methods The epidemiological exam scores of students majoring in preventive medicine from 2004 to 2007 grade were statistically analyzed and questionnaire survey was carried out among students of 2006 and 2007 grade.Results The skewness of epidemiological scores from four garades were negative skew,and the kurtosis of 2007 grade was positive,the others were negative;there were statistical differences among the average scores of different grades(F=2.70,P<0.05);there were statistical differences between 2004 grade and other grades in passing rate(x2=7.94,P<0.008).Most of the contents applied in survey were prevention and control of infectious deseases(16.0%),prevention and control of chronic diseases(13.9%),surveillance of diseases(11.8%).Conclusions Epidemiology teaching reform should be enhanced and should integrate theory with practice.
4.Pharmaceutical Care on a Patient with Cerebral Venous Sinus Thrombosis and Epilepsy
Xiaojun NI ; Xiaoyun PANG ; Han ZHONG
Herald of Medicine 2017;36(4):400-403
Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy.Methods One patient was hospitalized due to headache and twitch.Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy.During the treatment,the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy,assessed drug interaction between omeprazole-escitalopram and mannitoldexamethasone,monitored the adverse drug reaction of valproate,and provided medication education to the patient.Results Physician adopted clinical pharmacist's suggestion.The patient discharged with stable condition.Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.
5.Practice of Ward Round Model of Clinical Pharmacists
Jianghong NI ; Xiaojun SONG ; Xuejian XIE
China Pharmacy 2001;0(08):-
OBJECTIVE:To explore the ward round model of clinical pharmacists.METHODS:The ward round model of clinical pharmacists was designed and explored based on clinical practice.RESULTS & CONCLUSION:Clinical pharmacists can engage in ward rounds either in cooperation with physicians or alone in special department,or by targeting at those patients using certain drugs.Each model has its distinctive characteristics and clinical pharmacists can choose suitable model based on their own level as well as the conditions in software,hardware and environment so as to facilitate rational administration.
6.Analysis on the rationality of using parenteral nutrition preparation in Nanjing General Hospital
Qinyan WU ; Huijie YUE ; Rui WU ; Xiaojun SONG ; Jianghong NI
Journal of Medical Postgraduates 2014;(8):851-853
Objective Clinical parenteral nutrition( PN) support still lacks in standards on some degree .This paper was to analyze the clinical application of PN support in our hospital in order to provide the basis for clinical rational drug use . Methods Random weighting method was applied to collect 5% hospitalized patients′information from each patient unit each month from April 2012 to March 2013 in Nanjing Gerneral Hospital of Nanjing Military Region .NRS-2002 nutrition risk screening was applied to eval-uate whether the patient needed PN support .Statistical analysis were carried out on patients supported with parenteral nutrition from department distribution, PN detailed components and distribution intervals of aII in one admixture non-protein calorie and nitrogen ra-tio. Results According to the survey, 393 patients had received PN support, including 217 cases′NRS score <3 and 176 cases′NRS score ≥3.General surgery department ranked the first in the cases of usingall in oneadmixture support.Among 133 cases receiving all in one admixture support, the course of 37 cases(27.82%) <7 d.The aII in one admixture non-protein calorie and ni-trogen ratio(100~150∶1) only took up 28.57%. Conclusion Although PN has got wide application in clinical departments, the rationality of prescription should be strengthened .Pharmacists should help doctors set up appropriate prescription from the aspect of pharmacy.
