OBJECTIVE To provide a reference for pharmaceutical care of patients with deep vein thrombosis and acute renal insufficiency that develop toxic epidermal necrolysis （TEN） after taking warfarin in clinical practice. METHODS Clinical pharmacists participated in the pharmaceutical care for a patient with deep vein thrombosis and acute renal insufficiency that developed TEN after taking warfarin. Based on the Naranjo’s assessment scale and the causality judgment criteria of the National Center for Adverse Drug Reaction Monitoring， the clinical pharmacists determined that the association between TEN and warfarin was “probable”. The TEN score （SCORTEN） was 3. Regarding the TEN that occurred in the patient， the clinical pharmacists recommended discontinuing warfarin， strengthening anti-allergic treatment， requesting assistance from the burn and plastic surgery department for diagnosis and treatment， and strengthening monitoring. When the patient’s renal function gradually recovered， it was recommended to replace heparin with rivaroxaban. After the infection was controlled， the anti-infective drug withdrawal was suggested. RESULTS The physician adopted the clinical pharmacist’s suggestions. The patient improved after treatment， was allowed to be discharged with medication， and no similar reactions recurred during follow-up after discharge. CONCLUSIONS The occurrence of TEN caused by warfarin in patients with deep vein thrombosis and acute renal insufficiency is relatively rare. The mechanism is unclear. During clinical application， it is necessary to strengthen monitoring of blood routine， coagulation profile， renal function， and inflammatory indicators. If TEN is suspected， the drug should be immediately discontinued， and symptomatic treatment， such as anti-allergic treatment should be given. Communication of clinical pharmacists with the physicians should be strengthened， patient follow-up should be improved， and the drug treatment plan should be optimized to ensure the safety of the patient’s medication.

Objective To analysis the risk factors and drug resistance of multidrug-resistant pseudomonas aeruginosa(MDRP) infection and to provide the basis for clinical anti-infective therapy .Methods Predisposing factors and drug resistance to clinical commonly used antibacterial drugs of MDRP which were separated from September 2010 to December 2011 were adopted for retro-spective analysis .Results A total of 235 hospital MDRP infection were collected ,97 multidrug resistant strains were concluded ,the separation rate was 41 .2% .The separation rate of ICU and neurosurgery were higher ,account for 35 .54% and 22 .31% respective-ly .The main resource of specimen is respiratory tract ,about 75 .21% .The resistance of MDRP was very serious .The resistant rate of Amikacin was the lowest ,account for 37 .11% ,followed by piperacillin/tazobactam ,ceftazidime ,account for 47 .4% and 48 .45%respectively .The resistant rate of other antimicrobial agents were greater than 50% .Advanced age ,serious underlying diseases ,long hospital stay ,long-term repeated application of broad-spectrum antimicrobial drugs ,admission to ICU ,invasive treatment operations were the risk factors for MDRP resistance .Conclusion The resistance is very serious ,in order to reduce the generation and spread of drug-resistant strains ,the hospital infection control ,drug resistance monitoring ,rational use of antimicrobial drugs and prevention of cross-infections should be strengthened .

Objective To examine loss of heterozygosity(LOH) and microsatellite instability(MSI) of locus D8S277 on chromosome 8 and their influence on the expression of PINX1 in the gastric carcinoma,which may provide an experimental basis for the mechanism of PINX1 gene and tumor development.Methods DNA was extracted from formalin-fixed paraffin-embedded tissues.Polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) and ordinary silver staining were used to study LOH and MSI of locus D8S277.Envision immunohistochemistry and Leica-Qwin computer imaging techniques were used to assess the expression of PINX1.Results The frequency of LOH was significantly higher in the cases with lymph node metastasis than in those without metastasis(21.15% vs 0,P