OBJECTIVE:To evaluate the effects of clinical pharmacist participating in clinical consultation,and to provider ref-erence for clinical pharmacists participating in clinical practice. METHODS:436 cases/times of clinical consultation in which clini-cal pharmacists participated in Zhengzhou Seventh People’s Hospital from 2012 to 2015 were analyzed statistically. RESULTS:2012-2015,the number of clinical consultation in the hospital showed rising tendency;23 departments applied the consultation, among which top 5 were endocrinology department,gynaecology department,neurosurgery department,neurology department and orthopedics department. The reasons for consultation mainly were the formulation of therapy plan (430 cases/times,accounting for 97.95%). The consultation suggestions were adjusting drug types(303 cases/times,69.17%). Consultation suggestions were adopt-ed completely in 405 cases/times(92.89%). There were 307 cases/times of effective outcome,with effective rate of 75.80%(307/405). CONCLUSIONS:Clinical pharmacists participated in clinical consultation is helpful to optimize therapy plan,play a positive play on the safety of drug use. Clinical pharmacists should further learn clinical medical and pharmaceutical knowledge and summa-rize the experience of clinical practice to improve the quality of consultation.

Gelastic epilepsy is a special refractory epilepsy accompany with ictal laughing and/or crying which can be divided into cortical induced gelastic epilepsy and hypothalamic hamartomas induced gelastic epilepsy according to their epileptogenic focus.Currently, domestic scholars had lack of systematic understanding of the mechanism and clinical treatment involved in gelastic epilepsy.Recently, foreign scholars had achieved great progress in the research of gelastic epilepsy which included the ictal laughing mechanism in gelastic epilepsy, the primary molecular mechanism in hypothalamic hamartomas induced gelastic epilepsy, the secondary epileptogenesis mechanism in hypothalamic hamartomas induced gelastic epilepsy and the clinical treatment of gelastic epilepsy.Now, the study progress of pathogenesis and clinical treatment of gelastic epilepsy were reviewed.

Objective To explore the clinical value of 13C-methacetin breath test for the assessment of liver disorder and to analyze its predictive value to the severity of liver function injury in children.Methods Eighteen healthy children served as healthy control group,and 40 patients with different etiology and severity served as experimental group,and then the latter were divided into 2 subgroups,28 patients in Child-Pugh classification A,and 12 cases in below B(11 cases in B and 1 case in C).An oral dose of 2 mg/kg tracer 13C-methacetin was administered to each subject for the 13 C-methacetin breath test.At the same time,serum liver function markers including serum transaminase,bilirubin,albumin and prothrombin time were measured.The acquired data were analyzed by SPSS 17.0 software.Results (1) Metabolisation velocity (MV) max30 and cumulated dose (CUM) 120 in experimental group (46.64 ± 27.93,59.29 ± 30.73) were much lower than those of the healthy control group(73.56 ± 26.03,102.97 ± 41.80) (t =2.450,3.165,all P ＜0.05);(2) MVmax30 and CUM120 were closely correlated with the liver function markers of albumin,total bilirubin,direct bilirubin,prothrombin time (P ＜ 0.05);(3) MVmax30 and CUM120 could predict liver diseases in children,especially the CUM120.With CUM120 =85.80 as a cut-off value to predict liver diseases,the Youden index was 0.578 at its maximum,and the sensitivity and specificity were 77.8％ and 80.0％;(4) Compared with the Child-Pugh classification A,the CUM120 in Child-Pugh classification B and lower B was significantly lower(P ＜ 0.001);(5) CUM120 could predict the severity of liver diseases.With CUM120 =56.15 as a cut off value to predict the severity of liver diseases,the Youden index was 0.857 at its maximum,and the sensitivity and specificity were 85.7％ and 100.0％.Conclusion 13C-methacetin breath test index of CUM120 could predict liver diseases in children and the severity of liver function.

