OBJECTIVE:To explore the role of clinical pharmacists participating in the individualized treatment for purulent meningitis. METHODS:Clinical pharmacists participated in the therapy for a patient with purulent meningitis complicated with Staphylococcus aureus infection. According to patient's condition,clinical pharmacists assisted physicians to formulate preliminary therapeutic plan. Reviewing relevant guidelines,domestic and foreign literatures,clinical pharmacists suggested to combine with dexamethasone so as to relieve inflammatory reaction. According to the results of drug sensitivity test,based on vancomycin plasma concentration monitoring and population pharmacokinetics model fitting,clinical pharmacists suggested to reduce the dose of vanco-mycin to 0.5 g,ivgtt,q12 h. The pharmaceutical care were conducted throughout the therapy,including efficacy evaluation of an-ti-infective therapy,ADR monitoring,renal function monitoring,etc. RESULTS:Physicians adopted some suggestions of clinical pharmacists. The disease condition of the patient was recovred,and no ADR related to vancomycin was found. On the 16th day, the patient was discharged from the hospital. CONCLUSIONS:Clinical pharmacists participate in treatment of purulent meningitis, assist physicians to optimize therapy plan based on relevant guideline,literature,etiological examination,blood concentration moni-toring and pharmacokinetics model fitting results. It not only guarantee therapeutic efficacy of anti-infective therapy,but also pre-vent and reduce the occurrence of ADR.

BACKGROUND:Osteogenic differentiation is a complex process involving transcriptional and post-transcriptional regulation by multiple signaling pathways, and the specific mechanisms remain unclear. It is of great significance to study the role of critical miRNAs in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in the treatment of osteoporosis and bone defects. OBJECTIVE: To explore the regulatory ability of miR-21/Sprouty1 function axis in the osteogenic differentiation of BMSCs in patients with postmenopausal osteoporosis. METHODS:BMSCs were isolated from healthy people (H-hBMSCs) and patients with postmenopausal osteoporosis (PMOP-hBMSCs), and their osteogenic ability was compared. Expression of miR-21 and Spry1 at gene and protein levels was detected by real-time RT-PCR and western blot assay, respectively. miR-21 expression was upregulated via transfection in PMOP-hBMSCs, and the osteogenic ability and Spry1 expression of the cells were detected, while real-time RT-PCR and western blot were used to detect the expression of osteogenic marker genes, Runx2 and Osterix. RESULTS AND CONCLUSION:Compared with H-hBMSCs, PMOP-hBMSCs osteogenic ability was weakened significantly, miR-21 expression decreased, and Spry1 expression increased, indicating an inhibition to the miR-21-Spry1 function axis. Through the transfection of miR-21 and down-regulation of Spry1, the expression levels of Runx2 and Osterix were increased, and PMOP-hBMSCs osteogenic ability was partially restored.

BACKGROUND:Previous studies have found that miR-21 expression is increased during osteogenic differentiation of bone marrow mesenchymal stem cells, but the action and molecular mechanism of miR-21 are stil unclear. OBJECTIVE:To verify the target gene of miR-21, Spry1, and to explore the role of Spry1 in osteogenic differentiation of human bone marrow mesenchymal stem cells. METHODS:Luciferase report was used to verify Spry1 gene targeted by miR-21, and western blot assay was used to detect the expression of Spry1 in the osteogenesis of human bone marrow mesenchymal stem cells. Spry1 expression vector was established and transfected into human bone marrow mesenchymal stem cells. Osteogenesis ability of human bone marrow mesenchymal stem cells was analyzed after Spry1 high expression by alkaline phosphatase, alizarin red staining, RT-PCR and western blot. RESULTS AND CONCLUSION:Luciferase report suggested that Spry1 was a target gene of miR-21. The expression level of Spry1 was decreased in the osteogenesis of human bone marrow mesenchymal stem cells. Increasing expression of Spry1 could inhibit osteogenic differentiation of human bone marrow mesenchymal stem cells. These results indicate that Spry1 as a target gene of miR-21 negatively regulates osteogenic differentiation of human bone marrow mesenchymal stem cells, and plays an important role in bone formation process.

