Diabetes Mellitus, Type 2 ; complications ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelinolysis, Central Pontine ; complications ; diagnosis ; Prognosis

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.

Objective To investigate the effect of Octreotide on pancreatic head carcinoma patients with obstructive jaundice who underwent endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic stent placement.Methods Niney-nine patients hospitalized in Department of Gastroenterology of Wuhan Central Hospital from Jan 2006 to Dec 2011 were included in this study.All the patients were diagnosed as pancreatic head carcinoma with obstructive jaundice.The patients were randomly divided into the Octreotide treatment group and the control group.Both groups underwent ERCP with pancreatic duct stent placement for malignant biliary obstruction.The patients in Octreotide treatment group were injected with subcutaneous Octreotide at a dose of 0.1 mg twice per day for more than 90 day till death.The changes of serum total bilirubin before and after treatment were compared.The improvement of symptoms of nausea,vomiting,abdominal pain,diarrhea and anorexia was compared.The complication rates and survival were also determined.Results Postoperative recurrence of jaundice was observed in six patients in control group,and the cause may be stent occlusion,and 3 of the 6 patients underwent a second ERCP and stent placement,then jaundice was relieved,the other 3 patients did not receive a second ERCP.The serum bilirubin level in the remaining 45 patients returned to basically normal value (below 2 times of the normal value).The prevalence of nausea,vomiting,abdominal pain,diarrhea and anorexia in the 2 groups was not statistically different before treatment,and after treatment the prevalence of symptoms in the 2 groups was significantly decreased except for diarrhea.The decrease in Octreotide treatment group was more obvious than that in control group,and the difference between the two groups was statistically significant (P ＜ 0.01).In the control group,post-ERCP pancreatitis occurred in three patients,and all were cured after treatment.There was no post-ERCP pancreatitis occurred in the Octreotide treatment group.Minor pain at the injection site was noted in three patients in the Octreotide treatment group.Pain was relieved after changing the injection site.The survival was significantly longer in the Octreotide group than that in control group [(14.4 ± 8.7) months vs (7.3 ± 5.3) months,P ＜ 0.05),and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Octreotide can improve the quality of life and increase the survival of patients with pancreatic head carcinoma who undergo ERCP with pancreatic duct stent placement.

Objective To study the influence of fluoride on the expression of Runx2 in suckling rat osteoblasts. Methods Osteoblasts obtained from calvarium of suckling Wistar rats were cultured in the media supplemented with NaF at different doses(0, 1,2 and 4 rag/L), and Runx2 Mrna expression and protein expression were evaluated by RT-PCR and ELISA, respectively. Results Runx2 Mrna expression in suckling rat osteoblasts cultured in vitro significantly increased after exposure to NaF for 48 h at different doses (0.613±0.055, 0.773±0.070 and 0.775±0.070 for 1,2 and 4 mg/L,respecfively) compared to the control (0.482±0.043 ,P< 0.05). Runx2 Mrna expression further increased after 72 h exposure to NaF(0.969±0.048,1.229±0.061,1.255± 0.063 for 1,2 and 4 mg/L, respectively) ,which is significantly higher than the control(0.724±0.036,P<0.05) and corresponding groups at 48 h. NaF doses and exposure time exhibited a significant synergistic effect on Runx2 Mrna expression (P<0.05). Similarly, NaF also enhanced Bunx2 protein expression in suckling rat osteoblasts cultured in vitro. Significant differences were observed between groups exposed to NaF (1,2 and 4 rag/L) and control at48 h post-exposure (0.141±0.007, 0.143±0.008, 0.143±0.011 vs 0.129±0.012, P<0.05) as well as 72 h post-expesure(0.156±0.014, 0.168±0.018, 0.162±0.0100 vs 0.137±0.016, P<0.05). In addition, Runx2 protein expression at 72 h post-exposure was significantly higher than that at 48 h. Conclusions The results suggested that NaF could increase Runx2 expression in suckling rat osteoblasts with a synergistic effect between the doses and exposure time.

OBJECTIVE:To provide reference for rational drug use in respiratory department. METHODS:ADR/ADE report-ed by respiratory department of a class three grade A hospital during Jan. 2011 to Dec. 2015 from national ADR monitoring system were collected. 2011-2015 ADR/ADE database of respiratory department in a hospital was established and analyzed statistically. RE-SULTS:202 records were gotten,among which 89 cases were male(44.06%)and 113 cases were female(55.94%);the patients’ age approximated normal distribution,the incidence of ADR/ADE was the highest in 61-80 age group (55.94%);the occurrence time of ADR/ADE was mostly lower than 1 h (47.21%);the main route of administration was intravenous drip (71.29%);22 kinds of drugs were involved,and antibiotics took up the lead(43.11%);84 patients(41.58%)used 2 and more kinds of drugs before the occarrence of ADR/ADE;organs/systems involved in ADR/ADE were skin and its appendants (32.86%) and digestive system(26.19%). Most of the ADR/ADE could be cured or recovered after related treatment. CONCLUSIONS:The occurrence of ADR/ADE in respiratory department is related to various factors,of which advanced age,intravenous administration and antibiotics use are important ones. Great importance should be attached to rational clinical drug use as well as ADR/ADE monitoring and re-porting. Clinical also should pay attention to the safety of drug use in elderly patients.