7.The mechanisms of ARPD in treating radiation-induced lung fibrosis in rats
Buyou CHEN ; Shuguang LI ; Mingbing XIAO ; Feng JIANG ; Wenkai NI ; Runzhou NI ; Yapeng LU ; Hua HUANG ; Jianbo MA ; Xiaojun QIU
Chinese Journal of Radiological Medicine and Protection 2012;32(5):475-480
Objective To investigate the therapeutic effects and mechanism of anti-radiation pneumonia decoction(ARPD) on radiation induced lung fibrosis in rats.Methods One hundred and five male SD rats in a SPF grade were divided into Chinese medicine group,single radiation group and control group by random digits table method,with 35 in each group.After anesthetization,rats in Chinese medicine and single radiation groups were exposed to 6 MV X-rays at the dose of 15Gy.Rats in Chinese medicine group were treated with ARPD at the dosage of 10 ml·kg-1 ·d-1 once a day,but rats in single radiation group did not receive ARPD treatment.Rats in control group were treated with neither irradiation nor drugs.Five rats of each group were killed and the lung tissues and blood samples were collected at 15,30,60,75,90,105 and 140 d.The pathological changes of lung tissues were observed and the tissue protein and gene expressions of TGF-β1,PAI-1 and collagen type Ⅲ(C Ⅲ) were assayed by Western blot and RT-PCR.ELISA was used to detect serum TGF-β1 and plasma PAI-1.Tissue and serum HYP were determined by acid hydrolysis and alkaline hydrolysis methods respectively.Results Inflammation was found in the lung tissues of all the exposed rats.Obvious pathological lung fibrosis was found at 60 d,the inflammation and the fibrosis in treated group were slighter than those in single radiation group.In Chinese medicine group,the protein and gene expression levels of TGF-β1,PAI-1,C Ⅲ 30 d(Protein:t =2.49-3.74,t =2.63-4.57 and t =2.76-3.83;Gene:t =2.59-4.33,t =2.83-4.62 and t =2.83-3.96,P<0.05),serum TGF-β1 and plasma PAI-1 15 dlater (t =2.85-6.27 and t =3.69-5.27,P<0.05),and the levels of tissue and serum HYP60 dlater (t=3.65-4.40 and t =6.56-3.75,P<0.05),all of them were lower than those in single radiation groups.There were significant positive correlations between tissue TGF-β1 and PAI-1 as well as C Ⅲ (Protein expression:r =0.604,0.759,P <0.05;Gene expression:r=0.519,0.816,P<0.05).Conclusions ARPD may inhibit the pulmonary fibrosis by decreasing the levels of TGF-β1,PAI-1 and C Ⅲ.
8.A case-control study of the risk factors for neurosis
Xiaojun LI ; Yueqin HUANG ; Zhaorui LIU ; Xiaomin LUO ; Ni TANG ; Xiangqun WANG
Chinese Mental Health Journal 2010;24(2):99-102,115
Objective: To screen out suspected risk factors associated with neurosis, such as personality dis-order, life events, parental rearing behavior, and to explore degree of their associations. Methods: A case-control study was carried out among 100 cases with neurosis and 200 controls without mental disorder, matched by gender and age (+3 years) . The Life Events Scale (LES), Parental Rearing Style Questionnaire (EMBU), Personali-ty Diagnostic Questionnaire (PDQ-4) were self-reported by the subjects. Results: Single factor analysis showed that there were statistical differences (P <0.05) between case and control groups in negative life event (22.5 vs. 2.5), paternal rejection [(40.4±14.1) vs.(35.4±7.9)], paternal overprotection [(29.1±7.5)vs.(28.2±5.6)], maternal rejection rearing behavior [(40.4±13.7)vs.(36.8±8.5)], and overall personality disorder [(29.8±14.1)vs.(17.1±13.0)] . Using non-conditional logistic regression analysis, the potential protective factor was positive events (OR=0.92, 95% CI:0.87-0.98), and the potential risk factors included negative live events (OR=1.06, 95% CI:1.04~1.08) and overall personality disorder (OR=4.84, 95% CI: 2.24~10.49) . Conclusion: Positive life event may be a protective factor for neurosis, while negative life e-vent and personality disorder may be risk factors.
