Objective:To discuss the necessity of the opening of a pharmacist section for outpatients for risk assessment and com-munication of drugs in pregnancy by surveying the use situation and risk reasons of the drugs was in pregnancy. Methods:Referring to the risk classification of medicines in pregnancy formulated by FDA and integrating various factors in pregnant women, such as drug dosage, administration time, genetic factors, prenatal care and potential diseases et al, pharmacists established the section for outpa-tients for risk assessment and communication of drugs in pregnancy. Results:The visiting number of pregnant women was gradually in-creased after the establishment by reviewing the clinical data from the hospital information system. The new pharmacy service mode pro-vided by pharmacists for obstetrical patients was positively recognized by physicians and patients. Conclusion:The section for outpa-tients for risk assessment and communication of drugs in pregnancy should be established in order to promote the pharmaceutical knowl-edge in pregnancy and improve the medication safety.

Objective To explore the effect of internet + continuing nursing education teaching methodflipped classroomin the teaching of Assessment of Consciousness among junior nurses. Methods A total of 98 nurses who have graduated within two years in the third hospital of Mianyang city in Sichuan province were selected and divided into experimental group and control group by random digits table method with 49 nurses each. The experimental group used flipped classroom teaching method and the control group used the traditional teaching method. After the training, the scores of examination and nurses′ learning satisfaction were analyzed and compared. Results The scores of nurses′ learning satisfaction in the experimental group was (100.35 ± 12.21) points, learning process, learning content, learning result, learning environment, interpersonal relationship of the dimensions were (26.85 ± 3.38), (22.02±3.07), (20.90±3.15), (17.19±2.50), (13.40±1.51) points. The scores of nurses′learning satisfaction in the control group was (86.00±11.63) points, learning process, learning content, learning result, learning environment, interpersonal relationship of the dimensions were (23.63±2.81), (19.67±3.06), (17.76±3.32), (15.20±2.46), (9.74±2.74) points. There were statistical differences between two groups(t=3.46-7.97, all P=0.000). The score of nurses′examination in the experimental group was (78.19±6.11) points,the score of nurses′ examination in the control group was (49.64 ± 14.42) points, and there was statistical difference between two groups(t=10.19, P=0.000). Conclusions Internet+continuing nursing education teaching methodflipped classroomcan improve junior nurses′learning satisfaction and the effect of the training, worthy of further promotion.

Objective To study the effect of early enteral nutrition on stress ulcer in patients with severe craniocerebral injury.Methods 134 patients with severe craniocerebral injury were randomly divided into two groups,the early enteral nutrition group (the EEN group,69 cases) was given nasogastric intubation feeding after hospitalization or within 24 hours postoperation,the delayed enteral nutrition group (the DEN group,65 cases) was given nasogastric intubation feeding 24 hours postoperation.The incidence of upper gastrointestinal bleeding in two groups were compared.Results The incidence of upper gastrointestinal bleeding in the EEN group was significantly lower than that of the DEN group.Conclusions Patients with severe brain injury should be given enteral nutrition as soon as possible to reduce the occurrence of stress ulcer and prevent upper gastrointestinal bleeding.

Objective To understand the predictors and prognostic significance of cranial nerve impairment in non-acquired immune deficiency syndrome (AIDS) patients with cryptococcal meningitis.Methods A total of 145 non-AIDS patients with cryptococcal meningitis admitted to Huashan Hospital,Fudan University from Jan 2000 to Dec 2010 were reviewed retrospectively.Clinical characteristics,initial antifungal therapies and outcome of these patients were analyzed.Continuous variables were analyzed using t test and categorical variables were compared by x2 test or Fisher's exact test.Multivariate analysis was performed by binary Logistic regressions.Results Out of 145 patients,52 (35.9％) patients had cranial nerve impairment at enrollment.Optic (25/52,48.1％) and oculomotor (22/52,42.3％) nerves were the most commonly involved,followed by auditory (12/52,23.1％),abducens (6/52,11.5％),olfactory (4/52,7.7％) and facial (3/52,5.8％) nerves.The best predictive factor of cranial nerve injury was duration of diagnosis (OR =1.056,95％ CI:1.002-1.111).The risk of cranial injury would increase by 5.6％ with one-week delay of diagnosis.Intracranial hypertension and low cerebrospinal fluid cell count were also the independent predictive factors (both P＜0.05).In the follow-up period,73.3％ patients who had cranial nerve injuries were fully recovered,with a median time of 3 (0.5-24.0) months.The independent predictors of recovery were numbers of nerve involved (OR =0.230,95 ％ CI:0.066-0.800,P=0.021) and amphotericin B (AmB) plus 5-fluorocytosine,triazole antifungal agent therapy (OR=10.317,95％CI:2.086-51.025,P=0.004).Conclusions Cranial nerve impairment occurs in one-third of non-AIDS patients with cryptococcal meningitis.Delay in diagnosis,intracranial hypertension and low cerebrospinal fluid cell count are independent predictive factors.Less cranial nerve involvement and AmB plus triazole therapy predict recovery.

