Objective:To explore the breakthrough points of pharmaceutical care in the anti-infection treatment by clinical phar-macists. Methods:Using the pharmaceutical care carried out by clinical pharmacists in the treatment of infected patients as the exam-ple, the breakthrough points of pharmaceutical care in the anti-infection treatment by clinical pharmacists were discussed. Results:Clinical pharmacists should be in accordance with the specific clinical conditions to find out such breakthrough points of pharmaceutical care as judging the indications of antibacterial drugs use, assisting in the development of drug therapeutic regimens ( including the choice of species, dosage and solvent, the optimization of PK/PD parameters and the infusion speed) , paying close attention to bacteri-al culture, concerning on drug interactions, monitoring adverse drug reactions and efficacy, providing patient medication education and so on. Conclusion:Clinical pharmacists can participate in anti-infection treatment and carry out individual pharmaceutical care to en-sure the safety and efficacy of drugs.

BACKGROUND:Previous studies have found that the susceptibility genes of adiponectin gene and calpain 10 gene of type 2 diabetes are closely related with the incidence of diabetes in Chinese renal transplantation patients. So, are other susceptibility genes of type 2 diabetes also associated with posttransplantation diabetes mel itus? OBJECTIVE:To investigate the association between the zinc transporter solute carrier family 30 member 8 (SLC30A8) gene polymorphism and the posttransplantation diabetes mel itus. METHODS:A total of 97 patients with posttransplantation diabetes mel itus and 301 patents without posttransplantation diabetes mel itus (control group) were selected, and then the SLC30A8 gene rs13266634 genotype was detected with real-time PCR method. The association between gene polymorphism and posttransplantation diabetes mel itus was analyzed with Logistic regression test. RESULTS AND CONCLUSION:There were significant differences in al ele frequencies and genotype distributions of rs13266634 between the patients with and without posttransplantation diabetes mel itus (P<0.05). After adjustments of age, sex, body weight and body mass index, the incidence of posttransplantation diabetes mel itus of the CC genotype patients was 2.108 times to that of the TT genotype patients (odds ratio=2.108, 95%confidence interval:1.075-4.131, P=0.044);and the incidence of posttransplantation diabetes mel itus of the CC+CT genotype patients was 1.862 times to that of the TT genotype patients (odds ratio=1.862, 95%confidence interval:1.049-3.306, P=0.034). The results suggest that the C-al ele in rs13266634 of SLC30A8 gene is the independent risk factor of posttransplantation diabetes mel itus.

