OBJECTIVE To provide a reference for pharmaceutical care in patients with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation. METHODS Clinical pharmacists participated in the treatment practice of a patient with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation. Because the patient had a hemorrhagic transformation after cerebral infarction after stent implantation and arterial thrombolysis， the clinical pharmacists recommended stopping antiplatelet drugs and giving plasma and cold precipitation； because D-dimer was significantly elevated， the clinical pharmacists recommended anticoagulant therapy with low-molecular heparin. Due to the patient’s recurrence of hemorrhagic transformation after cerebral infarction， the clinical pharmacists recommended discontinuing rivaroxaban and administering human prothrombin complex concentrate. RESULTS The physician adopted the clinical pharmacists’ recommendation. After treatment， the patient’s condition tended to improve steadily and was allowed to be discharged with medication. CONCLUSIONS The clinical pharmacists assessed the individualized risk and optimized the patient’s medication regimen by suggesting discontinuation of antiplatelet and anticoagulant drugs， carrying out pharmaceutical care such as coagulation index monitoring， determining the time and indications for restarting anticoagulation， and pharmaceutical monitoring， to ensure the safety and efficacy of the patient’s medication.

Objective:To evaluate prognostic significance of metastated lymph nodes (LN) in patients with intrahepatic cholangio carcinoma (ICC) after radical resection.Methods:Data were reviewed on 90 patients at Department of Hepatobiliary and Pancreatic Surgery in our hospital from Feb 2013 to Oct 2019, 37 cases had no LN metastasis (N0 group), 21 cases were in N1 group (positive LN<3) and 32 cases in N2 group (positive LN≥3),and Kaplan-Meier method was used to construct survival curve. Univariate and multivariate COX regression analysis was used to screen independent risk factors.Results:In N0 group the 1-and 3-year survival rates were 57.7% and 35.2%, respectively. In N1 group the 1-and 3-year survival rates were 46.7% and 17.5%, respectively in N2 group. the 1-and 3-year survival rates were 19.6% and 0, respectively. There was statistical significance in overall survival rate among the three groups ( χ2=15.272, P<0.05). Multivariate analysis showed that resection margin ( P=0.009) and the number of positive LN ( P=0.002) were independent risk factors affecting the prognosis of patients. Conclusion:Resection margin and the number of metastasing LN were closely related to postoperative prognosis of ICC patients.

Objective To evaluate the feasibility of percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral burst fractures (OVBF) without nerve injury, and observe the clinical therapeutic effect. Methods A total of 32 patients with primary OVBF without nerve injury were treated by PKP from January 2009 to January 2013. The volume of bone cement intraoperative injection and complications after operation were observed. The visual analog scale (VAS) and Oswesty disability index (ODI) before and after operation were metered to evaluate pain relief and improvement of life quality. The Beck index, Cobb angle and vertebral canal bones occupying rate were metered before and after operation to evaluate the recovery of vertebral body height, correction of kyphosis and change of intraspinal bone block position. Results There were no serious complication occurred. The operation time was (52.05± 7.60) min, the volume of bone cement intraoperative injection was (4.08 ± 1.50) ml. After operation for one day, the VAS decreased from (7.89±0.52) scores to (2.31±0.39) scores, the Cobb angle decreased from (19.15±3.20)°to (11.19±2.58)°, the Beck index increased from 0.46±0.06 to 0.61±0.07, there were significant differences (P<0.01 or<0.05). The rate of spinal bones occupying after operation for one day was not decreased obviously, but after operation for 3 months, it decreased from (17.89±5.03)%to (9.18±4.17)%, there was significant difference (P<0.05).The ODI before operation was (76.89± 6.72) scores, after operation for 3 months was (30.86± 7.25) scores, there was significant difference (P<0.01). Conclusions The pain could be relieved effectively, and the quality of life could be improved by the method of PKP in treating OVBF. Meanwhile, the vertebral body height and kyphosis could be corrected and the rate of spinal bones occupying could not be increased significantly.

