OBJECTIVE:To summarize the method and experience of clinical pharmacist participating in pharmaceutical care for a case of refractory class Ⅳ+Ⅴ lupus nephritis (LN). METHODS:Clinical pharmacists and physicians formulated individualized treatment together,i.e. prednisone 30 mg/d+MMF 0.5 g,q12 h+FK506 1 mg,q12 h;on the fifth day of treatment,the patient suf-fered from ardent fever and increase of blood pressure,and clinical pharmacist suggested using linezolid 0.6 g,ivdrip,q12 h+merope-nem1.0 g,ivdrip,q8 h to control pulmonary infection;using Amlodipine besylate tablet 5 mg,po,qd+one Valsartan hydrochlorothia-zide capsule, po,qd+Arotinolol hydrochlorid tablet 10 mg,po,bid to control blood pressure. RESULTS:Multi-target treatment for re-fractory class Ⅳ+Ⅴ lupus nephritis achieved efficacy:the patient got higher plasma albumin and lower 24 h urine protein quantity af-ter 14 days;the patient suffered from secondary pulmonary infection and high blood pressure;physicians adopted the pharmacist’s suggestion so that pulmonary infection and blood pressure had been controlled. CONCLUSIONS:To ensure the effectiveness and safe-ty of the multi-target treatment,clinical pharmacists should formulate individualized treatment,focus on the possible ADR and provide phamaceutical care in the field of blood pressure monitoring,infection control,etc. when participating in multi-target treatment.

Objective To explore the influence factors of health literacy in middle-aged and elderly people in Hunan province.Methods With multi-stage randomized cluster sampling, people aged 45 years and over were selected from both urban and rural areas of six geographical regions of Hunan province, using the China residents health literacy questionnaire developed by Chinese Health Education Center, by face to face survey to get data. The influence factors were analyzed retrospectively with univariate and ordinal regression analysis.Results The 1158 persons were investigated and the valid questionnaires were 1154, the effective recovery rate was 99.7%. Univariate analysis showed that there were significant differences in heath literacy among different degree of education, age, gender, marital status, income, region and occupation (all P＜0.05). The results of ordinal regression analysis Showed that the major influence factors were degree of education, income,age and occupation.Conclusions The people at low levels of education or income should be concerned about health education and health promotion strategies.

Animals ; Macrophages, Alveolar ; drug effects ; enzymology ; Male ; Muramidase ; biosynthesis ; Quartz ; toxicity ; Rats ; Rats, Sprague-Dawley

Bronchial Diseases ; diagnosis ; diagnostic imaging ; physiopathology ; therapy ; Bronchioles ; pathology ; physiopathology ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Infant ; Male ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Objective: To investigate the outcome and inlfuencing factors of graft vessels including saphenous vein graft (SVG) and left internal mammary artery graft (LIMAG) in patients after coronary artery bypass grafting (CABG). Methods: A total of 92 patients with post-CABG symptom recurrence from 2010 to 2015 were analyzed by angiography and clinical features for their native coronary vessel and graft vessel. There were 83 male and 9 female patients with the mean age of (62.6±10.8) years. The outcomes of graft vessel were assessed; correlation study was conducted between SVG, LIMAG lesions and traditional atherosclerosis risk factors like age, gender, hypertension, hyperlipidemia, diabetic mellitus, smoking, family history of coronary artery disease (CAD) with other clinical factors such as the time of angina recurrence, thetime from coronary angiography (CAG) to CABG, type of SVG (sequential graft or individual graft), the features of native target vessel lesions prior grafting. Results: The average time from CABG to symptom recurrence was (35.10±24.7) months. There were 146 grafts including 52 LIMAG and 94 SVG (60 individual and 34 sequential grafts), the patency rate of LIMAG was higher than SVG (63.5% vs 44.7%),P=0.030. SVG lesion was positively related to symptom recurrence (OR=1.119, 95% CI 1.002-1.249,P=0.046) and trended to female gender (P=0.065), while not related to other clinical factors; LIMGA lesion was not related to any clinical factors. The patency rate of sequential SVG was higher than individual SVG (58.9% vs. 36.7%,P=0.038). The native target vessel lesion (deifned by pre-operative occlusion/stenosis) was similar between individual SVG group (24/14) and no-lesion SVG group (17/5),P=0.388; while the native target vessel lesion in LIMAG group (7/12) was lower than no-lesion LIMAG group (23/10),P=0.04. Conclusion: Post-CABG lesion was not obviously related to traditional risk factors of CAD, post-SVG lesion was positively related to the time of post-CABG angina recurrence. SVG mid-and long-term patency in sequential graft vessel was higher than that in individual graft vessel. Pre-CABG native coronary blood lfow would affect the outcome of individual LIMAG but not SVG.

AIM:To study the changes of mitochondria during apoptosis in Jurkat cells induced by arsenic oxide(As2O3).METHODS:By treated with 4?10-6 mol/L As2O3,apoptosis and necrosis of Jurkat cells were assessed by annexin V-FITC/PI double staining flowcytometry.Mitochondrial mass and its membrane potential(△?m)was measured by NAO/PI and DiOC6(3)/PI staining,respectively.Free radical formation was detected by DCFDA staining.RESULTS:After 48 h of As2O3 treatment,the rates of early apoptotic Jurkat cells in As2O3 and control groups were(18.98?1.40)% and(5.17?0.80)%,respectively(P

