Intratumoral and peritumoral radiomics features of apparent diffusion coefficient for predicting prognosis of children with medulloblastoma / 中国医学影像技术

Objective To observe the value of intratumoral and peritumoral radiomics features of apparent diffusion coefficient(ADC)for predicting prognosis of children with medulloblastoma(MB).Methods Data of 74 children with MB were retrospectively analyzed.The children were divided into progression group(n=29)or non-progression group(n=45)according to results of 2-year follow-up,also into training set(n=44)or validation set(n=30)at the ratio of 6∶4.The intratumoral and peritumoral radiomics features were extracted and screened based on ADC images.The intratumoral,peritumoralas well as intratumoral+peritumoral radiomics models were established,and 3 combination models were constructed combining with clinical and conventional imaging features.The predictive efficiency were compared between each 2 combination models.Results In training set,the area under the curve(AUC)of clinical-conventional imaging-peritumoral radiomics model and clinical-conventional imaging-intratumoral+peritumoral radiomics model were both larger than that of peritumoral radiomics models(both P＜0.05).In validation set,AUC of clinical-conventional imaging-intratumoral+peritumoral radiomics model was the largest,but no significant difference of AUC was found among 3 combination models(all P＞0.05).Conclusion The intratumoral and peritumoral ADC radiomics features could be used to predict prognosis of MB children.Combining with clinical and conventional imaging features might improve the efficiency of prediction.

Efficacy of different regimens and prognostic factors in patients with first relapsed multiple myeloma treated after front-line bortezomib, cyclophosphamide, and dexamethasone / 中华内科杂志

Objective:To analyze the efficacy of second-line regimens and prognostic factors in patients with first-relapsed multiple myeloma (MM) treated with bortezomib, cyclophosphamide, and dexamethasone (BCD).Methods:A retrospective cohort study. Clinical data were collected in first-relapsed MM patients after BCD treatment from three tertiary hospitals in north China from July 2009 to October 2022. Patients were classified according to the second-line regimen into the immunotherapy group, single novel agent group [either proteasome inhibitor (PI) or immunomodulatory drug (IMiD)], combination treatment group (both PI+IMiD), and traditional treatment group. Responses to second-line regimens and survival data were analyzed. The Kaplan-Meier method was used for survival analysis and the Cox proportional risk model was used for univariate and multivariate analyses.Results:A total of 217 patients were enrolled including 8.8% (19/217) in the immunotherapy group, 48.4% (105/217) in the PI/IMiD group, 29.9% (65/217) in the PI+IMiD group, and 12.9% (28/217) in the traditional treatment group. The median age was 62 years (range 31-83 years) and 56.2% (122/217) were males. The overall response rates (ORRs) in the four groups were 94.7% (18/19) vs. 56.2% (59/105) vs. 73.8% (48/65) vs. 32.1% (9/28) ( χ2=24.55; P<0.001), respectively. The progression-free survival (PFS) of the second-line regimens (2ndPFS) was 17.7 vs. 9.0 vs. 9.2 vs. 4.6 months ( χ2=22.74; P<0.001), respectively, among which patients in the PI/IMiD and PI+IMiD groups had comparable 2ndPFS ( χ2=1.76; P=0.923). Patients with high-risk cytogenetic abnormalities (HRCAs) achieved the longest 2ndPFS of 22.0 months in the immunotherapy group ( χ2=15.03; P=0.002). Multivariate analysis suggested that immunotherapy ( HR=0.11, 95% CI 0.05-0.27), achievement of efficacy of partial response or better ( HR=0.47, 95% CI 0.34-0.66), and non-aggressive relapse ( HR=0.25, 95% CI 0.17-0.37) were independent prognostic factors of 2ndPFS. Conclusion:In this real-world study, immunotherapy was associated with a more favorable efficacy and PFS for first-relapsed MM patients after BCD treatment, with similar outcomes in patients with HRCAs.

