Establishment of whole-process intelligent pharmaceutical care model for peritoneal dialysis patients / 中国药房

OBJECTIVE To develop a whole-process intelligent model of pharmaceutical care for peritoneal dialysis （PD） patients， and to provide a reference for clinical pharmacists to provide standardized PD pharmaceutical care. METHODS The pharmaceutical care mode of PD patients at home and abroad was investigated and analyzed. Based on the actual situation of the First Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”）， with “home→PD center outpatient→ inpatient department” as the main node， the recycling process of medication reconciliation was optimized. The whole-process intelligent pharmaceutical care model of PD was illustrated by improving the Chinese version of the drug-related problems （DRPs） classification tool， developing the corresponding pharmaceutical care process， and presenting specific cases. RESULTS Based on the medication therapy management （MTM） platform， our hospital had built a closed-loop PD whole-process intelligent pharmaceutical care model of “in-hospital pharmaceutical care （building document）-PD outpatient MTM-home pharmaceutical care （online App management）”. A “double cycle” workflow of “admission→discharge→outpatient” medication reconciliation cycle and “discovery-analysis-intervention-follow-up-record-evaluation” DRPs cycle was formed. CONCLUSIONS The establishment of the whole-process intelligent pharmaceutical care model for PD in our hospital provides experience for standardizing pharmaceutical care for PD patients， and can reduce DRPs.

Expression of miR-140-3p in children with autism spectrum disorders and its correlation with cyto-kines / 中华行为医学与脑科学杂志

Objective To investigate the expression of serum miR-140-3p in children with autism spectrum disorder (ASD) and its correlation with interleukin-4 ( IL-4),interleukin-8 (IL-8) and interleu-kin-17A (IL-17A),and provide evidence for the diagnosis and treatment of ASD. Methods Totally 172 ca-ses of ASD children admitted to Anning Hospital of Hainan Province from January 2015 to June 2018 were selected as case group,80 cases of healthy subjects as control group. ASD children were divided into mild-moderate group (n=116) and severe group (n=56) by ASD Behavior Rating Scale and Child Autism Rating Scale. Real-time fluorescence quantitative polymerase chain reaction ( RT-PCR) and enzyme-linked immu-nosorbent assay ( ELISA) were used to detect the changes of serum levels of miR-140-3p,IL-4,IL-8 and IL-17A in each group. ROC curve was used to analyze the diagnostic value of miR-140-3p,IL-4,IL-8 and IL-17A for ASD. Pearson correlation was used to analyze the correlation between serum miR-140-3p and IL-4,IL-8 and IL-17A in children with ASD. Results The serum levels of miR-140-3p ( 0. 86 ± 0. 17 vs 0. 15±0. 03),IL-4(48. 65±13. 82)pg/ml vs (31. 42±7. 50)pg/ml),IL-8((7. 14±2. 05) pg/ml vs (2. 30± 0. 74)pg/ml) and IL-17A((112. 35±51. 64)pg/ml vs (58. 20±26. 40)pg/ml) in the case group were sig-nificantly higher than those in the control group ( P<0. 05). Serum levels of miR-140-3p( 1. 08 ± 0. 24 vs 0. 71±0. 12),IL-4((53. 28±16. 30)pg/ml vs (43. 70±13. 52)pg/ml),IL-8((9. 42±2. 85)pg/ml vs (5. 63 ±1. 48)pg/ml) and IL-17A((138. 40±65. 72)pg/ml vs (96. 74±40. 83) pg/ml) in severe group were sig-nificantly higher than those in mild-moderate group(P<0. 05). The AUC (95%CI) of serum miR-140-3p for ASD diagnosis was 0. 827 (0. 773-0. 886),which were significantly higher than that of IL-4 (0. 719 (0. 651-0. 764)pg/ml),IL-8 (0. 683 (0. 625-0. 743)pg/ml) and IL-17A(0. 745 (0. 683-0. 817)pg/ml). The best cut-off value was 0. 75,and the sensitivity and specificity were 84. 8% and 78. 2%,respectively. The best cut-off value of serum miR-140-3p for diagnosing ASD was 0. 75, and its sensitivity and specificity were 84. 8% and 78. 2%,respectively. The correlation analysis showed that serum miR-140-3p was positively cor-related with IL-4,IL-8 and IL-17A in children with ASD (r=0. 681,r=0. 624,r=0. 775,all P<0. 01). Con-clusion Serum levels of miR-140-3p was significantly higher in ASD children, correlated with levels of IL-4,IL-8 and IL-17A,and miR-140-3p was a potential biomarkers for ASD diagnosis.

