Objective To analyze the clinical effect and the related performance of different tiotropium bromide in the treatment of adult asthma patients.Methods58 patients in the Second hospital of Shandong University from August 2014 to May 2016 admitted to the adult bronchial asthma, were randomly divided into observation group and control group, each of the 29 cases of patients, two patients were taken on the basis of routine treatment of tiotropium bromide in the treatment, the observation group in each given tiotropium 5 g treatment.The control group took a day sooner or later given tiotropium 2.5 g treatment, analysis of clinical effect of two groups were compared and the related performance.ResultsThis group of patients with different delivery methods after treatment, the observation group and the control group of arterial blood gas analysis results have significant difference compared to the clinical effect compared with statistical difference (P<0.05);treatment group the effective rate of treatment group and control the efficiency compared with significant differences (P<0.05);the two groups of patients after treatment, clinical symptoms were observed in groups of patients with asthma remission time were (6.24±1.92) d, while the control group was (8.33±2.47) d, the two groups were compared with statistical difference (P<0.05).ConclusionDifferent tiotropium dosing regimen for adult patients with asthma curative effect has significant clinical effect, compared with 5 per night given tiotropium Gtherapy and its clinical effect is more obvious.

Objective:To investigate the rationality of off-label use of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient. Methods:Based on the related literatures, the application rationality of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient was analyzed. Results:The combination of tacrolimus and Wuzhi capsules against membranous nephropathy was an off -label drug use, however, it showed certain clinical rationality and economic efficiency. Conclusion:Off-label drug use commonly exists in clinics. Clinical pharmacists should provide evidence support for off-label drug use through searching and analyzing clinical evidences and closely monitoring therapeutic outcome.

To investigate whether there is mutation in DC-SIGN promoter region in patients with chronic hepatitis B (CHB) and healthy persons previously infected with hepatitis B virus (HBV) and to explore the relationship between the mutation in dendritic cell-specific intercellular adhension molecule-3-grabbing nonintegrin (DC-SIGN) promoter region and HBV.Methods The studied population was composed of two cohorts:47 CHB patients and 20 healthy persons previously infected with HBV.The mutation in DC-SIGN promoter region was detected with PCR,single-stranded conformational polymorphism and heteroduplex analysis,cloning,sequencing and aligning the published DC-SIGN promoter sequence.Results The characteristic mutation within DCSIGN promoter region in HBV infected individuals was observed.In the DC-SIGN promoter region,4 hot spot mutations located in positions - 139,- 142,- 222,and - 336 were observed in the CHB patients,but only 1 spot mutation located in position - 139 was observed in the healthy persons previously infected with HBV.The -336C which was absent in the healthy persons previously infected with HBV was shown in 11 CHB patients (23.40％).The - 139T was far more frequent in the healthy persons previously infected with HBV ( 100％ ) than in the CHB patients (34.04％).Conclusion In the DC-SIGN promoter region,-336C may be a genetic risk factor for developing CHB,but -139T may be associated with protection against HBV.

Objective To analyze the incidence factors between accompanies and mwses in pediatric transfusion clinic, and find out the countermeasures. Methods 75 conflicts occurred between August 2004 to August 2008 were analyzed and made a contrast. Results The elements for the conflict were as follows: nurses, accompanies and patients. Conclusions The nurses should improve the emergency cop-ing abilities, communication skills, technical skills, supporting psychological nursing for the patients and the accompanies. All these are effective measures to avoid conflicts.

Objective To investigate the incidence and the risk factors of major adverse cardiac events of critical care patients after noncardiac surgery.To study the incidence of myocardial injury after noncardiac surgery (MINS).Methods A retrospective analysis of critical care patients (n =1 087) after noncardiac surgery from January 2012 to January 2013 in our hospital was carried out.The clinical data of the medical history, intraoperative conditions, postoperative conditions and cardiac troponin Ⅰ (cTNI) were collected.Major adverse cardiac events included unstable angina, non fatal myocardial infarction, severe arrhythmia, heart failure and cardiovascular death.Risk factors of major adverse cardiac events of critical care patients after noncardiac surgery were analyzed using Logistic regression.Results The 30 d non cardiac surgery incidence of major adverse cardiac events was (94/1 087) 8.6％, the incidence of MINS was (168/1 087) 15.5％, Logistic regression analysis showed that the risk factors of major adverse cardiac events after non cardiac surgery were age (OR 1.03,95％ CI 1.01-1.05, P =0.002), a history of chronic renal insufficiency(OR 3.12,95％ CI 1.44-6.74,P =0.004), rise of cTNI 24 h after operation (OR 2.04,95％ CI 1.16-3.58,P =0.014) and use of vasopressor drugs within 24 h after operation (OR 2.34,95％ CI 1.25-4.38,P =0.008).Conclusions The incidence of major adverse cardiac events and the MINS of critical care patients after noncardiac surgery is high.Old age, history of chronic renal insufficiency, rise of cTNI 24 h after operation and vasopressor drugs within 24 h after operation are the independent risk factors.

Objective: To compare the application of Sofren injection in respiratory department before and after the intervention to provide reference for clinical application and pharmacy management.Methods: A retrospective study was conducted on the medical records of inpatients treated with Sofren injection, and then intervene the found problems.Comparative study of Sofren injection in respiratory department before and after the intervention was performed.Results: Among the 584 cases in the retrospective study, those with off-indications were 438 ones (75%), those with inappropriate solvents were 555 ones (95.03%), and those with improper course were 196 ones (33.56%).After the intervention in the clinical practice, the improvement rate of improper solvents was 98.70%, that of off-indications was 29.85%, and that of unsuitable course was 77.71%.Conclusion: Through comparative study on the main problems before the intervention and the effective performance of specific solutions, the application of Sofren injection in respiratory department is greatly improved, which provides reference for the special management of other drugs.

