Pharmaceutical practice of clinical pharmacist participation in a patient with Epstein-Barr virus encephalitis / 中国药房

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.

Efficacy and safety of total aortic arch replacement in elderly patients with Stanford type A aortic dissection / 中华老年医学杂志

Objective:To evaluate the efficacy and safety of total aortic arch replacement in elderly patients with Stanford type A aortic dissection(TAAD).Methods:In this retrospective study, a total of 481 TAAD patients treated with total arch replacement in our hospital from January 2016 to January 2020 were divided into three groups: aged≤59 years, 60-69 years and ≥70 years.The differences between three groups in surgical method, extracorporeal circulation time, blocking time, circulatory time, stopping time, surgical time, ventilator use time, ICU time, hospitalization time, treatment rate of continued renal replacement, fatality rate, and cause of death were statistically analyzed and compared.Results:There were statistically significant differences in the stopping time between any two groups of the three groups(all P<0.05). The older the age, the shorter the circulatory arrest time.The difference of ventilator time and ICU time between ≤59 and 60-69 years was statistically significant( P<0.01). Patients with continuous renal replacement(CRRT)were 19.0%(71/373)in ≤59 years, 23.1%(18/78)in 60~69 years, and 26.7%(8/30)over 70 years.In-hospital mortality was 35/373(9.4%)in the group of ≤59 years old, 11/78(14.1%)in the group of 60~69 years old, and 5/30(16.7%)in the group of ≥70 years old.There was no death in patients undergoing type Ⅱ hybrid surgery. Conclusions:Age is one of the important death factors after total aortic arch replacement in TAAD patients.Total aortic arch replacement is an acceptable surgical method for elderly patients with TAAD.Hybridization may reduce hospitalization death in elderly patients.

Predictive modeling of morbidity and mortality in COVID-19 hospitalized patients and its clinical implications.

Clinical activity of 3740 de-identified COVID-19 positive patients treated at NYU Langone Health (NYULH) were collected between January and August 2020. XGBoost model trained on clinical data from the final 24 hours excelled at predicting mortality (AUC=0.92, specificity=86% and sensitivity=85%). Respiration rate was the most important feature, followed by SpO2 and age 75+. Performance of this model to predict the deceased outcome extended 5 days prior with AUC=0.81, specificity=70%, sensitivity=75%. When only using clinical data from the first 24 hours, AUCs of 0.79, 0.80, and 0.77 were obtained for deceased, ventilated, or ICU admitted, respectively. Although respiration rate and SpO2 levels offered the highest feature importance, other canonical markers including diabetic history, age and temperature offered minimal gain. When lab values were incorporated, prediction of mortality benefited the most from blood urea nitrogen (BUN) and lactate dehydrogenase (LDH). Features predictive of morbidity included LDH, calcium, glucose, and C-reactive protein (CRP). Together this work summarizes efforts to systematically examine the importance of a wide range of features across different endpoint outcomes and at different hospitalization time points.

The Influence of Naikan Therapy on the Family Function in Patients with Anxiety Disorder of Cerebral Infarction / 昆明医科大学学报

Objective To study the influence of Naikan therapy on the family function in patients with anxiety disorder of cerebral infarction.Methods A total of 192 patients with anxiety disorder of cerebral infarction were divided into control group and study group according to the set sequence.The study group was treated with Naikan therapy and the control group received routine therapy.All patients were assessed by family assessment device (FAD),Hamilton depression scale (HAMD),and Hamilton anxiety scale (HAMA).Results After 6-week treatment,the HAMD,HAMA,the affective reaction and behavior control scores in the study group were significantly lower than those before the treatment (t =2.24,2.43,2.37,2.35,P ＜ 0.05).The affective reaction and behavior control in the study group were obviously lower than that of the control group (t =2.51,2.41,P ＜ 0.05).Conclusion Naikan therapy can improve family function in patients with anxiety disorder of cerebral infarction.

The Influence of Naikan Therapyon on Depression in Patients with Schizophrenia / 昆明医科大学学报

Objective To study the influence of Naikan therapy on depression in patients with Schizophrenia.Methods 256 patients with Schizophrenia were divided into study group and control group according to the set sequence.The study group was simulated by Naikan therapy and the control group was given routine cure.All patients were assessed by Positive and negative symptom scale (PANSS),Simple coping style questionnaire (SCSQ),Defense way questionnaire (DSQ),Hamilton depression scale (HAMD),and Hamilton anxiety scale (HAMA).Restlts In the 6th week,the differences in HAMD score,Cover factor,negative coping were statistically significant between the two groups (t=2.37,2.33,2.36,P＜0.05).The differencs in HAMA score,Cover factor,negative coping were statistically significant between the 0th and the 6 th week in the study groups (t =2.31,2.42,2.47,P＜ 0.05).The difference of PANSS score were statistically significant between the 0th and 6th week of the two groups.Concltsion The Naikan therapy can improve the mental symptoms and depressive symptoms in patients with Schizophrenia.

Effect of exogenous hydrogen sulfide on BACE-1 enzyme expression and β-amyloid peptide metabolism in high-glucose primary neuronal culture / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of exogenous hydrogen sulfide (H2S) on β-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition.</p><p><b>METHODS</b>The cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100 µmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detected by fluorescent quantitative real-time PCR and Western blotting, respectively.</p><p><b>RESULTS</b>Compared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 µmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05).</p><p><b>CONCLUSION</b>Neurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.</p>

Montelukast,ketotifen combined with BCG-PSN decreased the incidence of asthma followig bronchiolitis / 中国基层医药

Objective To evaluate the efficiency of montelukast and ketotifen combind with BCG-PSN(polysaccharide nucleic acid fraction of bacillus calmette guerin for injection) in decreasing the incidence of asthma following brochiolitis.Methods 30 patients with brochiolitis were given montelukast,ketotifen and BCG-PSN,compared with 31 patients with brochiolitis without the treatment.The total course were two months for oral montelukast,three months for oral ketotifen,and six months for injecting BCG-PSN.The time of follow up was over 1 year and the cases of patients developed asthma were investigated,serum level of IgE,IgA,IgG,IgM were tested before and after the treatment.Results After follow up 1 year,1/30(3%) of patents with brochiolitis receiving treatment developed asthma compared with 9/31(29%) of the controls with brochiolitis(P