Objective To explore the effect of blood circulation punching apparatus on important vital signs and thrombus of lower extremity veins in stable blood pressure and normal cardiopulmonary function patients with cerebrovascular disease and hypertension and to evaluate safety and effectiveness of the apparatus for these patients.Methods We treated 30 patients with cerebrovascular disease and hypertension by blood circulation punching apparatus for 3 days,2 times per day,30 minutes per time.We monitored vital signs of these patients 15 minutes pre-,intra-and post-treatment.The thrombus of lower extremity veins and adverse reactions were observed during the treatment.Results We compared systolic pressure,diastolic pressure,pulse and breathe of patients 15 minutes pre-,intra-and post-treatment respectively.We didn't find any significant differences between these parameters.No patient had thrombus of lower extremity veins and adverse reactions in the hospital.Conclusion The blood circulation punching apparatus is suitable for cerebrovascular and hypertension patients with stable blood pressure and normal cardiopulmonary function and can prevent thrombus of lower extremity veins effectively.

Objective To prepare,purify and validate specific monoclonal antibodies(McAb) against fragment in C-terminal telopeptides of collagen type Ⅱ(EKGPDP)for clinical diagnostics and related research of osteoarthritis(OA).Methods 8 BALB/c mice were immunized with EKGPDP-KLH antigen complex.McAb against EKGPDP fragements were prepared by hybridoma technique.Immunoglobulin classes and subclasses were determined using an Immuno-Type~(TM)mouse McAb isotyping kit.Ascites were producted and McAb were purified by saturation ammonium sulfate(SAS)precipitation and protein G chromatography.Specificity and immunoactivity of antibodies were detected by indirect enzyme-linked imrnunosorbant assay(ELISA).Cartilage specimens were analyzed by immunohistochemical method.Results The hybridoma cells were obtained.10 IgG and 3 IgM single colonies were picked out by limiting dilution and ELISA kit.The titers of McAb in ascites were from 2.8?10~4 to 5.1?10~5.The McAb showed the characteristics of no cross reactions with KLH,BSA,cell culture supernatant,type Ⅰ,Ⅲ collagens and whole type Ⅱ collagen.The method of SAS could get better recovery,immunoactivity of the McAb than protein G chromatograply(t=25.26;P

Objective To further investigate the accuracy of the real-time three-dimensional echocardiography(RT-3DE) in evaluating right ventricular(RV) systolic function.Methods RT-3DE,MRI and SPECT were used to study a total 30 patients including 10 with coronary artery disease,7 with hypertension,5 with cardiomyopathy,5 with atrial septal defect,and 3 with pulmonary hypertension.The RV end-diastolic volume(RVEDV),RV end-systolic volume(RVESV),RV stroke volume(RVSV) and RV ejection fraction(RVEF) were measured.The correlation and the difference between different modalities were compared.Results RT-3DE had a good correlation with MRI in RVEDV,RVESV,RVSV and RVEF (rEDV =0.811,rESV =0.837,rSV =0.818,and rEF =0.701).Also RT-3DE had a correlation with SPECT in RVEDV,RVESV,and RVSV(rEDV =0.526,rESV =0.493,rSV =0.514),but there was no correlation between RT-3DE and SPECT in RVEF (rEF =0.235).Conclusions RT-3DE can assess RV systolic function accurately.

Objective:To observe the effect of herbal cake-partitioned moxibustion on the expressions of mitogen-activated protein kinase (MEK1/2) and extracellular regulatory protein kinase (ERK1/2) in gastric tissues of rats with spleen deficiency syndrome, and to explore the possible mechanisms of herbal cake-partitioned moxibustion in treating spleen deficiency syndrome. Methods:Sixty Sprague-Dawley (SD) rats were randomly divided into a blank control group (group A), a model group (group B), a ranitidine group (group C), and a herbal cake-partitioned moxibustion group (group D) by random digit, 15 rats in each group. Rat models of spleen deficiency syndrome were made by intragastric administration of 4℃ 200% concentrated Da Huang (Radix et Rhizoma Rhei). After successful modeling, the rats in group C were treated with 25 mg/(kg·bw) ranitidine by intragastric adminstration and rats in group D were treated with herbal cake-partitioned moxibustion at Zusanli (ST 36) and Zhongwan (CV 12), for 8 d. Excepted for rats in group A, all the other rats were treated with indomethacin at 5 mg/(kg·bw) at 8:00 a.m. on the second day after finishing all the intervention and sacrificed 7 h later to isolate the stomach. Histopathological changes of the gastric tissues were observed under light microscope after hematoxylin-eosin (HE) staining. The protein expressions of MEK1/2 and ERK1/2 in the gastric tissues were detected by immunohistochemistry. Results:After intervention, the gastric mucosal injury in group B was significantly severer than that in group A, with large breakage and ablating; the damage of gastric mucosa was decreased in group C compared with group B; the gastric mucosal surface remained relatively complete, and the status of breakage and ablating was significantly improved. After intervention, compared with group A, the protein expressions of MEK1/2 and ERK1/2 in gastric tissues of the other groups were significantly higher (P<0.01). Compared with group B, the protein expressions of MEK1/2 and ERK1/2 in group C and D were significantly higher (allP<0.01). Compared with group C, the protein expressions of MEK1/2 and ERK1/2 in group D were significantly higher (P<0.01). Conclusion: Herbal cake-partitioned moxibustion promotes the repair of gastric mucosa in rats with spleen deficiency syndrome, via improving protein expressions of MEK1/2 and ERK1/2 in gastric tissues, as well as activating MEK/ERK signaling pathway.