Foreign Bodies ; Humans ; Male ; Middle Aged ; Nasopharynx ; injuries ; Skull Base ; pathology ; Wounds, Penetrating

Alzheimer's Disease (AD) is a chronic neurodegenerative disease that usually takes many years from preclinical phase to prodromal phase characterized by mild symptoms before the onset of dementia. Once diagnosed with AD, the brain is already severely damaged and the disease will process quickly to the most severe stages since there is no medications that reverse the neuronal injuries in the brain. Thus, simple, inexpensive, and widely available methods for detecting potential AD patients during their preclinical phases are urgently needed. In such case, olfactory testing may offer a chance for early diagnosis of AD. However, there are limitations in these olfactory tests due to the complexity of the brain areas it extends to and the frequently olfactory fatigue occurred in the behavioral olfactory tests. Great efforts have been done epidemiologically to investigate the correlation between olfactory functions and possibility of developing AD. Different patterns of olfactory dysfunction have been found in AD at early stages and even mild cognitive impairment (MIC), but the cause of the dysfunction remained unclear. Various kinds of AD animal models have been used in the field to clarify the existence of olfactory dysfunctions and thus study the underling mechanism of the dysfunction. In this review we discuss (1) the function of Tau physiologically and pathologically; (2) the genetic background and biological characteristics of the most commonly used Tau transgenic mice; (3) the structural and molecule basis of olfaction; (4) the possible relationship between Tau pathology and olfactory dysfunction. Finally, we suggest that the tau transgenic mouse models may be helpful in studying the possible mechanisms of the dysfunction.
Alzheimer Disease ; physiopathology ; Animals ; Disease Models, Animal ; Mice ; Mice, Transgenic ; Olfaction Disorders ; physiopathology ; tau Proteins

Objective:To observe the effect of metformin on the expression of SIRT1 and UCP2 in rat liver of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD), and discuss the pathogenesis of T2DM with NAFLD, and the treatment with and possible mechanism of metformin.Methods:Thirty-six male SD rats were randomly divided into a normal control group (group NC, n=12), a T2DM with NAFLD group (group MC, n=12), and a metformin group (group A, n=12). We established the model of T2DM with NAFLD rats by feeding high-fat and high-sugar diet and injecting STZ. After the success establishment of the model, the metformin group was given metformin 300 mg/(kg.d) for 8 weeks. At the end of the experiment, we measured FBG, ALT, AST, TC, TG, HDL-C, LDL-C, VLDL, FFAs, FINs and HOMA-IR respectively in group NC, MC and A. We observed the change of liver tissue pathology by HE, determined the expression of SIRT1 and UCP2 in rat liver by immunohistochemical method and real-time quantitative method. Results:FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were higher in group MC than in group NC (P<0.05), while HDL-C was obviously lower in group MC than in group NC (P<0.05). After the metformin treatment, the serum parameters in the rats had improved in group NC compared with in group MC (P<0.05). On immunohistochemical staining and mRNA level, the expression of SIRT1 was obviously lower in group MC than in group NC (P<0.05), and the expression of UCP2 was obviously higher in group MC than in group NC (P<0.05). After the metformin treatment, the expression of SIRT1 was higher than in group MC (P<0.05), and the expression of UCP2 was lower than in group MC (P<0.05). There was negative correlation between the expression of SIRT1 and UCP2 (r=-0.61, P<0.01).
Conclusion:The expression of SIRT1 is low and the expression of UCP2 is high in rat liver of T2DM with NAFLD. Metformin can increase the expression of SIRT1 and reduce the expression of UCP2, with negative correlation between the expression of SIRT1 and UCP2.

Abstract: Objective To analyze the application value of pathological diagnosis in analyzing the reason of death in a case of Methods ， ， occupationalpneumoconiosis. Theoccupationhistory occupationalexposurehistory clinicaldataandpathological - Results data of a dead patient with occupational pneumoconiosis were retrospectively analyzed. The patient was exposed to ， inorganic dust for more than ten years in a private factory. In January 2019 the computed tomography showed diffuse nodular mass with dense shadows in both lungs and left pneumothorax. He was admitted to a number of hospitals and the clinical diagnosis suspected that he suffers from occupational pneumoconiosis. He eventual died of bilateral pneumothorax in a local hospital in December 2020. The forensic identification of the cause of death confirmed that the lungs of the deceased had ， pathologicalchangesconsistentwithoccupationalpneumoconiosisstage Ⅱ secondarybilateralspontaneouspneumothoraxand （ ）， bilateral pleural effusion significant on the left side and the primary cause of death was severe lung disease. According to GBZ 25-2014 Pathological Diagnosis Criteria of Pneumoconiosis，the medical examiner diagnosed that the deceased had （ ） Conclusion suffered from pneumoconiosis before death pneumoconiosis stage Ⅱ . Pathological diagnosis can provide ， objectiveevidenceforthediagnosis differentialdiagnosisandcauseofdeathduetopneumoconiosis.

OBJECTIVETo explore the clinical characteristics and management of non-traumatic epidural sequestered cervical disc extrusion.