A multi-cancer risk prediction model which constructed based on H4C6 methylation level and cfDNA concentration / 安徽医科大学学报

Objective@#To explore the difference in H4 clustered histone 6(H4C6) methylation level and circulating cell-free DNA (cfDNA) concentration between 94 normal group and 122 tumor groups (65 patients with lung cancer，22 patients with gastric cancer，23 patients with colorectal cancer，and 12 patients with liver cancer) ，and the age of total 216 subjects were between 18 and 85 years old．To construct a cancer risk prediction model based on H4C6 methylation level and cfDNA concentration and evaluate the predictive performance of the model．@*Methods@#cfDNA was extracted from blood samples using magnetic beads．Qubit 4. 0 fluorescence quantitative meter was used to detect the concentration of cfDNA. Real-time quantitative PCR( RT-qPCR) technology was used to detect the methylation level of H4C6 in cfDNA．Logistic regression algorithm was used to construct a cancer risk prediction model of H4C6 methylation level combined with cfDNA concentration．The accuracy of the model was assessed using receiver operating characteristic (ROC) curve and calibration curve．The clinical benefit of the model was as- sessed using decision curve analysis (DCA) . @*Results@#The model was constructed by combining H4C6 methylation level and cfDNA concentration to distinguish lung cancer，liver cancer，colorectal cancer，gastric cancer，pancancer from healthy control group had the area under curve (AUC) of 0. 769，0. 988，0. 934，0. 922，0. 830，respectively．The mean absolute error of the calibration curve was less than 0. 05 ; the net benefit of the DCA curve was greater than 0．@*Conclusion@#The cancer risk prediction model based on H4C6 methylation level and cfDNA concentration has good predictive performance，which helps to provide reasonable and effective suggestions for preclinical decision-making，and ultimately may provide patients with targeted and personalized cancer detection and diagnosis program.

Structure–Activity Relationship and Evaluation of Phenethylamine and Tryptamine Derivatives for Affinity towards 5-Hydroxytryptamine Type 2A Receptor

Among 14 subtypes of serotonin receptors (5-HTRs), 5-HT 2AR plays important roles in drug addiction and various psychiatric disorders. Agonists for 5-HT 2AR have been classified into three structural groups: phenethylamines, tryptamines, and ergolines. In this study, the structure-activity relationship (SAR) of phenethylamine and tryptamine derivatives for binding 5-HT 2AR was determined. In addition, functional and regulatory evaluation of selected compounds was conducted for extracellular signal-regulated kinases (ERKs) and receptor endocytosis. SAR studies showed that phenethylamines possessed higher affinity to 5-HT 2AR than tryptamines. In phenethylamines, two phenyl groups were attached to the carbon and nitrogen (R 3 ) atoms of ethylamine, the backbone of phenethylamines. Alkyl or halogen groups on the phenyl ring attached to the β carbon exerted positive effects on the binding affinity when they were at para positions. Oxygen-containing groups attached to R 3 exerted mixed influences depending on the position of their attachment. In tryptamine derivatives, tryptamine group was attached to the β carbon of ethylamine, and ally groups were attached to the nitrogen atom. Oxygen-containing substituents on large ring and alkyl substituents on the small ring of tryptamine groups exerted positive and negative influence on the affinity for 5-HT 2AR, respectively. Ally groups attached to the nitrogen atom of ethylamine exerted negative influences. Functional and regulatory activities of the tested compounds correlated with their affinity for 5-HT 2AR, suggesting their agonistic nature. In conclusion, this study provides information for designing novel ligands for 5-HT 2AR, which can be used to control psychiatric disorders and drug abuse.