OBJECTIVE To investigate the clinical effect of Ashi Dispel-itch solution on treatment of diabetic-candidal vaginitis.METHODS Totally 322 patients were randomly divided into 2 groups,one group was treated with Ashi Dispel-itch solution by fumigating and soaking ill section while the control group with Jieyin solution.The curative effect was divided into 4 grades according to symptoms,body appearance,level of pH,etc.RESULTS The total effective rate due to Ashi Dispel-itch solution was 93.5% and was significantly higher than that of Jieyin solution(P

Objective To study the relationship between knee osteoarthritis progression and the ration of fat,lean,or bone mineral content(BMC).Methods 36 joints of knee with osteoarthritis in 31 women were divided into two groups according to the knee joint space,joint space narrowing group and non-narrowing group.The body mass index(BMI)was calculated.The X-ray(weight bearing)of knee joint was taken.The fat,lean,BMC and mass of leg were detected with the dual energy X-ray absorptiometry(DXA).Results There was no distinct difference between sides and age distribution for the tested groups(P>0.05).The BMI and fat/mass ratio of leg in the joint space narrowing group were obviously higher than that of the non-narrowing group(P<0.05),while the lean/mass ratio of leg in the joint space narrowing group was distinctly lower than that of the non-narrowing group(P<0.05).Conclusion The deterioration of the female knee osteoarthritis can be mainly attributed to the increase of the BMI and fat/mass ratio as well as the decrease of the lean/mass ratio of leg.

Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.

BACKGROUND:Closed reduction and interlocking intramedullary nailing can protect blood supply of fractured bone,decrease infection and promote bone healing.which is becoming the first choice for treating femoral shaft fracture However,it is difficult to conduct in closed reduction and keep stabilization of fractured bone.OBJECTIVE:To explore the curative effect of closed reduction and interlocking intramedullary nailing in treating femoral shaft fracture with assist of rubber tourniquet 360°elastic fixation METHODS:From May 2008 to November 2009,18 patients(14 males,4 females;aged 18-65 years)with closed femoral shaft fracture were treated at the Dongguan Hospital of Traditional Chinese Medicine.Body skin was protected by cloth,elastic rubber tourniquet was doubled and 360°wrapped around the fractured bone with the length of 10 cm from up and down.Supracondylar femur was reamed by Kernig-needle;fractured bone was dealt with countertraction and horizontal rotation.Another assistant compressed the fractured bone according to the displacement of fracture,which contributes to bone fracture reduetion and interlocking intramedullary nailing.RESULTS AND CONCLUSION:All 18 patients were followed up postoperatively,no case was found with skim necrosis and damage of nerve and blood vessel.16 cases were bone union with excellent 15 cases,fine 1 case;2 cases were still being followed up.Callus was firstly found 1 month after operation and was obviously found in 3e months postoperatively The result suggested that the treatment of closed reduction and interlocking intramedullary nailing with assist of rubber tourniquet360°elastic fixation is a simple and applicable approach.which reduces the interruption of blood supply for fractured bone and closed reduction gets good result,which reduces the chance of open reduction.

Objective To investigate the arthroscopic presentations of knee joint of rheumatoid arthritis (RA). Methods During December 2005 to February 2008,223 patients with RA in our department underwent knee arthroscopy examination. The arthroscopic presentations of 310 knee joints were analyzed retrospectively. Results Synovial hyperplasia were observed in 305 knees (98.4% ) out of 310 ones. The medial part (88.4%), intercondylar fossa (86.1%) and lateral space (83.2%) were the most frequent localization of synovial hyperplasia, which was less common in the suprapatellar bursa. Hyperplastic synovium of 296 knees had coralloid or cotton-wool like presentation, with central nourishing vessels. Nine knees were lichen-like hyperplasia, without nourishing vessels. Different degrees of pathological changes or defect could be seen in 301 knees, including merely cartilage degeneration in 63 knees, cartilage degeneration plus cartilage damage or defect in femoral medial condyle or lateral condyle in 124, 163 knees, in which 53, 45 with the damage deep to the cancellous bone. Most anterior or posterior cruciate ligament (in 274 knees) were covered with hyperplastic synovium, anterior cruciate ligament of 51 knees were partial ruptured, 5 ones were completely ruptured,while 23 and 1 case had these presentations in the posterior cruciate ligament.. Meniscus damage was commonly seen under arthroscope. 234 and 38 knees had medial meniscus torn or disappeared completely, while 214 and 45 in the lateral meniscus. Conclusion Synovial hyperplasia is commonly seen in knee joints of RA and most commonly seen in the intercondylar fossa, medial space and lateral space, but less common in the suprapatellar bursa. The hyperplastic synovium appears most often in the coralloid or cotton-wool like form, Cartilage damage is commonly seen in knee joints of RA. The most serious damage of the cartilage is seen in the femoral medial condyle or lateral condyle. Partial or complete anterior cruciate ligament rupture can be seen in one proportion of knees. In most knees of RA, meniscus are torn or disappeared mostly or completely.

