Objective To explore the correlation of MPV,NLR,PT,APTT and FIB with early pro-gression of ACI in patients with BAD.Methods A total of 303 ACI patients with BAD admitted in our department of neurology from October 2021 to September 2023 were consecutively recrui-ted,and according to their progression within 7 d of onset,they were divided into progression group(89 cases)and un-progression group(214 cases).The general clinical data,blood routine re-lated indicators(MPV,NLR)and coagulation related indicators(PT,APTT,FIB)were compared between the two groups.Multivariate logistic regression analysis was applied to identify the rela-tionship of above indicators with early progression of ACI in BAD patients.ROC curve was plot-ted to analyze the predictive value of the indictors for disease progression in these patients.Results The progression group had significantly advanced age,larger proportions of diabetes,hyperlipi-demia and stroke history,and increased levels of uric acid,LDL-C,homocysteine,MPV,platelet distribution width,NLR,D-dimer and FIB,and shorter TT,PT and APTT when compared with the un-progressed group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that MPV,NLR,PT,APTT,and FIB were all independent influencing factors for early disease pro-gression of ACI in patients with BAD(P＜0.05,P＜0.01).ROC curve indicated that the AUC value of combined MPV,NLR,PT,APTT and FIB in detecting early disease progression was 0.859(95％CI:0.813-0.905).Conclusion Blood routine(MPV,NLR)and coagulation related indicators(PT,APTT,FIB)are closely associated with the early disease progression of ACI in BAD patients,and these indicators are of high value in predicting the early disease progression.

Objective To explore the role of pharmaceutical care in the treatment of patients with pulmonary infection secondary to suppurative thrombophlebitis. Methods The treatment of a patient diagnosed with pulmonary metastatic infection secondary to suppurative thrombophlebitis and the whole process of clinical pharmacists participating in the monitoring were analyzed retrospectively. The use of antibiotics was evaluated, and the experience of coagulation management in suppurative thrombophlebitis was explored. Results Based on the infection site, characteristics of septic thrombus, monitoring of vancomycin blood concentration, pharmacokinetics and pharmacodynamics characteristics of antibiotics, clinical pharmacists provided comprehensive pharmaceutical services for clinicians and patients in terms of anti-infection scheme adjustment, optimization of vancomycin individualized treatment, anticoagulant timing. Patient’s systemic infection and septic thrombus can be effectively controlled and which promotes the treatment of patients with suppurative thrombophlebitis. Conclusion Clinical pharmacists can play an important role in the treatment team of severe patients to improve the rational use of antibiotics.

Objective To investigate the role of clinical pharmacists in identifying adverse drug reactions (ADR), to draw clinical attention to the possibility of drug-induced lung injury caused by rhG-CSF, and distinguish them from infectious diseases. Methods A case of rhG-CSF induced acute lung injury was analyzed. After analyzing the relationship between rhG-CSF and acute eosinophilic pneumonia, exploring the possible mechanism, in combination with the patient's condition, the clinical pharmacist put forward the suggestion for the treatment of the disease. Results After receiving rhG-CSF, the patient's eosinophils increased, the pneumonia was aggravated, and the effect of anti-infection treatment was poor. Eosinophils pneumonia associated with rhG-CSF was considered. The patient's pulmonary symptoms improved after treatment with glucocorticoid in combination with withdrawal of antibiotics and antiviral drugs, and eosinophil returned to normal. Conclusion rhG- can cause rare eosinophilic pneumonia. The clinical pharmacist's participation in clinical treatment can help to identify drug-induced diseases, reorient the direction of treatment and ensure the success of clinical therapy.

Background and Objectives: Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity，and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. Methods: and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p＜0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. Conclusions We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.

Objective:To culture and identify dermal mesenchymal stem cells (DMSCs) in skin lesions of patients with psoriasis, and to determine the expression of hairy and enhancer of split-1 (HES1) and chemokine ligand 6 (CXCL6) in DMSCs.Methods:DMSCs were isolated from skin lesions of 15 patients with psoriasis and normal skin tissues of 18 healthy controls, and then subjected to culture. Cell phenotypes were identified by flow cytometry, and mRNA and protein expression of HES1 and CXCL6 was determined by real-time fluorescence-based quantitative PCR (RT-PCR) and Western blot analysis respectively. Comparisons were performed between 2 groups by using t test. Results:There was no difference in the morphology of DMSCs between the psoriasis group and control group. The mRNA expression of HES1 and CXCL6 in the psoriasis group was 3.56 and 3.44 times that in the control group respectively, and there was a significant difference between the two groups (both P < 0.05) . The protein expression of HES1 and CXCL6 in DMSCs was significantly higher in the psoriasis group than in the control group (both P < 0.05) . Conclusion:The high expression of HES1 and CXCL6 in DMSCs from lesions may be involved in the occurrence of psoriasis.

