The paper designs and implements an online exercise training system based on B /S mode and introduces the development process of ICD-10 online exercise training system , including the system requirement analysis , functional design , database design , sys-tem implementation and system testing .Moreover, it introduces key technologies used in the development process .

Objective To observe the distribution and drug resistance of pathogens cultured from the sputum of hospitalized patients with lower respiratory infection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods To i‐dentify the germiculture and test the drug susceptibility of the sputum or respiratory secretion isolated from the bronchial brush of 262 hospitalized AECOPD patients in People′s Hospital of Jiangxi Province from Janurary 2013 to December 2014 and analyze the results .Results Among all the AECOPD patients ,215 cases with positive sputum culture ,281 sputum pathogens were isolated . Gram‐negative bacilli were found in 190(67 .6% ) .Gram‐positive aureus were detected in 76(27 .1% ) .Fungus pathogens occurred in 15(5 .3% ) .The top six pathogenic bacteria were acinetobacter baumannii ,escherichia coli ,klebsiella pneumonia ,pseudomonas aeruginosa ,staphylococcus aureus ,streptococcus pneumonia .Drug susceptibility results showed that the drug resistance of acineto‐bacter baumannii was the strongest .Except that the drug resistance rate of cefoperazone/sulbactam and levofloxacin were less than 50 .0% ,the others were no less than 75 .0% .The drug resistance rate of escherichia coli and klebsiella pneumoniae to ampicillin , ampicillin sulbactam ,cefazolin ,ceftriaxone ,cefotetan ,gentamycin ,ofloxacin ,ciprofloxacin ,and compound sulfamethoxazole trime‐thoprim were no less than 70 .0% .The drug resistance rate of staphylococcus aureus to penicillin G ,oxacillin ,erythromycin ,clinda‐mycin were 100% .The drug resistance rate of streptococcus pneumoniae to erythromycin ,clindamycin ,tetracycline ,sulfamethox‐azole trimethoprim were greater than 75 .0% .Conclusion Gram‐negative bacilli are the main pathogenic bacterium in the AECOPD patients with lower respiratory infection .The key of treatment is to pay more attention to the bacterial culture and drug sensitive test ,use antibiotics reasonably according to the results of drug sensitive experiment .

Objective To investigate the effect of reinforcing spleen and kidney method on adriamycin-induced CKD in rats and to explore its possible mechanism.Methods Totally 36 Sprague-Dawley rats were randomly divided into a Adriamycin-induced model group and a control group.The model group was further divided into five groups:the Adriamycin-induced model control group,bennazepril-treated group,and TCM treated low,moderate,and high dose groups.The level of serum creatinine,urea nitrogen,24hours urine protein and urine creatinine were measured at 14,28,42 days after establishing the model rats.And the protein expression of transforming growth factor-β1 (TGF-β1) and cyclin-dependent kinase inhibitor p21cip1 (p21)were detected by immunohistochemistry.Results The proteinuria was observed on the seventh day after injection of adriamycin in adriamycin nephropathy model group,and reached summit on the fourteenth day.Both TCM treated groups and benazepril group reduced the level of urine protein within 24 hours (P＜0.05),the reduction was most remarkable in the TCM high dose group.The expression of p21 and TGF-β1 (p21 288627.66±97021.65,TGF-β1 98405.14± 19216.89) in kidney increased in the model groups,while the TCM treated high dose group (p21 518886.35±6810.89,TGF-β1 222012.95± 50484.73) was significantly lower than the model control group (P＜ 0.05).Conclusion Reinforcing spleen and kidney method could decrease the level of urine protein within 24 hours by regulating the expression of p21 and TGF-β1,so thus to protect renal function and delay progress of kidney disease.