To explore the role of mechanosensitive potassium channel TREK-1, Western blot analysis was used to investigate the expression changes of TREK-1 in left ventricle in acute mechanically stretched heart. Forty Wistar rats were randomly divided into 8 groups (n=5 in each group), subject to single Langendorff perfusion for 0, 30, 60, 120 min and acute mechanical stretch for 0, 30, 60, 120 min respectively. With Langendorff apparatus, an acute mechanically stretched heart model was established. There was no significant difference in the expression of TREK-1 among single Langendorff perfusion groups (P>0.05). As compared to non-stretched Langendorff-perfused heart, only the expression of TREK-1 in acute mechanically stretched heart (120 min) was greatly increased (P<0.05). This result suggested that some course of mechanical stretch could up-regulate the expression of TREK-1 in left ventricle. TREK-1 might play an important role in mechanoelectric feedback, so it could reduce the occurrence of arrhythmia that was induced by extra mechanical stretch.
Feedback ; Heart Ventricles/*metabolism ; Mechanotransduction, Cellular ; Potassium Channels, Tandem Pore Domain/*metabolism ; Random Allocation ; Rats, Wistar ; Stress, Mechanical

BACKGROUND:Massive blood loss was caused by an over-reactive fibrinolytic system, as a sequence of tourniquet usage and surgery trauma in total knee arthroplasty. As an antifibrinolytic drug, tranexamic acid has been proven to decrease not only the obvious and total blood loss, but also the ratio of alograft blood transfusion in total knee arthroplasty. Nevertheless, the effect of tranexamic acid on hidden blood loss in total knee arthroplasty had not been clarified yet. OBJECTIVE: To observe the effect of intravenous infusion of tranexamic acid on hidden blood loss in primary total knee arthroplasty. METHODS:Clinical data of 54 patients who received primary unilateral total knee arthroplasty in the Third Hospital, Peking University from June to December 2013 were retrospectively analyzed. They were divided into two groups according to the use of tranexamic acid. 22 patients in the tranexamic acid group were given 2 g tranexamic acid by intravenous infusion during surgery. 32 patients in the control group were given an equal volume of physiological saline. Patients in both groups were oraly given anticoagulant rivaroxaban after replacement. Hemoglobin level and blood hematocrit were recorded before and after surgery for 5 consecutive days. The total amount of blood loss and hidden blood loss were calculated by using Cross equation. The difference in the amount of blood loss was compared between the two groups. Lower extremity venous ultrasound examination was conducted at 1 week after replacement to determine deep venous thrombosis in the lower limb. RESULTS AND CONCLUSION:No significant difference in general data and perioperative conditions was detected between the two groups (P > 0.05). Postoperative drainage, dominant blood loss, total blood volume, the amount of autologous blood transfusion and the amount of alogeneic blood transfusion were significantly less in the tranexamic acid group than in the control group (P < 0.05). According to Gross formula, the difference of hidden blood loss was statisticaly significant between the tranexamic acid group (302.9±189.9) mL and the control group (596.8±271.4) mL (P < 0.05). Deep vein thrombosis appeared in one case between the two groups after replacement. Results indicate that intravenous infusion of tranexamic acid dramaticaly decreased the hidden blood loss in unilateral total knee arthroplasty, reduced alogeneic blood transfusion, and simultaneously did not increase the incidence of deep vein thrombosis in the lower limb.

Objective To explore the isometricity of grafts in ACL(anterior cruciate ligament)recon- struction under bone tunnel shifting condition.Methods Knee specimens from ten fresh frozen cadavers were used. Femoral tunnels of 2 mm were drilled at three points on the medial aspect of the lateral condyle.The first was“anterior bundle point”(located at the 11 o'clock position in the right knee and 1 o'clock position in the left knee).The second was“error point”(located at the place 5 mm anterior and distal to the“anterior bundle point”).The third was“posterior bundle point”(located at the crossing point of the long axis of the ACL attachment and a vertical line drawn across the femoral-tibial contact point with the knee flexed at 90?).Moreover,tibial tunnels of 2 mm were drilled at three points on the tibial plateau.The first was“central point”(located at the center of original insertion of ACL).The second was“5 mm posterior point”,located at the place 5 mm posterior to the“central point”.The third was“10 mm posterior point”,located at the place 10 mm posterior to the“central point”.Changes in distance between each pair of tibial and femoral tunnels were measured during passive knee flexion-extension.Results The anterior-posterior shifting of the tibial tunnel was found to have little influence(P＞0.05)on the isometricity after the femoral tunnel had been chosen.However,the shifting of the femoral tunnel was found to have significant influence(P＜0.01)on the isometricity.Changes in distance related to the“anterior bundle point”led to lengths within the physiologic isometric range.Changes in distance related to the“error point”led to lengthening(ligament stretching)beyond the physiologic isometric range.Changes in distance related to the“posterior bundle point”led to shortening(ligment relaxing)beyond the physiologic isometric range.Conclusion Anterior-posterior shifting of the tibial tunnel between the center of original insertion and posterior edge of inter-tibial eminence area has little influence on the isometricity of grafts in ACL double bundle reconstruction.

The Uncariae Ramulus Cum Uncis is a commonly used traditional Chinese medicine. In recent years, many studies have revealed its prominent neuroprotection function. The active ingredients in Uncariae Ramulus Cum Uncis could protect the nervous system in a multi-path and multi-target manner. Uncariae Ramulus Cum Uncis shows the neuroprotective effect by resisting oxidation, scavenging free radicals, modulating neurotransmitters and their related receptors, regulating the inflammatory factors and their related pathways, attenuating neuron apoptosis, reducing intracellular Ca2+ overloads and mitigating neurodegeneration. In this paper, the authors summarized the advance in studies on neuroprotective mechanisms of Uncariae Ramulus Cum Uncis.
Animals ; Calcium ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Free Radical Scavengers ; pharmacology ; Humans ; Inflammation Mediators ; metabolism ; Neuroprotective Agents ; pharmacology ; Neurotransmitter Agents ; metabolism ; Uncaria ; chemistry