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.

ObjectiveTo assess the psychosomatic health status of patients with facial steroiddependent dermatitis by using Pittsburgh sleep quality index (PSQI),self-rating anxiety scale (SAS) and selfrating depression scale(SDS).MethodsPsychosomatic health status was evaluated by using PSQI,SDS and SAS in 92 patients with facial steroid-dependent dermatitis and 50 healthy controls.ResultsThe scores on depression and anxiety in patients with steroid-dependent dermatitis were higher than those in the controls (63.11 ± 10.29 vs.36.78 ± 2.46,53.24 ± 9.98 vs.31.29 ± 9.45,both P ＜ 0.01).There were significant differences between the two groups in the quality of sleep.The general and mean PSQI global scores on subjective daytime function,sleep disturbances,time needed to fall asleep and sleep duration were significantly higher in the patients than in the controls.ConclusionsPatients with steroid-dependent dermatitis have a poor sleep quality with the presence of anxiety and depresssion.Psychosocial interventions are warranted for the treatment of patients with steroid-dependent dermatitis.

microRNAs (miRNAs) are short non-protein-coding RNAs,which play important roles in the cell proliferation,differentiation,apoptosis,as well as activation of oncogenic and antioncogenic signals.Researches show that the abnormal expressions of miRNAs are closely related to the tumorigenesis,histological type,diagnosis,treatment and prognosis of lung cancer.So miRNAs may be the most potential and promising therapeutic targets for lung cancer.

As a kind of source wide,low inherent immnunogenicity multipotent stromal cells,mesenchymal stem cells (MSCs) have been used to cell-based therapeutic researches of immunodeficient deseases or other severe clinical disorders.Despite low levels of engraftment in the injured lung,numerous preclinical trials indicate that mesenchymal stem cells can promote damaged tissue repair constructed by secreting paracrine factors to regulate the host immunity,inhibit inflammation and restore epithelial integrity.Acute lung injury(ALI) is a serious organ dysfunction occurred earliest and the most commonly affected organ.Currently there is no effective medicine therapy and the mortality remains high.Researches demonstrate MSCs can reduce alveolar edema,improve lung function and reduce motality.So understanding of the mechanism will be conductive to the MSCs from experimental stage into clinical application.This issue will put a brief overview pointed on the mechanism of mesenchymal stem cells in repairing the injured lung.

Objective To evaluate changes in cerebral blood flow before and after cranioplasty by 256-slice Spiral CT perfusion imaging,and evaluate the effect of cranioplasty on the cerebral blood flow in patients with skull defect.Methods 256-slice spiral CT scan was performed in 20 cases with early cranioplasty surgery,CTP check time points were 1 to 2 days before and 10 to 14 days after cranioplasty surgery.We recorded the the CBF and CBV of the cortex,basal ganglia,and thalamus and other parts,MTT on rCBV,parameter values rCBF,MTT and 1TrP etc.and analyzed and compared.(RCBF,rCBV,MTT and TTP) Results The CBF of cortex after cranioplasty at injured side had statistically significant increase (P＜0.05).The CBF of cortex,basic nuclei,thalamus on contrateral had no statistically significant difference.The cerebral blood flow on both sides of the basal ganglia and the thalamus was increased after surgery,but there was no significant difference between before and after surgery (P＞0.05) Conclusion Cranioplasty can significantly improve the ipsilateral cortex cerebral blood flow,and CT brain perfusion can accurately assess changes in brain tissue blood flow before and after cranioplasty.

Objective To investigate the cerebral regularity of dynamic charge and the correlation with intracranial pressure(ICP),clinical seriousness and prognosis on acute stage of intracerebral hemorrhage(ICH) patients by transcranial Doppler(TCD).Methods 54 patients with first acute supratentorial ICH 24h after onset were studied.All patients were dynamic evaluated by beside TCD on 1st,7th,21st day.The correlation of TCD with ICP,MESSS were studied.Results On the 1st day the TCD abnormity of the acute phase of the ICH occurred mainly in the anterior circulation of cerebrum,in which the cardinal manifestation was high-resistance,low-flow velocity blood waveforms,especially on the bleeding side.Continuous TCD monitoring revealed the low velocity of the cerebral blood flow increased;meanwhile the high value of PI decreased gradually and the TCD monitoring was within the normal range three weeks after the attack.The ICP had negative correlation with the VmMCA,positive correlation with the PI value.MESSS scale had negative correlation with the VmMCA,positive correlation with the PI value.Conclusions The TCD examination can be used to monitor the cerebral hemodynamics of the patients suffering from intracerebral hemorrhage.The combination of fVEP and TCD facilitate the evaluation of the dynamic changes of ICP so as to instruct lowering the ICP.

