Objective To provide reference for anti-infection treatment and individual pharmaceutical care in patient on peritoneal dialysis. Methods The plasma concentration of vancomycin in patient on peritoneal dialysis was monitored by clinical pharmacists. The anti-infection treatment plan was evaluated and adjusted according to the bacterial culture and drug sensitivity results of the abdominal dialysis fluid. The adverse reactions of pancytopenia induced by vancomycin were documented. Results Infection in the patient on peritoneal dialysis was effectively controlled. The related indicators of pancytopenia were improved. Conclusion A case of pancytopenia induced by vancomycin in the patient on peritoneal dialysis was analyzed to get clinical staff's attention to this adverse reaction and improve the safety of vancomycin administration.

OBJECTIVE: To examine the potential of intravoxel incoherent motion (IVIM) and blood oxygen level-dependent (BOLD) magnetic resonance imaging for detecting renal changes after iodinated contrast-induced acute kidney injury (CI-AKI) development in a diabetic rabbit model. MATERIALS AND METHODS: Sixty-two rabbits were randomized into 2 groups: diabetic rabbits with the contrast agent (DCA) and healthy rabbits with the contrast agent (NCA). In each group, 6 rabbits underwent IVIM and BOLD imaging at 1 hour, 1 day, 2 days, 3 days, and 4 days after an iohexol injection while 5 rabbits were selected to undergo blood and histological examinations at these specific time points. Iohexol was administrated at a dose of 2.5 g I/kg of body weight. Further, the apparent transverse relaxation rate (R2*), average pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were calculated. RESULTS: The D and f values of the renal cortex (CO) and outer medulla (OM) were significantly decreased compared to baseline values in the 2 groups 1 day after the iohexol injection (p < 0.05). A marked reduction in the D* values for both the CO and OM was also observed after 1 hour in each group (p < 0.05). In the OM, a persistent elevation of the R2* was detected for 4 days in the DCA group (p < 0.05). Histopathological changes were prominent, and the pathological features of CI-AKI aggravated in the DCA group until day 4. The D, f, and R2* values significantly correlated with the histological damage scores, hypoxia-inducible transcription factor-1α expression scores, and serum creatinine levels. CONCLUSION: A combination of IVIM and BOLD imaging may serve as a noninvasive method for detecting and monitoring CI-AKI in the early stages in the diabetic kidney.
Acute Kidney Injury ; Body Weight ; Creatinine ; Diffusion ; Iohexol ; Kidney ; Magnetic Resonance Imaging ; Methods ; Oxygen ; Perfusion ; Rabbits ; Relaxation ; Vascular Endothelial Growth Factor A

Objective To investigate changes in the collagen expression and elastic modulus in scleral tissues of experimental high myopia, so as to further explain the mechanism of high myopia. Methods Twenty one-month-old New Zealand white rabbits were monocularly treated by eyelid suturation randomly to build an experimental high myopia eye model. Eyes without such operation were set as the normal control. After 60 days, the experimental high myopia eye models were successfully established by measuring the eye axis. The eyeballs were obtained to assess three regions of the sclera (anterior, equatorial, and posterior area). The three regions of the scleral tissues were separately divided into four groups. The first group was made into scleral strips for elastic modulus measurement using an Instron5544. The second group was hematoxylin-and-eosin stained for observation of the scleral structures. The third group was used for electron microscopy to observe the size distribution of collagen fibrils. The last group was homogenized, and the concentration of hydroxyproline was measured to determine the collagen content. Results The elastic modulus, collagen content, and diameters of the collagen fibrils of each scleral region increased with age. The posterior sclera of high myopia had looser collagen fibril arrangement, less hydroxyproline concentration, and lower elastic modulus than the normal eyes. However, there was no significant difference as for the anterior and equatorial sclera. Conclusions The remodeled posterior sclera of high myopia has a looser collagen fibril arrangement, less collagen, and lower elastic modulus, which easily causes expansion and deformation and thus lead to high myopia. The research findings provide the theoretical guidance for high myopia prevention by targeting the collagen during early development.