A Young Hemophilia Patient with Advanced Hemophilic Arthritis and HIV Infection / 罕见病研究

A young male diagnosed with severe hemophilia A since childhood, was presented with recurrent joint and urinary bleeding. Annualized bleed rates dropped below five with low dose prophylactic medication.Bleeding in the right knee joint recently aggravated. Due to coexisting HIV infection and advanced hemophilic arthritis, the patient was managed by a multi-disciplinary team(MDT).Total knee arthroplasty was performed by an experienced surgeon using modern prosthesis design and intraoperative navigation technologies.Physical and rehabilitation therapy was provided during the postoperative period, and joint function improved. The MDT managed the young patient with HIV infection and advanced hemophilic arthritis. The patient was diagnosed with osteoporosis thought to have been caused by hemophilia, HIV infection and antiviral drugs; and he received treatment. The treatment of this patient reflects the importance of multidisciplinary cooperation in the management of difficult and rare diseases.

Construction of prediction model for early screening in male patients with gastric cancer based on cell －free DNA methylation and machine learning / 安徽医科大学学报

Objective @#To construct a cell-free DNA ( cfDNA) methylation model for early screening in male pa- tients with gastric cancer by using novel cfDNA methylation detection technology．@*Methods @#Methylation informa- tion of the whole genome of gastric cancer patients were detected by cell-free methylated DNA immunoprecipitation and highthroughput sequencing ( cfMeDIP-seq ) technology and locate gastrogenic cfDNA． Then bioinformation methods were used to extract specific methylation labels which could distinguish GC patients and establish diagnosis model by random forest algorithm. Related validation clinical researches were also conducted. @*Results @#63 most sig- nificant DMR were selected to construct the cfDNA methylation model based on GC samples and normal control samples，the goal sensitivity was above 85 percent while the goal specificity was above 95% ．The sensitivity and specificity of the validation set were 98. 7% and 99. 0% while the area under curve(AUC) was 0. 999．@*Conclusion@#The cfDNA methylation model constructed in this study has good performance in predicting GC.

Effects of optimum time of ambulation on comfort and safety of atrial fibrillation patients after radiofrequency ablation / 中国实用护理杂志

Objective:To explore the optimum time of ambulation of atrial fibrillation patients after radiofrequency ablation, to provide basis for patients' early postoperative rehabilitation.Methods:By convenient sampling method, a total of 120 patients with atrial fibrillation after radiofrequency ablation were collected at Yanghu Branch and City Branch of Changzhou Second People's Hospital from January 2020 to May 2021. They were divided into the early group, middle group and late group according to the random number table method, each group were 40 cases. All patients received routine postoperative intervention, the time of ambulation were 4, 6 and 12 h after operation in the early group, middle group and late group, respectively. The complication rate within 24 h after operation was compared among the three groups, and the comfort level of the three groups at 24, 48 and 72 h after operation was evaluated with Comfort Status Scale (GCQ).Results:Finally, 111 patients were included, including 37 in the early group, 38 in the middle group and 36 in the late group. There was no significant difference in the incidence of bleeding or hematoma, urinary retention, lumbago within 24 h after operation among the three groups ( P>0.05). The incidence of postural hypotension within 24 h after operation in the early group was 2.7% (1/37), which was lower than 21.1% (7/38) and 25.0% (9/36) in the middle and late groups, with a statistically significant difference ( χ2=4.86, 7.67, both P<0.05). At 48 and 72 h after operation, the scores of physiological dimension, psychological dimension and the total score of GCQ in the early group were (20.68 ± 3.07), (22.54 ± 3.35), (81.68 ± 6.11) and (22.54 ± 3.73), (24.38 ± 2.49), (84.92 ± 6.37), higher than those in the middle group (19.16 ± 2.19), (21.32 ± 2.27), (78.24 ± 5.58), (20.93 ± 2.85), (22.32 ± 2.04), (81.66 ± 6.56), and those in the late group (18.44 ± 1.50) (21.31 ± 1.99), (78.06 ± 4.32), (20.89 ± 2.25), (21.58 ± 1.86), (80.28 ± 6.44), the differences were statistically significant ( t values were 2.19-4.15, all P<0.05). Conclusions:Ambulation at 4 h after operation does not increase peripheral vascular complications, but can reduce the incidence of postural hypotension and improve the comfort of patients with atrial fibrillation after radiofrequency ablation.

