Piperacillin and Its Compound Preparation-induced Anaphylactic Shock ：A Case Report and Literature Analysis / 中国药房

OBJECTIVE：To i nvestigate the clini cal ch aracteristics of anaphylactic shock induced by piperacillin and its compound preparation ，and to provide reference for prevention and treatment of the severe ADR. METHODS ：A case of anaphylactic shock induced by piperacillin and sulbactam were analyzed in our hospital ，meanwhile ADR literatures about piperacillin alone and its compound preparation-induced anaphylactic shock were collected from Medline ，CNKI，Wanfang database and VIP during the inception to Jul. 2020. Gender and age of patients ，allergic history ，primary disease and treatment ，skin test ， administration route and dosage of piperacillin and its compound preparation ，occurrence time and main manifestations of anaphylactic shock ，treatment measure and prognosis were analyzed ，then prevention and treatment suggestions were put forward. RESULTS：The patient in this case was transferred to the ICU after partial hepatectomy. The use of piperacillin and sulbactam to prevent postoperative infection caused anaphylactic shock. A total of 28 literatures about anaphylactic shock induced by piperacillin and its compound preparations were collected from the database （involving 28 patients）. Among totally 29 patients，there were 12 male and 17 female；the majority of patients were 50-59 years old （6 cases，20.69％）. Three patients had allergic history （food， latex gloves ，etc.），and most of the primary diseases were infectious diseases or the drug used in perioperative period. Skin tests were carried out in 22 patients（75.86％）before medication and the results were negative. The possible allergenic drugs of 27 cases which were administered by intravenous route included piperacillin ，piperacillin sulbactam and piperacillin tazobactam. The dosage was different according to the primary disease and severity. 14 patients（55.56％）developed anaphylactic shock within 5 minutes after drug exposure. The main symptoms were systemic allergic reaction ，mainly involving the circulatory system. Except for two death cases ，the other patients ’symptoms were relieved after treatment. CONCLUSIONS ：Allergic history and skin test results may have limitation in predicting anaphylactic shock induced by piperacillin and its compound preparation. Close monitoring needs to be taken in patients during these medications. Rescue therapy should be prepared in advance and countermeasures need to be carried out promptly in case of anaphylactic shock.

Exploration and practice of "early clinical practice, multiple clinical practice and repeated clinical practice" teaching model / 中华医学教育探索杂志

"Early clinical practice, multiple clinical practice and repeated clinical practice" is the mainstream of the reform of higher medical education in the 21st century. Based on the shortages of the current medical education model, a university started to reform from both theoretical teaching and practical teaching, and constructed a teaching model of "early clinical practice, multiple clinical practice and repeated clinical practice" that fits China's reality. And the teaching effect was evaluated questionnaire survey and OSCE tests. The results showed that this teaching model could promote the all-round development of medical students' knowledge, ability and quality.

Effect of single-chamber balloon combined with dinoprostone suppository on cervical ripening induced by full-term maternal delivery / 中国基层医药

Objective@#To investigate the effects of single-chamber balloon combined with dinoprostone suppository on the progestation of the cervix in full-term maternal delivery.@*Methods@#From January 2017 to December 2018, 120 cases of full-term maternal women admitted to the Central Hospital of Yiwu were selected.According to the random number table method, all women were divided into control group (60 cases) and observation group (60 cases). The control group was given a single-cavity balloon to promote cervical ripening.The observation group received single-chamber balloon combined with dinoprostone to promote cervical ripening.The effects of maternal cervical ripening were observed.@*Results@#The total effective rate of maternal cervical ripening in the observation group (95.00%) was significantly higher than that in the control group (81.67%), and the difference was statistically significant (χ2=6.135, P<0.05). The differences of maternal postpartum hemorrhage and neonatal asphyxia rate were not statistically significant (t=1.684 , χ2=2.563, all P>0.05). The total maternal labor [(5.8±2.1)h] in the observation group was significantly shorter than that in the control group [(7.6±2.5)h], the difference was statistically significant (t=3.126, P<0.05). The vaginal delivery rate (95.00%) of the observation group was higher than that of the control group (73.33%), the difference was statistically significant (χ2=5.342, P<0.05). Before implanting the balloon and balloon combination, the Bishop score between the two groups had no statistically significant difference (t=3.623, P>0.05). After the balloon and balloon combination were taken out, the Bishop score of the maternal cervix[(8.6±1.5)points] in the observation group was higher than that in the control group [(7.2±1.3)points], and the difference was statistically significant (t=4.354, P<0.05). The incidence of adverse reaction of the observation group (6.67%) was lower than that of the control group (13.33%), the difference was statistically significant between the groups(χ2=3.821, P<0.05).@*Conclusion@#Compared with simple single-chamber balloon, single-chamber balloon combined with dinoprostone suppository has more significant effect on the maternal ripening of the cervix, it can improve the vaginal delivery rate and maternal cervical Bishop scores, effectively reduce the maternal total labor, and reduce the incidence of maternal adverse reactions.