Objective To evaluate the effect of honokiol on the activation of transient receptor potential (TRP) channel in rat spinal dorsal root ganglion cells and pruritus in mouse models.Methods Healthy male ICR mice aged 4-6 weeks were used to establish histamine-induced and acetone/ether/water (AEW)-induced itching models separately.Totally,mice were randomly divided into 7 groups (histamineinduced model experiment) or 6 groups (AEW-induced model experiment):normal control group and model group both gavaged with sodium chloride physiological solution,solvent group gavaged with sodium carboxymethylcellulose solution,chlorphenamine group (only set up in the histamine-induced model experiment) gavaged with chlorphenamine,50,25 and 12.5 mg/kg honokiol groups gavaged with 50,25 and 12.5 mg/kg honokiol respectively.In the histamine-induced model experiment,the mice were all injected with histamine except the normal control group injected with sodium chloride physiological solution 24 hours after the gavage treatment,while the mice in the AEW-induced model experiment were all topically treated with AEW except the normal control group topically treated with sodium chloride physiological solution for 4 days,followed by gavage with different drugs.The anti-itch effect of each treatment was evaluated by counting the scratching frequency within 30 minutes.Rat spinal dorsal root ganglion (DRG)cells were isolated and subjected to a primary culture.Then,the DRG cells were divided into 6 groups:capsaicin or allyl isothiocyanate (AITC)-induced model group pre-incubated with Hank's balanced salt solution (HBSS),500 μmol/L capsazepine or 10 μmol/L HSC030031 group pre-incubated with capsazepine or HSC030031,solvent group pre-incubated with dimethyl sulfoxide (DMSO),3 honokiol groups preincubated with 7.81,15.63 and 31.25 mg/L honokiol respectively,and Ca2+ fluorescence imaging system was used to observe changes of Ca2+ influx in these cells after capsaicin or AITC stimulation.Statistical analysis was carried out with SPSS 20.0 software by using one-way analysis of variance and Dunnett-t test.Results In the histamine-induced mouse models,the scratching frequency was significantly lower in the 50 and 25 mg/kg honokiol groups than in the model group (21.88 and 21.14 vs.63.70,t =3.48,3.49 respectively,both P =0.003),while no significant difference in the scratching frequency was observed between the 12.5 mg/kg honokiol group and the model group (t =2.01,P =0.062).After the treatment with 50 mg/kg honokiol in the AEW-induced mouse models,the scratching frequency significantly decreased compared with the model group (61.4 vs.101.17,t =0.45,P =0.009),while there were no significant differences among the 25,12.5 mg/kg honokiol groups and the model group (all P ＞ 0.05).Compared with the capsaicin or AITC-induced model group,the increase of Ca2+ fluorescence signal in the DRG cells was significantly inhibited in the 31.25 mg/L honokiol group:at the 45th second,the rate of relative fluorescence intensity change (AF/F0) was 1.11 in the model group,but-0.11 in the 31.25 mg/L honokiol group in the capsaicin-induced model experiment,and 0.56 in the model group,but 0.00 in the 31.25 mg/L honokiol group in the AITC-induced model experiment.Conclusion Honokiol shows an inhibitory effect on mouse models of pruritus induced by histaminergic or non-histaminergic factors,likely by inhibiting Ca2+ influx through activated TRPV 1 and TRPA 1 channels in the DRG cells.

Objective:To compare the clinical value of stent assisted intestinal bypass and temporary loop ileostomy in laparoscopic low anterior resection of rectal cancer.Method:In this retrospective analysis, 57 patients undergoing laparoscopic low anterior resection for rectal cancer in the First Affiliated Hospital of Ningbo University from Jan 2020 to Jan 2022 were divided into intestinal bypass group (36 cases) and loop ileostomy group (21 cases).Result:There were no significant differences in postoperative GI function recovery and postoperative complication rate between the two groups (all P>0.05). The levels of albumin, prealbumin and hemoglobin in the intestinal bypass group were better than those in the ileostomy group when evaluated on 3rd months after operation [(40.5±2.3) g/L vs. (38.1±2.6)g/L、(26.4±2.7)mg/dl vs. (24.5±2.0)mg/dl、(137.6±5.9) g/L vs. (134.0±7.0) g/L, t=3.605、2.743、2.085, all P<0.05]. Hospital expenses of the intestinal bypass group was lower [(571 000±7 500) yuan vs. (69 300±9 100) yuan, t=-5.477, P<0.05]. Conclusion:Compared with traditional ileostomy, the stent assisted intestinal bypass reduces trauma with lower expenses and improves patients' status after laparoscopic low anterior resection for rectal cancer.

