Danhong Injection Up-regulates miR-125b in Endothelial Exosomes and Attenuates Apoptosis in Post-Infarction Myocardium / 中国结合医学杂志

OBJECTIVE@#To investigate the involvement of endothelial cells (ECs)-derived exosomes in the anti-apoptotic effect of Danhong Injection (DHI) and the mechanism of DHI-induced exosomal protection against postinfarction myocardial apoptosis.@*METHODS@#A mouse permanent myocardial infarction (MI) model was established, followed by a 14-day daily treatment with DHI, DHI plus GW4869 (an exosomal inhibitor), or saline. Phosphate-buffered saline (PBS)-induced ECs-derived exosomes were isolated, analyzed by miRNA microarray and validated by droplet digital polymerase chain reaction (ddPCR). The exosomes induced by DHI (DHI-exo), PBS (PBS-exo), or DHI+GW4869 (GW-exo) were isolated and injected into the peri-infarct zone following MI. The protective effects of DHI and DHI-exo on MI hearts were measured by echocardiography, Masson's trichrome staining, and TUNEL apoptosis assay. The Western blotting and quantitative reverse transcription PCR (qRT-PCR) were used to evaluate the expression levels of miR-125b/p53-mediated pathway components, including miR-125b, p53, Bak, Bax, and caspase-3 activities.@*RESULTS@#DHI significantly improved cardiac function and reduced infarct size in MI mice (P<0.01), which was abolished by the GW4869 intervention. DHI promoted the exosomal secretion in ECs (P<0.01). According to the results of exosomal miRNA microarray assay, 30 differentially expressed miRNAs in the DHI-exo were identified (28 up-regulated miRNAs and 2 down-regulated miRNAs). Among them, DHI significantly elevated miR-125b level in DHI-exo and DHI-treated ECs, a recognized apoptotic inhibitor impeding p53 signaling (P<0.05). Remarkably, treatment with DHI and DHI-exo attenuated apoptosis, elevated miR-125b expression level, inhibited capsase-3 activity, and down-regulated the expression levels of proapoptotic effectors (p53, Bak, and Bax) in post-MI hearts, whereas these effects were blocked by GW4869 (P<0.05 or P<0.01).@*CONCLUSION@#DHI and DHI-induced exosomes inhibited apoptosis, promoted the miR-125b expression level, and regulated the p53 apoptotic pathway in post-infarction myocardium.

Research Progress on the Application of Intervention Mapping in Tertiary Prevention of Cancer / 中国医学科学院学报

Intervention mapping (IM) is a framework for formulating theory-and evidence-based health education projects with participatory approaches from ecological perspectives.The intervention program designed via IM plays a role in reducing the exposure of cancer risk factors,increasing cancer prevention behaviors,and promoting early cancer screening and rehabilitation of cancer patients.This study summarizes the characteristics,implementation steps,and application status of IM in tertiary prevention of cancer,aiming to provide reference for the application of IM in the health education projects for cancer in China.

Application of extended reality technology for real-time navigation in clinical operation / 南方医科大学学报

OBJECTIVE@#To explore the application of extended reality (XR) technology in clinical surgeries for improving the success rate of surgeries.@*METHODS@#To assist the surgeons to better understand the location, size and geometric shape of the lesions and reduce potential radiation exposure in minimally invasive surgical navigation based on two-dimensional images, we constructed three-dimensional models based on CT data and used XR technology to achieve intraoperative navigation. An improved quaternion method was used to improve the accuracy of electromagnetic positioning, with which the system error of positioning accuracy was reduced to below 2 mm. A 5G network was used to optimize the server GPU programming algorithm, and real-time video stream coding strategy and network design were adopted to reduce data transmission jam and delay in the remote surgery network, which achieved an average delay of less than 60 ms. A Gaussian distribution deformation model was used to simulate collision detection and stress deformation of the tissues to achieve a tactile perception effect.@*RESULTS AND CONCLUSION@#The intraoperative navigation system based on XR technology allowed more accurate determination of the location of the lesions, effectively reduced the surgical risk, and avoided the risk of intraoperative radiation exposure. The low latency and high fidelity of 5G network achieved real-time interaction during the surgery to provide a technical basis for multi-terminal remote cooperative surgery. The combination of force feedback technology and XR technology enables the surgeons to conduct deep immersion preoperative planning and virtual surgery to improve the success rate of surgery and shorten the learning curve.

