Objective To investigate the clinicopathological features,immunophenotype,diagnosis and treatment of SMARCA4(BRG1)-deficient carcinoma.Methods Clinical data of 11 patients with SMAR-CA4(BRG1)-deficient cancer were collected.The morphologic and immunohistochemical features of this tumour were summarized,and the relevant literature was reviewed.Results Among the 11 cases of SMARCA4(BRG1)-deficient carcinoma,eight were male and three were female,with median age of 60.Seven patients underwent radical resection,and four underwent traditional joint targeted chemotherapy and immunotherapy.Microscopically,the tumor cells were epithelioid,rhabdoid or spindle-shaped,with prominent eosinophilic nucleoli and frequent mitoses(>5/10 HPF).Multiple foci of necrosis were found in the tumor tissue,a large number of tumor emboli in the blood vessels and myxoid stromal degeneration.Among these cases,11 cases showed loss of SMARCA4(BRG1)expression,whereas the CK and Vim markers were expressed,SMARCB1(INI1)expression was retained,and p53 mutation was detected.The tumor cells showed high proliferation activity(Ki-67>60%),and synaptophsin was moderately positive.Three cases were mismatch repair deficient and respectively showed the loss of MLH1/PMS2,PMS2 and MSH6 expression.Conclusion The incidence of SMARCA4(BRG1)-dificient carcinoma is low.It can be easily confused with other tumors and is difficult to be diagnosed before operation,which requires confirmation by immunohistochemistry.

Objective:This study analyzes the expression level of miR-1180-3p and constructs the regulatory network of relevant ceRNA by integrating the DNA methylation and gene expression profile of hepatocellular carcinoma from the Cancer Genome Atlas (TCGA).Methods:Firstly, the expression level of miR-1180-3p in hepatocellular carcinoma and adjacent tissues was analyzed by TCGA database, and the differential expression of lncrna and mRNA was screened. Secondly, the LncBase database and the TargetScan database were used to predict the relationship between miR-1180-3p and lncRNA and mRNA, and the DNA methylation-mediated lncRNA was screened by the DNA methylation profile of lncRNA. Finally, Cytoscape software was used to construct miR-1180-3p relevant ceRNA network, and WebGestalt website was used to perform GO and KEGG analysis of related mRNA in ceRNA.Results:Compared with patients with low expression of miR-1180-3p (mean overall survival duration, 5.69 ± 0.35 years), patients with high expression of miR-1180-3p had shorter overall survival time (mean overall survival duration, 3.99 ± 0.47 years), indicating that the high expression of miR-1180-3p was hepatocellular carcinoma risk factor affecting the prognosis ( HR = 1.28, 95% CI = 1.1 ~ 1.5, P < 0.01). A miR-1180-3p related ceRNA regulatory network was constructed in this study, which contained 2 lncRNAs (F11-AS1 and LINC01511) and 37 mRNAs. Conclusion:This study has successfully constructed miR-1180-3p relevant ceRNA regulatory network, and DNA methylation-mediated F11-AS1 and F11-AS1/miR-1180-3p/C11of54 ceRNA regulatory axis has played an important role in the occurrence and development of hepatocellular carcinoma.

OBJECTIVE： To investigate the pratice of pharmaceutical care provided by clinical pharmacists in orthopedics department. METHODS： Based on the characteristics of orthopedic diseases and clinical drug use， combined with case analysis， the content， work focus and working methods of pharmaceutical care provided by clinical pharmacists were summarized in orthopedics department of our hospital. RESULTS： Clinical pharmacists of our hospital provided basal pharmaceutical care， such as pharmacy consultation， drug reforming， medication education. Focusing on the application standardization of antibiotics in perioperative period， pain evaluation， analgesic regimen optimization， hemostasis and anticoagulation medication safety monitoring of patients undergoing orthopaedic surgery， clinical pharmacists went deep into ward work to assist physicians in formulating treatment plans. Results of case analysis showed that the work of clinical pharmacists was recognized by doctors and promoted rational drug use in clinic. CONCLUSIONS： Clinical pharmacists should combine different specialty characteristics to carry out pharmacy services for specific groups， continuously improve the professional level and their ability to work， and improve the level of pharmaceutical care.

