Objective:To explore the methods and clinical effects of reconstructing facial and cervical scars with expanded flaps based on the "MLT" principle.Methods:The study was a retrospective observational study. From January 2019 to May 2022, 74 patients with facial and cervical scars after burn or trauma injuries who met the inclusion criteria were admitted to Xiangya Hospital of Central South University, including 38 males and 36 females, aged from 5 to 58 years, including 24 patients with simple facial involvement, 24 patients with simple cervical involvement, and 26 patients with both facial and cervical involvement, with scar area ranging from 12 to 145 cm2. By following the "MLT" principle (color and texture similar to the face; flap area large enough to reconstruct the entire defect; skin tissue thin enough to transmit the expression, so as to facilitate the shape of the face and five features); in the stage Ⅰ surgery, the skin and soft tissue expanders (hereinafter referred to as the expanders) were implanted, and in the stage Ⅱ surgery, the expander removal+scar resection+flap transplantation to repair the secondary wound was performed, and the wound in the donor area of flap was directly sutured. After operation, silicone gel preparation and laser therapy were used to prevent scar hyperplasia. The expansion ratio and time period of expanders, the occurrence of complications of skin and soft tissue expansion surgery, the type of flap used, and the survival of flap after the stage Ⅱ surgery were observed and recorded. The long-term effect of facial and cervical reconstruction and the recovery of donor area and recipient area of flap were evaluated during the postoperative follow-up after surgery.Results:The expansion ratio of 135 expanders ranged from 1.36 to 3.00 times, and the expansion time period ranged from 6 to 14 months. During skin and soft tissue expansion surgery, 8 patients had poor healing of incisions after expander placement, 7 patients had expander rupture, 5 patients had infection in incisions after expander placement, 3 patients had expander exposure, 2 patients had difficult filling the injection pot, and 1 patient had water leakage from the injection pot. Dorsal shoulder expanded flaps with double blood supply of transverse cervical artery and circumflex scapular artery were used in 8 patients, the expanded flaps of anterior transverse carotid artery perforator were used in 11 patients, the expanded flaps of internal thoracic artery perforator were used in 12 patients, tandem expanded flaps of upper chest and neck were used in 16 patients, dorsal thoracic artery perforator expanded flaps were used in 5 patients, and adjacent rotary propulsive expanded flaps were used in 22 patients. After the stage Ⅱ surgery, the flaps of 71 patients were completely survived. One patient had blood circulation disorder in the flap, and the flap survived after hyperbaric oxygen treatment. Necrosis occurred at the end of the flaps in 2 patients, which healed after dressing change. After the surgery, 42 patients were followed up for 3 to 24 months. The color, texture, and thickness of flaps were good and similar to the surrounding normal skin tissue in the recipient area, the appearance and function of the face and neck were significantly improved, and the wound location in the donor and recipient areas of flaps was concealed with slight scar formation.Conclusions:In the reconstruction of facial and neck scars, by following the "MLT" principle, the expanded flap was carefully designed before surgery, the local aesthetic features within the subunit are reconstructed during the stage Ⅱ surgery, and standard anti-scar treatment measures are actively adopted after surgery. After reconstruction, the color, texture, and thickness of flaps were close to the normal skin in face and neck, and the appearance and function of face and neck are significantly improved, with less linear scars left. It is beneficial to improve the therapeutic effect.

OBJECTIVE： To optimize the water extraction technology of Chaihu anxin capsules. METHODS： Taking comprehensive scoring value of  the contents of gallic acid，chlorogenic acid，puerarin，glycoside，rutin，cinnamic acid， quercetin and the yield of extract as investigation index， using multiple of adding liquid， soaking time， reflux time and extraction times as factors， water extraction technology of Chaihu anxin capsule was optimized by Box-Behnken response surface method based on single factor test. Validation test was conducted. RESULTS： The optimal extraction technology of Chaihu anxin capsules was adding 11 times of water， soaking for 10 h， extracting for 2 times， refluxing for 1.5 h each time. In validation test， the relative deviation of comprehensive scoring value to predicted value was 1.87％ for 3 batches of samples （RSD＜2％， n＝3）. CONCLUSIONS： The optimal extraction technology is simple， stable and suitable for further production of Chaihu anxin capsules.