[Assessment of soil quality under different land use types in the rocky mountain area of northern Hebei Province, China.] / 冀北土石山区不同土地利用类型土壤质量评价.

To assess the variations of soil quality among land use types and with altitude in the rocky mountain area of northern Hebei Province is critical for preventing further human-induced degradation of land and vegetation, and for formulating a strategic plan on vegetation restoration after the Beijing Winter Olympics. Taking Betula platyphylla natural forest, Larix gmelinii plantation, natural grassland and abandoned cropland as research objects, 13 soil physicochemical indices (e.g., soil bulk density, porosity and soil nutrient content) were measured to compare soil quality among land use types. The results showed that soil quality presented the trend as B. platyphylla natural forest > natural grassland > L. gmelinii plantation > abandoned cropland. B. platyphylla natural forest had the best soil quality due to high total nitrogen (3.24 ±1.42 g·kg-1) and phosphorus (0.59±0.10 g·kg-1) contents, suggesting that long-term soil nutrient accumulation played an important role in preventing soil degradation. Soil quality in natural grassland was lower than that in B. platyphylla natural forest, due to topographic factors and coarse soil fraction. Soil physical properties in L. gmelinii plantation had been substantially improved after 40 years restoration, as indicated by significant reductions in soil gravel fraction, while soil nutrient contents changed little. The low soil quality in abandoned cropland was attributable to low vegetation coverage and intense human activities in the low-altitude area. Driven by soil total nitrogen, soil quality under the four land use types increased with altitude, and peaked at about 1700 m. We suggested that enclosure and ecological restoration measures should be strengthened in ecologically-fragile, low-altitude areas, taking sustainable development into consideration for high-density stands and promoting plantations to adapt to environmental change.

[Main hypotheses on mechanisms underlying plant invasion: A review.] / æ¤ç‰©å ¥ä¾µæœºåˆ¶çš„ä¸»è¦å‡è¯´.

Plant invasion is one of the most serious global problems, destroying ecosystem structure and function. With the severity of plant invasion, it is particularly important to understand the mechanisms of plant invasion in order to control and solve the problem. We summarized different mechanisms of plant invasion and the synergy among them, expounded the allelopathy, the plant-soil feedbacks, the reciprocal symbiosis, the effects of plant functional traits and phenotype plasticity in the process of plant invasion, and comprehensively analyzed the synergy of multiple mechanisms on plant invasion trajectory. According to the results, the invasion trajectory of alien plants in the invasive site was divided into four stages: introduction, colonization, establishment, and invasion. Integrating all kinds of obstacles and promoting factors encountered into it and putting forward the invasion curve of plants would contribute to the future research and management of invasive plants. We further highlighted the current research deficiencies and future research directions and objectives based on analyzing current research methods of plant invasion.

Real-world experience with management of spinal ganglioneuroma: long-term follow-up observations of 31 cases.

INTRODUCTION: Spinal ganglioneuroma (GN) is the most benign neoplasm of neuroblastic origin. There is little knowledge about spinal GN because of sporadic cases reported. The objective of this study is to describe the clinical manifestations and long-term follow-up outcomes of spinal GN after consecutive treatment. METHODS: The clinical and follow-up data of 31 patients with spinal GN receiving consecutive treatment in our institute are retrospectively analyzed. RESULTS: The mean age of the 31 patients was 40.39 ± 14.8 years. They were diagnosed with spinal GN and received surgical treatment in our institution between February 2012 and August 2019. Of them, 22 (71%) patients presented preoperative neurological symptoms. The mean duration from symptom onset to surgery was 19.76 ± 49.59 months. Eighteen patients received complete surgical resection and 13 patients received subtotal excision. In addition, radicotomy was performed simultaneously after sophisticated consideration in 19 patients. The follow-up period averaged 64.13 ± 22.67 months. The preoperative neurological dysfunction was improved significantly during the follow-up period in all cases. No local recurrence or malignant transformation has occurred so far. CONCLUSION: Spinal GN is a rare but benign neoplasm, and the origin of spinal GN remains controversial. With our experience, we propose that the origin of spinal GN from dorsal root ganglion should be equally considered as its counterpart of sympathetic ganglion. Complete resection is the preferred surgical strategy to avoid malignant events and recurrence. And the close postoperative follow-up observations are warranted.

