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.

Caenorhabditis elegans (C.elegans), has developed into an useful model for biomedical research, particularly in the targets of novel drugs and the related mechanism.C.elegans, combining with cost-effective cultivation, simple biological structure, make for high-throughput screenings in vivo model.In this review, we explore the feasibility of C.elegans in drug activity evaluation of complex systems.Because of the body independence of C.elegans, it provided good platform for the efficacy and mechanism of research on new drugs as well as Chinese herbal extract in vivo, showing a good prospect.

Background and purpose: High-dose chemotherapy followed by autologous stem cell transplantation (auto-HSCT) is considered as the ifrst line treatment for patients with relapse/refractory lymphoma after conventional chemotherapy. However, most of these patients still relapse the second time. The purpose of this study was to analyze the efifcacy of the consolidation chemotherapy after autologous stem cell transplantation (HSCT) refractory/relapse lymphoma in high risk. Methods:A total of 38 patients with relapsed/refractory lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were included, who were underwent auto-HSCT in our transplan-tation department from Jan. 2010 to Dec. 2013. In treatment group, 19 patients received 2 courses of consolidation che-motherapy after auto-HSCT every 2 to 3 months, with the regimen of mini-BEAM or modiifed mini-CBV. Another 19 patients had no chemotherapy after auto-HSCT as control group. Results:The median follow-up duration was 17.2 and 7.5 months in the treatment and control group respectively. The follow-up data demonstrated prolonged progression-free survival (PFS) in the treatment group than the control group [24.7 months vs 7.8 months, P=0.029 under intend-to-treat analysis ITT;24.7 months vs 5.2 months, P=0.01 under per protocol analysis(pp)]. There is also a trend of improved overall survival (OS) in the treatment group (P=0.055, ITT). Conclusion:Consolidation chemotherapy after auto-HSCT for refractory/relapsed lymphoma patients delay the relapse and tend to improve the overall relapse rate.

Objective To explore the immunosuppression effects,outcomes and clinical significance of mesenchymal stem cells (MSCs) transplantation in burn treatment by comparing the levels of WBC,C-reaction protein (CRP),interferon-γ(IFN-γ),interferon-o (TNF-α),interleukin-6 (IL-6),interleukin-10 (IL-10) between control burn models and models conducting MSCs transplantation.Methods After stripping Wharton's Jelly from the neonatal umbilical cord,MSCs was cultured and expanded.Burn models were constructed in male SD rats weighted at (200± 5) g,and randomly grouped for control and MSCs transplantation.The rats in transplantation group were injected subcutaneously with hUCMSCs (1.5× 106) at 24 h after burning.The content of WBC,CRP,IFN-γ,TNF-α,IL-6,IL-10 in blood samples at 0,1,2,3,5 and 7 d after burning were detected by enzyme-linked immunosorbent assay (ELISA).The ELISA results,the wound healing rate at 7,14,21 and 28 d,as well as wound healing time were compared and analyzed statistically by ANOVA between the two groups.Results WBC in control group increased significantly at 1 and 2 d,and CRP in control group increased substantially at 2 and 3 d.IFN-% IL-6 and IL-10 levels in serum showed increase on 5 d,and TNF-α arrived at its peak value at 7 d.By contrast,WBC,CRP,TNF-α,IL-6 and IL-10 of the MSCs transplantation group showed slightly increase after burning and the differences were convinced by statistical analysis,while IFN-γ showed little difference among the two groups.The MSCs transplantation group also showed significantly higher wound healing rate at 14,21,28 d and shorter wound healing time than that of the control.Conclusions MSCs transplantation can suppress the over-inflammatory response by significantly mediating the inflammatory cytokines as WBC,CRP,TNF-α,IL-6,IL-10 in burn.IFN-γseems not affected by MSCs transplantation.MSCs would be suitable to promote wound healing and repair in burn,which is achieved not only by differentiation and paracrine,but also by subtle immunoregulation.

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 long-term effect of two different types of arterial reanastomoses for kidney transplantation [an end-to-side anastomoses (ESA) of renal artery to external iliac artery and an endto-end anastomoses (EEA) of renal artery to internal iliac artery] by comparing conventional ultrasound and contrast-enhanced ultrasonography(CEUS) after five years of renal transplantation.MethodsSixty patients underwent kidney transplatation were included and divided into EEA group or ESA group based on the type of anastomoses. Data of renal blood flow perfusion,hemodynamic parameters,and renal anatomical structure were collected and analyzed in each groups using CEUS,color Doppler flow imaging(CDFI) and B-mode ultrasound.ResultsThe patients of the two arterial reanastomoses had no significantly difference in B-mode ultrasound and CDFI. The ESA patients had a slightly better perfusion than the EEA ones in parameters of CEUS.Conclusions Transplant tissue perfusion imaging was performed by CEUS. The perfusion of ESA grafts was slightly better than that of EEA.

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.

Asthma is a common disease with recurrent onset which severely affects patients' quality of life.Acupuncture can improve pulmonary functions in asthma patients and thus treat this disorder.To summarize the status of acupuncture treatment for asthma,we have collected clinical literatures published in the recent 10 years and analyzed the influence of acupuncture on pulmonary functions in asthma patients from the aspects of frequently used points,needling techniques,manipulation and mechanisms to provide references for treating asthma with acupuncture.

Objective To explore the value of abnormal imaging findings on susceptibility weighted imaging (SWI) in delayed graft function (DGF). Methods The conventional MRI and SWI images of 26 cases with DGF and 20 cases with normal renal function of transplanted kidneys were retrospectively analyzed. Patients with cysts and angiomyolipomas were excluded. Normal structures of transplanted kidney were identified. If lesions of abnormal signal intensity were found in the transplanted kidney, the location, border and signal intensity compared to renal cortex would be analyzed. The differences in signal intensity between the abnormal signal lesions and normal renal cortex in the same SWI layer of DGF were compared by using independent-sample t test. The differences in positive detection rate of discovering the abnormal signal lesions in DGF between conventional MRI and SWI were compared by using McNemar test. Results Of the 26 cases with DGF, one case was found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on both conventional MRI and SWI images. Ten cases were found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images only. Fifteen cases exhibited no abnormal signal lesions on both conventional MRI and SWI images. Twenty cases with normal renal function of transplanted kidney, no abnormal signal lesions were found on both conventional MRI and SWI images. The differences in signal intensity between the abnormally low signal lesions (130±20) and normal renal cortex (177±25) in the same SWI layer of 11 cases with DGF were statistically significant (t=-4.582,P<0.01). The differences in positive detection rate of discovering the abnormally low signal lesions in DGF between conventional MRI [3.8%(1/26)] and SWI [42.3% (11/26)] were statistically significant (χ2=8.100,P=0.002). Conclusions Abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images suggest the presence of DGF. Compared with conventional MRI, SWI appears to be superior in detecting the abnormally low signal lesions.