Management strategy of antithrombotic therapy in thrombocytopenia patients with atrial fibrillation and atherosclerosis and a literature review / 中国药房

OBJECTIVE To provide reference for the management of antithrombotic therapy in thrombocytopenia patients with atrial fibrillation and atherosclerosis. METHODS The clinical pharmacist participated in the treatment of a thrombocytopenia patient with atrial fibrillation and atherosclerosis， and analyzed the causes of thrombocytopenia according to the patient’s medical history and laboratory examination results. At the same time， the risk of thrombosis-bleeding was evaluated according to the relevant guidelines， and the clinicians were assisted in formulating individual antithrombotic therapy plan and pharmaceutical care plan for the patient. The literature on antithrombotic therapy related to thrombocytopenia was collected and analyzed by retrieving CNKI. RESULTS Thrombocytopenia was considered as primary thrombocytopenia in this patient， and the main risk of bleeding was age ≥65 years old， bleeding tendency， and combined use of antithrombotic drugs. After the clinical pharmacist assessed the risk of thrombosis and bleeding， the clinician was recommended to give full dose of Bemiheparin sodium injection + Dronedarone hydrochloride tablets + Metoprolol succinate sustained-release tablets. In view of thrombocytopenia， the clinician gave Compound zaofan pill， Caffeic acid tablet and Sheng xuexiaoban capsule， but the patient developed diarrhea after the medication. The clinical pharmacist suggested stopping Sheng xuexiaoban capsule， and the clinician adopted the clinical pharmacist’s suggestion. When the patient was discharged from hospital， the clinical pharmacist suggested that the antithrombotic therapy plan for discharge was anticoagulation alone or selective anticoagulation. The clinician chose selective anticoagulation treatment considering that the patient’s current thrombocytopenia， urinary occult blood （+） and fecal occult blood were weakly positive， and ordered the patient to take Metoprolol succinate sustained-release tablets + Atorvastatin calcium tablets at discharge. Literature analysis showed that the causes of thrombocytopenia of patients with thromboembolism mainly included heparin induced-thrombocytopenia， immune thrombocytopenia， etc. All patients were improved after symptomatic treatment. CONCLUSIONS By participating in the management of antithrombotic therapy for the thrombocytopenia patient with atrial fibrillation and atherosclerosis， clinical pharmacists can help effectively control the patient’s condition and ensure the safety and effectiveness of drug use.

Research on related factors for hypoglycemic episodes in patients with type 2 diabetes mellitus based on continuous glucose monitoring system / 复旦学报（医学版）

Objective To identify related factors for hypoglycemic episodes in patients with type 2 diabetes mellitus(T2DM)through continuous glucose monitoring(CGM). Methods The included 147 patients with T2DM were those who had undergone CGM for 5 days in our ward of Department of Endocrinology and Metabolism,Huashan Hospital from Dec 2018 to Oct 2019. The general information, laboratory parameters and CGM parameters of the patients were collected. According to whether there wasan episode of hypoglycemia during the monitoring period,the patients were divided into non-hypoglycemia group and hypoglycemic group. A single hypoglycemia episode was defined as a sensor monitoring blood glucose of less than 3.9 mmol/L and lasting for more than 15 minutes.CGM parameters included the mean blood glucose(MBG),standard deviation(SD),coefficient of variation(CV),the differences between maximum and minimum blood glucose (BG) levels (ΔBG),mean amplitude of glycemic excursions (MAGE)and the percentage of time in range(％TIR)of BG at <3.9 mmol/L,3.9-7.8 mmol/L,>7.8 mmol/L,3.9-10.0 mmol/L,and >10.0 mmol/L. Results Logistic regression analysis showed that lower estimated glomerular filtration rate(eGFR)levels,increased use of insulin and its analogs and lower MBG levels were associated with hypoglycemic episodes. Spearman correlation analysis showed that the MBG level and the ％TIR of BG>7.8 mmol/L and BG>10.0 mmol/L were negatively associated while glycemic variability(GV)levels(SD,CV,ΔBG,MAGE)and ％ TIR of BG at 3.9-7.8 mmol/L were positively associated with hypoglycemic episodes. Pearson correlation analysis showed that the duration of hypoglycemic episodes was positively correlated with the use of sulfonylureas and CV levels. Conclusion Lower eGFR levels,increased treatment with insulin and its analogs and lower MBG levels were related factors for hypoglycemic episodes in patients with T2DM.