Research Progress of Adaptive Intervention / 中国医学科学院学报

Adaptive intervention(AI)is a methodology which dynamically evaluates adaptive variables at decision points and timely adjusts and develops tailored strategies to meet individual needs.The study reviewed the origin and development and elaborated the core elements(including intervention outcomes,intervention options,decision points,tailoring variables,and decision rules)and the classification of AI.Based on the literature,the key points of the design and implementation of AI were prospected,which can provide evidence for the research and development of health behavior intervention.

Mobile-health information searching behaviors and its influencing factors for patients with cancer / 中华行为医学与脑科学杂志

Objective:To explore the behavior and influencing factors of mobile health (m-Health) information searching among patients with cancer, aiming to provide evidence for the provision of medical health information.Methods:A cross-sectional survey was conducted.A total of 535 patients with cancer were recruited from a cancer hospital in Zhejiang Province from September to December 2017.Measurement tools included the demographic information questionnaire, mobile health information search behavior questionnaire, mobile health information search environment questionnaire, cancer needs questionnaires-short form and ehealth literacy scale.SPSS 26.0 was used for descriptive statistical analysis, one-way analysis of variance, Pearson correlation analysis and multiple linear regression analysis.Results:The total score of mobile health information search behavior of cancer patients was (60.84±9.60), and 66.5% of participants reported that they "never" or "occasionally" searched health information via mobile.The total score of information needs was (80.99±27.86), electronic health literacy was (26.54±7.85), mobile health information search environment was (8.00±2.86). m-Health information search behavior was positively correlated with information needs ( r=0.251, P<0.01), ehealth literacy ( r=0.538, P<0.01), and m-Health information search environment ( r=0.267, P<0.01). The stepwise regression analysis revealed that the place of residence, working status, income level, ehealth literacy, mobile health information search environment and information needs were statistically significant associated with the m-Health information searching behavior among cancer patients, which accounted for 39.3% of the total variance ( F=12.151, P<0.01). Compared with patients living in the central cities, those living in the small and medium-sized cities( β=0.092, P=0.031) had higher score in m-Health information behavior.Compared with patients working on normal schedule, those took sick days ( β=0.156, P=0.017) and working fewer hours ( β=0.138, P=0.002) had higher score m-Health information behavior.Compared with patients with monthly income of 1 000-3 000 yuan ( β=-0.194, P=0.002), those with monthly income less than 1 000 yuan had higher score in m-Health information behavior.The ehealth literacy ( β=0.425, P=0.000), mobile health information search environment ( β=0.179, P=0.000) and information needs ( β=0.091, P=0.027) were positive influencing factors of m-Health information search behavior. Conclusion:Patients with cancer did not report high m-Health information search behavior.Place of residence, working status, income level, ehealth literacy, m-Health information search environment and information demand were the influencing factors of m-Health information search behavior among patients with cancer.