Objective To explore the effects of individualized comprehensive intervention on complications during indwelling implantable venous access port (IVAP), so as to provide reasonable suggestion and theory evidence for reducing the incidence of IVAP complications. Methods We selected 400 breast cancer patients with IVAP. All of the patients were completely randomized divided into control group and experimental group. Patients of control group (n=200) received routine intervention including education before implanting IVAP and discharge instruction. On this basis of routine intervention, patients of experimental group (n=200) were treated with the individualized comprehensive intervention and enhancing continuous intervention out hospital aiming at common complications of IVAP. We compared patients' incidences of complications during IVAP between two groups. Results Patients' incidences of complications during IVAP in control group and experimental group were 27.0% and 7.5% respectively with a significant difference (P＜ 0.01). There were 12 patients with unplanned port drawing due to complications in control group and 3 in the experimental group with a significant difference (P＜ 0.05). Conclusions Individualized comprehensive intervention can effectively reduce the incidences of complications during IVAP, improve the utilization time and ratio of IVAP. Enhancing continuous intervention out hospital is also the important measure to decrease the incidence of severe complications.

Objective To explore the influence of extubation time of urinary catheter on post-operational urination and comfort degree of patients with orthopedic surgery, so as to and make clear the best extubation time of urinary catheter for them. Methods 900 patients treated with operation in Department of Orthopaedics in the Third Hospital of Hebei Medical University from April to June in 2016 were selected by convenience sampling and divided, according to extubation time of urinary catheter, into group A, B and C, each with 300 cases. For patients in group A, urinary catheters were removed in the morning the day after the operation(12~24 h after operation), while in group B, 6 h after, and in group C, 2 h after. Rate of successful urination after extubation of urinary catheter, bladder discomfort, incidence rate of acute urinary retention and comfort degree of indwelling catheter in the three groups were compared. Results Difference in rate of successful urination and incidence rate of frequent micturition, urgent urination, micturition pain and acute urinary retention of patients in the three groups showed statistic significance (P<0.05). It was shown in pairwise comparison that rates of successful urination in group A and B were higher than that in group C, while incidence rates of acute urinary retention were lower (P < 0.05), and that incidence rate of frequent micturition, urgent urination and micturition pain in group A was higher than that in group B and C (P<0.05). Difference in comfort degree of indwelling catheter in the three groups showed statistic significance (P < 0.05). Incidence rates of discomfort in degree Ⅱ in group B and C were less than that in group A, while incidence rate of discomfort in degree Ⅲ in group C was less than that in group A and B (P<0.05). Conclusions For orthopedic patients,the best extubation time of urinary catheter is 6 h after the operation, which helps to raise rate of successful urination, lower urethra irritative symptoms due to cathetering, and reduce bladder discomfort after extubation.

Objective To analyze the reasons of catheter fracture of implantable vascular access devices and to explore the prevention and handling measures. Methods A retrospective analysis was carried in 3 887 adult patients with implantable vascular access devices and 13 had catheter fracture. The clinical features and causes were analyzed and the successful handling measures were summarized. Results Of 3 887 cases, a total of 13 (0.33%) catheter fracture occurred. The incidence rate of catheter fracture via subclavian jugular venipuncture was 3.70%,(6/162) , via internal jugular venipuncture was 0.18% (7/3 725), via internal jugular venipuncture was significantly lower than that via the subclavian venipuncture (χ2=47.505,P=0.000). There had no statistical differences between the left and right of the two puncture ways(P=0.707,0.682). Conclusions Catheter fracture is one of the serious complications in the process of use and maintenance of implantable vascular access device. Choosing appropriate surgical method, strengthen maintenance education, specificating the operation procedure, closing observation and other measures can not only reduce the occurrence of the catheter fracture, but also can dealt with catheter fracture in time, which could ensure the safety of patients' life.

Objective To strengthen the standardized management of totally implanted vascular access devices (TIVAD) in order to prevent and reduce the complications.Methods The unified TIVAD maintenance record form was adopted.The form contained the embedded and maintenance information.The maintenance and propaganda handbooks were handed out to the patients.The incidence of complications between before and after the application of the maintenance record form was analyzed statistically.Results The incidence of infection and obstruction fell from 2.1％(20/942) and 8.3％(78/942) to 1.0％(13/1 258) and 2.8％(35/1 258),the difference was statistically significant.Conclusions The application of TIVAD maintenance record form can reduce the occurrence of complications and prolong the service life of TIVAD.

Objective To explore the effect of maintenance of interval time on catheter blockage and infection for intravenous infusion port patients during the off-treatment time. Methods A total of 100 patients with implanted ports, who drew blood well every time, bolus fluently and had informed consent, were divided into experimental group and control group by random number table method on average. The maintenance carried once in the control group every 4 weeks, while it happened in the experimental group every 12 weeks. We compared the catheter blockage and infection between two groups. Results There had no catheter completely block,Ⅲ grade catheter block and infection in the two groups during the 72 weeks, but Ⅰand Ⅱ grade blockage happened. In the experimental group, there was 3 patients having I grade catheter block, and that of the control group was 2 with no statistically significant difference between two groups (χ2 =0. 211,P>0. 05). In the experimental group, there was 1 patients hadⅡgrade catheter block, and that of the control group was 2 with no statistically significant difference between two groups (χ2 =0. 344,P >0. 05). Conclusions The intravenous infusion port patients had no correlation between the length of maintenance and blockage with infection. The maintenance carried once every 4 weeks is easily accepted for patients.