METHODSFrom January 2002 to July 2011, the clinical data of 10 patients with non-traumatic epidural sequestered cervical disc extrusion were treated by anterior cervical mostly vertebraectomy and nucleus pulposus removal after decompression and internal fixation through longitudinal ligament resection. Of them,there were 6 males and 4 females with an average age of 48.2 years old (ranged from 42 to 65), the course of disease ranged from 1 month to 4 years (mean, 15 months). All patients manifested numbness and weakness of four limbs, unstable walking and sphincter of oddi dysfunction. Preoperative MRI showed segmental cervical spinal cord compression. JOA scoring criteria was applied to evaluate preoperative and follow-up neurologic function.

RESULTSTen patients were followed up, and the duration ranged from 15 to 32 months, with an average of 21 months. No complications related to opreation occurred. Preoperative MRI showed nucelus puplposus sequestered longitudinal ligament were on equal signal on T1-weighted and corresponding pathological,while it showed equal and high signal on T2-weighted. JOA score were increased from 7.20 +/- 1.55 preoperative to 13.60 +/- 1.90 postoperative (t = -11.8, P < 0.001), and excellent in 3 cases, good in 6 cases and moderate in 1 case.

CONCLUSIONAnterior cervical mostly vertebraectomy and nucleus pulposus removal after decompression and internal fixation through longitudinal ligament resection after early diagnosis is the key to success of treating non-traumatic epidural sequestered cervical disc extrusion.

Adult ; Aged ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Epidural Space ; diagnostic imaging ; surgery ; Female ; Humans ; Intervertebral Disc Displacement ; diagnosis ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography

Objective To review the surgical methods and mid-term results of mitral valve repair in pediatric patients with moderate to severe mitral regurgitation (MR).Methods 132 children with moderate to severe MR,aged (18.9 ± 7.2)months,weighted(11.3 ±4.8) kg.The etiology for mitral regurgitation is congenital heart disease in 126 cases,infective endocarditis in 5 cases and Marfan syndrome in 1 case.Mitral valvuloplasty(MVP) was performed with cardiopulmonary bypass under moderate systemic hypothermia.The methods of MVP included annuloplasty,annuloplasty ring,cleft closure,reconstruction of posterior leaflet.The coucomitant cardiac anomalies were treated at the same time.The results of repair were evaluated by saline injection test and transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: 131 cases had none to mild MR,and only one case had moderate MR.The patient underwent second repair immediately,subsequent TEE was mild.Mean cardiopulmonary bypass (CPB) time was (80.0 ± 31.1) minutes.Mean aortic clump time was (48.0 ± 17.9) minutes.The in-hospital mortality was 2.3％ (3 cases died).One died of heart failure on postoperative day 7,the other died of low cardiac output syndrome resulting on postoperative day 2.Another one was large ventricular septal defect(VSD) with pulmonary hypertension (PH),died of pulmonary infection.Mean postoperative ventilation time was (34.4 ± 31.9) hours,and mean postoperative inhosptial time was (9.0 ± 5.4) days.The average follow-up period was (40.5 ± 8.3) months (2 to 74 months).122 cases were fully followed up.Echocardiography showed that moderate MR was in 7 patients,and 3 patients had severe MR.4 patients underwent re-do mitral valve repair or mitral valve replacement.There was no late death.The overall survival rate at 5 years was 97.7％ and the overall freedom from reoperation at 5 years was 92.0％.Conclusion Pediatric patients with moderate to severe MR need early surgical treatment,the early and mid-term results were satisfactory.Individualized treatment protocol based on specific pathology was the keypoint of surgical therapy.

Objective To determine the prognosis and staging non small cell lung cancer (NSCLC) that extends across the fissure into adjacent lobe after surgery.Methods 3752 patients with histopathologically confirmed non small cell lung cancer (NSCLC) received surgical reeessetion from January,1997 to April,2007.Among them,163 patients have a tumor invasion beyond fissure.After matching by pathologic TNM staging (7th),326 patients whose tumor defined in a single lobe were eligible for analysis.Results Histopatholngic staging of matched patients was I a:10 patiens(6.1％ ),I b:79 patients (48.5％),Ⅱa:5 patients (3.1％ ),111:44 patients (27.0％) and Ⅲa:25 patients( 15.3％ ).5 years survival in patients with stage 1 tumors crossing the interlobar fissure was 51％,while in patients not cross the interlobar fissure was 63％ ( P ＜0.05 ).There was no difference in survival for tumors stage Ⅱa and above with regard to importance of interlobar extension.The T2 tumor extending across a lung fissure had a reduction in survival compared with T2 tumor not cross the lung fissure and similar to the T3 tumor without the fissure invasion.Conclusion Our results suggest that TNM staging should be modified for tumor extends the fissure into adjacent lobe.