Effect of single-chamber balloon combined with dinoprostone suppository on cervical ripening induced by full-term maternal delivery / 中国基层医药

Objective To investigate the effects of single-chamber balloon combined with dinoprostone suppository on the progestation of the cervix in full-term maternal delivery.Methods From January 2017 to Decem-ber 2018,120 cases of full-term maternal women admitted to the Central Hospital of Yiwu were selected.According to the random number table method ,all women were divided into control group (60 cases ) and observation group (60 cases).The control group was given a single-cavity balloon to promote cervical ripening.The observation group received single-chamber balloon combined with dinoprostone to promote cervical ripening .The effects of maternal cervical ripening were observed.Results The total effective rate of maternal cervical ripening in the observation group (95.00%) was significantly higher than that in the control group (81.67%),and the difference was statisti-cally significant (χ2 ＝6.135,P＜0.05).The differences of maternal postpartum hemorrhage and neonatal asphyxia rate were not statistically significant ( t ＝1.684 ,χ2 ＝2.563,all P＞0.05).The total maternal labor [( 5.8 ± 2.1)h] in the observation group was significantly shorter than that in the control group [(7.6 ±2.5) h],the differ-ence was statistically significant (t＝3.126,P＜0.05).The vaginal delivery rate (95.00%) of the observation group was higher than that of the control group (73.33%),the difference was statistically significant ( χ2 ＝5.342,P＜0.05).Before implanting the balloon and balloon combination ,the Bishop score between the two groups had no statis-tically significant difference (t＝3.623,P＞0.05).After the balloon and balloon combination were taken out ,the Bishop score of the maternal cervix [(8.6 ±1.5)points] in the observation group was higher than that in the control group [(7.2 ±1.3)points],and the difference was statistically significant (t＝4.354,P＜0.05).The incidence of adverse reaction of the observation group (6.67%) was lower than that of the control group (13.33%),the differ-ence was statistically significant between the groups ( χ2 ＝3.821,P＜0.05).Conclusion Compared with simple single-chamber balloon,single-chamber balloon combined with dinoprostone suppository has more significant effect on the maternal ripening of the cervix ,it can improve the vaginal delivery rate and maternal cervical Bishop scores , effectively reduce the maternal total labor ,and reduce the incidence of maternal adverse reactions.

Pharmaceutical Practice for a Patient with 5-Fluorouracil Chemotherapy-induced Diarrhea and Neutropenia Associated with Fever / 中国药房

OBJECTIVE:To investigate the way to provide suitable pharmacecaical care for antineophastic drug-induced ADR by clinical pharmacists. METHODS:For one case of 5-FU chemotherapy-induced neutropenia associated with fever and diarrhea, clinical pharmacists provided advices on antibacterial treatment,including imipenem/cilastatin 0.5 g,q6 h,ivgtt;norvancomycin 0.4 g,q6 h,po;levofloxacin 0.4 g,qd,ivgtt;loperamide with initial dose of 4 mg for anti-diarrheal medication,maintaining at 2 mg,q4 h. RESULTS:After 22 days of appropriate antibacterial and anti-diarrheal treatment,the patient's body temperature and he-mogram returned to normal,diarrhea stopped and β-HCG decreased to 61.58 U/L;then the patient was discharged from hospital. CONCLUSIONS:It is beneficial to optimize chemotherapy plan and ADR disposal,and ensure the safety of the treatment that clini-cal pharmacists assist physicans to optimize therapy plan and provide pharmaceutical care.

ETME, a novel β-elemene derivative, synergizes with arsenic trioxide in inducing apoptosis and cell cycle arrest in hepatocarcinoma cells via a p53-dependent pathway

Arsenic trioxide (ATO) has been identified as an effective treatment for acute promyelocytic leukemia (APL) but is much less effective against solid tumors such as hepatocellular carcinoma (HCC). In the search for ways to enhance its therapeutic efficacy against solid tumors, we have examined its use in combination with a novel derivative of β-elemene, N-(β-elemene-13-yl)tryptophan methyl ester (ETME). Here we report the effects of the combination on cell viability, apoptosis, the cell cycle and mitochondria membrane potential (MMP) in HCC SMMC-7721 cells. We found that the two compounds acted synergistically to enhance antiproliferative activity and apoptosis. The combination also decreased the MMP, down-regulated Bcl-2 and pro-proteins of the caspase family, and up-regulated Bax and BID, all of which were reversed by the p53 inhibitor, pifithrin-α. In addition, the combination induced cell cycle arrest at the G2/M phase and reduced tumor volume and weight in an xenograft model of nude mice. Overall, the results suggest that ETME in combination with ATO may be useful in the treatment of HCC patients particularly those unresponsive to ATO alone.

