Humans ; Stem Cell Transplantation

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for patient with multiple pulmonary in-fection after renal transplantation. METHODS:Clinical pharmacists participated in drug therapy for a patient with multiple pulmo-nary infection after renal transplantation,and assisted physicians to formulate primary therapy plan:ganciclovir 250 mg,ivgtt,q12 h+ Cefoperazone sodium and sulbactam sodium 3 g,ivgtt,bid+ methylprednisolone 80 mg,ivgtt,qd+ Compound sulfamethoxazole tablet,2 piece,po,qd+Ciclosporin soft capsule 75 mg,po,q12 h+Sodium bicarbonate tablet 1 g,po,qd+Nifedipine controlled release tablet 30 mg,po,qd+Famotidine tablet 20 mg,po,bid. The dose of ganciclovir was adjusted twice because of complica-tion cytomegaloviral pneumonia;the dose of ganciclovir was adjusted twice because of complication pneumocystis pneumonia. Pre-vention and disposal of ADR,patient education were also conducted. RESULTS:Physicians adopted the suggestion of clinical phar-macists;the pulmonary infection had been controlled,and the patient was discharged from hospital. CONCLUSIONS:Clinical pharmacists identify the breakthrough point to promote rational drug use,indicating the value of pharmaceutical care in the clinical treatment.

Objective To construct recombinant lentivirus with the gene STAT3 of the Mus musculus,measure the expres-sion of STAT3,and conduct lentivirus packing and identification.Methods The mRNA of mouse myoblast was extracted and transformed into STAT3 cDNA by the special primer.then,STAT3 cDNA was amplified and reclaimed and inseted into pLVX-IRES-ZsGreen1 vector.Cleavage map and sequencing analysis were used for identification of the recombinant lentivirus vector (pLVX-IRES-ZsGreen1-STAT3).293 T cells were transfected with main vector pLVX-IRES-ZsGreen1-STAT3.and 48 h later, Western blott detected the expression of STAT3 protein.Lentiviral vectors were packaged and the titer was determined.Results The lentiviral vector plasmid pLVX-IRES-ZsGreen1-STAT3 was identified correctly by cleavage map and Co-transfection of 293 T cells with 48 h,the expression of STAT3 was significantly enhanced by western blot.And DNA sequencing analysis confirmed that STAT3 gene sequencing was exactly the same with that reported by genbank.Conclusion Lentiviral vector carrying STAT3 was successfnlly constructed and could express STAT3 with high efficiency,and can be used in further study.

Aim To detect the effect of Bio on impro-ving insulin resistance and explore its molecular mech-anism. Methods The HepG2 liver cells were derivat-ed by high concentration insulin to establish the insulin resistance cell model, and the cells were intervened by Bio. The glucose consumption was measured by glu-cose oxidase and peroxidase ( GOD-POD) assay. The expression of PPARγmRNA was detected by RT-PCR. The expression of PPARγ protein was detected by Western blot method. Results The glucose consump-tion was significantly decreased in the insulin resist-ance cells after incubated with 1 . 72 × 10 -5 mol · L-1 insulin ( P<0. 05 ) . 10 -5 ,10 -6 ,10 -7 mol · L-1 Bio increased the glucose consumption 135%,62%,39%separately in the insulin resistance cells. RT-PCR a-nalysis of PPARγ showed that Bio raised the PPARγmRNA. Western blot analysis displayed that the pro-tein of PPARγ with Bio was increased. Conclusion Bio can improve the insulin resistance of the HepG2 cells, and the molecular mechanism may be relevant with raising PPARγ expression.

BACKGROUND:Superparamagnetic iron oxide (SPIO) labeling can trace the migration of stem cells in vivo, and the fluorescent DiI dye is suitable for marking and tracing cells because of its less influence on cellviability, proliferation and differentiation.
OBJECTIVE:To observe the effect and safety of SPIO and fluorescent DiI dye to double label bone marrow mesenchymal stem cells.
METHODS:The bilateral lower limbs of rats were isolated sterilely. Bone marrow was obtained by rinsing using low-glucose DMEM. Bone marrow mesenchymal stem cells were isolated by the whole bone marrow adherence method and purified by differential attachment method. Purified cells were dual-labeled with SPIO particle and fluorescent DiI dye.
RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells could be separated at 8-10 days after primary culture and the subculturing cycle was 3-4 days. Rat bone marrow mesenchymal stem cells could be effectively labeled with SPIO-DiI and the labeling efficiency was almost 100%. Blue irons contained in intracytoplasmatic vesicles could be observed clearly with Prussian blue staining, and the fluorescence microscopy showed red fluorescence at cytoplasm. Survival and apoptosis percentages obtained by MTT analysis were similar among labeled and unlabeled bone marrow mesenchymal stem cells that were both about 95%.These findings indicate that the rat bone marrow mesenchymal stem cells could be efficiently labeled with SPIO-DiI to construct a nano-bioprobe, without significant changes in morphology, viability and proliferation.

Objective To study a novel method for the high-dose-rate brachytherapy (HDR) CT image to the intensity modulated radiation therapy (IMRT) CT image deformable image registration and dose accumulation.Methods The applicator in the HDR CT image is first segmented and removed,then a deflation step is performed on the applicator-free HDR CT image by solving the Navier-Stokes equation.Demons algorithm is utilized to register the deflated HDR CT image to the IMRT CT image,along with the HDR dose.The deformed HDR dose is then added on the IMRT dose and yield the final accumulated dose.Results The HDR CT image and IMRT CT image,as well as the corresponding dose distribution,from five cervical cancer patients are used for evaluation of the proposed algorithm,the results show that the proposed method can effectively get rid of the influence of the applicator and produce an accurate accumulated dose.Conclusions Dose accumulation and supervision is an important step in adaptive radiotherapy for accurate dose delivery and treatment plan re-optimization.The proposed method in this study can effectively accumulate the HDR dose to the IMRT dose domain,and the accuracy is proved to be sufficient for clinical needs.