Neurofeedback technique based on mismatched negativity in improvement of cognitive function / 中华神经医学杂志

Objective:To explore effective schemes for improving cognitive function in patients with subjective cognitive decline (SCD) by EEG neurofeedback (NF) technique.Methods:Ten SCD patients recruited in Department of Neurology, Xuanwu Hospital, Capital Medical University from April 2019 to August 2019, were chosen in our study; all patients were subjected to neuro-regulation of mismatched negativity (MMN) for 5 times in 2 weeks by EEG NF technique. By using the midlines of frontal zone (Fz), central zone (Cz) and peak zone (Pz) as training electrodes, auditory tones (1000 Hz as standard stimulus, individual hearing discrimination threshold as deviation stimulus) were used to induce MMN characteristics of event-related potential (ERP) via Oddball paradigm. SCD patients received visual disc stimulation feedback with dynamic neural signal activity. ERP waveforms and standard MMN characteristics (amplitude and latency) before and after training were used to evaluate the changes in neural activity of these patients; nine N-Back working memory tasks (three types×three gradients) and hearing discrimination ability tests were used in these patients to evaluate the improvement of cognitive competence.Results:ERP analysis showed that the MMN waveforms in SCD patients after training were obviously different as compared with those before training; their standard stimulus and deviant stimulus in the point-by-point paired t-test analysis were significant different ( P<0.05). The MMN amplitudes at the Fz, Cz and Pz electrodes in these patients after training were significantly higher than those before training ( P<0.05). The accuracy of auditory tone 3-Back task in SCD patients was statistically significant before and after training ( P<0.05). Conclusion:NF based on MMN can significantly improve the MMN amplitude and accuracy of auditory working memory task in patients with SCD, which might provide a potentially effective cognitive intervention method for patients with early AD and the elderly with normal memory decline.

Diagnostic value of two immunoassays for detecting heparin/PF4 complex antibodies in heparin-induced thrombocytopenia / 中华血液学杂志

Objectives@#To assess the diagnostic values of latex immunoturbidimetric assay (LIA) and particle immunofiltration assay (PIFA) for heparin-induced thrombocytopenia (HIT) .@*Methods@#Samples from 94 patients with suspected HIT from May 2016 to July 2018 in our hospital were prospectively analyzed by the two immunoassays. Their medical records and further follow-up data were also collected and analyzed by our hematologists to make the 4Ts scores and confirm the diagnosis of HIT, respectively. Performance characteristics of the two immunoassays were assessed, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) . Their post-test probabilities (PTP) were also calculated based on the 4Ts score.@*Results@#Among 94 cases, 15 (16.0%) had a positive HIT, including 6 of 37 (16.2%) with an intermediate, and 9 of 15 (60.0%) with a high 4Ts score. PIFA operating characteristics were: sensitivity 100.0% (15/15) , specificity 51.9% (41/80) , PPV 28.3% (15/53) , NPV 100.0% (41/41) . The positive PTP in intermediate and high 4Ts score group were 28.7% and 75.7%, respectively, while negative PTP were all 0. At manufacturers’ cutoffs, LIA operating characteristics were: sensitivity 66.7% (10/15) , specificity 94.9% (75/79) , PPV 71.4% (10/14) and NPV 93.8% (75/80) . The positive and negative PTP in intermediate 4Ts score group were 71.8% and 6.3%, while 95.2% and 34.4% in high 4Ts score group, respectively. Receiver operating characteristic (ROC) analysis manifested that LIA was preferable than PIFA, and combining the 2 assays together was significantly better than single test.@*Conclusions@#4Ts score is still an important tool for the diagnosis of HIT. Combining clinical score with heparin/PF4 antibody assay can increase the accuracy of confirming or excluding HIT. Although PIFA is inferior to LIA in the diagnostic value, its user friendliness and 100% NPV have major advantages. Combining the 2 assays together can achieve a higher diagnostic value.