OBJECTIVE： To establish the method for the content determination of chlorogenic acid， ligustrazine， ferulic acid， senkyunolide I， senkyunolide H， coniferly ferulate， senkyunolide A， n-butylphtalide， Z-ligustilide and n-butylidenephthalide in Ligusticum chuanxiong under different storage conditions. METHODS： HPLC method was adopted. The determination was performed on Boston C18 column with mobile phase consisted of acetonitrile-0.5％ acetic acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 285 nm， and the column temperature was 30 ℃. The sample size was 5 μL. RESULTS： The linear range of chlorogenic acid， ligustrazine， ferulic acid， senkyunolide I， senkyunolide H， coniferly ferulate， senkyunolide A， n-butylphtalide， Z-ligustilide n-butylidenephthalide were 0.030 53-0.519 01 μg （r＝0.999 5）， 0.001 02-0.017 34 μg （r＝0.999 9）， 0.012 83-0.218 11 μg （r＝0.999 5）， 0.007 63- 0.129 71 μg （r＝0.999 7）， 0.001 76-0.029 92 μg （r＝0.999 5）， 0.054 74-0.930 58 μg （r＝0.999 9）， 0.215 80-3.668 60 μg （r＝0.999 9）， 0.018 02-0.306 34 μg （r＝0.999 7）， 0.232 50- 3.952 50 μg （r＝0.999 9）， 0.002 40-0.040 80 μg （r＝0.999 5）.The limits of quantitation were 2.073 7， 0.556 6， 0.753 8， 0.231 5， 0.306 9， 0.925 2， 2.295 3， 4.624 0， 3.215 3， 0.910 5 ng， respectively. The detection limits were 0.622 1， 0.167 0， 0.226 1， 0.069 4， 0.092 1， 0.277 6， 0.688 6， 1.387 2， 0.964 6， 0.273 1 ng， respectively. RSD of precision， stability and repeatability tests were all less than 5％ （n＝6）. The recovery rates were 95.90％-103.28％ （RSD＝2.99％， n＝6）， 88.24％-107.84％ （RSD＝4.89％， n＝6）， 95.06％-102.08％ （RSD＝3.97％， n＝6）， 93.67％-101.05％ （RSD＝1.02％， n＝6）， 94.81％-104.33％ （RSD＝2.34％，n＝6）， 94.41％-105.59％ （RSD＝4.32％， n＝6）， 92.76％-104.83％ （RSD＝1.95％， n＝6）， 87.22％-102.56％ （RSD＝2.89％， n＝6）， 94.04％-99.52％ （RSD＝0.92％， n＝6）， 88.51％-103.83％ （RSD＝4.89％， n＝6）， respectively. At 5 ℃ and 15 ℃， no obvious deterioration was observed in medicinal materials. At room temperature， some samples were moth-eaten and mildewed. The content ranges of 6 batches of samples were 0.047 7％-0.160 8％， 0.006 1％- 0.022 7％， 0.048 2％-0.172 2％， 0.023 3％-0.145 2％， 0.004 6％-0.030 7％， 0.085 2％-0.835 4％， 0.182 6％-2.112 7％， 0.009 9％- 0.098 3％， 0.614 9％-3.176 2％ and 0.005 7％-0.036 9％， showing decreasing trend； the decrease rate was in descending order 5 ℃＜15 ℃＜room temperature； at the same storage temperature， the decrease rate of polyethylene plastic bag was lower than that of polypropylene woven bag. CONCLUSIONS： This method is accurate and feasible， and can be used for simultaneous determination of 10 kinds of components in L. chuanxiong. It is suggested that L. chuanxiong medicinal materials should be sealed and packed in dry and cool places and should not be stored for a long time.