Use of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis / 实用医学杂志

Objective To explore the clinical value of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis. Methods The clinical data on 86 patients who had undergone repeat surgery for hepatolithiasis during January 2010 to December 2015 were retrospectively analyzed. 36 patients received laparoscopy combined with choledochoscopy(laparoscopy group),while 50 patients received laparotomy(laparotomy group). Surgical duration,intraoperative blood loss,intraoperative transfusion,stone clearance rates,length of postopera-tive hospital stay,and rate of complications were observed and analyzed. Results There were no significant differ-ences in surgical duration,intraoperative blood loss,intraoperative transfusion,stone clearance rates,and rate of complications between the two groups(P>0.05). Length of postoperative hospital stay was significantly shorter in the laparoscopy group than in the laparotomy group(P 0.05). Conclusions Use of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis is safe and feasible and has a satisfactory efficacy.

Direct Detection of Dichlorvos in Honey by Neutral Desorption-Extractive Electrospray Ionization Mass Spectrometry / 分析化学

In this study, a neutral desorption-extractive electrospray ionization mass spectrometry ( ND-EESI-MS) method was developed for the direct and rapid detection of dichlorvos ( DDVP) in honey samples without any sample pretreatment procedure. Under the positive ionization mode, the main characteristic parent ion of DDVP was m/z 223 (MW:222) and daughter ions were m/z 109 and m/z127. Under the optimized working conditions, with the signal intensity of m/z 127 as quantitative index, the quantitative information of DDVP residues in honey was acquired effectively. The results showed that the linear range of DDVP for spiked honey was 5-1000 ng/mL (R2=0. 998) with the limit of detection (LOD) of 1. 0 ng/mL (n=3) and the recoveries for the DDVP spiked honey samples at the concentration levels of 10 , 30 and 400 ng/mL were 93 . 0%-103. 0%, with the relative standard deviations (RSDs, n=6) of less than 4. 4%. Meanwhile, for detection of spiked honey with gas chromatography-flame photometric detector ( GC-FPD ) , the linear range was 5-1000 ng/mL (R2=0. 999) with the LOD of 1. 6 ng/mL(n=3), and the recoveries of DDVP at the spiked honey concentration levels of 10 , 30 and 400 ng/mL were 94 . 9%-110 . 3%, with the RSDs of less than 7. 6%.

Clinical effect of percutaneous transhepaticcholangioscopic lithotomy combined with rigid choledochoscopyin treatment of postoperative recurrent hepatolithiasis / 实用医学杂志

Objective To evaluate the clinical value of percutaneous transhepaticcholangioscopic lithotomy (PTCSL)combined with rigid cholangioscopy in treatment of recurrent hepatolithiasis. Methods Retrospective analysisof therapeutic result of 54 patientswith postoperative recurrent hepatolithiasisduring January 2012 to January 2015. Twenty eight cases were recruited as the observation group (PTCSL group). Twenty six cases were recruited as the control group (Laparotomy group). Following parameters were observed, operation time, intraoperative blood loss, clearance of stones and postoperative hospital stay. Results The operation time, intraoperative blood loss , clearanceof stones , and the postoperative hospital stay of the PTCSL group werebetter than that of the laparotomy group (P<0.05). The number of patients with postoperative pain of the PTCSL group was significantly lower than in the laparotomygroup (P<0.05). There were no significant differences in other complication rates. There was no difference in terms of stone recurrence , incidence of cholangitis and intrahepatic biliary strictures recurrence ratebetween two groups in follow-up period. Conclusions PTCSL combined with rigid choledochoscopywas a safe and effectivemethod with minimal invasion formanagement of the postoperative recurrent hepatolithiasis. It could got a better resultsin the short-term outcomes.

