OBJECTIVE:To explore the role of clinical pharmacists in tumor pain management for patients receiving tumor pain palliative radiotherapy. METHODS:In prospective randomized controlled study, 60 patients with tumor pain who received palliative radiotherapy in radiotherapy department of our hospital from June 1,2013 to May 31,2014,according with the selection criteria,were randomized into observation group(30 cases)and control group(30 cases). Clinical pharmacists participated in the treatment of observation group;provided pharmaceutical care for doctors;and recorded drug treatment,pain evaluation,medica-tion compliance,Karnofsky Performance Status(KPS)and quality of life(QOL)of 2 groups. RESULTS:On the 5th day,the pain remission rate of observation group reached 63.3%,and was significantly higher than that(36.7%)of control group(P<0.05). 1 month treatment later,pain remission rate of 2 groups reached 70% and 80%,respectively (P>0.05). At the same time,KPS, QOL and medication adherence were all improved significantly,compared with before treatment(P<0.01 or P<0.05),and medi-cation adherence of observation group was obviously better than that of control group(P<0.01). CONCLUSIONS:The participa-tion of clinical pharmacists in the pain management can obviously improve medication compliance,relieve pain more effectively, and promote rational drug use.

Objective:To explore the clinical pharmaceutical care for cancer pain management. Methods: The intervention time of clinical pharmacists was determined. A comprehensive evaluation of cancer pain, physical function and life quality of patients was performed, the compliance of patients was scored, and individualized pharmaceutical service was carried out,consultation and sugges-tion on analgesics and adjuvant drugs were provided for doctors, and finally, the effect of pharmaceutical care was assessed. Results:Clinical pharmaceutical care could promote the rational drug use and improve the medical quality. Conclusion:Through the research of clinical pharmaceutical care for pain management,clinical pharmacists can play a practical and effective role in the pain treatment and management.

ATP-Binding Cassette Transporters ; immunology ; metabolism ; Animals ; Herpes Simplex ; immunology ; virology ; Herpesvirus 1, Human ; immunology ; metabolism ; Humans ; Immediate-Early Proteins ; immunology ; metabolism ; Viral Proteins ; immunology ; metabolism

Objective To discuss the significance of serum IgE before and after inhale glucocorticoid treat-ment of children's asthma. Methods 520 children with asthma were seleceted from the outpatient. Different type of fluticasone propionate were given to different age groups: Aerosol type by a spacer in less than 5 years old,and in-halant (Seretide) 5 years and the above. The dosage was between 200 μg/day to 375 μg/day. IgE was tested before and 3 months after the treatment. Results Serum IgE decreased significantly in 3 months treatment [ from (496.12±24.75) kU/L to (390.71±18.71) kU/L] (t=7.337,P<0.01). The change of IgE was related to clinical effect and age. The level increased in those less than 3 years [(307.05±34.71)kU/L vs (483.09±41.78) kU/L] (t=2.963,P=0.004),but decreased between 4 to 5 years old group [(543.46±51.03) kU/L vs (316.93±29.30) kU/L] (t=3.368,P=0.000) ,and decreased between 6 to 14 years old group[ (586.30±37.19)kU/L vs (387.61±27.60) kU/L] (t=4.827,P=0.000). In fluticasone group IgE level changed from (468.91±32.81) kU/L to (359.03±22.79) kU/L after treatment (t=5.988,P<0.01),which decreased from (586.30±37.19) kU/L to (387.6±27.60) kU/L in Salmeterol group (t=4.827,P<0.01). In 260 cases of IgE below 300 kU/L 109 cases (41.92%,109/260) increased while in 260 cases of IgE above 300 kU/L,total IgE lev-el increased in 45 cases (16.15% ,45/260) after treatment,with statistical significance(χ<'2>=37.789,P=0.000). Conclusion Inhale glucocorticoid can make the level of IgE decreased.

Objective To investiagte the serum adiponectin concentration in preeclampsia and its relationship with serum leptin and soluble leptin receptor levels.Method The level of adiponectin,leptin and soluble leptin receptor in serum were measured by enzyme-linked immunosorbent assay(ELISA)in 38 patients with preeclampsia and 42 patients as control.The relationship of free leptin index(leptin/soluble leptin receptor) to preeclampsia was analyzed.Results There were no significant differences in maternal age,gestational age and body mass index(BMI)between two groups.But the gestational age and birth weight were significantly lower in preeclampsia than in control.The patients with preeclampsia had significantly higher levels of serum adiponectin, leptin and free leptin index(1691.7?g/ml,37.5 ng/ml and 0.95 respectively)than the control(689.4?g/ml, 19.3 ag/ml and 0.49,respectively).But there was no significant difference in serum level of soluble leptin receptor between the groups(35.0 ng/ml vs 42.2 ng/ml).Serum adiponectin was not significantly correlated with the level of leptin,soluble leptin receptor and free leptin index.Area of serum adiponectin,leptin and free leptin index in preeclampsia under the ROC curve were less than 0.5.Conclusions The patients with preeclampsia have paradoxical higher serum levels of adiponecfin and more bioavailability of leptin,suggesting these may be important factom of this complication.