Status Quo of Pharmaceutical Care and Training Needs Research of Primary Pharmaceutical Staff Based on 9 Provinces(Regions,Cities)Investigation / 中国药房

OBJECTIVE:To provide reference for exploring the way to improve the ability of pharmaceutical care in primary pharmaceutical staff. METHODS:Questionnaire survey was conducted among pharmaceutical staff(including head of pharmacy department),director/vice-director of hospital in charge of pharmacy,medical staff and patients from primary medical institutions in 9 provinces(regions,cities). The results of investigation were analyzed statistically. RESULTS:A total of 77 primary medical institutions involved in the survey. Totally of 2 273 questionnaires were sent out,and 2 248 effective questionnaires were collected with effective recovery rate of 98.9%. Among effective questionnaires,278 questionnaires were filled out by pharmaceutical staff (68 by head of pharmacy department),48 by director/vice-director of hospital in charge of pharmacy,771 by medical staff and 1 151 by patients. Results of survey showed that only 140 pharmaceutical staff had obtained pharmacy practice qualification,accounting for 50.4%. The surveyed primary medical institutions provided limited pharmaceutical care projects,and the projects with high proportion were medication explanation(85.7%)and medication consultation(84.4%). The establishment of Health Service Record Card in elderly patients(19.5%),the development of chronic disease management(23.4%)and the development of chronic disease related pharmaceutical knowledge publicity at the primary level(37.7%)took up low proportion relatively. Overall satisfaction of surveyed medical staff to pharmaceutical care of pharmaceutical staff was general(77.2%). Surveyed patients greatly satisfied with the attitude of pharmaceutical staff(85.5%)but overall satisfaction of them to professional knowledge of pharmaceutical staff(78.2%)was general. Surveyed pharmaceutical staff training needs in descending order were medication explanation(74.5%),medication counseling(71.9%)and providing pharmaceutical information(64.0%). However,the projects which had low proportion of training needs included chronic disease management(22.3%)and lifestyle guidance (27.0%),etc. The more favorite training forms in descending order were further study in medical institution at higher level(65.4%),expert lectures(60.1%)and training in the training base (57.9%). CONCLUSIONS:The primary medical institutions provided limited pharmaceutical care. It is necessary to further explore and standardize pharmaceutical care criteria. The overall satisfaction of medical staff and patients on pharmaceutical care of pharmaceutical staff is not high in primary institutions,and it needs to be further improved. The related pharmacy training for primary pharmaceutical staff still needs to be strengthened,and can be conducted according to the favorite form of training so as to improve the ability of pharmaceutical care.

Temporal and cheek face lift combined with fat grafting in facial rejuvenation / 中华整形外科杂志

Objective@#To observe the safety and efficiency of face-lift combined with fat grafting in facial rejuvenation.@*Methods@#We performed a retrospective study, which included 23 patients. SMAS suspension and multi-site suspension were combined to correct the nasolabial fold, mid-cheek aging and malar mounds. Structural fat grafting was performed to treat the volume loss in mid-face.@*Results@#All patients demonstrated a significant improvement in midfacial appearance. No infection or nerve injury were found in this study. Only three patients did not get primary healing in temple region, which led to temporal hair loss from secondary healing.@*Conclusions@#This study demonstrates that fat grafting and multiple layers face-lift are efficient method for facial rejuvenation. These approaches appear to be very promising for facial anti-aging techniques.

Construction of the teaching case library on clinical pharmacy for pharmacy residents / 中华医学教育探索杂志

A teaching case library of clinical pharmacy was constructed to improve case teaching for pharmacy residents. Through establishment of draft requirement and organizing a group of authors consti-tuted by preceptors of pharmacy residents, the teaching cases were written, the contents and forms of which were assessed by teaching demonstration, interactively examined and revised by fellow teachers, audited and screened by senior pharmacists , and thus a case library was collaborated , processed and established . Finally, a case library was formed, which included 11 systems, such as endocrine, cardiovascular and neu-rological systems, and 32 cases of drug treatment for common diseases in each system. The construction ofcase library has enhanced the teaching consciousness and skills of resident pharmacists' teaching team. This case library will become an important resource for teaching and scientific research in the future.

