Objective To retrospectively analyzed the current application of warfarin in hospitalized patients with non-valvular atrial fibrillationand ( NVAF), explore the key role of clinical pharmacists in warfarin medication. Methods A retrospective survey of anticoagulant therapy for 179 hospitalized patients with non-valvular atrial fibrillation in Renming Hospotal of Wuhan University from January to December 2013 was retrived,including the usage of warfarin for NVAF and new-onset atrial fibrillation,dosage,international normalized ratio(INR),hemorrhage event and so on.The simple factor like the age,complicated chronic diseases and previous cerebrovascular events on the use of warfarin was explored. Results The total response rate to anticoagulants was 85.6% for patients with high risk of stroke(27.3% with warfarin and 58.3% with antiplatelet therapy),who are recommended to use warfarin,patient were treated with anti-thrombotic therapy.The total of 19.1% of the patients with new-onset atrial fibrillation used warfarin as therapy.The whole monitoring rate of INR was 89.8%,and the good control rate was 11.9%. Univariate analysis showed that some high risk factors such as age and high blood pressure affected the usage of warfarin. Conclusion The anti-thrombotic therapy for NVAF patients in the hospital is good,but usage of warfarin for those with new-onset atrial fibrillation is low,which couldn't reach the INR standard. More attention should be taken by the clinic pharmacists in effective managing the use of anticoagulant to build a safe,economic and effective medication system for warfarin application.

·AIM: To investigate the effect of vitamin A on the conjunctival goblet cells of rat after corneal transplantation.·METHODS: Rat graft rejection models of corneal transplantation were established. SD rats were receptor and Wistar rats were donors. After corneal allografts were performed, 48 SD rats were randomly divided into three groups, 16 rats in each group. Group A was blank control group; group B was treated by oculotect gel (containing vitamin A); group C was treated by 1g/L dexamethasone eyedrops. Besides, group D was normal unoperated eyes.Slit-lamp microscope was employed to record and compare rejection index (RI) of corneal transplantation. Through HE,PAS staining of conjunctival histological sections and image analysis system, the number and morphology of conjunctival goblet cells were observed and analyzed between operation group and normal group.·RESULTS: The HE, PAS staining detection showed that the number of conjunctival goblet cells in oculotect gel group,1g/L dexamethasone eyedrops group and control group is lower than that in normal group after surgery (P＜0.01). The number of conjunctival goblet cells in oculotect gel group and 1g/L dexamethasone eyedrops group is higher than that in control group (P＜0.05). The number of conjunctival goblet cells in 1g/L dexamethasone eyedrops group is higher than that in oculotect gel group (P＜0.05).·CONCLUSION: The results indicate that vitamin A may inhibit the decrease of conjunctival goblet cells after corneal allograft rejection in rats.

Objective To explore the expression and function of miR-125b, miR-30b and miR-424 in endometrial cells. Methods Human endometrial samples were obtained in natural cycles and stimulating cycles. Endometrial epithelial cells (EECs) and endometrial stromal cells (ESCs) were isolated and confirmed by immunofluorescence. The expressions of miR-125b, miR-30b and miR-424 were detected by real-time PCR. Results The expression levels of miR-125b, miR-30b and miR-424 were higher in proliferative phase in ESCs than those in EECs. And in EECs, the expression levels of miR-125b, miR-30b and miR-424 were significantly up-regulated in secretory phase than in proliferative phase, while it was stable in ESCs. In addition, the expressions of miR-125b in EECs and miR-30b were increased in ESCs in women with elevated progesterone on the day of HCG administration than those of the control. The target genes of miR-125b, miR-30b and miR-424 mainly participated in cell migration and motion, cell-cell adherens junction and Wnt signaling pathway. Conclusion miR-125b, miR-30b and miR-424 were differently expressed in endometrial cells in different phases, and may participate in regulation of endometrial receptivity.