The present study is to explore the change process and distribution of phosphorylated DARPP-32 (p-DARPP-32) in rat brain including cortex, hippocampus and striatum and to further deduce whether p-DARPP-32 was possibly involved in epilepsy induced by repetitive low doses of pentylenetetrazol (PTZ). PTZ-induced epilepsy model in rat was established with 30 male SD rats randomly divided into 6 groups, control group and five trial groups [PTZ 1 h, PTZ 6 h, PTZ 24 h, PTZ 48 h and PTZ 72 h respectively, after onset of status epilepticus (SE)]. Immunohistochemistry and immunofluorescence double-labeling were used to detect the temporal time change and distribution of p-DARPP-32 expression and to analyze the coexpression of DARPP-32 and p-DARPP-32 in rat brain after the onset of PTZ-induced generalized SE. The results showed that there was a temporal time change of p-DARPP-32 expression in rat brain after the onset of SE. The number of p-DARPP-32-positive cells increased significantly and reached the peaks at the ends of 1 hour and 6 hours after the onset of SE, but decreased at the end of 24 hours. The moderate to strong p-DARPP-32-immunopositive neurons were observed in cortex, hippocampus and striatum, and located in cell cytoplasm and cell nucleus. Further immunofluorescence double-labeling revealed that denser colocalization of p-DARPP-32 and DARPP-32 in the neurons existed in the area mentioned above. Therefore, PTZ-induced SE may cause phosphorylation of DARPP-32 in rat brain. The temporal time change and distribution of p-DARPP-32 suggest that phosphorylation of DARPP-32 may be involved in PTZ-induced epilepsy in rat brain including cortex, hippocampus and striatum, and p-DARPP-32 may play a central role in the onset of SE.
Animals ; Cerebral Cortex ; metabolism ; Corpus Striatum ; metabolism ; Dopamine and cAMP-Regulated Phosphoprotein 32 ; metabolism ; Hippocampus ; metabolism ; Male ; Neurons ; metabolism ; Pentylenetetrazole ; Rats ; Rats, Sprague-Dawley ; Status Epilepticus ; chemically induced ; metabolism

Dengue virus (DENV) envelope [E] protein is the major surface protein of the virions that indued neutralizing antibodies. The domain III of envelope protein (EDIII) is an immunogenic region that holds potential for the development of vaccines; however, the epitopes of DENV EDIII, especially neutralizing B-cell linear epitopes, have not been comprehensively mapped. We mapped neutralizing B-cell linear epitopes on DENV-1 EDIII using 27 monoclonal antibodies against DENV-1 EDIII proteins from mice immunized with the DENV-1 EDIII. Epitope recognition analysis was performed using two set of sequential overlapping peptides (16m and 12m) that spanned the entire EDIII protein from DENV-1, respectively. This strategy identified a DENV-1 type- specific and a group-specific neutralizing epitope, which were highly conserved among isolates of DENV-1 and the four DENV serotypes and located at two regions from DENV-1 E, namely amino acid residues 309-320 and 381-392(aa 309-320 and 381-392), respectively. aa310 -319(310KEVAETQHGT319)was similar among the four DENV serotypes and contact residues on aa 309 -320 from E protein were defined and found that substitution of residues E309 , V312, A313 and V320 in DENV-2, -3, -4 isolates were antigenically silent. We also identified a DENV-1 type-specific strain-restricted neutralizing epitope, which was located at the region from DENV-1 E, namely amino acid residues 329-348 . These novel type- and group-specific B-cell epitopes of DENV EDIII may aid help us elucidate the dengue pathogenesis and accelerate vaccine design.
Amino Acid Sequence ; Animals ; Antibodies, Neutralizing ; immunology ; Dengue ; virology ; Dengue Virus ; chemistry ; genetics ; immunology ; Epitope Mapping ; Epitopes, B-Lymphocyte ; chemistry ; genetics ; immunology ; Humans ; Mice ; Molecular Sequence Data ; Viral Envelope Proteins ; chemistry ; genetics ; immunology