OBJECTIVE： To evaluate the effects of clinical pharmacist-led ischemic stroke management， and to provide reference for chronic disease management. METHODS： Totally 184 patients with ischemic stroke who were hospitalized in neurology department of the First Hospital of Hebei Medical University from May to August 2018 were included prospectively， and then divided into control group （92 cases） and intervention group （92 cases） by random number method. Control group did not receive clinical pharmacist intervention. In the intervention group， clinical pharmacists were the leader in the pharmaceutical care during the hospitalization， the medication education at discharge， and pharmacy follow-up after discharge. The rate of medication compliance （antiplatelet drugs， antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs） and the rate of secondary prevention and control indicators of ischemic stroke， such as blood pressure， blood glucose [glycated hemoglobin （HbA1c）] and blood lipid [low-density lipoprotein cholesterol （LDL-C）] were investigated between 2 groups at 6 months after discharge. The incidence of adverse drug reaction and the rate of rehospitalization were compared between 2 groups at 6 months after discharge. RESULTS： The number of patients in the intervention group and the control group was 84 and 82， respectively. At 6 months after discharge， the compliance rate of antiplatelet drugs in the intervention group was 96.43％， which was higher than 95.13％ of control group， but the difference was not statistically significant. The good compliance rates of antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs in the intervention group were 92.86％， 91.67％ and 77.38％， which were higher than 78.57％， 69.70％ and 60.98％ of control group， with statistical significance （P＜0.05）. The qualified rate of index of blood pressure was 89.29％ in intervention group， which was higher than 76.79％ of control group， but the difference was not statistically significant. The qualified rates of HbA1c and LDL-C in the intervention group were 80.56％ and 66.67％， which were higher than 57.58％ and 48.785 of control group， with statistical significance （P＜0.05）. The incidence of total adverse drug reactions in the intervention group was 15.48％， which was lower than 20.73％ of control group， but the difference was not statistically significant. The total rehospitalization rate in the intervention group was 7.14％， which was lower than 17.86％ of control group， the difference was statistically significant （P＜0.05）. CONCLUSIONS： The management of ischemic stroke patients with clinical pharmacists as the leading factor can improve the patient’s medication compliance， improve the qualified rate of secondary prevention and control indicators of ischemic stroke， and reduce the rate of rehospitalization.

OBJECTIVE： To optimize the ultrasonic extraction technology for Jinjuan shengban capsules. METHODS： Using comprehensive score of indexes as transfer rate of gallic acid， chlorogenic acid， baicalin， aloe emodin and emodin methyl ether， with ethanol volume fraction， ultrasonic power， ultrasonic extraction time and liquid-material ratio as factors， the ultrasound extraction technology of Jinjuan shengban capsules was optimized by Box-Behnken response surface methodology based on single factor test. The validation test was conducted. RESULTS： The best extraction technology was 50-fold 70％ ethanol， extracting 40 min under 300 W. In validation test， average transfer rates of gallic acid， chlorogenic acid， baicalin， aloe emodin and emodin methyl ether were 85.92％， 86.37％， 92.76％， 90.84％ and 87.26％ （RSD＜3.57％，n＝3） in 3 batches of samples； comprehensive score was 88.95％， relative error of which to predicted value of 88.27％ was 1.10％. CONCLUSIONS： The response surface method combined with multi-index comprehensive scoring can be used to optimize the extraction technology of Jinjuan shengban capsules which is simple and stable.

OBJECTIVE:To investigate the compatible stability of cefpirome sulfate with ornidazole. METHODS:At room temperature [(20±1)℃],the appearances(color,clarity,sedimentation and gas)and pH changes of the mixtures by Cefpirome sulfate for injection with Ornidazole for injection in 0.9% Sodium chloride injection and 5% Glucose injection after 0,1,2,4,6 h were observed. RP-HPLC was adopted to determine its content changes. RESULTS:No significant change was noted for the mix-ture in appearance within 6 h,pH value ranged in 3.359-3.588;compared with the beginning(0 h),the contents of cefpirome sul-fate and ornidazole ranged in 100.2%-100.3%,99.9%-100.4% in 0.9% Sodium chloride injection at each time point,as well as 99.7%-99.9%,99.4%-99.6%in 5%Glucose injection. CONCLUSIONS:At room temperature,cefpirome sulfate mixed with orni-dazole show stable appearance,pH value and content in 0.9%Sodium chloride injection and 5%Glucose injection within 6 h.

OBJECTIVE:To explore the effects of extracts from Siegesbeckiae herba (HS) on doxorubicin (DOX)-induced chronic myocardial injury in mice. METHODS:48 mice were randomly divided into 3 groups. Mice in blank control(Con)group received distilled water once every day,ig,and normal saline(2 mL/100 g)once every day,ip,for 8 weeks;mice in DOX mice received distilled water(2 mL/100 g)once every day,ig,and DOX(3 mg/kg)once every week,ip,for 8 weeks;mice in DOX+HS group received HS(340 mg/kg)once every day,ig,and DOX(3 mg/kg)once every week,ip,for 8 weeks. After administra-tion,body mass,heart coefficient,cardiac function changes,serum biochemical index levels [alanine aminotransferase(ALT),as-partate aminotransferase (AST), creatine phosphokinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH)and total cholesterol(TC)] of mice were determined. RESULTS:Compared with Con group,body mass of mice in DOX group was decreased(P<0.01);heart coefficient was increased(P<0.05);heart rate slowed down,R-wave was increased(P<0.05 or P<0.01);serum biochemical indexed were increased,there was significant difference in AST(P<0.01). Compared with DOX group,heart coefficient of mice in DOX+HS group was decreased (P<0.01);heart rate was increased (P<0.01);serum biochemical indexes were decreased,there was significant differences in CK,LDH,TC(P<0.01). CONCLUSIONS:HS has cer-tain protective effects on DOX-induced chronic myocardial injury in mice.