Objective: To analyze vaccination situation of oral live attenuated rotavirus vaccine (LLR strain) among children from six provinces in China. Methods: In 2014, we selected 12 counties in Guangdong, Jiangsu, Chongqing, Jiangxi, Heilongjiang and Gansu provinces by using stratified cluster random sampling method and extract information of children born from January 1, 2008 to December 31, 2012 from Children's Immunization Information System. We investigated ten children of each birth cohort in each county by checking the vaccination certification, and a total of 606 children were investigated. A survey was conducted to check the information of the children's vaccination certification with the data of Children's Immunization Information System by questionnaire including the basic information (province, county, name, gender, birth date, etc) and the rotavirus vaccination (vaccination date, dose, etc) to analyze the rotavirus vaccination situation. Results: 340 of 606 children were male. There were 121, 124, 122, 119 and 120 children born in 2008-2012, respectively. The proportions of the first and the second dose of rotavirus vaccination were 32.8% (199) and 9.7% (59). The proportion of the third dose of rotavirus vaccination among children born between 2008 and 2010 was 3.5% (13) since children born in 2011 and 2012 did not reach the age of third dose vaccination. The proportion of the first dose of rotavirus vaccination in high, middle and low per capita disposable income areas was 45.0% (91), 37.7% (77) and 15.5% (31) respectively (χ²= 43.15, P<0.001). Among 199 children vaccinated with the first dose of vaccine, the vaccination age mainly concentrated in 2 to 21 months, of which the peak was 5 to 13 months (66.8%, 133). The intervals between 2 doses of vaccination were mainly from 12 to 13 months (42.4%, 25) among the 59 children who received at least 2 doses of vaccine. In the 13 children vaccinated with 3 doses, the intervals between the second and the third dose were 12 months (5). Of the 271 doses of rotavirus vaccine vaccinated during 2008-2014, 34.7% (94 doses) were vaccinated in June-August, 88 were vaccinated simultaneously with 18 other vaccines, accounting for 32.5% of the total. Of the 18 other vaccines, inactivated vaccines such as diphtheria vaccine (30 doses), Hib vaccine (14 doses), group A meningitis vaccine (10 doses) were predominant. Conclusion The proportion of rotavirus vaccination was low and the vaccination age was relatively late. The vaccination mode was different from the recommendation of WHO. It is recommended that routine immunization of rotavirus vaccines should be carried out in early-months of children.

Objective To evaluate the appilcation value of intraoperative transesophageal echocardiography (IOTEE) in aortic valve replacement with bovine pericardium.Methods Totally 106 patients were ready to underwent the surgery of aortic valve replacement.The parameters of the aortic valves (diameter of aortic annular,aortic sinus and aortic sinus tube,effective height [eH]) were measured before cardiopulmonary by using IOTEE and during intraoperation.Results Eight cases were removed from the study due to supplemental preoperative diagnosis and modification of operative method,the rest of the 98 cases were enrolled.The coincidence rate of initial diagnosis hy using IOTEE and intraoperative diagnosis was 100 ％;5 cases (5/98,5.10 ％) of secondary diagnosis were inconsistent with intraoperative diagnosis.The coincidence rate of the number of aortic valves with preoperative IOTEE diagnosis and intraoperative diagnosis was 100 ％,the aortic valves perforation fistulas was 80.00％,the aortic valves vegetation was 85.71％,the senile calcified valvular disease was 100％,and the rheumatic disease was 100％.Diameter of aortic annular,aortic sinus and aortic sinus tube,eH measured by preoperative IOTEE had good correlation with intraoperative measurement (all r＞0.8,all P＜0.05).Conclusion IOTEE has feasibility and guiding value in aortic valve replacement with bovine pericardium,and is also of great significance to evaluate the prognosis of surgery.

Objective To study one male patient with cirrhosis for spironolactone induced gynecomastia and promote clinical pharmacists providing better pharmaceutical cares .Methods Based on the patient′s diseases and medication history , clinical pharmacists searched related literature and analyzed the cause of gynecomastia for the patient .Results The patient′s breast pain was relieved and finally disappeared after termination of spironolactone .Therefore ,spironolactone was suspected to be the drug to cause gynecomastia .Conclusion Clinical pharmacists can improve pharmaceutical cares by carefully monitoring the adverse reactions and selecting appropriate medications .