Using the immunohistochemical method combined with tract tracing techniques, a new subdivision, the marginal division, was found in the striatum of the rat. In this subdivision, substance P, enkephaline and dynorphin B terminals were densely localized. The present study investigated the synaptic organization of the substance P-like immunoreactive nerve terminals in the marginal division. Four major types of substance P immunoreactive synapses were identified. Axodendritic and axospinous synapses were the most common ones. Compound synapses with more than two synaptic components were also observed. One axo-axonic synapse was present. Both symmetric and asymmetric substance P-like immunoreactive synapses were seen in the marginal division. The existence of asymmetric synapses, small postsynaptic dendrites and axo-axonic synapses, distinguished the substance P-like immunoreactive nerve terminals in the marginal division from those in the other part of the striatum. The characteristics and complexity of the synaptic organization suggested that the substance P-like immunoreactive nerve terminals in the marginal division probably orginate from a different source and have a different function, as compared to those in the rest part of striatum.

OBJECTIVE:To discuss the role of clinical pharmacist participating in drug therapy for severe ulcerative colitis (UC)during late pregnancy. METHODS:Clinical pharmacists participated in the therapy for a UC patients during late pregnancy, assisted the doctors to optimize and improve drug therapy plan from antidiarrheal,anti-intestinal inflammation,regulating intestinal flora,recovering damaged mucosa;suggested regimen was as follows:montmorillonite powder 3 g,pr,qd,to avoid drug interac-tion;hydrocortisone 100 mg,ivgtt,bid to resist intestinal inflammation;prednisone 30 mg,po,qd+20 mg,po,qn,instead after symptom relieved;stopping taking Bifid triple viable capsules,supplementing Human serum albumin injection,Nutrients,Potassi-um chloride injection,Concentrated sodium chloride injection,etc. RESULTS:The suggestion provided by clinical pharmacists was adopted by doctors,and the patient was recovered. There was no significant difference in the intelligence development,body weight and height charge between born baby boy and infants with same month age. CONCLUSIONS:Clinical pharmacists assist physician to optimize and improve drug therapy plan to promote rational drug use in the clinic and guarantee the safety of drug use.

AIM:To investigate the effects of Zhenwu decoction ( ZWD) on the expression of α-smooth muscle actin (α-SMA) and NF-κB in diabetic nephropathy ( DN) rats.METHODS:Diabetic rat model was induced by intrape-ritoneal injection of streptozotocin ( STZ) , and the animals were randomly divided into STZ group ( n=22) and STZ+ZWD group (n=23).The normal rats served as control (n=16).All rats were sacrificed on 8 weeks after modeling.Biochemical assay and pathological observation ( HE staining and transmission electron microscopy ) were used to evaluate the effects of Zhenwu decoction on the renal function and pathological morphology .The body weight , renal index , blood glucose , total urinary protein in 24 h, and superoxide dismutase ( SOD ) , malondialdehyde ( MDA ) , inducible nitric oxide synthase ( iNOS) were determined as well .Western blotting was used to observe the effects of Zhenwu decoction on the expression ofα-SMA and NF-κB in diabetic nephropathy ( DN) rats.RESULTS:Compared with normal group , the renal index , blood glucose concentration, total urinary protein in 24 h, blood urea nitrogen (BUN), serum creatinine (SCr) and MDA were significantly higher and body weight was lower in DN rats (P<0.05).Pathological examination of the kidneys in DN group showed glomerular hypertrophy , glomerular basement membrane thickening , tubular epithelial cell degeneration , me-sangial matrix proliferation , protein cast formation in some renal tubules .The protein expression levels of α-SMA and NF-κB were markedly increased (P<0.05).After ZWD treatment, the level of renal index, total urinary protein in 24 h, BUN, SCr and the expression of α-SMA and NF-κB at the protein level were significantly decreased (P<0.05).The renal histological injury in ZWD group was significantly ameliorated .CONCLUSION: Zhenwu decoction might protect kidney against STZ-induced injury via decreasing the expression of α-SMA and NF-κB.