Objective To investigate the effect of miR-10b on migration and invasion of human hepatocellular carcinoma (HCC) cell lines.Methods Transwell assay was used to evaluate the motility and invasiveness in different HCC cell lines,qRT-PCR was then used to detect the expression levels of miR-10b in different HCC cell lines.Artificial mimics of miR-10b were transiently transfected into HepG2 cells,which have low expression of miR-10b,and then the changes in migration and invasion were evaluated by Transwell assay.Antagomirs of miR-10b (miR-10b-AS) were transiently transfected into MHCC97H cells,which have high expression of miR-10b,and then the changes in migration and invasion were evaluated as well.Cell morphology changes were detected by immunofluorescence and electron microscopy,Results There was a significant correlation of miR-10b expression level with cell motility and invasiveness.Low-level expression of miR-10b was observed in HepG2 cells,which exhibited weak motility and invasiveness; whereas high-level expression of miR-10b was observed in MHCC97H cells,which exhibited strong motility and invasiveness.Up-regulation of miR-10b expression in HepG2 cells increased cell motility and invasiveness,whereas inhibition of miR-10b reduced cell motility and invasiveness in MHCC97H cells.Immunofluorescence and electron microscopy results showed that up-regulation of miR-10b in HepG2 cells significantly increased proliferation of filopodia and lamellipodia,whereas inhibition of miR-10b decreased filopodia and lamellipodia amount in MHCC97H cells.Conclusion miR-10b is involved in the invasion and metastasis of HCC cell through regulation of cytoskeleton in vitro and inhibition of miR-10b is likely to be a new molecular target to block metastasis.

BACKGROUND:The ligamentum flavum is important to connect the rear of the spine. If the flexibility of the ligamentum flavum is decreased due to degeneration, in the role of various factors, it can reduce the effective space of the spinal canal to induce spinal cord and nerve root compression, thereby resulting in neurological symptoms, even paralysis or residual disease. OBJECTIVE:To study the mechanism of over-dose fluoride on the degeneration and ossification of the ligamentum flavum in rats. METHODS:Thirty male Sprague-Dawley rats were randomly divided into two groups: experimental group was given distiled water containing NaF (mass fraction 10-4) and control group was given the same amount of distiled water. After 3 and 6 months, the bone mineral density, Ca2+ and P3+ contents in serum and bone tissue and serum alkaline phosphatase activity were detected, respectively. Meanwhile, the ligamentum flavum specimens were taken for X-ray examination and histopathological observation. RESULTS AND CONCLUSION: In the experimental group, chalk stripes or spots occurred in the lower incisors of five rats at 3 months after treatment and dental fluorosis that was mostly in chalk color was found in al the rats at 6 months after treatment; moreover, the bone density of the lumbar spine significantly increased (P < 0.05). Compared with the control group, the contents of serum Ca2+ were significantly higher, while the contents of P3+were significantly lower in the experimental group at 3 and 6 months after treatment (P < 0.05); the serum alkaline phosphatase activity was also significantly higher in the experimental group than the control group at 3 and 6 months after treatment (P < 0.05). X-ray films, at 6 months after treatment, showed that the bone density of the lumbar vertebra was increased obviously; pathological observation showed that the number of elastic fibers in the ligamentum flavum was reduced further, a large amount of colagen fibers, fibroblasts and calcium deposition were found, and the ossification of the ligamentum flavum was visible at the lamina attachment site. These findings indicate that the over-dose fluorides can lead to the degeneration and ossification of the ligamentum flavum in Sprague-Dawley rats, which may plan an important role in the ossification of the ligamentum flavum.