Cross-neutralization antibodies against SARS-CoV-2 and RBD mutations from convalescent patient antibody libraries

The emergence of coronavirus disease 2019 (COVID-19) pandemic led to an urgent need to develop therapeutic interventions. Among them, neutralizing antibodies play crucial roles for preventing viral infections and contribute to resolution of infection. Here, we describe the generation of antibody libraries from 17 different COVID-19 recovered patients and screening of neutralizing antibodies to SARS-CoV-2. After 3 rounds of panning, 456 positive phage clones were obtained with high affinity to RBD (receptor binding domain). Then the positive clones were sequenced and reconstituted into whole human IgG for epitope binning assays. After that, all 19 IgG were classified into 6 different epitope groups or Bins. Although all these antibodies were shown to have ability to bind RBD, the antibodies in Bin2 have more superiority to inhibit the interaction between spike protein and angiotensin converting enzyme 2 receptor (ACE2). Most importantly, the antibodies from Bin2 can also strongly bind with mutant RBDs (W463R, R408I, N354D, V367F and N354D/D364Y) derived from SARS-CoV-2 strain with increased infectivity, suggesting the great potential of these antibodies in preventing infection of SARS-CoV-2 and its mutations. Furthermore, these neutralizing antibodies strongly restrict the binding of RBD to hACE2 overexpressed 293T cells. Consistently, these antibodies effectively neutralized pseudovirus entry into hACE2 overexpressed 293T cells. In Vero-E6 cells, these antibodies can even block the entry of live SARS-CoV-2 into cells at only 12.5 nM. These results suggest that these neutralizing human antibodies from the patient-derived antibody libraries have the potential to become therapeutic agents against SARS-CoV-2 and its mutants in this global pandemic.

Clinical Outcomes and Plasma Concentrations of Baloxavir Marboxil and Favipiravir in COVID-19 Patients: an Exploratory Randomized, Controlled Trial

BackgroundEffective antiviral drugs for COVID-19 are still lacking. This study aims to evaluate the clinical outcomes and plasma concentrations of baloxavir marboxil and favipiravir in COVID-19 patients. MethodsFavipiravir and baloxavir acid were evaluated for their antiviral activity against SARS-CoV-2 in vitro before the trial initiation. We conducted an exploratory trial with 3 arms involving hospitalized adult patients with COVID-19. Patients were randomized assigned in a 1:1:1 ratio into baloxavir marboxil group, favipiravir group, and control group. The primary outcome was the percentage of subjects with viral negative by Day 14 and the time from randomization to clinical improvement. Virus load reduction, blood drug concentration and clinical presentation were also observed. The trial was registered with Chinese Clinical Trial Registry (ChiCTR 2000029544). ResultsBaloxavir showed antiviral activity in vitro with the half-maximal effective concentration (EC50) of 5.48 {micro}M comparable to arbidol and lopinavir, but favipiravir didnt demonstrate significant antiviral activity up to 100 {micro}M. Thirty patients were enrolled. The percentage of patients who turned viral negative after 14-day treatment was 70%, 77%, and 100% in the baloxavir, favipiravir, and control group respectively, with the medians of time from randomization to clinical improvement was 14, 14 and 15 days, respectively. One reason for the lack of virological effect and clinical benefits may be due to insufficient concentrations of these drugs relative to their antiviral activities. ConclusionsOur findings do not support that adding either baloxavir or favipiravir under the trial dosages to the existing standard treatment.

Antithrombotic therapy after iliac vein stenting / 浙江大学学报·医学版

Stenting for iliac vein stenosis or compression has become a common therapeutic approach in recent years. The antithrombotic therapy after the stent deployment, however, reaches no consensus. Medications strategies and patients' prognoses differ in non-thrombotic, acute thrombotic and chronic thrombotic these three circumstances. Non-thrombotic patients usually possess satisfactory stent patency whatever antithrombotic therapy is used. Anticoagulant is the basic medication for acute thrombotic patients, benefits from additional antiplatelet drug remains to be clarified. In terms of chronic thrombotic patients, their prognoses are unsatisfactory under all antithrombotic therapies. In this review, we outlined the recent progress of antithrombotic therapy after iliac vein stenting, aiming to provide feasible medication plans for each circumstance.