9.Clinical study of comprehensive Traditional Chinese Medicine treatment for limb dysfunction after ischemic stroke
Jianli NI ; Zhiheng MA ; Dongmei WU ; Jie HUANG ; Zhongdong WANG ; Xiaojun YI ; Qing YUAN
International Journal of Traditional Chinese Medicine 2021;43(2):128-132
Objective:To evaluate the clinical effect of Limb dysfunction after the comprehensive treatment of ischemic stroke by Traditional Chinese Medicine (TCM).Methods:A total of 160 patients with limb dysfunction after ischemic stroke. Who in line with the inclusion criteria, were randomly divided into 2 groups by random number table, 80 cases each. These patients were treated in Multicenter Union Hospital from June 2017 to Janunry 2019. The patients in the control group were given basic Western medicine treatment and rehabilitation training, while the patients in the observation group were given a comprehensive treatment combined with traditional Chinese medicine based on the control group (Chinese herbs, herbal fumigation and ear point press). Both groups were treated for 4 weeks and follow-up for 2 months. The Fugl-Meyerscale were used to evaluate the degree of limb dysfunction and balance dysfunction, the National Institutes of Health Stroke Scale were used for assessing the damage extent of nerve function, the Barthel index for evaluating the mobility of daily life. The clinical efficacy was evaluated according to the method of Brunnstrom assessment.Results:After treatment, the Limb strong spasm (1.57 ± 0.36 vs. 1.98 ± 0.53, t=5.724), Hemianesthesia (1.37 ± 0.31 vs. 1.80 ± 0.36, t=8.096), Inhibited bending and stretching (1.31 ± 0.25 vs. 1.84 ± 0.46, t=9.055) in the observation group were significantly lower than those in the control group ( P<0.01). The Fugl-Meyer activity and balance rating in the observation group were significantly higher than those in the control group ( t values were 2.739, 4.705, respectively, P<0.05 or P<0.01). The total effective rate of observation group was 93.3% (78/80), the control group was 73.3% (71/80), and there exist statistical significance ( χ2=4.783, P=0.028) in the two group’s comparative difference. Conclusion:The comprehensive TCM treatment can improve the hemiplegia syndrome of ischemic stroke patients and their limb activity and balance function, promote their neural functional recovery, enhance the activity of their daily life and clinical efficacy.
10.Cervical Lymphadenitis Caused by Candida albicans:A Case Report
Hong SANG ; Rongzhi NI ; Xianping SHEN ; Bo WU ; Jie FU ; Xinhua ZHANG ; Yousheng LI ; Xiaojun ZHOU ; Guiqin SUN ; Xiaogang ZHENG
Chinese Journal of Dermatology 1994;0(05):-
Objective To report the first case of cervical l ymphadenitis caused by Candida albicans in China.Methods A series of clinical,histopatholog ic.and mycologic studies were carried out in an 8year-old-boy with cervical lymphadenitis,who had no definite underlying disease.Candida albicans was isolated fromthe patient.The lymph node was investigated by me ans of culture,pathological and tra nsmission electron microscopic examination and cellular immunology detected by flow cytometer.Results There were several enlarged,warm,a nd fluctuant cervical lymph nodes which varied fr om 1cm?1cm to 4cm?4cm in size.One swo llen node was excised,and Candida albicans was found in the culture.The histopathologic changes of the cervical lym ph node were compatible with chronic granulomatous disease.PAS and methenamine silver(PAM)stain of a touch preparation of the bi opsy specimen revealed budding spores an d pseudohyphae.Lymphopenia with a p roportionate decrease of T-helper a nd T-suppressor cells was shown with flowcytometry.The patient received a combination therapy of surgery,flu conazole,thymosin and so on.After one month,t he patient's condition was improved.Many small lymph nodes disappeared,large lymph nodes became smaller.Tw o months later,only one large lymph n ode could be touched.Conclusion It is the first case of cervical lymphad enitis caused by Candida reported in China.Combination therapy of surgery,fluconazole and thymosin is effective.