OBJECTIVE:To explore the method of pharmaceutical care for antifungal drug treatment of new type crypto-coccal meningitis by clinical pharmacist. METHODS:Clinical pharmacist participated in the drug treatment process for a pa-tient with new type cryptococcal meningitis. Clinical pharmacist provided pharmaceutical care in following aspects:assisting doctor to optimize antifungal drugs treatment plan,providing patients pharmaceutical monitoring and medication education, etc. During amphotericin B treatment,the patient developed refractory hypokalemia. Clinical pharmacists suggested doctors to reduce the dose of amphotericin B and additionally use voriconazole for antifungal treatment. RESULTS:The patient devel-oped refractory hypokalemia no more after the plan was adjusted. After 11 weeks of systematic antifungal treatment,the pa-tient was on the mend. CONCLUSIONS:The participation of clinical pharmacist in antifungal treatment of new type cryptococ-cal meningitis indicates that following the instructions,but not lost flexible disposal;providing service actively,and details is guarantee of safety.

Objective To construct pEGFP-N1-TGF-β1 recombinant plasmid and transfect it into primary cultured neonatal piglet type Ⅱ alveolar epithelium cell (AEC-Ⅱ) by using lipofectamine 2000,in order to provide basis of methodology for producing recombinant plasmids for transplantation of transfected AEC-Ⅱ into ALI/ARDS animal model lungs.Methods PCR primers were designed to amplify the human TGF-β1 cDNA fragment from plasmid.XhoI and EcoRI were used for double digesting the empty plasmid pEGFP-N1 and cDNA fragment of human TGF-β1.Then the products of double enzyme digestion by using T4 DNA ligase were connected and transformed into DH5α and cultured over night for 16 hours.The structure of recombinant plasmid was identified by using PCR and base sequencing to verify the correctness of pEGFP-N1-TGF-β1 recombinant plasmid.It was then transfected into primarily cultured AEC-Ⅱ by lipofectamine2000 mediated transfection and cultured for another 48 hour.Plasmid DNA (pEGFP-N1-TGF-β1 recombinant plasmid) and lipofectamine 2000 were added into serum-free DMEM respectively,then DNA suspension and Lipofectamine 2000 suspension were blended together and added into cells.After 24-48 hours later,the expression level of enhanced green fluorescent protein (EGFP) was evaluated under fluorescence microscope.Results The structure of vector was verified as pEGFP-N1-TGF-β1 recombinant plasmid by using PCR and base sequencing.Green fluorescence found in some cells showed that the pEGFP-N1-TGF-β1 recombinant plasmids had been successfully transfected into primary cultured AEC-Ⅱ,however,the transfection efficiency still need tobe further improved such as repeating the transfection procedure once again or using adenovirus mediated transfection method to improve the efficiceny and to transplant the cells into animal lungs eventually.Conclusions pEGFP-N1-TGF-β1 recombinant plasmid was successfully constructed and,for the first time,transfected into primarily cultured AEC-Ⅱ of newborn piglets.This established method should be useful for investigation of therapeutic effect and outcomes of lung with experimental acute lung injury.

Objective To study the related factors of hemorrhage of uterine scar again after cesarean section,available for peer exchange.Methods A retrospective analysis of clinical data of 650 patients with scar uterus again cesarean section patients,analysis of postoperative hemorrhage patients,the causes of bleeding.They were divided into placental group (n =6),incision dehiscence group (n =7),uterine atony group (n =17)according to the causes of hemorrhage,and related factors of postoperative bleeding were analyzed.Results The bleeding volume of the placental group in operation[(2 500 ±500)mL]was higher than the uterine atony group[(1 300 ±400)mL] and the incision dehiscence group[(700 ±200)mL].The bleeding volume of the uterine atony group was higher than the incision dehiscence group (t =10.29,5.56,4.33,all P <0.05).The bleeding volume of the uterine atony group after operation[(100.09 ±36.45)mL]was higher than the placental group[(90.71 ±20.31)mL]and the uterine atony group[(81.23 ±30.34)mL].The bleeding volume of the placental group after operation were higher than the uterine atony group (t =3.94,3.02,2.78,all P <0.05).4 cases of hysterectomy,3 cases of conservative surgery in placental group.1 case of hysterectomy,16 cases of conservative surgery in uterine atony group.7 cases conservative surgery in incision dehiscence group.Conclusion placental factors,uterine atony,incision dehiscence all can lead to scar uterus again cesarean section hemorrhage.We should also strengthen the clinical prevention work,and actively take relevant measures,reduce postoperative bleeding risk,to ensure the safety of the mother and infant.