The inhibition mechanism of the uptake of lamivudine via human organic anion transporter 1 by Stellera chamaejasme L. extracts / 中国天然药物

Stellera chamaejasme L. is a traditional Chinese medicine with a long history to treat stubborn skin ulcer, and it also has antiviral and antitumor effects. Neochamaejasmine B (NCB), Neochamaejasmine A (NCA) and Chamaechromone (CMC) are the major components in dried roots of Stellera chamaejasme L.. Our studies suggested that NCB, NCA and CMC are inhibitors of Organic anion transporter 1 (OAT1). OAT1 is encoded by solute carrier family 22 member 6 gene (SLC22A6) in humans and plays a critical role in the organic anion drug uptake and excretion in the kidney. Lamivudine is the typical substrate of OAT1 and is frequently used in combination with other antiviral drugs in clinical antiviral treatments. The aim of this study is to investigate the interaction and its mechanism between these bi-flavone components in Stellera chamaejasme L. and lamivudine via OAT1 both in vitro and in vivo. In vitro, the uptake studies in Madin-Darby canine kidney (MDCK) cells overexpressing OAT1 suggested that NCB inhibited the uptake of 6-CFL and lamivudine.Similar results were obtained for NCA and CMC. NCB was a noncompetitive and competitive inhibitor interaction with OAT1. IC values of NCB, NCA and CMC for inhibiting OAT1-mediated lamivudine transport were 2.46, 8.35 and 0.61 μmol·L, respectively. In vivo, the pharmacokinetic results of lamivudine in rats showed that the mean area under the plasma concentration-time curve (AUC) and maximal plasma concentration (C) of lamivudine after co-administration is increased 2.94-fold and 1.87-fold, respectively, compared to lamivudine administration alone. The results of interactions between lamivudine and these bi-flavone components in Stellera chamaejasme L. extracts via OAT1 in vivo are consistent with studies in vitro. The inhibition of OAT1-mediated uptake of lamivudine by NCB, NCA and CMC is the possible mechanism for Stellera chamaejasme L. extracts improving the oral bioavailability of lamivudine in rats.

Effects of dexmedetomidine on early postoperative cognitive function in elderly patients undergoing liver resection / 实用医学杂志

Objective To investigate the effect of dexmedetomidine on early postoperative cognitive func-tion in elderly patients undergoing liver resection. Method Fifty-four ASAⅡ~Ⅲelderly patients scheduled for liver resection were divided into 3 groups(18 in each group):the control group(group C),group D1 and group D2. The levels of serum 8-iso-PGF2α,IL-6,TNF-α and S100β protein were measured,and Da-jvO2,CjvO2and CERO2were calculated at the time before operation and at the end of operation,respectively.Incidence of postoper-ative cognitive dysfunction(POCD)were recorded within seven days after operation. Results Compared with the time before operation,levels of serum 8-iso-PGF2α,IL-6,TNF-α,S100β protein and Da-jvO2,CERO2of patients in 3 groups significantly increased at the end of operation(P < 0.05,respectively). The levels of serum 8-iso-PGF2α,IL-6,TNF-α,S100β protein and Da-jvO2,CERO2of patients decreased in group D1 and D2 than those in group C at the end of operation(P<0.05).Incidence of POCD in group D1 and D2 was lower than that of group C (P<0.05).Conclusion Dexmedetomidine can decrease the incidence of POCD for the elderly patients undergo-ing liver resection,the potential mechanism is that dexmedetomidine can reduce oxidative stress response,inhibit inflammatory response in patients and improve the cerebral oxygen metabolism during the operation.

Research progress in toxic effects of antitumor drugs based on drug transporter / 药学学报

Differences of the individual toxic effects of antitumor drugs have been a concern in clinical treatment of cancers. The drug toxicity was not only related to the age, sex, and drug interactions, but also to the expression of protein involved in the metabolism, targets and transporters of drugs. Drug transporter mediates the absorption, distribution and elimination of some drugs, which exhibits a great significance in pharmacology and clinical practice. The purpose of this review is to provide information regarding trans-porter-medicated toxic effects of antitumor drugs in order to reduce or avoid the transporter-medicated toxic effects, and to promote reasonable drug use and individualized application of antitumor drugs in clinics.