Application of laparoscopic peritoneal lavage and drainage for severe acute pancreatitis:a report of 87 cases / 实用医学杂志

Objective To explore the effect of LPLD (laparoscopic peritoneal lavage and drainage ) on SAP (severe acute pancreatitis), and to compare its effect with that of non- LPLD (conservative medical management). Methods We collected data from 87 consecutive patients with SAP, from January 2009 to May 2014, including LPLD group (n = 46) and non-LPLD group (n = 41). LPLD was performed in the 1st and 2nd week after the disease onset in LPDP group and other treatment in LPDP group was the same as that in non-LPLD group. Data were comparatively analyzed in two groups about the length of hospital stay, ICU stay, cure rate, incidence of complications and in-hospital mortality. Results In LPLD group, hospital stay, and ICU stay were shorter while cure rate was higher than those in non-LPLD group , and the difference was statistically significant (P 0.05). Conclusion Compared with non-LPLD, LPLD is effective in short outcome, which is a promising treatment for SAP.

Evaluation of gastroesophageal varices with three-dimensional visualization technology / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the prognostic value of Medical Image Three-dimensional (3D) Visualization System (MI-3DVS) in evaluation of the distribution and blood supply of gastroesophageal varices (EGV).</p><p><b>METHODS</b>3D reconstruction was played by MI-3DVS and CT-maximum intensity projection (CT-MIP) respectively on multi slice computed tomography (MSCT) date of 51 patients with EGV from February 2010 to October 2012. The demonstration rate of collateral vessels in spleen and stomach area, EGV typing and the blood supply between the two methods were observed and compared.</p><p><b>RESULTS</b>The demonstration rates of LGV, gastro-renal shunt, splenorenal shunt and PGV showed a high coincidence between the MI-3DVS and CT-MIP (κ = 0.882-1.000), and moderate agreements in SGV and paraesophageal varices (κ = 0.646 and 0.757). The outcome of EGV classification (MI-3DVS vs. CT-MIP) were typeIfor 31 vs. 28 cases, type II for 6 vs. 4 cases, type III for 4 vs. 4 cases and type IV for 6 vs.10 cases, the 2 methods show high agreements (weighted Kappa value of 0.848 and P < 0.01).Significant differences were found in the blood supply distribution among the four types of EGV (χ(2) = 36.647, P < 0.01); and the blood supply of the EGV tended to be a strong correlation with EGV classification (C = 0.769 and 0.744, P = 0.000). There were 12 patients with gastro-renal shunt and 5 patients with Spleno-renal shunt.</p><p><b>CONCLUSIONS</b>MI-3DVS can explicitly determine the location, blood vessel diameter and blood supply of the EGV, which is helpful for us to grab the formation of collateral circulation completely. The 3D reconstruction of MI-3DVS has guidance and current significance in optimizing therapeutic schedule or preoperative planning.</p>