Objective: As cancer stem cells (CSCs) are considered as the origin of tumor development, recurrence, and drug resistance, we aimed to explore the mechanism related to modulating stemness in CSCs, thus facilitating to search for new therapeutic strategy for ovarian cancer. Methods: In this study, ovarian cancer stem cells (OCSCs) induced from cell line 3AO and A2780 were enriched in serum-free medium (SFM). The effect of SURF4 on CSC-like properties was evaluated by sphere-forming assays, re-differentiation assays, quantitative real-time polymerase chain reaction, flow cytometry, Western blotting, cell viability assays and in vivo xenograft experiments. The downstream molecule participating in SURF4 maintaining stemness was screened by RNA-sequencing and identified by the experiments of gene function. Results: SURF4 was upregulated expressed in OCSCs. Knockdown of SURF4 reduced the expression of the related stem markers (SOX2 and c-MYC), inhibited self-renewal ability, and improved the sensitivity to chemotherapeutic drugs (paclitaxel and cisplatin) in OCSCs.SURF4 knockdown also inhibited tumorigenesis in nonobese diabetic/severe combined immunodeficiency mice. BIRC3 expression was controlled by SURF4, and BIRC3 showed the similar effect as SURF4 did, and BIRC3 overexpression partially recovered stem-like properties abolished by SURF4 knockdown. Conclusion Our findings suggest that SURF4 possesses the ability to maintain stemness of OCSCs via BIRC3, and may serve as a potential target in stem cell-targeted therapy for ovarian cancer.

Objective: To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST). Methods: 28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery. Patients′clinicopathologic characteristics, operative outcomes, postoperative complications, and follow up results were analyzed retrospectively. Results: Surgery was successfully completed in all patients, and no one was converted to open surgery.The average operation time was (66±15) min, and the intra operative blood loss was (16±10) ml, the time of passage of gas by anus after operation was (20±10)h, the time starting liquid diet was(2.5±1.6)d, and the length of postoperative hospital stay was (7±3)d. One patient had delayed gastric emptying, one had incisional infection. All the specimen had complete pseudocapsule and negative margin. pathology was all gastric GIST. After a median 22 months followed up, no recurrence or metastasis were found. Conclusion Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST.

OBJECTIVE： To investigate and evaluate perioperative medication in elective surgery elderly patients， and to provide reference for perioperative medication management of clinical pharmacists for elderly patients. METHODS： Totally 210 elective surgery elderly patients were selected from Beijing Tsinghua Chang Gung Hospital during Oct. 2015 to Oct. 2016. Pharmacists carried out drug reconstitution， obtained information about their diseases and medication， analyzed and evaluated perioperative medication （indication， usage and dosage， interaction， drug selection， if these drugs should be stopped before surgery） according to Optimal Guidelines for Preoperative Evaluation of Elderly Patients so as to put forward related medication suggestions. RESULTS： Among 210 patients， there were 132 males （62.86％） and 78 females （37.14％） with an average age of （69.96±7.67） years； 43.81％ of patients had more than 3 kinds of diseases， and 13.33％ of patients suffered from more than 5 kinds of diseases； 31.43％ of patients took more than 5 kinds of drug for long term before surgery； 38.10％ patients had more than 2 drug-induced risks； The preoperative medication of 110 patients （52.38％） included drugs that should be avoided before surgery （such as antiplatelet aggregation agents）， 23 patients （10.95％） had potentially inappropriate medication （such as proton pump inhibitors）， 12 patients （5.71％） should use drugs （such as aspirin） cautiously， 35 patients （16.67％） should use drugs （β receptor blocker） continuously during perioperative period. The pharmacists provided 177 times of medication suggestions such as stopping some medications for patients and physicians through medication reconciliation and preoperative medication evaluation （71 times for patients， 106 times for physicians）； the final adoption rates were 100％ and 95.28％， respectively. CONCLUSIONS： The elderly patients have many preoperative complications， various risk factors， multiple medications， so it is vital for their preoperative medication management. The medication reconciliation is an effective way to evaluate preoperative medication in elderly patients， preoperative medication evaluation and analysis in elderly patients is of great significance to ensure the safety of clinical medication.