Effect of Cholecalciterol Cholesterol Emulsion on Liver of Zymosan-induced Multiple Organ Failure in Mice / 中国医科大学学报

Objective To study the effect of cholecalciterol cholesterol emulsion(CCE)in the zymosan(Z)-induced acute hepatic injury. Meth-ods A total of 36 C57 BL/6 mice were randomly divided into 4 groups,namely negative control(CON)group,CCE group,Z group and CCE+Z group,respectively. There were 9 mice in each group. Mice from CON group and Z group were fed with pure water. Mice from CCE group and CCE+Z group were fed with cholecalciterol cholesterol emulsion 20μL dissolved in 200 mL pure water which was kept in darkness. After 14 days, Z group and CCE+Z group were injected with zymosan at a dose of 500 mg/kg. After 18 hours,all the mice in each group were sacrificed. The liver tissues were harvested for histopathological examination. The serum ALT levels were determined. The molecular expression of IL-6 and IL-18 in liv-er tissue of mice were evaluated by Western blotting and real-time quantitative PCR method. Results The results of histopathological examination showed that liver tissue damage in CCE+Z group was lighter than that of Z group ,and heavier than that of the CON group. Compared to the CON group,Z group had the highest serum ALT level,followed by CCE+Z group,while in Z group was significantly lower than that in CON group(all P<0.05). The expression of IL-6 and IL-18 protein and mRNA showed level of Z group was apparently higher than those of CON group and CCE+Z group(all P<0.05). Conclusion Cholecalciterol cholesterol emulsion can play certain protective effect on zymosan-induced liver injury in mice.

Guideline Formulation of the Off-label Use of Drugs Based on Evidences / 中国药房

OBJECTIVE:To explore an effective method to formulate management-related strategies for off-lable use of drugs by the evidence-based medicine. METHODS:The process of guideline formulation included seven procedures,i.g. establishment ofguideliesformulation workgroup;investigation and selection of the status quo on off-label drug use;identification of the clinical problems;retrieval and evaluation and comprehensing of evidence;applification of GRADE in evidence quality grading;formation of the recommendations consensus;peer review and result publication. And eventually guidelines were formed based on the steps. This study took off-label use of rheumatoid immunoprotective subjects as a case to explore. RESULTS & CONCLUSIONS:Based on the evidence evaluation system and above 7 steps,the methods and process of guideline formulation on off-label use of rheuma-toid immunoprotective subjects that integrated administration,law,clinical medicine,pharmacy subjects were made .The process of guideline formulation fully reflects multidisciplinary characteristics of the workgroup,the advanced nature of the process,the comprehensiveness of evidence ,the rigor of evidence quality grading,and the normalization of consensus. It provides reference in methodology for establishing a comprehensive evidence-based evaluation and management system of off-label use of drugs for all clinical specialist disease. Therefore,this scientific research results may promote the standardization and legalization of the off-label use of drugs management in China.

Effect of montelukast sodium intervention on airway remodeling and percentage of Th17 cells/CD4+CD25+ regulatory T cells in asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the dynamic changes in the percentage of Th17 cells/CD4CD25regulatory T cells after intervention with montelukast sodium, a leukotriene receptor antagonist, in asthmatic mice and the association between them.</p><p><b>METHODS</b>Balb/c mice were randomly divided into blank group, asthma group, and montelukast sodium group. The asthmatic mouse model of airway remodeling was established by sensitization with intraperitoneal injection of chicken ovalbumin (OVA) and aluminum hydroxide suspension and aerosol inhalation of OVA. The mice in the blank group were given normal saline, and those in the montelukast sodium group were given montelukast sodium by gavage before aerosol inhalation. Eight mice were randomly sacrificed within 24 hours after 2, 4, and 8 weeks of aerosol inhalation. The pathological sections of lung tissue were used to observe the degree of airway remodeling. Flow cytometry was used to measure the percentages of Th17 cells and CD4CD25regulatory T cells in CD4T cells.</p><p><b>RESULTS</b>The asthma group and the montelukast sodium group had significantly higher bronchial wall thickness and smooth muscle thickness at all time points compared with the blank group (P<0.05). At 8 weeks of intervention, the montelukast sodium group had significantly greater improvements in the above changes compared with the asthma group (P<0.05). Compared with the blank group, the asthma group and the montelukast sodium group had significant increases in Th17 cells (positively correlated with airway remodeling) and significant reductions in CD4CD25regulatory T cells (negatively correlated to airway remodeling) at all time points (P<0.05). At 8 weeks of intervention, the montelukast sodium group had a significant reduction in the number of Th17 cells and a significant increase in the number of CD4CD25regulatory T cells compared with the asthma group (P<0.05).</p><p><b>CONCLUSIONS</b>Montelukast sodium intervention can alleviate airway remodeling and achieve better improvements over the time of intervention. The possible mechanism may be related to the improvement of immunologic derangement of CD4CD25regulatory T cells and inhibition of airway inflammation.</p>