Evaluations on the diagnostics practice teaching effect by application of computer simulated human / 中华医学教育探索杂志

Objective To evaluate the resultof applying computer simulated human for the diagnostics teaching.Methods The survey was conducted on medical simulation teaching and traditional teaching applied in 338 medical students through statistical evaluation of operative performance and questionnaire.Results The simulation teaching group performed better than the traditional teaching group on the operative assessment(P<0.05).79.2%students thought it was necessary to have simulation teaching.Conclusions Computer simulated human Can improve students'clinical practice ability.

Study of antisense oligonucleotide miR-21 on radiosensitivity of SHG-44 in vitro / 中华放射医学与防护杂志

Objective To investigate the radiosensitizing effect of knock-down the expression of miR-21 on human SHG-44 glioma cells and explore the possible mechanism. Methods Antisense oligonuleotidas of miR-21, mediated by LipofectamineTM 2000, were transfected to SHG-44 cells. Three groups were: blank control group ( mock group), negative control and antisense transfected group ( AS-miR-21 gorup). Cells of each group were irradiated with 6 MeV X-rays at the doses of 0,1,2,4,6 and 8 Gy.Dose-suvivial curve was established by colony-forming assay. The influence of AS-miR-21 on cell cycle and cell apoptosis was analyzed by flow cytometry assay after 6 Gy irradiation. Results The value of D0 and Dq of AS-miR-21 group declined obviously compared with the mock group and negative control group. Flow cytometric analysis showed that cell cycle distribution changed( G0/G1 phase arrest, S phase decreased)after transfected with AS-miR-21 (t = 8.18, -4.52,P ＜ 0.05 ). The sensitization enhancement ratios of D0 and Dq were 1.32 and 2.10 respectively. Apoptosis assay showed the early apoptosis rate was signiflcantely increased in AS-miR-21 、irradition alone and combined group than mock control group( t = 20.14,11.11,50.07, P ＜ 0.05). Conclusions AS-miR-21 can enhance the radiosensitivity of human glioma cells SHG-44 by promoting cell apoptosis and faciliating cell cycle redistribution.

Mechanism study of beta-elemene derivative (ET) in NB4 cell on apoptosis induction / 中国中药杂志

<p><b>OBJECTIVE</b>beta-Elemene is an active component of herb medicine Curcuma wenyujin, N-(beta-elemene-13-yl)tryptophan (ET) was synthesized to increase the activity. The antiproliferative and apoptotic effects of ET were investigated with NB4 cell.</p><p><b>METHOD</b>The mechanism of ET were studied with the technology of cell culture in vitro using MTT assay, flow cytometry and Western blot analysis.</p><p><b>RESULT</b>ET inhibited cell growth and induced apoptosis in NB4 cell at concentrations less than 40 micromol x L(-1). The apoptosis induction of ET in NB4 cell was associated with the generation of hydrogen peroxide (H2O2) and activation of caspase-3. Catalase pretreatment blocked ET-induced apoptosis in NB4 cells.</p><p><b>CONCLUSION</b>ET induces apoptosis through generation of H2O2 in NB4 cell.</p>

Prediction of the Shelf Life of Compound Sodium Citrate Injection by Initial Average Rate Stability Test / 中国药房

OBJECTIVE:To predict the shelf life of compound sodium citrate injection by initial average rate stability test. METHODS: The initial average rate stability test was performed at 7 different temperatures to investigate the relationship between the initial average rate (V0) of the glucose degradation reaction and Kelvin's temperature (1/T), and the activation energy of reaction, the drug reaction velocity constant and shelf life were computed as well. RESULTS: The regression equation was lgV0=18.15—6 774.6?1/T(r=—0.937 5), the reaction activation energy was 31.0Kcal?mol-1, the drug reaction velocity constant at 20℃ was 1.1?10-5h-1, and the shelf life was 1.09 years. CONCLUSION: The method is simple and it can accurately predicate the shelf life of compound sodium citrate injection.