Background Previous study showed that both hydroxycamptothecin (HCPT) and etoposide (VP-16) can induce the apoptosis of human Tenon capsule fibroblasts (HTFs).However,whether the combination of HCPT with VP-16 enhance the efficacy of drugs is unknown.Olbjeetive This study was to investigate the synergistic effect and its mechanism of HCPT combined with VP-16 on apoptosis of HTFs.Methods Human Tenon capsule tissue was obtained from the eye bank of Jiangsu Province People's Hospital.HTFs were cultured in vitro using explant method and identified by immunofluorescence with vimentin.The fourth generation of cells were incubated in 96-well plate,and different concentrations of HCPT (1,5,10,50,100 mg/L),VP-16 (0.6,2.5,5.0,25.0,50.0 mg/L) and HCPT+VP-16 (2:1,final concentrations 0.80,3.75,7.50,37.50,75.00 mg/L) were added for 24 hours.The inhibiting rate of drugs to HTFs growth was detected using CCK-8 kit.The HTFs were divided into blank control group,HCPT (50 ng/L) treated group,VP-16 (25 mg/L) treated group and HCPT+ VP-16 (37.5 mg/L) treated group,and the apoptosis rates of HTFs in various groups were assayed by flow cytometry.The expressions of caspase-3,cleaved caspase-3,bax,bcl-2,JNK,p-JNK,Akt,p-Akt in the cells were detected by Western blot assay.Results Cultured cells grew well with the polygon shape and positive response for vimentin.The inhibiting rate was elevated with the increase of drug dosage 24 hours after addition of drugs (HCPT:F=41.34,P=0.00 ; VP-16:F =62.60,P =0.00 ; HCPT+VP-16:F =46.77,P =0.00).The half maximal inhibitory concentrations (IC50) of HCPT,VP-16,HCPT+VP-16 were 80.99,27.93,19.81 mg/L,respectively,and the combined index (CI) of HCPT with VP-16 was 0.399,showing a stronger synergistic action.The apoptotic rates of HTFs were (4.87±0.78) ％,(11.20± 1.94)％,(12.67±1.51)％ and (19.77±2.01)％ in the blank control group,HCPT treated group,VP-16 treated group and HCPT+VP-16 treated group,respectively,with a significant difference among them (F=18.23,P ＜ 0.01),and the apoptotic rate was significantly raised in the HCPT + VP-16 treated group,HCPT treated group and VP-16 treated group compared with the blank control group (q'=15.67,16.32,26.88,all at P＜0.01).Compared with the blank control group,the grey scale values of cleaved caspase-3,bax,p-JNK in the cells of HCPT+VP-16 treated group,HCPT treated group and VP-16 treated group were significantly increased (all at P＜0.01),and those in the HCPT+VP-16 treated group significant ascent in comparison with the HCPT treated group and VP-16 treated group (all at P＜0.01).However,the changes of caspase-3,JNK and Akt expression were insignificant.The grey scale values of bcl-2 and p-Akt in the HTFs of the HCPT,VP-16 and HCPT+VP-16 treated groups were significantly lower than those of the blank control group,with a dominant reducing in the HCPT+VP-16 treated group (all at P＜0.01).Conclusions HCPT and VP-16 induce the apoptosis of HTFs in vitro at a dose-dependent manner.The combination of HCPT with VP-16 has a stronger synergistic efficacy.The up-regulation of p-JNK and bax as well as the down-regulation of p-Akt and bcl-2 in HTFs are involved in the coaction of HCPT and VP-16.

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.