Selection of optimal qRT-PCR reference genes for Aconitum vilmorinianum / 中国中药杂志

Screening suitable reference genes is the premise of quantitative Real-time PCR(qRT-PCR)for gene expression analysis. To provide stable reference genes for expression analysis of genes in Aconitum vilmorinianum, this study selected 19 candidate re-ference genes(ACT1, ACT2, ACT3, aTUB1, aTUB2, bTUB, 18S rRNA, UBQ, eIF2, eIF3, eIF4, eIF5, CYP, GAPDH1, GAPDH2, PP2A1, PP2A2, ACP, and EF1α) based on the transcriptome data of A. vilmorinianum. qRT-PCR was conducted to profile the expression of these genes in the root, stem, leaf, and flower of A. vilmorinianum. The Ct values showed that 18S rRNA with high expression level and GAPDH2 with large expression difference among organs were not suitable as the reference genes. NormFinder and geNorm showed similar results of the expression stability of the other candidate reference genes and demonstrated PP2A1, EF1α, and CYP as the highly stable ones. However, BestKeeper suggested EF1α, ACT3, and PP2A1 as the top stable genes. In view of the different results from different softwares, the geometric mean method was employed to analyze the expression stability of the candidate re-ference genes, the results of which indicated that PP2A1, EF1α, and ACT3 were the most stable. Based on the comprehensive analysis results of geNorm, NormFinder, BestKeeper, and geometric mean method, PP2A1 and EF1α presented the most stable expression in different organs of A. vilmorinianum. PP2A1 and EF1α were the superior reference genes for gene expression profiling in different organs of A. vilmorinianum.

Rule mining of acupoint and medication selection of acupoint application therapy for functional constipation / 中国针灸

OBJECTIVE@#To analyze the rules of acupoint and medication selection of acupoint application therapy for functional constipation (FC) by data mining technology.@*METHODS@#The clinical research literature regarding acupoint application therapy for FC from published to February 26, 2020 was searched in CNKI, VIP, Wanfang, SinoMed and PubMed. The prescriptions were extracted, and by using SPSS24.0 and SPSS Modeler14.0 software, the use of high-frequency acupoints and medication was summarized. The association rule analysis, cluster analysis and core prescription analysis of acupoints and medication were analyzed.@*RESULTS@#A total of 122 prescriptions of acupoint application therapy were included, involving 32 acupoints. The core prescription of acupoints was Tianshu (ST 25), Dachangshu (BL 25), Shenque (CV 8) and Guanyuan (CV 4). The high-frequency meridians mainly included conception vessel, @*CONCLUSION@#The use of local acupoint and regulating-