Adolescent ; Blood Vessel Prosthesis Implantation ; Child ; Child, Preschool ; Ductus Arteriosus, Patent ; therapy ; Equipment and Supplies ; Female ; Humans ; Infant ; Male ; Video Recording

OBJECTIVETo summarize experiences of aortoiliac reconstruction through retroperitoneal approach.

METHODSTwenty-eight patients underwent retroperitoneal aortoiliac reconstructions, including aortic aneurysmectomy with graft replacement, aortic endarterectomy with patch angioplasty, thoraco-abdominal aortic bypass, resection of retroperitoneal mass with ilio-femoral bypass, iliac aneurysmectomy with aorto-external iliac artery bypass, removal of aortoiliac foreign body, common iliac endarterectomy, aorto (ilio)-femeral bypass and common ilio-femo-popliteal bypass. Drainage tubes were placed retroperitoneally in 24 cases.

RESULTSAll operations in this group were successful without perioperative death. The volume of intra-operative bleeding was 100-400 ml (mean 240 ml). Blood transfusion were employed in 2 cases. Retroperitoneal drainage was 50-170 ml (mean 85 ml). Naso-gastric tubes were removed 28 h on average after operation. All patients recovered uneventfully except that cardiac insufficiency, stress ulcer and retroperitoneal hematoma were present in 3 patients respectively. Twenty-two patients were followed up from 3 months to 2.5 years. One patient died of AMI 2 years after operation. One patient receiving ilio-femo-popliteal bypass was found to have occlusion of femo-popliteal segment of prosthetic graft. One patient developed brain hemorrhage 1.5 years postoperatively. All the other followed-up patients were living well.

CONCLUSIONRetroperitoneal approach, not violating the peritoneal cavity, offers certain physiological advantages associated with minimal disturbance of gastrointestinal and respiratory function, thereby decreasing respiratory complications and postoperative ileus, avoiding intra-abdominal adhesions with their attendant risk of early and late small bowel obstruction. It proved to be a simple and safe alternative for surgical treatment of aortoiliac diseases.

Adult ; Aged ; Aorta, Abdominal ; surgery ; Aortic Aneurysm, Abdominal ; surgery ; Arterial Occlusive Diseases ; surgery ; Endarterectomy ; Female ; Femoral Artery ; surgery ; Humans ; Iliac Aneurysm ; surgery ; Iliac Artery ; surgery ; Male ; Middle Aged ; Retroperitoneal Space ; surgery ; Retrospective Studies ; Treatment Outcome ; Vascular Surgical Procedures ; methods

OBJECTIVETo observe the effect of Wenyang Huazhuo Tongluo Recipe (WYHZTLR) on the proportion of T helper 17 cells (Thl7)/regulatory T cells (Treg), and serum levels of IL-17 and IL-10 in peripheral blood of systemic sclerosis (SSc) patients with yang qi insufficiency and turbidity induced collaterals blockage syndrome (YQITICBS).

METHODSTotally 82 SSc patients were randomly assigned to the Western medicine group (as the control group) and the integrated Chinese and Western medicine group (as the treatment group), 41 cases in each group. All patients took methotrexate (MTX) tablet and prednisone tablet. Patients in the treatment group additionally took WYHZTLR. The treatment course for all was six consecutive months. Besides, another 70 healthy volunteers were recruited as a healthy control group (as the healthy group). Percentages of Th17 and Treg in peripheral blood were detected by flow cytometry. Serum levels of IL-17, IL-10, von Willebrand factor (vWF), aminoterminal propeptide of type l procollagen (PIIINP), and cross-linked carboxyterminal telopeptide of type I collagen ( I CTP) were measured by double antibody sandwich ELISA. The correlations between Th17/Treg and levels of vWF, PIIINP, I CTP, skin score, and disease activity index were observed by Pearson correlation analysis.

RESULTSThe percentage of Th17 in peripheral blood, ratios of Th17/Treg, and the serum level of IL-17 were significantly higher, but the percentage of Treg and the serum level of IL-10 were significantly lower in SSc patients, when compared with those of the healthy group (P <0. 05, P <0. 01). Compared with the same group before treatment, the percentage of Thl7, ratios of Thl7/Treg, and levels of IL-17, vWF, and PIIINP all decreased in the two groups after treatment (P <0.05, P <0.01), but the percentage of Treg and the IL-10 level increased (P <0. 05, P <0. 01). Meanwhile,the level of I CTP was higher in the treatment group after treatment (P <0. 05). The improvement of all indices except the percentage of Th17 was more obvious in the treatment group than in the control group (P <0. 05, P <0. 01). The ratio of Th17/Treg was positively correlated with levels of vWF, PIIINP, skin score, and disease activity index before and after treatment respectively (P <0. 01), but with no obvious correlation with the level of I CTP (P >0. 05).

CONCLUSIONWYHZTLR could achieve its therapeutic effect on SSc patients by regulating Th17/Treg imbalance, lowering levels of vWF and PIIINP, and elevating the level of I CTP.

Drugs, Chinese Herbal ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Interleukin-10 ; Interleukin-17 ; Methotrexate ; Peptide Fragments ; Procollagen ; Scleroderma, Systemic ; drug therapy ; T-Lymphocytes, Regulatory ; Th17 Cells

Adult ; Female ; Humans ; Kidney Glomerulus ; metabolism ; pathology ; Lipoproteins ; metabolism ; Male ; Nephrosis, Lipoid ; metabolism ; pathology