Objective To understand the clinical distribution characteristics and antimicrobial resistance of pathogens causing healthcare-associated infection(HAI) in a comprehensive hospital.Methods Clinical data of patients with HAI in this hospital between May 2012 and May 2015 were collected,the distribution and antimicrobial resistance of pathogens isolated from patients were analyzed.Results A total of 6 563 cases of HAI occurred among 183 850 patients,incidence of HAI was 3.57％,445 patients were isolated at least two kinds of pathogens,375 (84.27％) patients were isolated two kinds of pathogens,132 of whom were infected with both gram negative bacilli.4 478 specimens were sent for pathogenic detection,2 503 (55.90％) of which were isolated pathogens;a total of 2 755 pathogens were isolated,including 1 713(62.18％) strains of gram-negative bacilli,732(26.57％) gram positive cocci,304(11.03％) yeast-like fungi,and 6(0.22％) anaerobic bacteria.524(19.02％)strains were mainly from patients in department of neurology.The main specimen was sputum (n =1 340,48.64％).The isolation rates of carbapenem-resistant Escherichia coli (CREC),Klebsiella pneumoniae (CRKP),Acinetobacter baumnannii (CRAB),and Pseudomonas aeruginosa (CRPA) were 0.39％ (2/510),1.66％ (3/181),59.14％ (207/ 350),and 5.29 ％ (11/208) respectively;isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 21.55％(25/116).Conclusion Multidrug-resistant organisms causing HAl are various,it is necessary to understand distribution characteristics and prevalence of pathogens,monitor multidrug-resistant organisms,and implement contact isolation measures,so as to prevent the outbreak of HAI.

Objective To investigate the clinical study on drynaria injection for delayed healing of fracture patients.Methods 108 patients with fracture delayed union from February 2010 to February 2016 in our hospital were selected and randomly divided into the control group and the experiment group by different treatment,54 cases in each group.The control group were treated by conventional therapy,the experiment group were treated with drynaria rhizome injection on the bases of control group.The total effective rate,serum alkaline phosphatase,NGF and BMP-2 levels were observed and compared after treatment.Results After treatment,the total effective rate of experiment group was higher than control group (P<0.05);After treatment for 7 and 14 days,the serum alkaline phosphatase level of the two groups were significantly increased (P<0.05),and compared with the control group, the serum alkaline phosphatase content of the experimental group was higher (P<0.05);After treatment for 7 and 14 days,the serum NGF and BMP-2 levels of two groups were significantly increased(P<0.05),and compared with the control group,the experimental group was higher than those in the control group.Conclusion Injection of rhizoma drynariae in the treatment of delayed healing of patients with significant effect,increase the levels of serum alkaline phosphatase, serum NGF and BMP-2,promote fracture healing in patients and improve clinical efficacy.

Objective To compare the virological responses between Peg IFNαt-2a and Peg IFNα-2b in treatment of chronic hepatitis C.Methods Clinical data of 46 chronic hepatitis C (CHC) patients were retrospectively reviewed.Patients were divided into two groups:Peg IFNα-2a group ( n =24) was given Peg IFNoα-2a 180 μg/week and ribavirin; Peg IFNα-2b group (n =22 ) was given Peg IFNα-2b1.5 μg · kg-1 · week-1 and ribavirin.Serum HCV RNA load at 4th,12th and 24th week of the treatment were detected to evaluate the virological responses.Softwares SPSS 13.0 and PEMS 3.1 were used for statistical analysis.Results There was no significant difference in rapid response rate,early response rate,complete response rate and non-response rate between the two groups (x2 =0.689,0.105,0.105 and 0.105,P ＞ 0.05 ).However for patients with high viral load ( HCV RNA ＞ 6 logl0 copies/mL) at baseline,the rapid response rate in Peg IFNα-2a group ( 86.67％ ) was higher than that in Peg IFNα-2bgroup (42.86％ ) (x2 =4.365,P ＜ 0.05 ).Conclusion Peg IFNα-2a combined with ribavirin may have higher rapid response rate than that of Peg IFNα-2b combined with ribavirin in CHC patients with high viral