A prospective study of the efficacy and safety of maintenance therapy with recombinant human thrombopoietin in patients with primary immune thrombocytopenia: a multicenter study / 中华血液学杂志

Objective@#To evaluate the efficacy and safety of maintenance therapy with reduced dose of rhTPO in the patients with primary immune thrombocytopenia (ITP) who attained stable platelet (PLT) counts after daily administration of rhTPO.@*Methods@#Treatment was started with a daily administration of rhTPO (300 U/kg) for 2 consecutive weeks. Patients who attained stable PLT≥50×109/L were enrolled to maintenance therapy starting with every other day administration of rhTPO, then adjusted dose interval to maintain platelet count (30-100) ×109/L.@*Results@#A total of 91 eligible patients were enrolled. Fourteen patients discontinued the study due to noncompliance (12/14) and investigator decision (2/14) . Among 77 patients who completed the study, 38 patients with the administration of rhTPO at every other day or less could maintain PLT≥30×109/L for 12 weeks. The percentage of patients with a platelet response (PLT≥30×109/L) at 4th week, 8th week and 12th week of maintain therapy was 92.6% (63/68) , 82.7% (43/52) and 85.0% (34/40) , respectively. Median platelet counts remained in the range of (70-124) ×109/L. The overall incidence of rhTPO-related adverse events was 7.7%. All the adverse events were generally mild.@*Conclusion@#Extending the dose interval of rhTPO is feasible to maintain stable platelet count in the patients with ITP, but the optimal dose interval is uncertain and might vary with individuals.

Effects of combined application of culture supernatant of human umbilical cord mesenchymal stem cells and ciprofloxacin on Staphylococcus aureus in vitro / 中华烧伤杂志