Objective To evaluate the effects of Aidi injection on the short-term curative effect,pain level,quality of life and the survival time for the elderly and infirm patients with advanced cancer.Methods A total of 143 elderly patients with advanced cancer were randomly divided into two groups,71 patients in control group were treated with routine support therapies,and 72 patients in treatment group were injected with 50-60 ml Aidi injection infused in NS 250 ml by i.v drip every day combined with routine medicines,each cycle was 21 days,all patients were received for 2 cycles.Results After treatment the short-term curative effect rate (CR+PR) was 2.8 ％ (2/72) only compared with no effect of control group.But the effective and stabilization rate (CR+PR+SD) was 66.7 ％ (48/72),it was 31.0 ％ (22/71) in control group.There was significant difference between the two groups (P ＜ 0.05).The overall effective rate of easement of pain was 67.7 ％ (48/72) in treatment group versus 36.1％ (13/36) in control group (P ＜ 0.05).The median survival time (MST) was 6.2 months in treatment group versus 5.1 months in control group (P ＞ 0.05).The quality of life in treatment group was improved obviously (P ＜ 0.05).The side effects of patients in treatment group were very slight.Conclusions Aidi injection can reduce the cancer pain,improve the quality of life and prolong the survival time of the elderly and infirm patients with advanced cancer.It is safe,and effective to inhibit growth of tumor.It can be recommended widely to clinical use.

Objective To screen monoclonal antibodies (mAbs) for early diagnosis of invisive Aspergillus. Methods Monoclonal antibodies against different antigens of Aspergillus fumigatus were produced. The two pairs of combinations of monoclonal antibodies were selected accoring the distinct epitopes and double-antibody sandwich ELISA based on mAbs above were established. The sensitivity and specificity of the methods were analyzed by detecting culture supernatants of clinical isolates and environmental isolatesof Aspergillus. spp, Penicillium Marneffei, Candidas, and serum from animal models and patients. The epitopes recognized by mAbs were identified by immunobotting. Results A total of 32 hybridoma cell lines that stably produced MAbs were obtained. Two double- antibody sandwich ELISAs were established. One method was specific for 19 clinical isolates and environmental isolates of Aspergillus. spp, whereas the other one was specific for the clinical and environmental isolates of Aspergillus fumigatus without cross-reation with other Aspergillus. spp. For the same kind of medium of Aspergillus fumigatus, the sensitivity of the first method was 10 fold higher than the second method. Conclusions The specific mAbs for early diagnosis of invisive Aspergillus were obtained. Antigen recognized by the specific mAbs was mannoprotein with molecular weights of approximately 25 000-75 000. This antigen was potential early diagnostic marker for invasive Aspergillus.

OBJECTIVETo observe the effects of increased-intensity conditioning regimen with FBCA (Fludarabine, Busulfan, Cyclophosphamide, and Antithymocyte globulin) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acquired severe aplastic anemia (SAA).

METHODSFrom January 2000 to June 2011, twenty-two patients (male 12, female 10) with SAA underwent allo-HSCT with FBCA conditioning regimen which consisted of fludarabine (30 mg·m⁻²·d⁻¹×5 d), busulfan (3 mg/kg×2 d), cyclophosphamide (60 mg·kg⁻¹·d⁻¹×2 d) and ATG (2.5 mg·kg⁻¹·d⁻¹×5 d). GVHD prophylaxis was performed by cyclosporine and short-term course methotrexate. Nine patients received mobilized peripheral blood stem cells transplantation and 13 patients underwent mobilized peripheral blood combined with bone marrow stem cells. Fourteen cases were human leukocyte antigen (HLA)-matched related donors, while the other 8 cases were HLA-haploidentical transplantation. Engraftment was documented by short tandem repeats with polymerase chain reaction (STR-PCR) on approximately day + 30, + 90, + 180, + 1 year and + 2 year, respectively. Long-term survival and transplantation-related complications were analyzed.

RESULTSAll patients obtained prompt and sustained hematopoietic reconstitution. Median time for neutrophil and PLT engraftment was 15 (range: 11-22) days and 16 (range: 12-27) days, respectively. All patients were full donor chimerism identified by STR-PCR. 2 of the total 22 cases (9.1%) had grade I-III acute GVHD and 3 (15.8%) was chronic GVHD. Three patients (13.6%) died of transplantation related mortality and the other 19 cases were disease-free survival with a median time of 24 (range: 0.5-140.5) months. The causes of death were cytomegalovirus pneumonia (n=1), acute GVHD (n=1) and severe pulmonary infection (n=1).

CONCLUSIONIncreased-intensity of FBCA conditioning regimen could favor donor stem cell sustained engraftment for allo-HSCT in SAA.

Adolescent ; Adult ; Anemia, Aplastic ; therapy ; Child ; Child, Preschool ; Female ; Graft Survival ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Male ; Middle Aged ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Vidarabine ; analogs & derivatives ; Young Adult