Objective To investigate the risk factors and clinical features of mild cognitive impairment (MCI) in patients with ischemic cerebral small vessel disease (SVD) for early diagnosis and prevention.Methods Montreal Cognitive Assessment Scale (MoCA) was used to screen MCI.The related risk factors and other clinical data were collected,and other neuropsychological tests were conducted.SVD was divided into leukoaraiosis (LA),lacunar infarction (LI),and LA + LI.Results A total of 143 patients with SVD were enrolled (68 in an MCI group,75 in a non-MCI group).Univariate analysis showed that there was no significant difference in the constituent ratio of age and gender between the MCI group and the non-MCI group,but the years of education in the MCI group was shorter than that in the non-MCI group,while the composition ratios of hypertension (69.11％ vs.45.33 ％;x2 =8.215,P =0.004),diabetes (57.35％ vs.40.00％;x2 =4.301,P =0.038),hyperlipidemia (48.53％ vs.24.00％ ; x2 =9.352,P =0.002),carotid atherosclerosis (41.18％ vs.21.33％ ;x2 =6.592,P =0.010),and smoking (32.35％ vs.14.67％ ;x2 =6.285,P =0.012),as well as the levels of uric acid (351.81 ± 83.21 mmol/L vs.323.03 ± 80.43 mmol/L; t =2.102,P =0.037) and total cholesterol (5.26 ± 1.26 mmol/L vs.4.56 ± 1.23 mmol/L; t =3.326,P =0.001) were significantly higher than those in the non-MCI group.Multivariate logistic regression analysis showed that hypertension (odds ratio OR]2.227,95％ confidence interval [CI],1.001-4.954; P =0.026),diabetes (OR 2.056,95％ CI 1.862-4.937; P =0.046),hyperlipidemia (OR 2.528,95％ CI 1.361-5.770; P =0.028),carotid atherosclerosis (OR 2.658,95％ CI 1.110-6.367; P =0.029),smoking (OR 2.566,95％ CI 1.017-6.474; P =0.046),and years of education (OR 0.825,95％ CI 0.745-0.914; P =0.000) were the independent risk factors for the occurrence of MCI in patients with SVD.The subscores in the MCI group,including MoCA total score (18.44 ± 5.60 vs.27.09 ± 1.37; t =-12.422; P =0.000),as well as visuoconstructional skills (2.65 ± 1.39 vs.4.49 ± 0.74; t =-9.762; P =0.000),attention (4.48 ± 1.70vs.5.89 ± 0.31; t =6.706,P=0.000),language (1.69 ± 0.80vs.2.41 ± 0.95 ; t =4.893,P=0.018),abstraction (0.85 ± 0.69 vs.1.71 ± 0.53; t=-7.081,P=0.000),delayed recall (1.29 ±1.01 vs.4.04 ± 0.99; t =13.824,P =0.000) were significantly lower than those in the non-MCI group,and there were no significant differences in naming and orientation scores.In the MCI group,the subscores such as theMoCA total score in the LA+LI group (17.04 ± 6.15 vs.21.04 ± 3.98; P＜0.05),as well as visuoconstructional skills (1.68 ± 1.16 vs.3.24 ± 1.13; P ＜ 0.05),attention (3.92 ± 2.03 vs.5.19 ±0.87; P ＜0.05),delayed recall (1.35 ± 1.01 vs.1.86 ± 1.58; P ＜0.05) were significantly lower than those in the LI group; the subscores such as the MoCA total score in the LA group (18.18 ± 5.31 vs.21.04 ± 3.98; ＜ =0.05),as well as visuoconstructional skills (2.56 ± 1.78 vs.3.24 ± 1.13; P＜0.05),language (0.64 ± 0.23 vs.1.24 ± 0.83; P ＜0.05),delayed recall (0.69 ± 0.58vs.1.86 ± 1.58;P＜0.01)were significantly lower than those in the LI group; the visuoconstructional skills in the LA + LI group was significantly lower than that in the LA group (1.68 ± 1.16 vs.2.56 ± 1.78; P＜0.05) and the LI group (1.68 ± 1.16 vs.3.24 ± 1.13; P＜ 0.05).Conclusions Hypertension,diabetes,hyperlipidemia,carotid atherosclerosis,smoking,and the low level of education were the independent risk factors for MCI in patients with SVD.After SVD,the cognitive impairment in MCI presented as multiple cognitive domains impairments,including visuoconstructional skills and delayed recall.Cognitive impairment differed among the different types of SVD.

OBJECTIVE:To investigate the effect of clinical pharmacist intervention on prophylactic application of antibiotics in cardiothoracic surgery. METHODS:Medical records of patients underwent cardiothoracic surgery were collected from our hospi-tal during Mar. to Apr. in 2014 (before intervention) and during Jun. to Jul. in 2014 (after intervention). Those were divided into pre-intervention group(n=115)and post-intervention group(n=119). The prophylactic application effect of antibiotics was com-pared before and after intervention. RESULTS:After intervention,the rates of prophylactic application were decreased significantly from 96.5% to 72.3%;the rationality rate of antibiotics selection was improved significantly from 27.9% to 94.2%;The course of prophylactic medication decreased significantly from(5.4±2.8)days to(2.3±1.8)days;the difference had statistical significance before and after intervention(P<0.01). The postoperative infection rate was decreased from 13.0% to 5.9%,the difference had no statistical significance(P=0.074). The average hospitalization time,average drug costs,and average hospitalization expenses were decreased significantly,the difference had statistical significance(P<0.05 or P<0.01). CONCLUSIONS:Clinical pharmacist inter-vention to prophylactic application of antibiotics in cardiothoracic surgery can control the infection effective and guarantee reason-able and safe use of drugs during perioperative period.