In order to reveal genetic diversity of domestic Andrographis paniculata and its impact on quality, genetic backgrounds of 103 samples from 7 provinces in China were analyzed using SRAP marker and SNP marker. Genetic structures of the A. paniculata populations were estimated with Powermarker V 3.25 and Mega 6.0 software, and polymorphic SNPs were identified with CodonCode Aligner software. The results showed that the genetic distances of domestic A. paniculata germplasm ranged from 0. 01 to 0.09, and no polymorphic SNPs were discovered in coding sequence fragments of ent-copalyl diphosphate synthase. A. paniculata germplasm from various regions in China had poor genetic diversity. This phenomenon was closely related to strict self-fertilization and earlier introduction from the same origin. Therefore, genetic background had little impact on variable qualities of A. paniculata in domestic market. Mutation breeding, polyploid breeding and molecular breeding were proposed as promising strategies in germplasm innovation.
Andrographis ; classification ; genetics ; China ; Genetic Variation ; Phylogeny ; Polymorphism, Single Nucleotide

Objective To investigate the prevalence,genotype and epidemiology of plasmid- mediated AmpC enzyme of Escherichia coli and Klebsiella pneumoniae.Methods A total of 67 clinical isolates of nonrepetitive cefoxitin-resistant Escherichia coli and Klebsiella pneumoniae collected by Fuzhou General Hospital and Fujian Provincial Hospital during a period of Sept.2004 to Mar.2005 were detected by three-dimensional extract test for AmpC enzyme,and PCR for AmpC enzyme and other ?-lactamase gene amplification and DNA sequencing were carried out for genotype of ?-lactamase.Plasmid transformation experiment was used to study the transfer of cefoxitin resistance.The homology of the isolates was determined by ERIC-PCR fingerprinting.Results At two hospitals in Fuzhou,the prevalence of plasmid-mediated AmpC enzyme among cefoxitin-resistant Escherichia coli and Klebsiella pneumoniae were 16.7% and 10.5%, 8.0% and 0,respectively.Two isolates of Klebsiella pneumoniae produced DHA-1 plasmid-mediated AmpC enzyme,and 4 isolates of Escherichia cob and one strain of Escherichia coli produced CMY-2 and CMY-22 plasmid-mediated AmpC enzyme respectively.Furthermore,5 strains of Escherichia coli with CMY AmpC enzyme were also found simuhaneously to produce TEM-144,CTX-M-27,CTX-M-14 and TEM-1 ?-lactamase respectively.Three strains of Escherichia coli and one isolate of Klebsiella pneumoniae could transfer cefoxitin resistance to acceptant bacillus.ERIC-PCR fingerprinting reveals 2 strains of Klebsiella pneumoniae came from same clone,but 5 strains of Escherichia coli came from different clones.Conclusions The clinical isolates of Klebsiella pneumoniae producing DHA-1 plasmid-mediated AmpC enzyme and Escherichia coli producing CMY-2,CMY-22 plasmid-mediated AmpC enzyme are found in Fuzhou.CMY-22 AmpC enzyme and TEM-144 ?-lactamase are the first reported in the world,GenBank accession number: DO256079,DO256080

OBJECTIVETo evaluate the efficacy and safety of deferasirox in heavily iron-overloaded patients with beta-thalassemia major.

METHODSA single arm, open-label clinical trial was conducted to evaluate the efficacy and safety of deferasirox in the treatment for 23 patients with beta-thalassemia major and heavily iron-overloaded in 3 years follow-up.

RESULTSThe 23 patients never received regular chelation before enrolling this trial [the mean baseline of serum ferritin was (5433.96 ± 2873.90) µg/L]. In this trial, a deferasirox dose of 20 mg×kg(-1)×d(-1) could stabilize serum ferritin levels, while of ≥ 30 mg×kg(-1)×d(-1) reduced the levels and achieved negative iron balance. There were no serious adverse events related to the drug. Most common adverse events were mild increases of liver enzyme and serum creatinine levels. Overall, 23 patients could tolerate the drug on schedule and all completed the trial.

CONCLUSIONAs a new oral iron chelator, deferasirox has a significant efficacy for the treatment of iron overload. The effectiveness is dependent on the courses of treatment and the dose of deferasirox. The single-dose used is safe and tolerated, so deferasirox can remarkably improve life quality of patients.

