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OBJECTIVE To investigate the role of clinical pharmacists in the treatment of a patient with Epstein-Barr （EB） virus encephalitis. METHODS Clinical pharmacist participated in drug diagnosis and therapy for a patient with EB virus encephalitis. According to the physiological characteristics of the disease and the pharmacokinetic-pharmacodynamic characteristics of antibiotics， clinical pharmacists suggested that the dose should be adjusted as ceftriaxone 2 g， q12 h+meropenem 2 g， q8 h. Based on the uncontrolled infection of the patient， pharmacists suggested that ceftriaxone should be stopped and vancomycin 1 million U and q12 h should be used as alternative therapy. According to the results of etiology， pharmacists suggested that acyclovir should be discontinued and replaced with ganciclovir 5 mg/kg， q12 h. The electrolyte disturbance of the patient may be adverse drug reactions caused by Mannitol injection， it was recommended to stop the drug. RESULTS The clinician followed the advice of the clinical pharmacists. After treatment， the patient improved and was discharged. CONCLUSIONS Clinical pharmacists can carry out pharmaceutical care for patients with EB virus encephalitis， assist physicians in optimizing the treatment plan of patients， and ensure the effectiveness and safety of drug treatment.
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Background@#Benzo(a)pyrene (BaP) is a carcinogenic compound in contaminated foodstuffs.The effect of oral intake of the environmental carcinogen BaP under low doses and frequent exposure on a digestive system has not been thoroughly verified. @*Methods@#In this regard, this study was conducted to prove the toxicity effects of BaP on the stomach and colon tissue after exposure to C57BL/6 mouse (3 and 6 µg/kg) following daily oral administration for 60 days. This study investigated acute gastric mucosal injury, severe gastric edema, cell infiltration, and mononuclear cells, multifocal cells, and tumoral inflammatory cells. @*Results@#The results of ELISA showed that the expression of serum interleukin (IL)-6 and tumor necrosis factor-α in the BaP exposure group were significantly increased, and a high level of DNA adduct distribution in their stomach and colon. Moreover, this study has confirmed the expression of early carcinogenesis markers: nuclear factor (NF)-κB, p53, IL-6, superoxide dismutase 1 (SOD1), mucin (MUC1 and MUC2), and β-catenin in the stomach and colon, and showed that there was a significant increase in IL-6, NF-κB, SOD1, β-catenin, and MUC1 (P< 0.05). At the same time, there was a significant decrease in MUC2 and p53 (P < 0.05). Thus, even in low doses, oral intake of BaP can induce DNA damage, increasing the potential risk of gastrointestinal cancer. @*Conclusion@#This study will provide a scientific basis for researching environmental contaminated food and intestinal health following daily oral administration of BaP.
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Objective To investigate the role and prognostic impact of E-cadherin( E-cad)on in-vasion and metastasis of gastric carcinoma by analyzing E-cadherin expression at DNA,RNA and protein levels. Methods RNA and protein expression of E-cad were tested in 60 cases of gastric carcinoma and adjacent tissues by streptavidin peroxidase( SP )immunohistochemistry and in situ hybridization. DNA methylation of E-cad was tested with methylation-specific polymerase chain reaction( MSP). Results The positive rates of E-cadherin protein and mRNA in gastric carcinoma were significantly lower than those in adjacent tissues. DNA methylation of E-cad negatively correlated with the E-cad protein and RNA expres-sion in gastric carcinoma respectively(r= -0. 355,r = -0. 271). DNA methylation of E-cad negatively correlated with the 5-year survival rate of gastric carcinoma(r = -0. 381,P ﹤0. 01). However,E-cad protein positively correlated with the 5-year survival rate of gastric carcinoma(r=0. 378,P﹤0. 01). Con-clusion The decreased expression of E-cad is one of the most important biological features in gastric car-cinoma. Methylation of E-cad DNA may be an important agent causing low expression of E-cad protein and mRNA and it can be used as an important indicator in predicting invasion and metastasis of gastric cancer.