Objective:To evaluate the effect of continuing intervention on prophylactic application of antibiotics in sterile operation in urology department by clinical pharmacist to provide reference for the clinical prophylactic application of antibiotics. Methods:All cases of discharged patients underwent sterile operation in urology department of our hospital from July 2010 to June 2014 were divided into three groups according to the intervention time and methods: non-intervention group(n=141), stage Ⅰ intervention group(n=139), stage Ⅱ intervention group (n=162) and stage Ⅲ intervention group (n=137). The prophylactic application of antibiotics was statistically analyzed. Results:After the continuing intervention, the prophylactic application rate of antibiotics in the three inter-vention groups was decreased significantly from 100% before the intervention respectively to 34. 5%,18. 5% and 14. 6% after the in-tervention (P<0. 01). The rationality rate of prophylactic application was improved significantly from 36. 9% before the intervention respectively to 58. 3%, 63. 3% and 85. 0% after the intervention (P<0. 01). The course of prophylactic application was decreased significantly from (138.2 ±31.6)h respectively to (89.9 ±48.0)h,(72.8 ±32.5)h and(45.1 ±29.5)h (P<0.01) and the post-operative infection rate was decreased from 2. 8% respectively to 2. 1%,1. 8% and 1. 4%. Conclusion:The pharmaceutical interven-tion is feasible and valid to improve the rational prophylactic use of antibiotics in urological surgery.

ObjectiveTo study the protective effects of tert-butylhydroquinone(tBHQ) on sodium arsenite (NaAsO2)-induced cytotoxicity and oxidative injuries. Methods Chang liver cells were pretreated with tBHQ[0(control), 5, 25 μmol/L]for 24 h, and then co-treated with tBHQ(5 μmol/L) together with NaAsO2[0(control),30, 40, 50, 60 μmol/L] for another 24 h, and Alamar blue reduction rates were used to evaluate cell viability,the results were expressed as the relative ratio of Alamar blue reduction rates between the experimental group and the control group. On the other hand, Chang liver cells were pretreated with tBHQ[0(control), 5, 25 μmol/L] for24 h,and then co-treated with tBHQ(5 μmol/L) together with NaAsO2[0(control), 40, 50 μmol/L] for another 24 h,and the levels of cellular reactive oxygen species(ROS) were detected by staining cells with 2',7'-dichlorofluorescin diacetate(DCFH-DA), the results were expressed as the relative ratio of mean fluorescence intensity between the experimental group and the control group. ResultsCell viability decreased dramatically by treatment with NaAsO2(30, 40, 50, 60 μmol/L), while relieved to some extent by pretreatment with 5, 25 μmol/L tBHQ, the main effects of NaAsO2 and tBHQ, as well as their interaction were all statistically significant(F =566.57, 55.09, 14.50,all P ＜ 0.05) ; the cell viability of NaAsO2(30, 40, 50, 60 μmol/L) pretreated with tBHQ(5, 25 mol/L) were 0.75 ±0.02, 0.70 ± 0.04, 0.59 ± 0.03, 0.43 ± 0.03 and 0.75 ± 0.02, 0.73 ± 0.03, 0.65 ± 0.02, 0.50 ± 0.02, respectively,all significantly higher than corresponding NaAsO2 alone groups(0.70 ± 0.03, 0.64 ± 0.03, 0.43 ± 0.03, 0.33 ±0.01, all P ＜ 0.05), the cell viability of NaAsO2(50, 60 μmol/L) pretreated with 25 μmol/L tBHQ was higher than corresponding 5 μmol/L tBHQ pretreatment groups(all P ＜ 0.05). On the other hand, 40, 50 μmol/L of NaAsO2 significantly induced hepatocellular ROS generation, while tBHQ(5, 25 μ mol/L) pretreatment significantly decreased NaAsO2-induced intracellular ROS levels, the main effects of NaAsO2 and tBHQ, as well as their interaction were all statistically significant (F =181.78, 60.55, 4.93, all P ＜ 0.05) ; the ROS levels of NaAsO2(40, 50 μ mol/L) pretreated with tBHQ(5, 25 μmol/L) were 1.87 ± 0.09, 1.80 ± 0.07 and 1.36 ± 0.11, 1.44 ± 0.12,all significantly decreased than corresponding NaAsO2 alone groups(2.30 ± 0.18, 2.18 ± 0.17, all P ＜ 0.05),the ROS levels of NaAsO2(40, 50 μmol/L) pretreated with 25 μmol/L tBHQ decreased than corresponding 5 μmol/L tBHQ pretreatment groups (all P ＜ 0.05). ConclusiontBHQ has a certain antagonism on arsenic induced cytotoxicity and oxidative injuries.