Objective To investigate if the 23 strains of highly-resistant P.aeruginosa isolated from different patients in the in- tensive care unit (ICU) have the same origin;and explore the related mechanisms of carbapenem resistance in these multidrug- resistant P.aeruginosa.MethOds Antimicrobial susceptibility testing was performed using disk-diffusion technique.The strains were genotyped by rep-PCR with the primer ERIC2 followed by electrophoresis in agarose gel.We used a previously described imipenem-EDTA double-disk test for screening MBL-producing P.aeruginosa.Polymerase chain reaction for amplification of blaOprD, blaIMP, and bla VIM were performed to detect corresponding mutants.Results The result of antimicrobial suscepti- bility testing showed that 20 of the 23 P.aeruginosa isolates were muhidrug-resistant and highly resistant to imipenem and meropenem, and at least 5 antimicrobial agents tested in this study.The analysis of the rep-PCR products indicated that all the 19 carbapenem-resistant strains had an identical band pattern, which was different from that seen in the sensitive strains.Al- though imipenem-EDTA double-disk test identified 5 MBL-producing strains, PCR found that all the 23 strains were negative for bla VIM and blaIMP.Only one OprD-deficient mutant was identified.Conclusions The 19 highly-resistant strains of P. aeruginosa derive from a common origin.More researches are needed to clarify their mechanism of carbapenem resistance.

Objective To investigate the meridians and acupoints selection in the treatment of post-stroke spastic paralysis with Tuina (Chinese massage). Methods The literatures about Tuina therapy for post-stroke spastic paralysis were retrieved. The frequency of meridians and acupoints used was counted and analyzed. Results 99 papers were collected, which involved in 226 acupoints and 1602 times of application. The selected acupoints were distributed in all the fourteen meridians and 64.5% (1033/1602, 606 on upper limb, 427 on lower limb) of them were on the limbs. The acupoints of the Yang meridians was 75.0% (1200/1602) and the specific acupoints was 71.7% (1148/ 1602). Conclusion The acupoint selected was basically focused on the local areas in Tuina for post-stroke spastic paralysis, assisted with the involved meridians and distal acupoints. The acupoints of the Yang meridians were the first option, mainly on the extremities. The specific acupoints were the major components of the prescription, especially the Five-shu acupoints and the He acupoints.

2cm~2.Conclusions The auto-cranial pedicle flap via endonasal repairing blow-out fractures of or- bital inferior wails is an effective technique.The results are good for improving eye movement especially for fracture ranged≤2cm~2. (Ophthalmol CHN,2007,16:388-390)

Objective To compare the efficacy and tolerability of nateglinide with those of acarbose in Chinese type 2 diabetes mellitus (T2DM) patients.Methods This multi-center,randomized,double-blind,parallel-arm study compared the efficacy and tolerability of nateglinide( 120 mg,3/d,n = 119) and those of acarbose( 100 mg,3/d,n = 118) during a 12-week treatment in T2DM patients uncontrolled by diet with glycosylated haemoglobin (HbA1c) 6.5% - 11.0% .Results Monotherapy with nateglinide (120 mg,3/d)or acarbose (100 mg,3/d)decreased HbA1c to a similar extent during 12-week treatment.The mean change from baseline to end-point in HbAlc was ( -0.90±0.98)% and ( -0.83±0.81 )% in patients receiving nateglinide and acarbose,respectively,with no significant difference between the two groups (P>0.05).The decrease in fasting plasma glucose (FPG)was similar between nateglinide and acarbose (P > 0.05).The mean change in 2-hour postprandial plasma glucose ( PG2h ) was ( - 1.45 ± 2.74) mmol/L and ( -2.20±2.21 ) mmol/L in patients receiving nateglinide and acarbose(P =0.0017).Body weight was significantly decreased in both groups at the end-point ( P < 0.05 ),although the decrease was more with acarbese than nateglinide [( -0.66±1.79)kg vs (-2.06±2.00) kg,P=0.0000].And the proportion of patients experiencing any presumed drug related adverse events was not significantly different between the two groups.Conclusions Nateglinide ( 120 mg,3/d) is effective and well tolerated in T2DM patients uncontrolled by diet,demonstrating similar HbA1c reductions as compared with acarbose (100 mg,3/d).