OBJECTIVE:To evaluate the meta-analysis effect of pharmaceutical care(PC)program in asthma patients in community pharmacies.METHODS:The author searched 5 electronic databases(China Journal Net,Academic Search Premier(ASP),Blackwell,Elsevier,John Wiley)from 1999 to Mar 2006.And then the randomized controlled trials by the intervention measures of the medicine consultation and health education were made,Moreover,the literatures were selected by 2 valuators.A meta-analysis was conducted by means of Review Manager 4.2 software.RESULTS:We included 4 randomized controlled trials,1 298 asthma patients,homogeneityte test result X2=1.28(P=0.73).Geostatistical analysis is made by fixed effect model.As compared with the control group,the PC program increased patients'PEFRs in PC group significantly(the combined SMD=0.19,95%confidence interval:0.08～0.30(P=0.0 006).CONCLUSION:PC program in community pharmacies is an effective option in asthma prevention and treatment.The pharmaceutical care program in asthma patients in community pharmacies is effective management model of disease.

Objective To investigate the pediatric intensive care unit (PICU) in critically ill children with pediatric critical score (PCIS) and pediatric death risk score (PRISM),comparing its value.Methods A total of 100 cases of matching children with acute respiratory distress syndrome (ARDS) to stay in our hospital during 2007.07 ～2012.07 was retrospectively analyzed.Check PICU most serious disease in this group of children,living PICU most severely ill when diagnosed with acute respiratory distress syndrome (ARDS),when it was suffering from ARDS most serious line PCIS with PRISM score,and then using the Logistic multiple regression to analyze the scores of the two scoring ability as predicting the ARDS death in children with risk factors,and using two-factor analysis of variance of the two scoring methods by judging linear correlation existence.Results (1)PCIS with PRISM score showed a negative correlation (r=-0.6031,P ＜0.01),the linear regression equation y =-0.2389x +74.816 (P＜0.01).(2) There was no statistical difference between the ARDS death group and survival group (P ＞ 0.05) ; By PCIS PRISM score LOGISTIC regression analysis of the risk of death in children,there was no statistical difference (P ＞ 0.05).Conclusions PCIS and PRISM score cannot be the standards to forecast the death of the ARDS patients,but can provide an objective referring standard of ARDS's treatment.

A predominant chrysene-degrading strain was isolated and screened from biological sludge sampled from a coking plant,which can use chrysene as sole carbon source for growth in the selective culture me-dium.The phylogenetic tree of the strain was produced on the basis of morphology observation by SEM,experimental results of physiology and biochemistry and analysis of 16S rDNA sequence.The strain was identified as Achromobacter xylosoxidans.The effect of initial concentration of chrysene solution,inoculat-ing dose and pH on degradation efficiencies was investigated.The results indicate that the degrading charac-teristics of the strain is fine.The optimal degrading conditions are:initial concentration of chrysene solution 40 mg/L,inoculating dose(V/V)10%,pH 7.0~7.5,respectively.Under the optimal conditions,the degrading efficiency can reach more than 80% after 5 days at 30?C.

Objective To evaluate Alberta stroke programme early CT score on diffusion-weighted imaging (DWI-ASPECTS)and clot burden score on MR angiography (MRA-CBS)in predicting hemorrhagic transformation(HT) in acute anterior circulation cerebral infarction after thrombolysis in diffusion-weighted imaging Alberta stroke program.Methods A total of 37 consecutive patients with acute anterior circulation cerebral infarction were treated with thrombolysis.The clinical information , score of DWI-ASPECTS before thrombolysis , score of MRA-CBS before thrombolysis and images of enhanced gradient echo T 2*-weighted angiographywithin ( ESWAN) 24 hours before and after thrombolysis were all collected.The interval between onset and the two MRI scans were recorded respectively.We identified HT according to the images of ESWAN scanned after thrombolysis , and divided patients into 2 groups:with HT(14 cases) and without HT (23 cases).Differences of clinical data and imaging indicators between the two groups were compared by using Fisher′s exact test and Wilcoxon rank sum test.Logistic regression analysis was performed by taking HT as the dependent variable , and the scores of NIHSS , DWI-ASPECTS and MRA-CBS at admission were taken as independent variables.The variables which were statistically significant in logistic regression analysis were enrolled in receiver operating characteristic analysis.Results In HT group, the scores of NIHSS, DWI-ASPECTS and MRA-CBS were 15.00 ±5.30, 6.00(4.75,7.00) and 7.00(0.75,8.50) respectively.In the other group without HT, these scores were 7.00 ±4.80, 9.00(8.00,10.00)and 10.00(6.00,10.00) respectively.Compared with patients without HT , patients with HT had a higher baseline NIHSS score ( Z=-3.72,P<0.01), a lower DWI-ASPECTS (Z=-4.13,P<0.01) and a lower MRA-CBS (Z=-2.00, P<0.05).Logistic regression analysis showed that the scores of DWI-ASPECTS ( OR 0.42,95%CI 0.21-0.87,P <0.05 ) and NIHSS ( OR 1.22, 95%CI 1.00-1.48, P <0.05 ) at baseline predicted HT development independently.Receiver operating characteristic analysis showed that the optimal cut -off point of DWI-ASPECTS to predict the development of HT was≤7.Its sensitivity, specificity and area under ROC curve were 92.9%, 78.3% and 0.902 respectively ( P<0.01 ).Conclusions ASPECTS on DWI is of great value in predicting HT after thrombolysis in acute cerebral infarction.CBS on MRA can provide additional information for predicting HT.