Study on protective mechanism of kushenin injection on colonic mucosa of experimental colitis rats / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of NOD2 on colitis pathogenesis in experimental rats, and discuss therapeutical effect and mechanism of kushenin injection (OMT) on colitis in experimental rats.</p><p><b>METHOD</b>Fourty Sprague-Dawley (SD) rats were randomly divided into four groups: the normal control group, the model group, the SASP group, and the OMT group, with 10 rats in each group. Except the normal control group, models were established in the remaining three groups with TNBS. The OMT group was injected with kushenin injection, the SASP group was orally administered with mesalazine suspension, the model group and the normal group were orally administered with distilled water for 15 days. Colon lesion score and histological score of experimental rats were observed. Expression of NOD2, NF-kappaB p65 protein in rats colonic mucous was detected by immunohistochemistry. Expression of IL-6 in rat colon mucous was detected by ELISA.</p><p><b>RESULT</b>Compared with normal control group, the expression of NOD2, NF-kappaB p65 and IL-6 in colonic mucosa of the model group were significantly increased (P < 0.01). The SASP group and the OMT group showed lower expressions of NOD2, NF-kappaB p65 and IL-6 in colonic mucosa than the model group (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>The over expression of colonic mucosa proteins NOD2 and NF-kappaB p65 and increasing secretion of IL-6 take part in the appearance and development of ulcerative colitis. OMT can attenuate ulcerative colitis and protect colonic mucosa by inhibiting expression of NOD2, NF-kappaB p65 and decreasing IL-6.</p>

Safety of three-dimensional technique in patients undergoing complicated hepatectomy / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of abdominal three-dimensional medical image visualization system (MI-3DVS) in assisting complicated hepatectomy.</p><p><b>METHODS</b>Twenty-four patients undergoing complicated hepatectomy for hepatic carcinoma or hepatic focal nodular hyperplasia were enrolled in this study. Three-dimensional models of the organs, vessels and tumors were reconstructed with MI-3DVS, and virtual operations were carried out to assess the feasibility of hepatectomy. The diameter of the liver tumors, intraoperative blood loss and transfusion, complications, in-hospital mortality rate, and one-year survival rate were analyzed in these cases.</p><p><b>RESULTS</b>The operations were safely completed in all the cases without perioperative deaths. The mean diameter of liver tumor was 9.8∓4.3 cm, and the median volumes of intraoperative blood loss and transfusion were 800 ml and 600 ml, respectively, with a blood transfusion rate of 91.7% (22/24). The incidence of complications was 29.2% (7/24), and the one-year survival rate was 37.5%.</p><p><b>CONCLUSION</b>Three-dimensional techniques such as volumetric analysis and risk evaluation of residual liver blood supply and drainage can increase the accuracy of surgical planning and improve the safety of complicated hepatectomy.</p>

Characteristics of three dimensional reconstruction of the portal vein systems of patients with portal hypertension / 中华消化外科杂志

With the development of modern imaging technologies,three-dimensional (3D) reconstruction techniques based on the computed tomography (CT) or magnetic resonance imaging (MRI) data has been gradually applied in clinical diagnosis and treatment of hepatobiliary diseases.In order to study the characteristics of the 3 D model of portal branches and collateral circulation in various types of portal hypertension,the data of 64-slice spiral CT scan of5 patients with portal hypertension were collected and imported to the abdominal medical image three-dimensional visualization system (MI-3DVS) for sequence segmenting and 3D reconstruction,and then the results of 3D models were compared with operation findings.The 3D models were vividly,visually and clearly displayed the portal system and the collateral circulation,which is helpful in the diagnosis and treatment of the portal hypertension.

The impact of fast track surgery on host cell-mediated immunity and inflammatory responses for colorectal cancer patients / 肠外与肠内营养

Objective: The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in colorectal cancer patients.Methods: Sixty colorectal cancer patients were prospectively divided into fast track surgery(FTS)group(n=30)and conventional perioperative care group(n=30).In addition to clinical parameters(recovery of gastrointestinal function,complication rates and postoperative length of stay), the parameters of perioperative cell-mediated immunology function,and the serum level changes of CRP and IL-6 were determined.Results: FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group(P<0.05).Serum concentration of CRP and IL-6 in FTS group were lower(P<0.05) than in the conventional care group on postoperative day(POD) 1 and POD 3(P<0.05).CD4/CD8 ratio in FTS group were higher(P<0.05) than in the conventional care group on postoperative day(POD)1 and POD 3(P<0.05).Conclusion: Fast track surgery for colorectal cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care.