ObjectiveTo investigate the clinical features of hepatic follicular dentritic cell sarcoma (FDCS).MethodsClinical data of a patient with hepatic FDCS treated in Cancer Hospital Affiliated to Zhengzhou University in 2004 were retrospectively analyzed. The informed consent of the patient was obtained and the local ethical committee approval had been received. The patient, female, 49-year-old, was admitted to the hospital for the complaint of abdominal pain for 1 month . A 12 cm×12 cm in diameter, hard, poor activity tumor was found below xiphoid by physical examination. Abdominal tenderness was positive and laboratory examinations were essentially normal. CT scan showed a 20 cm in diameter solid lesion in the left lobe of liver. The tumor was observed irregularly enhanced in the arterial phase by enhanced CT scan. The enhancement faded away in the delayed phase, and the tumor revealed a low-density lesion. The initial diagnosis was primary liver cancer.ResultsAfter an active preoperative preparation, the patient underwent left lobectomy under endotracheal general anesthesia on August 31, 2004. A tough tumor measuring 23 cm×20 cm in diameter was found in the left lobe of liver during the surgery. Nodule foci were found beside the tumor and no obvious metastasis was found within the abdomen, pelvic cavity and peritonium. Postoperative pathological examination indicated inlfammatory pseudotumor FDCS and Immunohistochemistry indicated positive CD21, CD23, CD35 and vimentin (VIM). Tumor recurrence and matastasis were observed in the liver, abdomen cavity and chest wall etc. repeatedly and was resected during 2006 to 2014. The patient is currently in stable condition and no recurrence or metastasis was observed during regular follow-up till submission date. ConclusionsHepatic FDCS is a very rare disease. The diagnosis relies on the results of pathological examination. Surgical resection is a reliable treatment and the prognosis is favorable.

Objective To investigate the expression of E-cadherin and Snail proteins in rectal cancer and their significance. Methods The expression of Snail and E-cadherin proteins was detected using immunohistochemical SABC method in 101 cases of rectal cancer tissues. Results The positive rate of Snail in rectal cancer was 78.2% (79/101). The negative expression rate of E-cadherin in rectal cancer was 62.4% (63/101). The expression of Snail and E-cadherin were significantly related with the lymph node metastasis and Dukes' stage of rectal cancer (P ＜ 0.05). Conclusion The overexpression of Snail and the decreased expression of E-cadherin might be important biological markers for malignant transformation, invasion and metastasis of rectal carcinoma.

Objective To study the alteration of microbial population distribution and resistance of clinical bacterial isolates in patients with severity muhiple injuries. Methods The distributed Features of 432 strains of infection germs detected among the patients with severe muhiple iniuries admitted into hospital from January 2004 to December 2006 were statistically analyzed during. Results In the total 432 strains,the G accounted for 62.9%(272/432),dominated mainly by pathogens including Pseudomonas aeruginosa,Acinetobacter baumanni I and Escherichia Coli.The G+accounted for 37%(160/432),mainly including Staphylococcus anreus,enterococci and coagulase negative staphylococcus (CNS).Mixed infection rate was 41.1%.The isolating rate of enterococci.CNS and Sten Matophilia was obviously upgraded. Conclusions The source of infection in patients with severity multiple injuries is Gram-negative bacterium,suggesting that surveillance of bacterial resistance and rational use of antimicrobial agents should be emphasized during clinical therapy.

OBJECTIVE: To probe into the status quo and the tendency of the application of intravenous infusions. METHODS: Data on the application of intravenous infusions in one of the tertiary Grade A comprehensive hospital in 1996, 1999, 2002 and 2004 were analyzed statistically. RESULTS: The variety of infusion, the total quantity and the total amount of money of infusions increased year by year,the total consumption sum of infusions accounted for 10% of that of the whole year drugs; the majority of which were the consumption of nutritional and dielectric medicines, of which, glucose and sodium chloride injections accounted for 74% of the total; the infusion of treatment type increased fast, much as in cases of anti - infec-tives; the drug expense for each bottle of infusion increased year by year, the amount of money involved in infusion drugs accounted for 60% of the total year round drug consumption sum. CONCLUSION: There is an upward trend in both the quantity and consumption sum of infusions.

Objective: To investigate the influence of the closed re-infusion of intestinal juice and EN on the treatment of intestinal fistula.Methods: The study group was composed of 21 patients of intestinal fistula from October 2004 to December 2006.The fistulae was in the 50 cm of the proximate jejunum and caused by trauma and operatin.The leak amount of intestinal juice was more than 1 000 mL.The protein level in serum and the absorption rates of the glucose,fat and nitrogen after the reinfusion of the intestinal juice were measured.Resutls: The protein level in serum and the absorption rates of the glusose,fat and nitrogen was increased after the re-infusion of the intestinal juice.Conclusion: The absorption of the glucose,fat and nitrogen in EN and the protein level in serum can be increased after the closed re-infusion of the intestinal juice.