Objective To investigate whether catestatin (bovine chromogranin A 344-364) can inhibit the biofilm formation of Candida albicans and examine its relationship with the expression of adhesion gene HWP1.Methods Clinical strains and standard strain ATCC 10231 of C.albicans were studied.XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] method was used to assess the ability of C.albicans biofilm formation.Antifungal activity against planktonic Candida ceils was evaluated in terms of minimum inhibitory concentrations (MICs) according to the description in CLSI-M27-A3.XTT assay and colony count were used to assess the effect of catestatin on inhibiting C.albicans biofilm formation.The lowest concentration showing 50 ％ inhibition on biofilm formation (BIC50) was decided by calculating the metabolic activity.The adhesion of C.albicans reduced by catestatin was visualized under an inverted microscope and quantified by colony count.The expression of HWP1 was analyzed by RT-PCR.One-way analysis of variance (ANOVA) and Dunnett's T3 test were used to compare the results.Results Clinical strains and standard strain ATCC 10231 of C.albicans showed strong ability in forming biofilm.Catestatin exhibited MICs ranging from 40 μmol/L to 80 μmol/L against planktonic C.albicans cells,and BIC50 of 80-160 μmol/L in inhibiting C.albicans biofilm formation.Catestatin reduced the adhesion of C.albicans.The colony forming unit (CFU) was 27 822.22-±-2 472.74 in blank control group,while the CFU was 5 355.55± 1 264.03,11 377.78±2 232.58,17 488.89±1 136.27,22 377.78±3 521.99,and 26 044.44±1 329.57 in the presence of 160,80,40,20,and 10 μmol/L catestatin,respectively (F=147.018,P=0.001).The difference between control group and 160,80,and 40 μmol/L catestatin was statistically significant (P＜0.05).RT-PCR found the expression of HWP1 in the presence of 160 μmol/L catestatin was about 12.24％ of that in blank control group.Conclusions Catestatin can effectively prevent C.albicans biofilm formation.This effect may be related to the down-regulated expression of adhesion gene HWP1 by catestatin,which results in reduced adhesion of C.albicans.Promising clinical prospect is expected for this finding.

Aged ; Aged, 80 and over ; Endoscopy ; Epistaxis ; diagnosis ; surgery ; therapy ; Female ; Humans ; Male

Cerebral Infarction ; drug therapy ; etiology ; Female ; Humans ; Infant, Newborn ; Intracranial Hemorrhages ; drug therapy ; etiology ; Male ; Vitamin K Deficiency ; complications ; drug therapy

Objective To investigate the interventional effect of multidimensional strategy to reduce the incidence of neonatal ventilator-associated pneumonia.Methods The patients who were admitted to the NICU department and received mechanical ventilation (MV) for more than 48 hours from October 2012 to September 2014 were recruited. The control group received the experienced interventions from October 2012 to September 2013, neonates from October 2013 to September 2014 were recruited as the intervention group receiving multidimensional controlling strategy, including bundle care, education, pro-cess and outcome surveillance and feedback on the practices. The compliance of before-after implementation of interventions were quantitatively evaluated,and the rate of VAP was compared between the two groups.Results The compliance rate of hand hygiene and the qualiifed rate of sputum suction, oral care, drain condensation from ventilator circuit, semi-recumbent posi-tion, and preventing of stress-ulcers were increased 17.0%, 11.4%, 14.7%, 18.2%, 37.5% and 56.3% respectively after implemen-tation of multidimensional strategy, and had statistical difference (χ2=36.47-294.36,P<0.01). But the qualiifed rate of antibiotic use only was 66.1% in the post-VAP bundle phases, and showed no statistical difference before and after(P>0.05). The VAP rate was 41.7 cases per 1000 MV-days during control group and 19.7 cases per 1000 MV-days during intervention group, had statis-tical signiifcance (P<0.05). But the rate of ventilator application showed no statistical difference between two group (P>0.05). ConclusionThe multidimensional strategy can effectively prevent the incidence of VAP.