This study was aimed to observe influence of disease/syndrome on the toxicity and effect of aconite roots, in order to reveal relationship among disease/syndrome, toxicity and effect. The mice model of cold syn-drome was establish by wind-cold stimulation. The pain model was established by intraperitioneal injection of glacial acetic acid. Then, LD50 and ED50 of analgesic effect were compared, as well as the therapeutic index (TI) of crude aconite roots. The rat model of cold syndrome was also established by wind-cold stimulation. And the rheumatoid arthritis (RA) model was established by intracutaneous injection of CII and CFA. TD50 of cardiac toxic-ity and arthroncus degree of prepared aconite roots were compared among the normal rats, RA rats, RA with wind-cold stimulation rats according to the recording of lead II ECG. The results showed that after wind-cold stimulation, mice and rats appeared with symptoms which were similar to Chinese medicine cold syndrome. Com-pared with normal mice, LD50 and TI increased, but ED50 decreased in the group of wind-cold stimulation after using powders of crude aconite roots. Compared with normal rats, TD50 of cardiac toxicity and arthroncus degree in-creased in groups of RA and RA with wind-cold stimulation after using prepared aconite roots. It was concluded that in the case of disease/syndrome state, the toxicity of aconite roots decreased, but its effect increased. It sug-gested that there is a significant correlation among disease/syndrome, toxicity and effect.

Objective To identify the expression of PTPRD in esophageal squamous cell carcinoma (ESCC)and analyze its correlation with pathological features and patient survival.Methods Immunohistochemistry analysis was applied to detect the expression level and location of PTPRD in 236 patients with ESCC.Clinical and pathological features were collected and a 5 years’follow-up after surgery were performed.Results Statistic analysis showed that expression of PTPRD in ESCC was lower than in normal esophageal epithelial cells (22.0% vs 57.2%,P =0.000).The expression of PTPRD was correla-ted to the differentiation grade,depth of tumor invasion and lymph nodes metastasis.The expression of PTPRD was higher in group with well differentiation,less invasion depth and no lymph node metastasis (P =0.013,0.025,0.019).The expres-sion of PTPRD was not correlated to age or gender (P =0.170,0.787).The survival analysis showed that thegroup with more PTPRD expression had better prognosis.Conclusion PTPRD was correlated to progression and prognosis of ESCC.It may be a new potential tumor suppressor gene of ESCC,and its expression level might may a useful marker for predicting prognosis for ESCC patients.

Tooth agenesis is the most common form of congenital craniofacial dysplasia seen in stomatology clinics, which may be caused by genetic and/or environmental factors. Tooth development is regulated by a series of signaling pathways, and variants in any of these strictly balanced signaling cascades can result in tooth agenesis and/or other oral defects. Notably, variants of genes of the Wnt/beta-catenin signaling pathway are important cause for both non-syndromic and syndromic tooth agenesis. This article has provided a review for the molecular genetics of tooth agenesis associated with Wnt/beta-catenin signaling pathway, which may shed lights on the etiology and molecular mechanism of this disease.
Anodontia/genetics* ; Genetic Research ; Humans ; Tooth ; Wnt Proteins/genetics* ; Wnt Signaling Pathway/genetics*

OBJECTIVETo investigate the progression and drug resistance of long-term non-progressors during three follow-up in Henan province.

METHODSIn May 2009, 26 cases of long-term non-progressors were recruited who infected HIV more than 10 years with blood collection and supply routes, did not receive anti-retroviral therapy, CD4(+)T lymphocyte count ≥350/μl and did not show typical symptoms of AIDS from Weishi, Shangcai, and Linying of Henan Province. Continuous follow-up were conducted three times since 2009 every two years with cohort analysis, the epidemiological information of infection routes, infection time and blood were collected, and 78 parts of 10 ml EDTA anticoagulated whole blood were collected. The changes of CD4 (+) T lymphocytes, viral load, and virus gene variety were characterized from 2009 to 2014. In-house methods were used to explore primary drug resistance of long-term non-progressors. Nonparametric Kruskal-Wallis test were used to compare CD4(+) T lymphocyte count and viral load changes during different follow-up times.

RESULTSThe average age and infection time of 26 cases were (48.51 ± 6.75) years, (13.42 ± 4.26) years, respectively. Three follow-up times, CD4(+) T lymphocyte count P50 (P25-P75) was 573.5 (487.4-789.8), 499.8 (403.5-635.7), and 418.8 (297.6-537.8)/μl (H=63.99,P<0.001), respectively. And natural logarithm of viral load P50 (P25-P75) were 3.93 (3.43-4.55), 4.29 (3.78-4.75), 4.50 (4.01-4.81) (H=3.19,P=0.355), respectively. Subtype and phylogenetic analysis of HIV showed that prevalent cases were B subtype, accounting for 88.5% (23/26), and three cases showed restructuring changes. Two cases appeared highly resistant of 18 infected patients whose viral load >1 000 copies/ml.

CONCLUSIONThe CD4(+)T lymphocyte had a declining trend, virus subtype recombinant changes in a few cases, and primary drug resistance was found of long-term non-progressors in Henan province.

Adult ; CD4 Lymphocyte Count ; China ; Cohort Studies ; Disease Progression ; HIV ; classification ; drug effects ; HIV Infections ; epidemiology ; HIV Long-Term Survivors ; Humans ; Middle Aged ; Phylogeny ; Viral Load