Actins ; metabolism ; Aged ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Fasciitis ; metabolism ; pathology ; Female ; Fibroma ; metabolism ; pathology ; surgery ; Humans ; Keratin-5 ; metabolism ; Mastectomy, Modified Radical ; Neoplasms, Muscle Tissue ; metabolism ; pathology

Objective This paper attempts to explore the application of dizziness handicap inventory (DHI) in evaluation of health -related quality of life (QOL ) changes of patients with benign paroxysmal positional vertigo (BPPV) before and after the treatment with canalith repositioning procedure (CRP) .Methods The DHI was em-ployed to investigate and evaluate the dizziness handicap of 120 patients with BPPV before and after 3 months of CRP treatment (treatment group) and 60 healthy controls (control group) ,while the DHI scoring results were com-pared .Results As indicated by DHI evaluation ,the scoring of each DHI items of patients with BPPV before treatment was higher than that of control group ,treatment group before treatment :functional score 22 .60 ± 6 .54 ,emotional score 18 .50 ± 8 .28 ,physical score 17 .90 ± 5 .05 ,total composite score 59 .00 ± 14 .32 .For the control group:functional score 1 .35 ± 1 .74 ,emotional score 1 .00 ± 1 .01 ,physical score 1 .37 ± 1 .86 ,total composite score 3 .72 ± 3 .46 ,with the differ-ence statistically significant (P<0 .05) .The DHI scoring of treatment group of patients with BPPV after 3 months of CRP treatment was lower than that before the treatment (treatment group after 3 months CRP treatment :functional score 1 .10 ± 1 .42 ,emotional score 1 .50 ± 1 .70 ,physical score 1 .45 ± 1 .46 ,total composite score 4 .05 ± 3 .66) ,and the difference was statistically significant (P<0 .05) .There was no statistically significant difference comparing to the control group (P>0 .05) .Conclusion CRP is effective to treat BPPV .The DHI is available for the evaluation of QOL of BPPV patients .

Objective To analyze neuraminidase(NA) inhibitor resistance of seasonal H1N1 influenza A viruses isolated in Shenzhen during 2008 to 2009. Methods The NA gene of these viruses were sequenced. Phylogenetic analysis of the sequences was performed with Mega3. 1 software. Results In 2008, most isolates of the seasonal H1 N1 virus were susceptible to neuraminidase inhibitors, but the H275Y mutation in the neuraminidase gene region associated with high-level oseltamivir resistance had been detected in 92.6% of the strains isolated in 2009. Furthermore, a strain with Q136K was found, which showed the resistance to Zanamivir. Conclusion In the light of emerging resistance, close monitoring and understanding of the nature and dynamics of resistance mutations in influenza virus should be a priority.

Objective To observe morphological characteristics and activity distribution of T. asahii biofilm. Methods The morphological characteristics of T. asahii biofilm were observed under an inverted microscope and scanning electron microscope, and activity was measured and quantitatively analyzed by 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazo-lium hydroxide (XTT) assay and viable count, respectively. Spatial distribution of dead/vital cells, activity and thickness of biofilm at different layers were assessed under a confocal laser scanning microscope (CLSM) following double staining with FDA/PI. Results T. asahii formed a biofilm in vitro on the surface of polystyrene materials. Under a scanning microscope, the biofilm displayed a complex three-dimensional structure which composed of spores, pseudohy-pha and true hypha. As time prolonged, the activity and quantity of biofilm increased. The results of XTT assay were correlated with those of viable count (r = 0.94, P < 0.01). The activity was of no obvious difference between different layers of the biofilm. The thickness of biofilm varied from 14.3 μm to 31 μm. Conclusions The structure of T. asahii biofilm in vitro is more complex than that of planktonic T. asahii. The activity is of no significant difference between different layers of T. asahii biofilm.