Objectives To understand the control and prevention status of water-borne endemic fluorosis in Jiangxi Province, in order to provide a scientific basis for evaluate and perfect the strategies in control and prevention of the disease. Methods According to monitoring project of national water-borne endemic fluorosis, three villages were chosen to investigate the status and the fluoride content of fluorosis villages with water-improving and defluoridation projects in Yushui district and Ningdu county of Jiangxi Province. Investigation consisted of the status of dental fluorosis of children aged from 8 to 12 years and adult skeletal fluorosis, as well as fluoride content of drinking water and urinary fluorine. The standard detection methods of domestic drinking water was used for water fluoride content detection, fluoride selective electrode was chosen for urinary fluorine detection, Dean detection method was used to determine dental fluorosis, and diagnostic criteria of endemic skeletal fluorosis was chosen for diagnose of skeletal fluorosis. Results In fluorosis villages with water-improving and defluoridation projects which operated normally, the fluoride content of drinking water was lower than 1.00 mg/L. In fluorosis villages with water-improving and defluoridation projects which never operated normally, the average fluoride content of drinking water was 1.76 mg/L. The detection rate of dental fluorosis of children aged 8-12 years was 12.50%(22/176). A total of 294 adults were examined by X-ray, 3 adults were diagnosed as skeletal fluorosis, and the detection rate was 1.02%. A total of 294 adult urine samples were tested. The urinary fluoride content varied from 0.28 to 7.74 mg/L, and the geometric mean was 1.10 mg/L. Conclusions The illness condition of water-borne endemic fluorosis has been under control effectively. The maintenance of water-improving and defluoridation projects and surveillance were main tasks in control and prevention of the disease in the future.

Objective To explore the application value of calcium hydroxide agent in root canal disinfection of patients with chronic periapical periodontitis in stomatology department.Methods 108 cases patients with chronic periapical periodontitis from June 2013 to June 2014 in Cixi Guanhaiwei Zhen Health Centers were randomly divided into study group (n =54) and control group (n=54).The control group received camphor phenol cotton for root canal disinfection, and study group received calcium hydroxide agent.The clinical curative effect between two groups was compared.Results After 7 days’ treatment, the total effective rate was 98.15%in study group, which was significantly higher than 79.63%in control group (χ2 =9.375,P<0.05).After follow up 6 months, the total effective rate was 94.44%in study group, which was significantly higher than 77.78%in control group (χ2 =6.271,P<0.05).The incidence of endodontic interappointment pain (EIP) in study group was 11.11%, which was significantly lower than 25.93%of control group (χ2 =3.93,P<0.05).Conclusion Calcium hydroxide agent has a significant efficacy on in root canal disinfection of patients with chronic periapical periodontitis in stomatology department, could reduce the incidence of EIP and promote healing of chronic periapical periodontitis, which is the first disinfectant in the stomatology department of primary hospital.

Objective To study the therapeutic effect of Jiedu Quyu Formula (Formula for Removing Toxins and Blood Stasis) on psoriasis vulgaris of progressive stage and its mechanism. Methods The 70 patients of progressive psoriasis vulgaris were randomized into treatment group (35 cases), treated by Jiedu Quyu Formula, and control group (35 cases), treated by Compound Qingdai Capsule. Healthy control group was of 30 healthy subjects. The contents of plasma endothelin (ET) were determined before and after treatment respectively, and the therapeutic effect of both treated groups were observed. Results After treatment, the psoriasis area and severity index (PASI) of both treated groups were significantly decreased in comparison with before treatment (P