Clinical Significance Interpretation of Positive Sputum Samples from One Patient with Acinetobacter Bau-manni Infection after Colon Cancer Surgery / 中国药师

Objective:To discuss the results interpretation and clinical significance of Acinetobacter Baumanni ( AB) positive spu-tum samples .Methods:The anti-infection treatment of one patient with lung infection after colon cancer surgery in ICU was analyzed , and the results interpretation and clinical significance of AB positive sputum samples were discussed .Results:Although the culture re-sults of sputum samples were positive , the quality of sputum samples was low and the credibility was poor .The possibility of multiple drug resistance AB ( XDR-AB) screened by antibiotics selective stress was small .Meanwhile, the clinical infection symptoms were mild, and the treatment with imipenem was effective .Although the patient had high risk factors for the colonization of Baumanni infec-tion, XDR-AB was not a pathogen .Conclusion:When respiratory samples are AB positive , the quality of samples should be evaluated by smear results firstly , especially the existence of white blood cell phagocytosis or accompanying should be paid attention to , and then the possibility of AB screened by antibiotics selective stress and high risk factors for colonization should be analyzed .Finally, combined with the clinical symptoms of patients and the treatment efficacy before drug sensitivity tests , whether XDR-AB is pathogenic bacteria should be judged , and then the corresponding anti-infection treatment plan should be determined .

Clustering Analysis on Subject Terms of SCI Papers Related to Medical Treatment Cloud / 医学信息学杂志

The paper retrieves SCI papers related to medical treatment cloud and analyzes the current research direction of this topic.It makes the bibliometric analysis of SCI papers on this topic in Web of Science TM core integrated database,counts up the occurrence frequency of high-frequency subject terms in the same document and generates the co-occurrence matrix.By clustering analysis of various document contents in the matrix with SPSS,it obtains the research direction of this topic.

Role of Clinical Pharmacists in Therapy for Patient with Interstitial Lung Disease Induced by Erlotinib / 中国药房

OBJECTIVE:To explore the role of clinical pharmacists in therapy for patient with interstitial lung disease (ILD) induced by erlotinib. METHODS:Clinical pharmacists participated in the therapy for ILD in a patient receiving erlotinib target treat-ment after thoracic vertebra and lumbar radiation,analyzed the cause of ILD and suggested to stop taking imipenem and cilastatin sodium,fluconazol and erlotinib according to lab indexes and patient’s symptom;took prednisone 30 mg,po,qd,for anti-inflam-mation instead of methylprednisolone;adjusted the dose of prednisone to 40 mg/d,and additionally took Carbocisteine oral solution 10 ml,tid,for improving respiratory symptom;panipenem betamipron 1 g,ivgtt,bid,instead of piperacillin sodium and sulbactam sodium. RESULTS:Physicians adopted the suggestions of clinical pharmacists,and the symptom of anhelation and double pneumo-nia recovered;discharged medication plan was erlotinib 150 mg,po,qd. CONCLUSIONS:The patient with radiation history easily suffers from ILD when using erlotinib,and should use erlotinib carefully in the clinic. Clinical pharmacists participated in drug ther-apy and promote safe and rational use of drugs in the clinic.