Objective:To share a drug treatment experience for multiple drug resistant Pseudomonas aeruginosa.Methods:A retrospective analysis of the pharmaceutical care participated by clinical pharmacist for one case of intervertebral space infection with multiple drug resistant Pseudomonas aeruginosa was carried out.Results:Pharmacists participated in the whole treatment process,made the combined antimicrobial regimen (fosfomycin + ceftazidime + ciprofloxacin),and adjusted the time sequence.As a result,satisfactory curative effect was obtained.Conclusion:The infection with multiple drug resistant Pseudomonas aeruginosa may be treated with the three-drug therapy.Clinical pharmacists can play a positive role in the treatment of complicated infections.

OBJECTIVE To investigate the cause,diagnosis and treatment of the empyema of the anastomotic fistula after esophageal cancer resection.METHODS The clinical data of 624 cases after esophageal cancer and cardia cancer resection from Jan 2000 to Dec 2006 were analyzed retrospectively which included 14 cases of the empyema of the anastomotic fistula.RESULTS All the cases were treated with the closed thoracic drainage,in which 9 cases were cured with closing double-tube chest douching technique,3 cases were succeeded to operate secondary thoracotomy for anastomosis,1 case died after being sent to the higher grade hospital,1 case died for toxic shock and respiratory failure without the chance of reoperation.CONCLUSIONS The key measures of prevention of empyema of post-operative esophagogastrostomy anastomotic fistula inside thorax are strictly distincting between indication and contraindication,carefully preparating before operation,commanding operative time and technical skill,strengthening nursing management,and fulfilling the oral manipulation and nursing prcedures about the drainage tube after operation.

Objective To compare the difference of pregnancy outcomes between women who had a history of recurrent spontaneous abortion ( RSA) and women who were primigravida. Methods A case-control study was carried out. A total of 98 cases with a history of RSA and giving birth in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January of 2010 to September of 2014 served as the case group, while 98 primigravida giving birth at the same period in the same hospital were randomly selected as controls. The information collection form was designed following literature review before the research. All of the available data, including maternal demographic, reproductive information, medical history and present pregnancy outcomes, were collected from in-patient medical records. The number of valid information forms in case group was 91 and was 94 in control group after excluding the forms with incomplete data. The data was analyzed with SPSS 16.0 software. Results Univariate analysis results showed that maternal age, marital status, distribution of ABO blood groups, the history of infertility, clinical manifestation of threaten abortion, miscarriage treatment during pregnancy, medication of Zishen Yutai Pills for preventing miscarriage, time of delivery, adverse pregnancy outcome, and newborn sex were statistically significant different between the two groups ( P<0.05) . Logistic regression analysis results showed that there were significant differences in 5 factors between the two groups. Maternal age ( OR=1.466, 95%CI=1.267-1.698) , medication of Zishen Yutai Pills for preventing miscarriage ( OR=4.484, 95%CI=1.073-18.519) , and adverse pregnancy outcome ( OR=8.850, 95%CI=2.994-26.316) were the risk factors of RSA. Set blood type O as the classification reference, blood type A was a protective factor ( OR=0.259, 95%CI=0.088-0.765). And newborn sex was another protective factor of RSA ( OR=0.336, 95%CI=0.139-0.813). Conclusion Older women or women with blood type O are more likely to suffer from RSA than women with blood type A. Comparing with primigravida, women who had a history of RSA are more willing to accept medication of Zishen Yutai Pills for miscarriage, and women giving birth of a boy are more likely to have RSA and thereatened abortion, having high risk of adverse pregnancy outcomes particularly for the increase of gestational diabetes incidence.

Objective To investigate the differences of the correct memorization of a sentence with auditory between the hearing-impaired children after rehabilitation training and normal children.Methods Twenty-four hearing-impaired children and 14 normal hearing children at age 3~4 were selected.The hearing-impaired chil-dren were divided into two groups according to the length of the hearing device.The closed-set sentence test of e-valuation of auditory response to speech (EARS)was used.Results 1 .In the first test,the hearing-impaired chil-dren with hearing device 2 to 3 years whose correct rate was 57.14%were close to the normal children whose correct rate was 58.93%.The hearing-impaired children with hearing devices 1 to 2 years whose correct rate was 32.5%were worse than the children of other two groups 2 .In the second test,the hearing-impaired children with hearing devices 2 to 3 years whose correct rate was 44.64% were better than the hearing-impaired children with hearing devices 1 to 2 years whose the correct rate was 22.5%.The normal children whose the correct rate was 55.36%were better than the children of other two groups.3.There was no significant difference to correctly memorize a sen-tence between three groups in the first test,but there was significant difference to correctly memorize a sentence between the hearing-impaired with hearing device 1 to 2 years and the hearing-impaired children with hearing de-vice 2 to 3 years (P<0.05),and significant differences also existed between the hearing-impaired with hearing de-vice 1 to 2 years and normal children (P<0.05),but there was no significant difference between the hearing-im-paired children with hearing device 2 to 3 years and normal children (P>0.05).Conclusion The length with hear-ing device strengthens the ability of hearing-impaired children in correctly memorizing a sentence after rehabilitation training.And the content of test affects the result ,it provides reference to the hearing-impaired children's auditory training .