Adult ; Drainage ; Female ; Humans ; Hysterectomy, Vaginal ; adverse effects ; Laparoscopy ; adverse effects ; Radiography ; Subphrenic Abscess ; diagnostic imaging ; etiology ; therapy ; Ultrasonography

Objective To investigate the level of uncertainty of illness and social support state in patients with prediabetes,and to discuss the correlation between the two.Methods 243 cases with prediabetes were analyzed by Uncertainty in Illness Scale and Social Support Rating Scale.Results There was a middle uncertainty in the elderly patients with prediabetes.The objective support,sabjective support,social support utilization degree and social support score were negatively related to the complexity of uncertainty(r--0.419,-0.433,-0.390 and-0.421,respectively,all P＜ 0.05).Conclusions Medical staff should evaluate the uncertainty in illness in elderly patients with prediabetes and conduct nursing intervention accordingly,in order to reduce the uncertainty,increase social support,and ultimately improve the quality of life.

Objective To analyze the differences with the expression of glucocorticoids receptor isoforms ( GRα, GRβ, GRγand GR-P ) and cytokines [ IL-6, macrophage migration inhibitory factor (MIF), IFN-γand IL-10] between patients with systemic lupus erythematosus (SLE) and rheumatoid ar-thritis ( RA) , and to further understand their correlations with disease activities.Methods Fifty-five pa-tients with SLE, forty-nine patients with RA and thirty-eight healthy subjects were recruited in this study. All patients were steroid-naive.The expression of GRα, GRβ, GRγ, and GR-P in peripheral blood mononu-clear cells at transcript levels were determined by real-time PCR.Enzyme-linked immunosorbent assay was used to detect the expression of IL-6, MIF, IFN-γand IL-10 in serum samples.Results The percentages of GRαin all subjects were the highest among four isoforms of GR, followed by GR-P, GRγand GRβ.Com-pared with healthy subjects, patients with SLE or RA showed significantly decreased expression of GRα( P<0.05), but increased expression of GR-P (P<0.05).The percentages of GR-P in patients with RA were higher than those in patients with SLE (P<0.05).The expression of GRαwas negatively correlated with SLE disease activity index (SLEDAI) and disease activity score 28 (DAS28).SLE or RA patients with high disease activity showed lower expression of GRαthan those with low disease activity.The levels of IL-6, IFN-γand MIF in patients with SLE or RA were significantly higher than those in healthy subjects ( P<0.05).A negative correlation was observed between the expression of IL-6 and GRαin patients with SLE (P<0.05).The expression of IFN-γwas negatively correlated with GRαin patients with RA (P<0.05). Conclusion There were significant differences with the expression of GR isoforms among patients with SLE, patients with RA and healthy subjects, indicating the change of internal environment in patients might be in-volved in GR alternative splicing.GRαwas the predominant isoform and was negatively correlated with dis-ease activities.Oversecretion of cytokines resulted in a decreased expression of GRα.This study would be useful for the diagnosis of the disease status and for monitoring clinical treatment.

Objective:To explore diagnostic value of nocturnal ST-T changes in 24h dynamic electrocardiogram (DCG)for coronary heart disease (CHD)and its clinical significance.Methods:A total of 103 cases,who showed ST-T changes in 24h DCG,received selective coronary angiography (CAG).Among them,the 56 patients with in-termittent nighttime significant ST-T changes were regarded as research group,while the other 47 patients with per-sistent ST-T changes were treated as control group.CAG results were compared and analyzed between two groups. Results:Compared with control group,there were significant rise in CAG positive rate (31.9% vs.67.9%),inci-dence rates of dyspnea and chest pain (27.7% vs.66.1%),hypertension (48.9% vs.71.4%),hyperlipidemia (31.9% vs.42.9%)and diabetes mellitus (17.0% vs.46.4%),percentages of lesions in left anterior descending artery (LAD,21.3% vs.57.1%),left circumflex coronary artery (LCX,14.8% vs.37.5%)and right coronary artery (RCA,12.8% vs.35.7%)in research group,P <0.05 or <0.01. Conclusion:Nocturnal ST-T signifieantly changes in 24h DCG,it possesses more diagnostic value for CHD,which can be regarded as a more sensitive index diagnosing myocardial ischemia.

Objective To investigate the effects of early rehabilitation therapy in mechanically ventilated ICU in patients.Methods A randomized controlled trial was carried out.Sixty mechanically ventilated patients,with tracheal intubation or tracheostomy more than 48 h and less than 72 h,were admitted to the intensive care unit (ICU) of the Affiliated Hospital of Medical College Qingdao University from May 2010 to May 2012.These patients were randomly (random number) divided into two groups,the rehabilitation group and the control group,30 patients in each group.In rehabilitation group,rehabilitation therapy was taken twice daily,and the training time and intensity was adjusted according to the condition of the patients.Early rehabilitation therapy included head up actively,transfer from the supine to sit,out of bed,transfer to a chair,standing bedside bed and walking bedside bed.The patient' s body mass index,days to first out of bed,duration of mechanical ventilation,ICU stay,APACHE Ⅱ score,highest FiO2,lowest PaO2/FiO2 and hospital mortality of patients were compared between rehabilitation group and control group.The differences between the groups were compared using t test.Results There was no significant difference in body mass index,APACHE Ⅱ score,highest FiO2,lowest PaO2/FiO2 and hospital mortality between rehabilitation group and control group (P ＞ 0.05).Patients in the rehabilitation group had shorter first out of bed time [(3.8 ± 1.2) d vs.(14.9 ±4.7) d; P =0.00],duration of mechanical ventilation [(5.6±2.1) dvs.(12.7±4.1) d; P=0.005] andICUstay [(7.3±2.8) dvs.(15.2±4.5) d;P =0.01] compared with control group.Conclusions Early rehabilitation therapy was safe and effective in improving the outcomes of mechanical ventilation patient.

0.05).Conclusion Long-term inhaled glucocorticosteroids has no obvious effect on GH and height growth of asthmatic children.