Objective:To explore risk factors for slow coronary flow (SCF) phenomenon in male patients .Methods:A total of 123 male patients ,who were suspecting coronary heart disease because of chest pain ,then coronary angiography indica‐ted there was no significant lesion in epicardial coronary arteries ,were selected .According to presence of SCF or not ,they were divided into SCF group (n=69) and normal group (n=54) .Case data of two groups were retrospectively analyzed , and Logistic regression analysis was use to analyze risk factors for male SCF .Results:Compared with normal group ,there were significant rise in body mass index [BMI , (24. 01 ± 1. 57 ) kg/m2 vs . (27. 06 ± 3. 40 ) kg/m2 ] , hemoglobin level [ (145.79 ± 9.63) g/L vs .(150.00 ± 11.84) g/L] and hematocrit [ (0.43 ± 0.03) L/L vs .(0.45 ± 0.06) L/L] in SCF group ,P<0.05 all .Logistic regression analysis indicated that BMI (OR= 1.373 ,95% CI 1.146~1.645 ,P=0.001) and hemoglobin (OR=1.037 ,95% CI 1.000~1.176 ,P=0.048) were independent risk factors for male SCF .Conclusion:El‐evated body mass index and hemoglobin level are independent risk factors for slow coronary flow in male patients ,so corre‐sponding preventive measures must be carried out to improve prognosis .

Objective To investigate the surgical approaches indication, technique and efficacy for treatment of intracranial arachnoid cysts (IAC). Methods The clinical data of 56 patients with IAC who were diagnosed with MRI and/or CT techniques were retrospectively analyzed. According to the surgical approaches adopted, these cases were classified into 4 groups, group A with expectant treatment (12 cases), group B with endoscopic cystocisternal fenestration (15 cases), group C with cystoperitoneal shunting (21 cases), and group D with surgical cyst removal (8 cases). The outcomes of the patients were compared. Results The patients were followed up for 3 months to 46 months (mean 15 months). The rate of symptomatic improvement in group B was 14/15, in group C was 95.24%(20/21) and in group D was 5/8, and there was significant difference ( χ2=8.335, P<0.05). The rate of radiographic improvement in group B was 14/15, in group C was 90.48%(19/21) and in group D was 5/8, and there was significant difference (χ2=8.235, P<0.05). The rate of complication in group B was 1/15, in group C was 14.29%(3/21), and in group D was 5/8, and there was significant difference ( χ2=8.256, P<0.05) Conclusions In terms of therapeutic effect, surgical safety and minimal invasiveness, cystoperitoneal shunting and endoscopic cystocisternal fenestration should be the primary choice .

Thirty-one children suffered from speech retardation were found to have normal hearing level through ABR and/or acoustic immittance tests. Some of them were further checked by psychiatrists and pediatricians. The results demonstrate that among reasons for speech retardation in children,autism and mental retardation are important factors that can not be ignored. A-mong children with unclear diagnosis .some harmful factors were found on themselves and in surroundings. We emphasize that for children with speech retardation,not only hearing disorders,but also other factors should be considered.

Objective To investigate the expression and distribution of cyclooxygenase-2(COX-2) in periodontal tissues during experimental tooth movement in rats,and study the relationship between COX-2 and vesscular reconstruction in experimental tooth movement process.Methods Thirty-five healthy Wistar rats were divided randomly into 7 groups on average:normal group and experimental groups for 1,3,5,7,14 and 21 d.A NiTi coil spring with 0.294 N mesial force was connected between first molars of maxillary and the upper incisors.The histological sections were stained with goat anti rat COX-2 antibody,and computer image analysis was used to study the expression of COX-2 in the periodontal tissues of rats.Results Pressure area:compared with normal group(134.75?5.25) the COX-2 expression in 1 d group (147.73?3.27)increased(P0.05).Conclusion The expression of COX-2 in periodontal tissues during experimental tooth movement increase,suggesting that COX-2 can promote the vascular reconstruction in periodontal tissues during orthodontic tooth movement.