OBJECTIVE:To evaluate the rationality of cefoxitin use in our hospital. METHODS:Evaluation index and evalua-tion criteria were established on the basis of DUE. The relative weight of evaluation index were calculated by using attribute-based AHM weight method,and the gas between medical orders and complete rational ones were evaluated by using TOPSIS processing method. The proportion of rational medical orders were calculated to evaluate the rationality of drug use. RESULTS:Among 116 medical records,there were 19%reasonable medical orders(including 4.3%complete reasonable medical orders,5 cases),50%ba-sically reasonable medical orders(58 cases)and 31% unreasonable medical orders(36 cases). CONCLUSIONS:It is reasonable and feasible to use AHM weighted TOPSIS method to evaluate the rationality of cefoxitin. The utilization of cefoxitin in our hospital is basically reasonable,but there are still many problems.

Objective To research the reliability and validity of the N-QOL Chinese version system.Methods A total of 260 nocturia patients were surveyed by the Chinese version of N-QOL and the reliability and validity of the Chinese version of N-QOL were assessed.Results Cronbach's α of the total questionnaire and two dimensions were 0.899,0.672 and 0.799,respectively.The split-half reliability was 0.828 and re-test reliability was 0.796.The correlation coefficients of scores of the items with its subordinate dimensionality were 0.595～0.854,and those with the total scores were 0.578～0.754.Two common factors were found through exploratory factor analysis,which explained the percent of 57.20％ rotation sums of squared loadings.Conclusions The reliability and validity of the Chinese version of N-QOL were good,so it could be used to evaluate the life quality of nocturia patients.

Objective To access evaluate the efficacy and safety of on-line hemodiafiltration for treating a-cute cerebrovascular disease (ACVD) patients complicated with hyperosmolar nonketotie diabetic coma (HNDC).Method Totally 11 patients of ACVD complicated with HNDC were observed for this prospective control study.All of them underwent on-line hemodiafiltrafion for 90 minutes using Fressnius 4008S Hemodialysis Machine withONLILNEplus TM and F60 one hour after final diagnosis was made. The bicarbonate ultrafiltrate rate was set at 500ml/min and blood flow at 150 ～ 180 ml/min; and the substitute fluid were infused with post-dilution at 50 ～ 60ml/min. The symptom of brain edema and cardiac insufficiency during the same course of treatment was observed.Blood were taken from the patients to detect serum kalium, serum glucose, serum natrium, BUN and plasma os-motic pressure at one hour before treatment and six hours after treatment, respectively. The change of in conscious-ness and adverse effects were evaluated at 24 hours after treatment. Results All patients were treated successful-ly. The blood glucose, serum natrium, serum kalium, BUN and plasma osmotic pressure were decreased after on-line hemodiafiltration. Among the 11 patients, consciousness was improved obviously in 8 patients, 3 patientsdied, accounting for 73% of successful effectiveness. Conclusions The on-line hemodiafiltration was effectiveand safe for treating ACVD patients complicated with HNDC.

OBJECTIVE:To explore the establishment of DUE criteria for the evaluation of glucocorticoids(GCs)use in oncol-ogy department of our hospital,and to evaluate the rationality of glucocorticoid use. METHODS:DUE criteria for GCs in our hos-pital was established preliminary,and used to evaluate medication indication,medication course,medication results,etc. Medical records of 300 patients receiving GCs were collected from oncology department of our hospital during Apr. to Dec. in 2013(before intervention)and Jun. 2014 to Mar. 2015(after intervention)via hospital information system. The application of GCs was evaluat-ed. RESULTS:Pexamethasone sodium phosphate injection was used most frequently in our hospital(82.34%),followed by Dexa-methasone acetate tablet(15.33%)and prednisone asetate tablets(2.33%). The mest common purpose of GCs use in oncology de-partment of our hospital is radiotherapy and chemotherapy induced vomiting prevention and treatment(55.55% of total case),fol-lowed by anti-inflammatory therapy(14.19%)and chemotheraphy drug pretreatment(12.76%). After intervention,rational use of GCs for tumor had been improved greatly,and the rate of unqualified drug dosage and medication course decreased from 6.87% to 3.95%,and that of decreased from 3.58% to 2.74%. CONCLUSIONS:The establishment of DUE criteria and continuous criteria improvement during clinical rational drug use guidance can promote rational use of GCs in oncology department.

Objective To detect the mutations of GJB2 and GJB6 genes in the first Chinese case of keratitis, ichthyosis and deafness (KID) syndrome. Methods Genomic DNA was extracted from the patient with KID syndrome and his family members. All encoding exons and adjacent splice sites of the GJB2 and GJB6 genes were amplified by PCR. Mutation scanning was carried out by direct bidirectional DNA sequencing. Results No mutation was found in GJB6. A G148A mutation was found at exon2 of GJB2 in the patient, which caused a change from aspartic acid to asparagine at codon 50(D50N). Conclusion This case of KID syndrome may be caused by the mutation in GJB2.

Objective To report one case with congenital ichthyosiform eruption, neurosensory deafness and vascularizing keratitis. Methods The overall clinical and laboratory examinations were conducted to confirm the diagnosis of keratitis, ichthyosis and deafness (KID) syndrome. Results The case presented with the typical hypotrichosis features of the eye lashes and eyebrows, alopecia of the scalp, and ophtalmological lesions. The keratotic plaques over the face, nose, ears, and the extremities were characterstic, and the skin of the trunk was leather-like, dry and hyperkeratotic. Dysplasia of cerebellum, and cystic enlargement of the fourth ventricle of cerebrum, and Dandy Walker syndrome were observed on MRI scanning. Treatment with oral acitretin for 3 weeks cleared the hyperkeratotic ichthyotic lesions on her posterior scalp and also improved other lesions on the extremities and the trunk. Conclusion Acitretin seems to be promising in the treatment of keratotic skin lesions in KID syndrome.