Modified Qiaohetang and Xiehuangsan in Treatment of Acne Due to Dampness-heat Accumulation / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Qiaohetang and Xiehuangsan in the treatment of acne due to dampness-heat accumulation and its influence on the levels of inflammatory factors and sex hormones. Method:One hundred and sixty-eight eligible patients were divided into an observation group （84 cases） and a control group （84 cases） according to the random number table. Adapalene gel was applied externally in both groups， one time per day. In the control group， Jinhua Xiaocuo pills was taken orally， 4 g per time， three times a day. In the observation group， the modified Qiaohetang and Xiehuangsan was provided for oral administration， one bag per day. The treatment lasted for eight weeks. The Global Acne Grading System （GAGS） score， skin lesion count， dampness-heat accumulation syndrome score， and Dermatology Life Quality Index （DLQI） score were recorded before and after treatment， followed by the detection of interleukin-8 （IL-8）， IL-10， IL-17， interferon-<italic>γ</italic> （IFN-<italic>γ</italic>）， free testosterone （FT）， estradiol （E₂） and sex hormone binding globulin （SHBG） before and after treatment as well as the safety evaluation. Result:The GAGS， dampness-heat accumulation syndrome， and DLQI scores of the observation group were lower than those of the control group （<italic>P</italic><0.01）. The counts of inflammatory skin lesions （papule and pustule）， non-inflammatory skin lesions， and total skin lesions in the observation group declined in contrast to those in the control group （<italic>P</italic><0.01）. The IL-8， IL-17， IFN-<italic>γ</italic> and FT levels of the observation group were decreased as compared with those of the control group （<italic>P</italic><0.05， <italic>P</italic><0.01）， while the IL-10， E₂， and SHBG levels were increased （<italic>P</italic><0.01）. The overall response rate in clinical symptom alleviation of the observation group was 93.67%（74/79）， which was higher than 81.82%（63/77） of the control group （<italic>χ</italic>²=5.121， <italic>P</italic><0.05）. The overall response rate in dampness-heat accumulation syndrome relief of the observation group was 92.41% （73/79）， still higher than 79.22% （61/77） of the control group （<italic>χ</italic>²=5.595， <italic>P</italic><0.05）. No adverse reactions occurred after the oral administration of Chinese medicinal preparations. Conclusion:The modified Qiaohetang and Xiehuangsan combined with adapalene gel can reduce the skin lesion count and severity， relieve both clinical symptoms and dampness-heat accumulation syndrome， regulate the inflammatory response and sex hormones， and improve the quality of life of patients with acne of dampness-heat accumulation syndrome without inducing side effects.

Progress and prospect of machine learning in research of acupuncture and moxibustion / 中国针灸

The application progress of machine learning in research of acupuncture and moxibustion was reviewed from three aspects: mining of acupuncture and moxibustion prescription and indications, acupuncture efficacy prediction and its influencing factors, acupoint specificity and acupuncture manipulation research, and the existing problems in current research and future research trends were discussed. It is believed that the appropriate machine learning algorithm should be selected to build the model according to the research purpose and data characteristics in the future research; attention should be paid to feature design, feature selection and feature cleaning; sample data collection should be a priority, and data sharing platform and standardized data collection should be developed to improve the data quality.

Investigation of Mechanism of Tryptanthrin Inhibiting Breast Cancer in Mice Based on Proteomics / 中国实验方剂学杂志

Objective:A systematical study on the anti-breast cancer mechanism of tryptanthrin in breast cancer-bearing mice was done by Label-free proteomics. Method:UPLC-MS was used to detect the expressed-proteins of tryptanthrin inhibiting breast cancer in mice， chromatographic separation was achieved on the Ionoptics nano UPLC C18 column （0.075 mm×250 mm， 1.6 μm）， and gradient elution was performed with 0.1% formic acid aqueous solution-0.1% formic acid acetonitrile solution as mobile phase. Data acquisition was carried out in electrospray ionization （ESI） under the positive ion mode， the scanning range was m/z 100-1 700， MaxQuant 1.6.5.0 was used for database retrieval. Label-free proteomics with high resolution mass spectrometry was used to screen differentially expressed proteins between the model group of 4T1 breast cancer mice and oral administration group of tryptanthrin （100 mg·kg-1）. The proteomics of tryptanthrin against breast cancer was carried out. Result:A total of 3 997 proteins were identified in this proteomics research， and 2 911 proteins were quantifiable. A total of 750 differentially expressed proteins were identified between the model group and the tryptanthrin group， 286 proteins were up-regulated and 464 proteins were down-regulated. Gene ontology analysis showed that these differentially expressed proteins were mainly involved in biological processes of proliferation， cell migration， apoptosis， immunity， angiogenesis， inflammatory regulation， etc. Kyoto encyclopedia of genes and genomes pathway analysis further indicated that these proteins were mainly concentrated in T cell receptors， B cell receptors， Toll-like receptors， nuclear transcription factor-κB （NF-κB）， Ras proteins， interleukin-17， tumor necrosis factor， phosphatidylinositol 3-kinase/protein kinase B （PI3K-Akt）， mitogen-activated protein kinase （MAPK） and other signaling pathways. Conclusion:The differentially expressed proteins closely related to anti-breast cancer effect of tryptanthrin on 4T1 breast cancer mice are effectively screened out， including up-regulating proteins of leukocyte differentiation antigen 14 （CD14）， prostaglandin G/H synthase 2 （PTGS2）， E3 ubiquitin-protein ligase and down-regulating proteins of CD44， heat shock 70 kDa protein 1A （HSPA1A）， macrophage migration inhibitory factor （MIF）， NF-κB， ribosomal protein S6 kinase alpha-4 （RPS6KA4） and high mobility group protein B1 （HMGB1）. These findings suggest that tryptanthrin can inhibit breast cancer in mice mainly through regulating tumor inflammatory microenvironment.

Effects of gender and age on protein secretion in saliva of transgenic mice expressing human nerve growth factor / 生物工程学报

Nerve growth factor (NGF) can promote the development, differentiation and regeneration of neurons. Recently, in order to efficiently produce human NGF (hNGF) drugs with better efficacy, we created transgenic mice expressing hNGF specifically in their salivary glands, and purified highly active hNGF protein from their saliva. Some studies reported that the NGF secretion in mouse saliva is affected by gender and age. Here, in order to select hNGF transgenic mice with high NGF secretion for saliva collection and hNGF purification, we divided transgenic mice into 4 groups, including 28-day-old young males and females, 63-day-old adult males and females. We compared their saliva volume, total salivary protein amount, salivary mNGF protein amount and salivary hNGF protein amount. The results showed that the saliva volume as well as amounts of total salivary protein, salivary mNGF protein and salivary hNGF protein secreted by 63-day-old transgenic mice were significantly higher than those secreted by sex-match 28-day-old transgenic mice, and the salivary hNGF protein amount secreted by male transgenic mice at the age of 63 days was significantly higher than that of female transgenic mice at the same age; Among 4 groups of mice, 63-day-old male transgenic mice secreted the highest salivary hNGF content, which was about 46 times higher than that secreted by the 28-day-old female transgenic mice. Therefore, 63-day-old male transgenic mice should be selected for saliva collection and hNGF purification.

Therapeutic effect of fructose-1, 6-diphosphate combined antiviral treatment on pediatric patients with viral myocarditis / 心血管康复医学杂志

Objective: To explore therapeutic effect of fructose-1, 6-diphosphate (FDP) combined antiviral treatment on pediatric patients with viral myocarditis (VMC). Methods: A total of 118 VMC children were randomly and equally divided into routine treatment group and combined treatment group (received FDP therapy based on routine treatment), both groups were treated for two weeks. Therapeutic effect after treatment, levels of creatine kinase (CK), lactate dehydrogenase (LDH), CK isoenzyme MB (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH), heart rate (HR), stroke volume (SV), cardiac output (CO) and left ventricular ejection fraction (LVEF) before and after treatment were measured and compared between two groups. Results: Total effective rate of combined treatment group was significantly higher than that of routine treatment group (91. 53％ vs. 71. 19％, P=0. 005). Compared with before treatment after two-week treatment, there were significant reductions in levels of CK, LDH, CK-MB, HBDH and HR, and significant rise in SV, CO and LVEF in two groups, P＜0. 01 all. Compared with routine treatment group after two-week treatment, there were significant reductions in levels of CK [(168. 2±33. 7) U/L vs. (126. 4±30. 4) U/L], LDH [(199. 0±41. 3) U/L vs. (162. 7±47. 1) U/L], CK-MB [(18. 3±6. 4) U/ L vs. (12. 2±6. 6) U/L], and HR [(85. 4±12. 6) times/min vs. (80. 2±12. 3) times/min], and significant rise in SV [(82. 4±13. 4) ml vs. (89. 5±14. 0) ml]and LVEF [(50. 1±8. 5) ％ vs. (59. 7±8. 8) ％]in combined treatment group, P＜0. 05 or＜0. 01. Conclusion: Fructose-1, 6-diphosphate combined antiviral therapy could significantly improve myocardial enzyme levels, recover cardiac pump function with significant therapeutic effect in VMC pediatric patients.

Relationship between Anxiety and Cognitive Function or Activity of Daily Living in Parkinson's Disease Patients / 医学研究杂志

Objective To explore the effects of anxiety on cognitive function and activity of daily living in Parkinson's disease patients (PD).Methods Anxiety,cognitive function and activity of daily living in 55 cases of PD patients and 30 cases of normal control group were evaluated by beck anxiety inventory(BAI),montreal cognitive assessment(MOCA) and Barthel index scale (BI).The relationship between BAI score and MoCA score or BI score were analyzed.Results The incidence of PD combined anxiety disorder was as high as 41.8％.MoCA score of anxiety group was significantly lower than the control group and significantly negatively related to the BAI scores(P ＜ 0.05),but there was no statistical difference compared with the anxiety group(P ＞ 0.05).Visual space and executive function,memory and delayed memory score and BI score of the anxiety group were significantly lower than the anxiety group and control group (P ＜ 0.05) and significantly negatively related to the BAI scores (P ＜ 0.05).Visual space and executive function of the non-anxiety group were significantly lower than the control group,but had no significant correlation with the BAI score (P ＞ 0.05).Conclusion PD patients often have a certain degree of cognitive impairment and obvious barriers to daily living activities.Anxiety often has different extent effect on cognitive function in PD patients,especially in the visual space and executive function,memory function,and seriously affects the patient's activity of daily living,makes the life quality decreased obviously.

Wide-detector Revolution CT with 70 kV tube voltage and prospective ECG-gated technique in diagnosis of congenital heart disease in infants and children / 中国医学影像技术

Objective To investigate the value of wide-detector Revolution CTA with 70 kV tube voltage and prospective ECG-gated technique in diagnosis of congenital heart disease (CHD) in infants and children.Methods Forty-five infants and children with complicated CHD underwent echocardiography and wide-detector Revolution CTA.According to the sur gical findings,the diagnostic efficiency of Revolution CTA and echocardiography were calculated and compared.The radiation effective dose (ED) and iodine dose were calculated.The quality of CT images was also evaluated.Results There were 25 separate cardiovascular anomalies including 6 congenital cardiac structure anomalies and 19 congenital extracardiac vascular anomalies.For congenital extracardiac vascular anomalies,there was significant difference of diagnostic accuracy and the detectable rate between CTA (99.77％ [853/855],97.73％ [86/88]) and echocardiography (98.71％ [844/855],88.64％ [78/88];x2 =6.28,5.72,both P＜0.05).The average of ED was (0.20±0.05)mSv and the mean iodine dose was (2.06± 1.09)g.All CT images were qualified for diagnosis.Conclusion The wide-detector Revolution CTA,with the prospective ECG-gated technique and 70 kV tube voltage,can provide high accuracy for assessment of CHD in infants and children,which can keep good image quality,with the low radiation dose.

Curative effect of Chaiqin tiaogan capsule in treatment of patients with hepatitis B virus / 中国生化药物杂志

Objective To investigate the clinical superiority of Chaiqin tiaogan capsule in the treatment of hepatitis B virus.Methods 126 cases of patients admitted to hospital from January 2014 to June 2015 were randomly divided into two groups, the control group (interferon and lamivudine) and the experimental group (interferon, lamivudine and Chaiqin tiaogan capsule), each group of 63 cases.The HBsAg and HBV-DNA negative rate, the changes of liver function and the incidence of adverse reactions in the experimental group were observed and compared.Results The HBsAg negative rate and the HBV-DNA negative rate after treatment three and six months in the control group were significantly higher than the experimental group ( P<0.05).The levels of ALT, AST and DBiL in the control group and the experimental group were significantly decreased, and the levels of ALT, AST and DBiL after treatment six months in the control group were significantly lower than the experimental group ( P <0.05 ) .There were no serious adverse reactions in the control group and experimental group, there was no significant difference between two groups.Conclusion Chaiqin tiaogan capsule can effectively inhibit HBV replication and improve liver function, it has good tolerability and safety applied to clinical.

Outcome and Influencing Factor Analysis for Graft Vessels in Patients After Coronary Artery Bypass Grafting / 中国循环杂志

Objective: To investigate the outcome and inlfuencing factors of graft vessels including saphenous vein graft (SVG) and left internal mammary artery graft (LIMAG) in patients after coronary artery bypass grafting (CABG). Methods: A total of 92 patients with post-CABG symptom recurrence from 2010 to 2015 were analyzed by angiography and clinical features for their native coronary vessel and graft vessel. There were 83 male and 9 female patients with the mean age of (62.6±10.8) years. The outcomes of graft vessel were assessed; correlation study was conducted between SVG, LIMAG lesions and traditional atherosclerosis risk factors like age, gender, hypertension, hyperlipidemia, diabetic mellitus, smoking, family history of coronary artery disease (CAD) with other clinical factors such as the time of angina recurrence, thetime from coronary angiography (CAG) to CABG, type of SVG (sequential graft or individual graft), the features of native target vessel lesions prior grafting. Results: The average time from CABG to symptom recurrence was (35.10±24.7) months. There were 146 grafts including 52 LIMAG and 94 SVG (60 individual and 34 sequential grafts), the patency rate of LIMAG was higher than SVG (63.5% vs 44.7%),P=0.030. SVG lesion was positively related to symptom recurrence (OR=1.119, 95% CI 1.002-1.249,P=0.046) and trended to female gender (P=0.065), while not related to other clinical factors; LIMGA lesion was not related to any clinical factors. The patency rate of sequential SVG was higher than individual SVG (58.9% vs. 36.7%,P=0.038). The native target vessel lesion (deifned by pre-operative occlusion/stenosis) was similar between individual SVG group (24/14) and no-lesion SVG group (17/5),P=0.388; while the native target vessel lesion in LIMAG group (7/12) was lower than no-lesion LIMAG group (23/10),P=0.04. Conclusion: Post-CABG lesion was not obviously related to traditional risk factors of CAD, post-SVG lesion was positively related to the time of post-CABG angina recurrence. SVG mid-and long-term patency in sequential graft vessel was higher than that in individual graft vessel. Pre-CABG native coronary blood lfow would affect the outcome of individual LIMAG but not SVG.

Investigation on Intervention of Clinical Pharmacists to Develop Pharmaceutical Care in Intensive Care Unit Based on Medication Characteristics / 医药导报

Objective To investigate the entry points for clinical work of intensive care unit (ICU) pharmacists.Methods Through combination with daily work and referring the domestic and foreign literature,the characteristics of ICU medications were discussed to find out the entry point for clinical work of ICU pharmacists.Results ICU patients particularly need individualized pharmaceutical care because of the special pathophysiological characteristics and medicine use.Conclusion ICU pharmacists should provide pharmaceutical care based on Pharmacokinetics/pharmacodynamics knowledge and focus on the drug dosage adjustment,drug interactions and adverse event prevention.

Analyzing the usage of glucocorticoid in the treatment of occupational medicamentose-like dermatitis due to trichloroethylene / 中国职业医学

OBJECTIVE: To analyze the usage of glucocorticoid in patients who were treated with occupational medicamentose-like dermatitis due to trichloroethylene( OMDT),in order to provide a reference for regulating the glucocorticoid treatment of the disease. METHODS: Using a retrospective survey method,144 OMDT cases of patients who were diagnosed and cured by Guangdong Province Hospital for Occupational Disease Prevention and Treatment from 2001 to2013 were selected. The general information,clinical data and the use of glucocorticoid were collected and analyzed.RESULTS: i) The usage of glucocorticoid. The median and the 0th to 100 th percentile [M( P_0-P_(100)) ] of first dose of methylprednisolone was 100. 00( 40. 00-1 000. 00) mg / d; 58 patients( 40. 3%) using the first dose of treatment were ineffective. The dosage of glucocorticoid was increased one week after admission,the M( P_0-P_(100)) to an initial dose of120. 00( 40. 00-1 000. 00) mg / d; The M( P_0-P_(100)) of maintenance time of initial dose was 5. 5( 1. 0-14. 0) days. After treating effectively,should the decrement to stop using gradually the first glucocorticoid. The dose was gradually cut down to 20-50 mg every 1 to 3 days if the glucocorticoid dose was more than 100 mg / d; it was cut down to 10 mg every 2 to 3days if the glucocorticoid dose was less than 100 mg / d. The M( P_0-P_(100)) of glucocorticoid using time was 66. 0( 22. 0-229. 0) days. The M( P_0-P_(100)) of total amount of glucocorticoid was 3 510. 0( 420. 0 ~ 27 336. 3) mg. ii) The first dose of glucocorticoid in patients of erythema multiforme group were less than those of exfoliative dermatitis group and bullous epidermal necrolysis group( P < 0. 05),the initial dose and total amount of glucocorticoid were less than the other 3 types of rash( P < 0. 05). iii) Compared with the patients with severe impaired liver function,the first dose,the initial dose and the total amount of glucocorticoid were significantly higher than those in mild impaired liver function( P < 0. 05),and the time of using glucocorticoid was longer than that in mild impaired liver function( P < 0. 05). iv) The first dose and the initial dose of glucocorticoid in patients were positively correlated with the total amount of glucocorticoid [Spearmen correlation coefficient( r_S) were 0. 73 and 0. 78 respectively,P < 0. 01). The maintenance time of the initial dose of glucocorticoid was not correlation with the time of patients who were out of contact with trichloroethylene or the urinary level of trichloroacetic acid at admission( r_Swere- 0. 14 and 0. 10 respectively,P > 0. 05). v) Binary Logistic regression analysis showed that,if the patients who had no erythema multiforme,the more severe the degree of liver dysfunction or the white blood cell count higher than 9. 5 × 10~9/ L,the first dose of glucocorticoid used should be more than 120 mg / d( P <0. 05). CONCLUSION: Liver function and type of rash are important factors that affect the usage of glucocorticoid in patients with OMDT. Glucocorticoid therapy should be prescribed in reference to the liver function and skin lesion of patients with OMDT.

Cellular delivery of modified peptide nucleic acids: a review / 生物工程学报

Peptide nucleic acid (PNA) is a DNA surrogate in which the phosphate deoxyribose backbone of DNA is replaced by repeating N-(2-aminoethyl)glycine units. PNA can hybridize to the complementary DNA and RNA with higher affinity than their oligonucleotide counterparts. This character of PNA not only makes it a new tool for the studies of molecular biology but also the potential candidate for gene-targeting drugs. The non-ionic backbone of PNA leads to stable hybrids with the nucleic acids, but at the same time, the neutral backbone results in poor cellular uptake. To address this problem, studies on modified PNA progress rapidly in recent years. We reviewed literature reports combined with our study about the delivery methods, including backbone modified PNA and PNA-ligand conjugates, and the cellular uptake of modified PNA. In addition, we summarized the problems and future prospect of the cellular delivery of modified PNA.

Pharmaceutical Care for One Case of Multi-target Treatment for Refractory ClassⅣ+ⅤLupus Nephritis / 中国药房

OBJECTIVE:To summarize the method and experience of clinical pharmacist participating in pharmaceutical care for a case of refractory class Ⅳ+Ⅴ lupus nephritis (LN). METHODS:Clinical pharmacists and physicians formulated individualized treatment together,i.e. prednisone 30 mg/d+MMF 0.5 g,q12 h+FK506 1 mg,q12 h;on the fifth day of treatment,the patient suf-fered from ardent fever and increase of blood pressure,and clinical pharmacist suggested using linezolid 0.6 g,ivdrip,q12 h+merope-nem1.0 g,ivdrip,q8 h to control pulmonary infection;using Amlodipine besylate tablet 5 mg,po,qd+one Valsartan hydrochlorothia-zide capsule, po,qd+Arotinolol hydrochlorid tablet 10 mg,po,bid to control blood pressure. RESULTS:Multi-target treatment for re-fractory class Ⅳ+Ⅴ lupus nephritis achieved efficacy:the patient got higher plasma albumin and lower 24 h urine protein quantity af-ter 14 days;the patient suffered from secondary pulmonary infection and high blood pressure;physicians adopted the pharmacist’s suggestion so that pulmonary infection and blood pressure had been controlled. CONCLUSIONS:To ensure the effectiveness and safe-ty of the multi-target treatment,clinical pharmacists should formulate individualized treatment,focus on the possible ADR and provide phamaceutical care in the field of blood pressure monitoring,infection control,etc. when participating in multi-target treatment.

Treatment Practice of Clinical Pharmacists in One Case of Postoperative Infection after Brain Surgery / 中国药师

Objective:To evaluate the anti-infective therapy in a patient with multi-site infections after brain surgery and explore the role of clinical pharmacist in the treatment. Methods:With the applications of PK/PD characteristics of drugs and the coping strategies of resistant , vancomycin combined with fosfomycin were used to treat the intracranial infection caused by methicillin-resistant Staphylococcus epidermidis with vancomycin MIC of 2 mg·L-1 , and the dynamic adjustment of antibiotics was applied to treat the pulmonary infection caused by two kinds of pathogens including MDR bacteria. Results:The intracranial infection was successfully controlled, the pulmonary infection was also under control, and the overall condition of the patient was significantly improved. Conclusion: In the medical team, clinical pharmacists should make full use of their advantages in drug characteristics to carry out clinical pharmaceutical care.

Progress of synthesis of modified peptide nucleic acid / 中国药学杂志

Peptide nucleic acid (PNA) is DNA mimic, in which the sugar-phosphate backbone is replaced by polyamide structure. Its basic framework is N-(2-aminoethyl) glycine. PNA has good chemical, physical, and biological properties, such as high stability, strong specificity, not hybridization by nuclease and protease. But it has poor water solubility, low membrane permeability. In this paper, the synthesis of modified peptide nucleic acid is reviewed from the backbone, bases and the linker of backbone and base, which makes PNA have better application prospect.

Comments on "Acupuncture for chronic knee pain: a randomized clinical trial" from Journal of the American Medical Association / 中国针灸

The development of TCM acupuncture represents a internationalized and modern trend. A recent study with the title of "Acupuncture for chronic knee pain: a randomized clinical trial" published in Journal of the American Medical Association on October 1st, 2014, which raised doubts on acupuncture efficacy as well as traditional manipulation and acupoint theory, makes some negative impact and challenges on the development of acupuncture. From the view of future development of acupuncture, the potential influence of this research on acupuncture development is proposed, and by combining acupuncture theory, some discussions and doubts on the research design and outcome explanations are made. Additionally, enlightenments of this research on further clinical research are summarized.