Objective@#To explore the effects of combined application of culture supernatant of human umbilical cord mesenchymal stem cells (hUCMSCs) and ciprofloxacin on Staphylococcus aureus (SA) in vitro.@*Methods@#hUCMSCs were isolated from umbilical cord tissue of full-term healthy fetus after cesarean section and cultured. Cells in the third passage were used in the experiments after identification. SA strains isolated from wounds of burn patients in our burn wards were used in the experiments. Cells were divided into 0, 10, 100, and 1 000 ng/mL lipopolysaccharide (LPS) groups according to the random number table (the same dividing method below). Cells were cultured with culture medium of mesenchymal stem cells (MSCs) after being treated with medium containing the corresponding mass concentrations of LPS for 12 h. At post culture hour (PCH) 6, 12, and 24, 6 wells of culture supernatant of cells in each group were obtained to measure the content of LL-37 with enzyme-linked immunosorbent assay. Ninety blood agar plates were divided into ciprofloxacin control group (CC), ciprofloxacin+ supernatant group (CS), and ciprofloxacin+ supernatant+ LL-37 antibody group (CSL), with 30 blood agar plates in each group. Blood agar plates in group CC were coated with 1.5×108 colony forming unit (CFU)/mL bacteria solution prepared with normal saline. Blood agar plates in group CS were coated with 1.5×108 CFU/mL bacteria solution prepared with normal saline and culture supernatant of hUCMSCs (cultured by culture medium of MSCs, the same below) in double volume of normal saline. Blood agar plates in group CSL were coated with 1.5×108 CFU/mL bacteria solution prepared with normal saline, culture supernatant of hUCMSCs in double volume of normal saline, and 2.6 μL LL-37 antibody in the concentration of 2 μg/mL. At PCH 12, 24, and 48, 10 blood agar plates of each group were harvested to observe the distribution of SA colony on blood agar plate and to measure the diameter of bacterial inhibition ring of ciprofloxacin. The minimum inhibitory concentration (MIC) of ciprofloxacin against SA of each group was recorded. Fractional inhibitory concentration (FIC) indexes of ciprofloxacin in groups CS and CSL at PCH 12, 24, and 48 were calculated, and the effect of synergy was evaluated. Data were processed with analysis of variance of factorial design, one-way analysis of variance, LSD-t test, Kruskal-Wallis test, and Mann-Whitney U test.@*Results@#(1) At each PCH, the content of LL-37 in culture supernatant of cells in 10, 100, and 1 000 ng/mL LPS groups was higher than that in 0 ng/mL LPS group (with t values from 11.22 to 33.36, P values below 0.01); the content of LL-37 in culture supernatant of cells in 100 and 1 000 ng/mL LPS groups was higher than that in 10 ng/mL LPS group (with t values from 2.24 to 18.73, P<0.05 or P<0.01); the content of LL-37 in culture supernatant of cells in 1 000 ng/mL LPS group was higher than that in 100 ng/mL LPS group (with t values from 12.46 to 14.70, P values below 0.01). (2) At PCH 12, 24, and 48, the bacterial colonies in groups CC, CS, and CSL began to integrate over time. At PCH 12, 24, and 48, the diameters of bacterial inhibition ring of ciprofloxacin in group CC were 26, 24, and 23 mm, respectively, with no obvious change. At PCH 12, 24, and 48, the diameters of bacterial inhibition ring of ciprofloxacin in groups CS and CSL were 82, 71, 68 mm, and 74, 59, 56 mm, respectively, significantly longer than those of group CC. (3) At each PCH, the MIC of ciprofloxacin against SA was significantly higher in group CC than in groups CS and CSL (with Z values from 6.22 to 6.71, P values below 0.01); the MIC of ciprofloxacin against SA was significantly higher in group CSL than in group CS (with Z values all equal to 6.72, P values below 0.01). (4) FIC indexes of ciprofloxacin in groups CS and CSL at PCH 12, 24, and 48 were 0.011, 0.032, 0.032, and 0.122, 0.350, 0.350, respectively. The results indicated that culture supernatant of hUCMSCs had synergistically antibacterial effect on ciprofloxacin.@*Conclusions@#hUCMSCs can secrete LL-37, and the secretion level is increased with increase of LPS concentration. Combination of culture supernatant of hUCMSCs and ciprofloxacin can decrease the dosage of ciprofloxacin in resisting SA. Once LL-37 is neutralized, the synergistically antibacterial effect of culture supernatant of hUCMSCs is decreased.

Establishment, Implementation and Evaluation of a Case-based Education Program for Resident Pharmacists / 中国药师

Objective: To establish an education program for resident pharmacists to improve clinical problem solving skills with pharmaceutical knowledge.Methods: A case-based education program for resident pharmacists with drug knowledge was established after a questionnaire survey in resident pharmacists and the discussion with clinical teachers.A teaching team was built and the resident pharmacists were divided into several study groups.After a pilot run, the program was operated in pharmacy department.The program was divided into 10 sections by drug indications, and each section was composed of basic drug knowledge lecture and case discussions, which mobilized the study initiative of resident pharmacists.At the half time, resident pharmacists and clinical teachers participated in a midterm survey by a questionnaire.Results: More than 95% resident pharmacists and teachers believed that basic drug knowledge lecture before case discussion was necessary, and compared with previous trainings, the program could further increase study interests of resident pharmacists and improve the clinical problem solving skills.However, 33.3% resident pharmacists and 60% teachers thought the cases were difficult, and 18.5% resident pharmacists and 10% teachers disagreed the cases were close to the actual work.Conclusion: The program is effective in drug knowledge training for resident pharmacists, which can improve pharmaceutical care for patients, while further modifications are still needed to satisfy the demands of resident pharamcists with different working years.