Humans ; Iron ; blood ; Iron Overload ; Quality of Life ; Treatment Outcome ; beta-Thalassemia ; blood

This study was aimed to investigate the clinical, pathological and biological features of a special case of chronic myeloid leukemia (CML) with marked thrombocythemic onset. The morphological changes of cells were analyzed by using bone marrow smear and biopsy; Ph chromosome, a specific marker of CML, was assayed by conventional chromosomal analysis and fluorescence in situ hybridization, bcr/abl fusion gene was detected by reverse transcription-polymerase chain reaction. The results indicated that CML mimicked essential thrombocythemia (ET) at presentation was relatively rare and might be misdiagnosed as ET, bone marrow smear and biopsy revealed, marked thrombocytosis and moderate leukocytosis; RT-PCR, FISH and conventional chromosomal analysis demonstrated the existence of Ph chromosome and bcr/abl fusion gene. This special CML could progress into accelerated phase or blast crisis. The megakaryocytes in Ph+ ET were smaller than normal ones and had typically hypolobulated round nuclei. Patients diagnosed as Ph+ ET might progress into CML and showed a high tendency to myelofibrosis and blastic transformation. It is concluded that the value of routine cytogenetical and molecular biological analysis in diagnosis for potential CML cases, which mimicked ET as in this presentation, is very distinctive, and the importance is magnified by the recent availability of imatinib, a specific inhibitor of the bcr/abl tyrosine kinase produced by the Philadelphia chromosome. Every case of "ET" should be tested for the Philadelphia chromosome and bcr/abl transcript.
Adult ; Diagnosis, Differential ; Female ; Fusion Proteins, bcr-abl ; genetics ; Gene Rearrangement ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; diagnosis ; genetics ; Megakaryocytes ; pathology ; ultrastructure ; Philadelphia Chromosome ; Reverse Transcriptase Polymerase Chain Reaction ; Thrombocythemia, Essential ; diagnosis

Adolescent ; Adult ; Aged ; DNA, Viral ; Female ; Hepatitis B Core Antigens ; genetics ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Young Adult

To decrease the hemolysis side effect of puerarin, the basic formula and preparation of puerarin submicron emulsion were optimized and the physicochemical properties were evaluated. Puerarin submicron emulsions were prepared by phase inversion-ultrasound combining with phospholipids complexes technology. The effects of preparative parameters, such as emulsification time, stirring velocity and ultrasound time, on mean diameter, span of dispersity, entrapment efficiency and overall desirability were investigated. The three dimensional response surface graphs were produced by second-order polynomial and liner equation, which predict the optimal experiment conditions. All response variables were found to be greatly dependent on three independent variables. Second-order polynomial equations were fitter than liner equations for this study. The optimal emulsification time, stirring velocity and ultrasound time was 15 min, 2 000 r x min(-1), 30 min, respectively. The mean diameter, span of dispersity, entrapment efficiency, drug content and zeta potential of emulsions prepared by the method were 228.23 nm, 0.628 4, 84. 32%, 9.98 mg x mL(-1), - 29.03 mV, respectively. Puerarin submicron emulsion was prepared by the optimized preparation method. The narrow particle diameter distribution, high envelopment efficacy and good stability were obtained. The physicochemical properties were suitable for the requirement of the intravenous emulsion.
Emulsions ; Isoflavones ; administration & dosage ; chemistry ; Particle Size

BACKGROUNDMortality rates for patients with gas gangrene from trauma or surgery are as high as 25%, but they increase to 50%-80% for patients injured in natural hazards. Early diagnosis and treatment are essential for these patients.

METHODSWe retrospectively analyzed the clinical characteristics and therapeutic results of 19 patients with gas gangrene of the limbs, who were injured in the May 2008 earthquake in the Wenchuan district of China's Sichuan province and treated in our hospital, to seek how to best diagnose and treat earthquake-induced gas gangrene.

RESULTSOf 226 patients with limbs open injuries sustained during the earthquake, 53 patients underwent smear analysis of wound exudates and gas gangrene was diagnosed in 19 patients. The average elapsed time from injury to arrival at the hospital was 72 hours, from injury to definitive diagnosis was 4.3 days, and from diagnosis to conversion of negative findings on wound smear analysis to positive findings was 12.7 days. Anaerobic cultures were also obtained before wound closure. The average elapsed time from completion of surgery to recovery of normal vital signs was 6.3 days. Of the 19 patients, 16 were treated with open amputation, two with closed amputation, and 1 with successful limb salvage; 18 patients were successfully treated and one died.

CONCLUSIONSIn earthquakes, rapid, accurate screening and isolation are essential to successful treatment of gas gangrene and helpful in preventing nosocomial diffusion. Early and thorough debridement, open amputation, and active supportive treatment can produce satisfactory therapeutic results.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Earthquakes ; Extremities ; pathology ; surgery ; Female ; Gas Gangrene ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult