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OBJECTIVE：To explore the role of clinical pharm acists in anti-infective therapy in patients with septic shock in the ICU. METHODS ：A total of 180 patients with septic shock were retrospectively collected from ICU of Chongqing Qianjiang Central Hospital during Jan.-Dec. 2018. According to whether clinical pharmacists participated in anti-infective therapy in the whole process，the patients were divided into intervention group （92 cases）and control group （88 cases）. Both groups were given routine treatment according to clinical diagnosis ；on this basis ，clinical pharmacists participated in the whole anti-infective therapy of the intervention group ，including participating in pharmaceutical rounds ，formulating anti-infective programs ，guiding nurses to implement anti-infective plan ，and providing pharmaceutical care for patients. The effectiveness ，safety and antibiotics clinical use indexes（such as proportion ，treatment course and cost of key monitored drugs ）were evaluated in 2 groups. RESULTS ：The cure rate of intervention group （98.91％）was significantly higher than that of control group （93.18％），while the incidence of ADR in the intervention group （8.70％）was significantly lower than control group （23.86％）. The use of antibiotics types was more rational（the proportion of carbapenems used in intervention group and control group were 20.65％，36.36％；those of quinolones were 15.22％，28.41％，respectively）；the duration of antibiotics use in the intervention group [ （15.18±2.25）d] was significantly shorter than control group [ （19.84±3.81）d]. The cost of antibiotics per capita [ （2 846.99±712.48）yuan] was significantly lower than control group [ （3 991.26±577.82）yuan]，with statistical significance of all above （P＜0.05 or P＜0.01）. CONCLUSIONS ： Clinical pharmacists participating in the anti-infective treatment of ICU patients with septic shock and providing pharmaceutical care，can improve the anti-infective effect ，reduce adverse drug reactions and drug-induced diseases ，optimize the use of antibiotics and reduce medical cost.
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Objective To propose a method of dynamic scatter correction for direct 4-dimensional (4D) PET parametric image reconstruction. Methods Scatter correction for direct 4D PET parametric im-age reconstruction was achieved by extending 3-dimensional (3D) static single scatter simulation (SSS) into 4D dynamic SSS with the help of spatiotemporal cubic polynomial interpolation. The 2 h-serotonin transporter tracer 11 C-2-(2-(dimethylaminomethyl)phenylthio)-5-fluoromethylphenylamine (AFM) brain List mode data of 3 volunteers were obtained from a human brain-dedicated high resolution research tomograph (HRRT) PET scanner. Parametric images (K1 and VT ) were reconstructed by both conventional frame-based method (FM) and direct 4D method. Estimated scatter fractions by both methods were compared. Paired t test was used to analyze the data. Results Scatter fractions derived from FM and direct 4D method were 30.1％(6. 35×107 / (2.11× 108 )), 32.0％ (6.82× 107 / (2.13× 108 )) and 34.4％ (7.22× 107 / (2.10× 108 )), 30. 0％(6.33×107 / (2.11×108 )), 33.3％(7.10×107 / (2.13×108 )) and 34.1％(7.16×107 / (2.10×108 )) for the three subjects, respectively (t = -0.002, P>0.05). Scatter fractions obtained by the two methods were comparable. There was no significant difference between K1(FM: (0.51±0.11) ml·min-1 ·cm-3 , 4D: (0.48±0.09) ml·min-1 ·cm-3) and VT (FM: (24.77±11.80) ml/ cm3, 4D: (27.85±12.65) ml/ cm3) in the two methods (t values: -0.01, -0.97, both P>0.05). Conclusion The proposed dynamic scatter cor-rection method can be used for direct 4D parametric imaging and make it feasible for clinical use.
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Objective To discuss the imaging findings of the sex cord-stromal tumors of ovary.Methods The pathologically confirmed CT and MRI images of 69 patients with sex cord-stromal tumors of ovary were collected retrospectively.Results Among 69 cases of ovarian sex cord-stromal tumors,there were fibrothecoma 3 1 cases,thecal cell tumor 1 9 cases,fibroma 1 2 cases,granulosa cell tumors 5 cases and stromal sarcomas 2 cases.CT and MRI had detected all the 69 tumors.Most of the tumors (52 cases,accounting for 75%)were presented as mainly solid tumors combined with cystic changes,some (13 cases,accounting for 19%)were presented as all solid and a few cases (4 cases,accounting for 6%)were presented as cystic tumors.The tumors were round or oval,with clear boundary,which showed low density,and either no obvious enhancement or mild delayed enhancement on CT scan.The solid part of tumors showed low signal on T2WI and slightly higher signal on diffusion weighted imaging(DWI).Conclusion The sex cord-stromal tumors of ovary are mainly solid tumors combined with cystic changes,with clear boundary,either with no obvious enhancement or mild delayed enhancement and low signal on T2WI and slightly higher signal on DWI.The study shows that the above imaging features are helpful to improve the diagnostic accuracy of sex cord-stromal tumors of ovary.
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Objective To investigate the prognostic value of metabolic parameters of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(FDG PET-CT)before radiotherapy in patients with esophageal cancer receiving radiotherapy. Methods We retrospectively analyzed the clinical data of 37 patients with stage Ⅱ-Ⅲ esophageal squamous cell carcinoma admitted to Anhui Provincial Hospital from 2010 to 2015,who underwent PET-CT scans within 4 weeks before radiotherapy. The following information was collected:age,sex,the location of primary lesion,clinical stage,and treatment regimen.The maximum standard uptake value(SUVmax), mean standard uptake value(SUVmean), metabolic tumor volume(MTV), PET tumor length(PTL),and total lesion glycolysis(TLG)were calculated. The optimal cut-off values of SUVmax, SUVmean,MTV,PTL,and TLG were determined by the receiver operating characteristic(ROC)curve. The Kaplan-Meier method was used to calculate survival rates,and the log-rank test was used for survival comparison and univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis of significant variables. Results The area under the ROC curve suggested that MTV>TLG>PTL=0.713>0.679>0.670. The Kaplan-Meier survival analysis showed that patients had better survival time when MTV was less than 27.44 cm3,TLG was less than 166.2 g,and PTL was less than 36.74 mm(P<0.05).The Cox multivariate regression analysis showed that only MTV was an independent prognostic factor for radiotherapy in patients with esophageal cancer(P=0.000). Conclusions MTV, TLG and PTL have certain values in predicting the prognosis of patients with esophageal cancer before radiotherapy, and are helpful for selecting and adjust the clinical treatment regimen and improving the survival rate and prognosis.
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Objective To determine key medical disciplines construction elements and specific contents.Methods The information of national and provincial level construction standards in medical key discipline was collected,and the key indexes and specific requirements in the standards were analyzed.Results There were 10 one-class indexes with a frequency of five and plus,including the overall situation,academic leaders,scientific research performance and support conditions which have emerged to 10 times.There are 4 first-class indexes set,4～14 second-class indexes respectively,and the frequencies of the second-class indexes were from 1 ～ 10.Conclusions Research on a number of the construction and evaluation criteria from different levels and regions was the best way to discover and identify priority disciplines and the best way to assess the contents.It is an important guidance for build a scientific,sustainable development key medical disciplines.It had important guiding significance to how to construct and develop the medical key disciplines.
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Objective To analyze the current situation and existing problems in the construction of key disciplines of medicine and health in 20 years in Shandong province and to explore the development countermeasures.Methods The data of all key disciplines of medicine and health certified by former Shandong Provincial Health Department from 1993 to 2013 were collected and analyzed.Results A total of 99 key professionals,71 key disciplines and 115 key laboratories were constructed in 20 years in the provincial medical and health institutions.The key projects in general hospitals had accounted for 74.38％.The numbers of key projects in Jinan,Qingdao,Weifang City were over the provincial average.Provincial Hospital and Qilu Hospital stayed top with 25 key projects among medical and health institutions.63.16％ of the key projects take the three grade discipline name as the standard name.There were ten discipline names emerged in the three key projects conjointly,including the names of 71 items.Conclusions The construction of three key projects of medicine and health in 20 years in Shandong province had gain the marked achievement.However,the problems of regional inequality,the lack of public health discipline,discipline name confusion and other issues still existed.To amendthe management approach,unified specification,strengthening process supervision,balanced development are the countermeasures for the constructions of key projects in Shandong Province.
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Objective To observe the clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma.Methods Thirty-six uveal metastatic carcinoma patients (43 eyes) were enrolled in this study.The patients included 21 males and 15 females.The patients' ages ranged from 28 to 71 years,with a mean age of (47.3 ±10.2) years.Seven patients had bilateral carcinoma and 29 patients had unilateral carcinoma.There were 30 patients with lung cancer,three patients with breast cancer,one patient with gastric cancer and two patients without primary tumors.There were 20 patients with known primary cancer,16 patients visited the Department of Ophthalmology first.All the patients were examined documenting visual acuity,intraocular pressure,slit-lamp microscopy and mydriatic fundus examination.Meanwhile,22 patients (26 eyes) were examined using B-type ultrasound and/or color Doppler flow imaging(CDFI).Twelve patients (12 eyes) were examined using fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA).Seventeen patients (22 eyes) were examined using MRI and/or CT.The clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma patients were observed.Results Among 43 eyes,four lesions were in the iris,three lesions in the ciliary body and 32 lesions were in the choroid.Fundus examination showed an isolated mass in 26 eyes and more than two masses in nine eyes.Metastatic tumors of the iris and ciliary body often showed irregular cauliflower-like mass with gray-white or meat-red color and abundant vessels.The choroidal metastasis usually demonstrated flat rounded or irregular intraocular masses with gray-yellow or gray-white color in the posterior pole.B-type ultrasound showed ill-defined,flat,and irregular-shaped masses with uneven internal reflectivity.CDFI showed rich blood flow within the tumor.FFA and (or)ICGA showed pinpoint and mottled leaks against hyperfluorescence background.MRI revealed low or middle signal using T1 WI and low signal intensity using T2WI.Conclusions The uveal metastatic carcinoma usually occurs in one eye with an isolated mass.Most of them show a flat gray-yellow mass in posterior choroids and have the primary cancer sites of the lung.FFA and/or ICGA show pinpoint and mottled leaks against hyperfluorescence background.B-type ultrasound and (or) CDFI show ill-defined,flat,and irregular-shaped mass with rich blood flow within the tumor.MRI reveals low signal intensity on T2 WI.
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Anxiety and depression has become the most popular state of mind and body in people in transition.Chinese in Heaven,body and apirit unified,coordinated organs,under the guidance of the theory of yin and yang balance,through diagnosis and treatment,the diseases have psychosomatic coherent advantage.This article discussed the TCM mechanism of anxiety and depression disorders from the aspects of Chinese five internal organs and emotions,the five organs system function and emotion caused disease,and finally proposed the treatment principle of reconciliation with cardinal Yin and Yang which may offer clinical references to anxiety and depression.
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With the method of bibliometric analysis, we analyzed the scientific papers on health pol-icy research embodied by CBMdisc from 1978 to 2007. It was found that the status quo of studies on health policy research in China developed rapidly. And the core journals has preliminarily formed , there were a number of highly productivity authors, besides the Ministry of Health and universities were the main units of output of health policy research papers although core authors not yet appeared.
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<p><b>OBJECTIVE</b>To investigate the effects of ambient conditions on the antibacterial activity of inorganic antibacterial agent based on sodium titanium phosphate.</p><p><b>METHODS</b>The number of live E. Coli ATCC 44113 was counted after the suspension was shaken and incubated in flask with antibacterial agent under ambient conditions.</p><p><b>RESULT</b>The number of live bacteria increased when the concentration of bacteria increased in the range of 1.2 x 10(2) to 1.2 x 10(8) cfu/ml. The antibacterial activity increased with the increase of ambient temperature in the range of 16 approximately 46 degrees C, showing good antibacterial activity at human body temperature. With the increase of the concentrations of co-existing NaCl and protein, the antibacterial activity was found to decrease at first and level off at 0.01 g/ml and 0.0005 g/ml respectively.</p><p><b>CONCLUSION</b>The antibacterial agent has to be used together with organic antibacterial agent in order to achieve good antibacterial effect when the ambient bacterial concentration is high. The antibacterial agent is promising to be used in the preparation of antibacterial cloth because it is highly effective at body temperature and expected to remain antibacterial in perspiration.</p>
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Anti-Bacterial Agents , Pharmacology , Bacteria , Body Temperature , Environment , Microbial Sensitivity Tests , Sodium , Chemistry , Titanium , PharmacologyABSTRACT
Objective To evaluate spiral CT features and differential diagnosis of cystadenocarcinoma in the hepatic biliary duct.Methods CT findings of cystadenocarcinoma in the hepatic biliary duct proved by pathology in 4 cases were retrospectively analysed with review literatures.Results Biliary cystadenocarcinoma appeared as unilocular or multilocular cystic tumor,the cystic wall was irregular with mural nodules and satellite leisons,and the distal biliary duct was dilated.Conclusion Spiral CT is efficient method in diagnosis of cystadenocarcinoma in the hepatic biliary duct.
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AIM: To investigate the intraocular growth characteristics of mice embryonic stem (ES) cells in nude mice.METHODS: Murine embryonic stem cells (D3 cell lines) were cultured and maintained in an undifferentiated state in vitro, then transplanted into the eyes of nude mice. In 6-45 d, the nude mice were executed for Morphological and immunohistochemical examinations.RESULTS: ES cells were developed into masses which enlarged gradually in the anterior chamber and vitreous cavity. Morphological examination showed different component: cysts, sheets and cords of medullary epithelium and rosettes in the eyes of the nude mice. Most of cells were highly stained by NSE, and some cells were moderately stained by GFAP.CONCLUSION: The embryonic stem cells(D3 cell lines) could differentiated into medulloepithelioma-like tissue in the anterior chamber and vitreous cavity of the Balb/c nude mice.
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[Objective] To observe the effect of Shuhou Kangyan Decoction (SKD), a liver-kidney nourishing, Qi-strengthening and blood-activating, wind-dispelling and heat-clearing prescription mainly composed of Radix Astragali, Radix Angelicae Sinensis, Fructus Lycii, Radix Rehmanniae, Radix Saposhnikoviae, Rhizoma Atractylodis Macrocephalae, etc. , on interleukin-2 (IL-2) and soluble IL-2 receptor (SIL-2R) in serum and tears of patients with cataract after operation. [Methods] Forty-seven cases of cataract after ultrasonic emulsification plus artificial lens implantation were randomized into two groups. Group A (n = 26) was treated with routine operation and eye drops and group B ( n = 21) with SKD additionally and other 15 healthy aged people ( n = 15) receiving physical examination in the out-patient department served as normal controls. [Results] Post-operative serum SIL-2R level was higher in groups A and B than that before operation ( P 0.05). Post-operative IL-2 and SIL-2R levels in the serum and tears were higher in group A than that in groups B and C (P
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Objective To probe the significance of application of ultrasound biomicroscopy (UBM) in the diagnosis and management of the iris and ciliary tumors. Methods UBM (Mode 840, Humphrey, 50 MHz 5 mm?5 mm) was done in 34 cases (35 eyes) of iris and ciliary body tumors, and some of the affected eyes underwent B scan or Doppler ultrasound and CT scan. Histopathological examination of the resected tumor tissues was performed in 21 eyes of the operation. Results Among this series of 35 eyes with iris and ciliary body tumors detected by UBM, the characteristics of locality and solidity of the tumors, i,e., anterior chamber in plantation cyst, cyst behind the iris, and solid tumors of iris and ciliary body, of 21 eyes undergone surgical treatment revealed the same results both in UBM and histopathological examinations. Conclusion UBM can supply precise informations in diagnosis and treatment of tumors of iris and ciliary body.
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Giving up treatment in ophthalmology is common in our country. Financial difficulty is the main reason of abandoning treatment in ophthalmology. We should make every effort to deal with some patients with ocular diseases who had no light perception at all. Misdiagnosis and wrong therapy ought to be avoided as much as possible in our clinical practice. The giving up treatment of retinoblastoma is relatively common in our country at present time and its early diagnosis and early treatment is very important. Therapeutic giving up treatment is a new concept and eye doctors can make use of it in some special situations in that the disease can be treated effectively.
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Objective To assess the value of spiral CT in the diagnosis of hilar cholangiocarcinoma.Methods 13 patients of hilar cholangiocarcinoma underwent CT plain and dynamic enhanced scan.CT findings were analysed in comparison with that of surgery and pathology.Results On plain scan,the lesions appeared as soft tissue mass with low density in hepatic hilar(n=11),bile duct wall irregularly thickened and bile duct narrowed(n=2).On dynamic enhanced scan,delayed enhancement was seen in 13 cases.Conclusion Plain spiral CT and dynamic enhanced scan have great value in showing the morphological features and improving the diagnosis of hilar cholangiocarcinoma.