Objective To study the meaning of breast cancer staging system by AJCC eighth edition to invasive lobular carcinoma and analysis the clinical pathological characteristics.Methods According to the eighth edition of the AJCC staging to evaluate the TNM stage and prognosis evaluation of invasive lobular carcinoma cancer patient in Peking University Shenzhen Hospital from 2011 to 2016,and compared with others in clinical pathological data.Results There were 21 cases of invasive lobular carcinoma,accounting for 2.7％ of all invasive breast cancer.We found that invasive lobular carcinoma shows no significant difference (P ＞ 0.05) in ages,menstrual status,molecular features and anatomic staging and prognosis staging with others;histological grade were significantly different (P ＜ 0.05).There were significant differences in the prognosis and staging of invasive lobular carcinoma.Conclusions Eighth AJCC staging systemn provides a new reference for the clinical treatment of breast cancer,should be evaluated with anatomic stage.Histological grade is relatively good in invasive lobular carcinoma and the prognosis is good,needs more research to the individualized treatment of invasive lobular carcinoma.

Objective To study the homology relationship among clinically isolated imipenem-resistant klebsiella pneumoniae strains and possible transmission route of drug resistant strains to provide a basis for blocking the transmission of this kind of bacteria in clinc.Methods Clinical samples collection and bacterial culture were routinely conducted,meanwhile the hand surface of ICU medical staffs and the surfaces of patien's bedside objects were performed the sample collection for conducting the bacterial count and culture.The bacterial identification and drug susceptibility test were performed by the VITEK-2 COMPACT system.The bacterial homology detection adopted the ERIC-rep-PCR method.Results Totally 642 strains of imipenem-resistant Klebsiella pneumoniae were clinically isolated from January 2011 to December 2013.Among them,389 strains(60.59％) were derived from ICU.72 strains (11.21％) fsrom the respiratory department,53 strains (8.26％) from the neurology department,41 strains (6.39 ％) from the cardiovascular department,31 strains (4.83％) from the surgical department,11 strains (1.71％) from the gastroenterology department,5 strains (0.78 ％) from the renal department,17 strains (2.65 ％) from the emergency department and 23 strains(3.58％) from the other departments.One strain of imipenem-resistant Klebsiella pneumoniae was isolated from the IGU object surface.Among 642 clinical bacterial strains,there were 8 main clones,these 8 clone strains added up to 394 strains,which accounted for 61.37％ of whole bacterial strains,the other 248 strains were single clones.Conclusion The monoclonal prevalence of imipenem-resistant klebsiella pneumonia in this hospital actually exists.The contact transmission may be the possible transmission route of this kind of infection.

Objective To explore the health guidance role on treating uterine fibroids in high intensity fo-cused ultrasound thermal ablation(HIFU).Methods High intensity focused ultrasound ablation treatment was used in 74 cases of uterine fibroids patients before and after treatment to enable patients to better health guidance with treatment.Results After treatment,symptoms of patients with the clinical manifestation including menstrual too much,dysmenorrhea,frequent urination,constipation and anemia,were significantly improved.The volume of myoma of uterus before treatment and after treatment for 3 months,6 months and 1 year were (100.780 ±104.243 )cm3 , (53.446 ±49.546)cm3,(32.704 ±32.246)cm3 and (21.991 ±16.301)cm3,respectively.The volume of myoma of uterus gradually reduced after treatment as compared with that before treatment,the difference had statistical signifi-cance(t=6.758,186,7.567,all P<0.01).Conclusion Effective health guidance is beneficial to HIFU treatment for patient.

Objective To understand the cleaning status of hospital environment,and evaluate the effect of fluo-rescence labeling method plus feedback and training on hospital environmental cleaning effectiveness.Methods A total of 27 departments in a hospital were investigated,1 cleaning staff and 2 inpatients were selected from each de-partment,cleaning staff’s knowledge about cleaning and disinfection of environmental object surfaces,as well as cleaning status of inpatients’wards were surveyed,cleaning efficacy of hospital environmental object surfaces were detected with fluorescence labeling method,the surveyed results were performed timely feedback to clinical depart-ments,training on cleaning and disinfection knowledge was conducted,the effective cleaning rate of environmental object surface before and after the training was compared.Results A total of 27 cleaning staff were surveyed,the correct response rate for cleaning frequency was 96.30% ,awareness rate for section concept was 96.30% ,accuracy rate of cleaning order was 92.59% ,accuracy rate of post-cleaning immersion time of sanitary wares in disinfectant was 85.19% ,accuracy rates of replacing,drying,and repeated immersing wiping cloths were 81.48% ,48.15% ,and 25.93% respectively,rates of correct disinfectant formulating method and mop drying time were both 0. Among 54 investigated patients,bed units and ground of wards of 28 patients were cleaned both 1-2 times/day;bed units of 8 patients had never been wiped,18 patients in 9 departments cannot be conducted statistics due to completely in-consistent responses with the other patients of the same departments. The effective cleaning rates of environmental object surfaces before and after the training were 34.62% and 64.96% respectively,difference was significant(χ2=21.81,P<0.01).Conclusion Fluorescence labeling method plus feedback and training can improve cleaning efficacy of hospital environmental object surfaces.