OBJECTIVE:To explore the role of clinical pharmacists in the therapy for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with allergic bronchopulmonary aspergillosis (ABPA). METHODS:Clinical pharmacists participated in the therapy for a AECOPD patient with ABPA. According to patient's con-dition,clinical pharmacists suggested adjusting the inhalation order of salbutamol and budesonide aerosol inhalation;stop-ping cefatriaxone and adjusting to intravenous injection of voriconazole;and then adjusting voriconazole to oral dosage form timely,monitoring therapy duration. Clinical pharmacists paid close attention to therapeutic efficacy and ADR,and provided medication education for patients. RESULTS:Physicians adopted the suggestion of clinical pharmacists to adjust inhalation order of aerosols,the dosage and route of administration of voriconazole. The patient's condition was improved obviously,and the drug therapy was continued after discharge. CONCLUSIONS:Clinical pharmacists participating in the whole process of treatment improves therapeutic efficacy,reduces the occurrence of ADR and promotes rational drug use in clinic.

Objective To investigate the effect of total flavones of Rhizoma Drynariae on femur distraction osteogenesis in the rabbits. Methods Thirty-two healthy rabbits were randomly divided into treatment group and control group, 16 rabbits in each group. The femoral fracture was treated with unilateral femoral distraction and was fixed with a self-made distraction instrument. After 7-day intermittent period, the fractured femur was distracted at a rate of 1 mm/d, twice a day for 10 continuous days. The treatment group was fed with total flavones of Rhizoma Drynariae from the first post-operative day to the end of the experiment. And then all of the animals were sacrificed after fixation for 28 days. The bone specimens were used for histological observation and immunohistochemical detection. Results The area of mature bone in the newborn bone tissue of the treatment group was increased, and osteoblasts number and the percentage of trabecular bone area were significantly higher than those of the control group . The bone morphogenetic protein-2 (BMP-2) and transforming growth factor-β1 (TGF-β1) were stained brown deeply, the staining degree being stronger than that of the control group. Conclusion Rhizoma Drynariae total flavones can effectively accelerate the formation and maturation of newborn bone tissue during bone distraction.

OBJECTIVE:To study the correlation between antibacterials amount and drug resistance of Echerichia coli,and to provide reference for clinical use of antibacterials. METHODS:Retrospective review was used to calculate DDDs of antibacterials and resistance rate of Escherichia coli to 11 kinds of antibacterials each quarter. The correlation analysis was carried out using the SPSS 13.0 statistical software. RESULTS:The resistance rates of E. coli to piperacillin/tazobactam,cefoperazone/sulbactam and le-vofloxacin were with upward trends,and the others showed downward trends. The resistance rates of E. coli to meropenem and imi-penem/cilastatin appeared in 2014,increasing from 0 to 8.8% and 9.4%,respectively. DDDs of them were significantly correlated to drug resistance of E. coli,showing positive correlation(r=0.915,0.793,P<0.01). DDDs of piperacillin/tazobactam was signif-icantly correlated to resistance rate of E. coli(r=0.807,P<0.01),while that of ceftazidime was negatively correlated to resistance rate of E. coli(r=-0.672,P<0.05). There was no statistical significance in resistance rate of E. coli to other 7 kinds of antibacte-rials. CONCLUSIONS:There are some correlations between the DDDs and resistance rates. We should strengthen the monitoring of bacterial resistance and the management of rational application of antibacterials.

Objective To establish a method for determining cinnamic aldehyde content in Xianggui Huazhuo capsules by gas chromatography-mass spectrometry (GC-MS). Methods The content of cinnamic aldehyde was determined by GC-MS. Separation was performed on a capillary column (30 m×0. 25 mm, 0. 25 μm) with HP-5 as the stationary phase. A programmed temperature was employed. The flow rate was 1 mL·min-1 with He as carrier gas, and split ratio was 50∶1. The injection volume was 1. 0 μL. Results The cinnamic aldehyde was well isolated from the other ingredients. A good linear relationships of cin-namic aldehyde in range of 0. 02-4. 00 mg·mL-1 was observed. The correlation coefficient was 0. 999 4. The average recovery of cinnamic aldehyde was 96. 2% , and RSD was less than 2. 11% . Conclusion The method is simple, accurate and suitable for determination of cinnamic aldehyde content.