Feasibility of diagnosis of perimembranous ventricular septal defect with right aortic valve prolapse by ul-trasonic echocardiography / 实用医学杂志

Objectives To explore the feasibility ofdiagnosis of Perimembranous Ventricular Septal Defect with Right Aortic Valve Prolapse by ultrasonic echocardiography. Methods 131 VSD patients aged 1 to 22 years, weight 8.0 to 54.0 kg, underwent transthoracic echocardiography (TTE) and left ventricular angiography to show the diameter of VSD and the degree of AVP. Results Among 131 patients, 87 cases were diagnosed as VSD,14 as VSD with slight AVP, 12 as, VSD with middle AVP, and 18 as VSD with severe AVP by ultrasonic echocardiography respectively. After the left ventricular angiography and aortic root angiography , it proved that positive rate of VSD was 44.8%, positive rate of VSD with slight AVP was 42.86%, positive rate of VSD with middle AVP was 58.3%,and positive rate of VSD with severe AVP was 83.3%. Conclusion The transthoracic echocardiography (TTE) contributes to diagnosis of severe degree of AVP,while TTE evaluates the slight degree of AVP incorrectly enough. Left ventricular angiography and aortic root angiography are needed to realize the di-agnosis of AVP.

Consideration and Practice of Training and Examination Mode for Hospital Pharmacy Teachers / 中国药房

OBJECTIVE:To provide reference for the training and evaluation for hospital pharmacy teachers. METHODS:19 pharmacists-in-charge in the pharmacy department of our hospital received training of teaching ability,and theory test and multi-sta-tion practical technique test were conducted after training. The items examined in theory test included training rules,the profession-al knowledge of pharmacy and teaching method;the content of practical technique test included checking prescriptions/medication orders,drug dispensing,medication management,patient education and ADR report. Each teacher’s test included 3 of 5 items above based on different responsibilities. All scores were analyzed and summarized. RESULTS:The score of practical technique test was higher than the score of theory test;teachers’grasp of training rules was the worst in theory test;in practical technique test,the score of medication management was the highest for teachers worked at the post of dispensing;while the score of patient education was higher than the score of ADR report for teachers who were clinical pharmacists,the differences were statistically sig-nificant(P<0.05). CONCLUSIONS:In order to improve teaching ability, teachers should receive intensive training on the train-ing rules and the professional knowledge of pharmacy;the multi-station examination mode will be improved in many modes such as increasing stations,standardized test paper and standardized trainees;meanwhile,the young pharmacists should be encouraged for positive commitment to the teaching work and continuously enriched with experience.

Drug-induced liver injury:metabolic and genetic basis / 中国药理学通报

Drug-induced liver injury ( DILI) is a significant rea-son of acute liver failure and is the main cause of therapeutic drugs withdrawal from the market .Multiple mechanisms can cul-minate in DILI , but metabolism and genetics play distinct roles in this process .This review will cover papers we consider have addressed these mechanisms of DILI in commonly used medica-tions for adults , and discuss the hot issues .The aim is to gener-ate discussion about the potential clinical significance among these researchs and point out the key areas for further study of DILI.

Study on the Status Quo of Teachers'Teaching Ability of Standardized Training for Hospital Pharmacists in Beijing Area / 中国药房

OBJECTIVE:To investigate the status quo of teachers'teaching ability of standardized training for hospital pharma-cists in Beijing area,and provide reference for strengthening the faculty construction. METHODS:A dynamic assessment of stan-dardized training base for hospital pharmacists of 17 inpatients in Beijing area was conducted to organize evaluation experts to as-sess the teaching ability of outpatient pharmacy,ward pharmacy and clinical pharmacy in training base. Questionnaire was designed and trainees were organized to evaluate the teaching ability,time,attitude,feedback and others and related results of teaching in bases were vegarded as objects for analysis and summary. RESULTS:The overall ability of teaching was high,and the most promi-nent was clinical pharmacy,which was well received by trainees. But there are differences among departments,the ability of ward pharmacy is slightly lower than the clinical pharmacy and outpatient pharmacy. And the teaching ability still had great improvement. CONCLUSIONS:In order to improve the overall teacher strength in training base,competence-based training for hospital pharma-cists must be strengthened to encourage teachers to attend training courses,strengthen cultivation of humanistic quality and enrich students'evaluation forms.