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Objective To observe the effects and mechanism of ischemic postconditioning(IPo) on alleviating injuries of small intestine and remote organs induced by intestinal ischemia-reperfusion (IR).Methods A total of 48 rabbits were divided randomly into three groups(n =16 in each):the Sham group,the IR group and the IPo group.After 2 hours of reperfusion,arterial and venous blood and tissues of intestine,liver and lung were harvested.The levels of TNF-α,IL-1β,IL-6 and IL-10 in arterial blood and levels of ALT,AST,BUN,Cr,LDH,CK-MB activity and endotoxin in venous blood were tested.MDA, CAT,SOD and MPO levels in serum,small intestine,liver and lung were also measured.HE staining was performed for observation of injured intestinal mucosa.Bacterial translocation rate was calculated after bac-teria culture.Results Compared with the IR group,MDA and MPO levels in serum,small intestine,liver and lung decreased in the IPo group,while CAT and SOD levels increased obviously.Compared with the IR group,ALT,AST,LDH,CK-MB and BUN levels in the venous blood,and TNF-α,IL-1β,IL-6 and endotox-in levels in arterial blood were all decreased.IL-10 increased and the intestinal mucosal injury score de-creased obviously.Conclusion Ischemic post conditioning can decrease the damage of intestinal mucosa, reduce endotoxin translocation,promote activation of anti-inflammatory cytokines,inhibit excessive release of inflammatory mediators,enhance the antioxidant capacity of intestine and remote organs,reduce injuries to the small intestine and remote organs.
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Objective To investigate the prevention and countermeasures of complications following laparoscopic cholecystectomy(LC) in aged patients.Methods The study was based on a retrospective view of clinical date of 182 aged patients(60～85 years old) who had been treated with LC from January 2000 to October 2006 in this hospital.Co-morbidities existed in 87 patients.The operation was performed under general anesthesia and endotracheal intubation,by using 3-port technique in 137 patients and 4-port technique in 45 patients. Results The LC was successfully completed in 174 patients,with an operation time of 30～100 min and a postoperative hospital stay of 3～10 d.Conversions to open surgery were required in 8 patients due to a difficult dissection(6 patients) or a diagnosis of gallbladder carcinoma(2 patients).No death or serious complications occurred.There were 3 patients with port-site infection and 2 patients with pulmonary infection.Follow-up observations in the patients for 3～12 months revealed no abdominal pain,fever,or jaundice.Conclusions Strictly following indications, properly treating the accompanying diseases,and promptly converting to open surgery are key factors to prevent and reduce complications of LC in aged patients.
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Objective To explore the effects of CO2 pneumoperitoneum on pancreatic function in diabetic rabbits. Methods Forty-eight rabbits were divided into 4 groups: control group (the group of N0, n=4), the group of T0 (n=4), the group of T10 (n=20), and the group of T15 (n=20). The animal used in the groups of T0, T10 and T15 was diabetic rabbit, and the pressures of pneumoperitoneum of the three groups were 0 mm Hg, 10 mm Hg and 15 mm Hg respectively.The model of diabetic rabbits were made through intrvenous administration of Allxon. Arterial blood samples were collected before the onset of CO2 pneumoperitoneum, 0, 2, 6, 12 hours after deflation for measuring blood glucose, amylase, insulin and C-peptid. Then the rabbits were sacrificed and their pancreases were removed for measuring SOD activity and MDA content. Results After abdominal deflation, the blood glucose, amylase, insulin, C-peptid, MDA content were significantly increased (P
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Objective: To summarize the clinical experiences and effect of laparoscopic cholecystectomy(LC)combined with laparoscopic appendectomy(LA). Methods: The clinical data of 92 cases which successfully underwent three-trocar LC and LA was retrospectively analyzed. Results: All operations were performed successfully without complications. The mean operation time was 70 min. The mean hospital stay was 5 days. No complications occurred in the 85 cases who were followed up in 6 months. Conclusion: The simultaneous approach to LC and LA is a safe and effective treatment.