Useing professional post to improve clinlical teaching work / 中华医学教育探索杂志

Professional post means the personal capability certified by nation. Professional post has the function of choosing approriate person and helping to reform salary distribution system,and has beome an important lever to arouse the working enthusiasm of staffs.This article introduces the experience of using professional post to improve clinlical teaching work in the first affiliated hospital of Chongqing Medical University.

A retrospective analysis of 33 primary intraspinal tumors treated with postoperative radiotherapy / 中华放射肿瘤学杂志

Objective To describe the clinical characteristics,outcome and prognostic factors of primary intraspinal tumor treated with postoperative radiotherapy.Methods Thirty-three patients diagnosed as suffering from intraspinal tumor treated with postoperative radiotherapy were analyzed.There were eighteen male and fifteen female,with a median age of 37 years(range 7-64 years).Two patients were treated with grossly total resection,25 subtotal resection,2 biopsy only.These patients were treated either with(~(60)Co)(n =18,before 1998) or 6?MV-X ray(n =15,after 1998) to the total dose of 45-68?Gy.The overall response and survival rates were calculated by Kaplan-Meier method and the difference between groups was tested by the log-rank method.The prognostic factors related to the characteristics of patient,tumor,and treatment were determined.Results The overall response,five-year and disease-free survival rate was 81.3%,59.4% and 56.3%,respectively.By multivariate analysis,the histological type(P= 0.039) and gender(P= 0.049) had independent impact on the 5-year survival rate.Ependymoma had a better prognosis compared to other histological subsets and female gained more survival advantage over male.There was no close relationship between survival and other factors,such as age,extent of surgery,initial site,irradiation dose,or the interval between surgery and radiotherapy.Conclusions Postoperative radiotherapy is safe and effective for primary intraspinal tumor.The histological type and gender are important prognostic factors of survival in primary intraspinal tumors.

Analysis on Incidence and Related Factors of Anemia in Cancer Patients Caused by 7 Kinds of Chemotherapy Regimes / 中国药房

OBJECTIVE:To study the situation of anemia in newly diagnosed ovarian cancer and breast cancer patients treated with 7 kinds of chemotherapy regimes. METHODS:110 cases of newly diagnosed ovarian cancer and breast cancer from May 2008 to Feb. 2009 in People’s Hospital of Peking University were analyzed retrospectively. The level of hemoglobin in patients treated with different chemotherapy regimes were evaluated and analyzed with SPSS software. RESULTS:Of total 110 patients, class Ⅰ anemia occurred 194 times and class Ⅱ anemia occurred 55 times. High incidence of anemia appeared in chemotherapy regimes with platinum as base. Low incidence of anemia occurred in TA chemotherapy regime. The older patient is,the more easily anemia occurred. CONCLUSION:The incidence of anemia after chemotherapy is related to type of cancer,chemotherapy regime, chemotherapy cycle and patient’s age.

Bottleneck problems in the development of higher medical bilingual teaching and countermeasures / 中华医学教育探索杂志

Based on the practical situations of higher medical education in china,the author discussesd the bottleneck problems in the development of medical bilingual teaching and proposed some measures to overcome these difficulties on the teaching objective,teaching staffs,textbooks,students' quality and evaluation mechanism of teaching quality.

Survey of diagnostics bilingual teaching in 5-year-proguam medicinal underguaduate course / 中华医学教育探索杂志

In order to raise international comprehensive medical talents to have strong competition capability,the bilingual teaching is on the rise in the domain of medical education. Questionnaire-based survey among the 5-year-proguam medicinal undergraduate students was conducted to investigate the students'learning condition,acquaintanceship and requirements on the bilingual teaching so as to further reform and explore ways to improve the quality of bilingual teaching

Study on apoptosis and changes of cell cycle in ovarian cells induced by paclitaxel / 中国医师杂志

Objective To investigate whether paclitaxel can efficiently induce the apoptosis of ovarian cell HO-8910,and to study the relationship between the apoptosis of cells and the cell cycle.Methods With the treatment of paclitaxel with different concentrations and different time,the morphologic change of HO-8910 ovarian cells was observed using fluorescence microscopy and transmission electron microscopy(TEM),and the apoptosis of cells and the changes of cell cycle were determined by flow cytometry(FCM). Results The typical changes of HO-8910 cell apoptosis were observed by TEM and Fluorescence microscopy.With the treatment of paclitaxel,the HO-8910 ovarian cells were firstly arrested in G_2/M phase,and the typical ultrastructural changes of apoptosis were appeared only after the cells were apparently arrested in G_2/M phase.Conclusion Paclitaxel can induce the apoptosis of HO-8910 cells and the apoptosis is associated with the blockage of G_2/M phase in cell cycle.