To cultivate more excellent pharmacists, ensuring patients rational drug use, standardiza-tion training of hospital pharmacists in Beijing has been carried out since 2000, and the wonderful effect has been achieved. The teaching methods mainly include centralized training model, small lectures, practice teaching and self-study. The training teaching content mainly includes prescription audit, drug dispensing and management as well as the pharmaceutical care. In this paper, based on the analysis of the status quo, it is recommended that detailed training formulate, teaching methods and content of the second stage of the training about the training management policy, and the clinicians teaching should be added to the contents of teaching. The thought moral qualities, laws and regula tions, as well as academic and research training should also be added to the teaching content.

Objective To investigate the feasibility and the preliminary curative effect of the deep inferior epigagtrie perforator(DIEP)flap for child's foot and malleolus reconstruction.Methods A series of 5 child patients were treated with DIEP flap from August to December in 2007.All of them had foot and malleolus defects secondary to traumatic injuries and significant exposure of the tendons and skeleton.The maximum defect Wag 17 cm×6 em in size,the minimum defect Was 11 cm x 6 cm in size.In 2 eases,suture the inferior epigastric artery(vein)to the anterior tibial artery(vein).In 1 case,suture the inferior epigagtric artery(vein)to the dorsal artery (vein)of foot.In 2 cases,suture the inferior epigastric artery (vein)to the posterior tibial artery(vein).The minimum flap in size was 12 cm×7 cm.The maximum flap in size was 18 cm×7 cm.The donor site of the DIEP flaps Wag always closed primarily.Results Donorsite and receptor-site weIe primary healing in all patients.The mean follow-up was 3 months(range from 1to 5 months),all flaps survived with excellent color and quality,and no extremely fat contour.In 4 cases,a protective sensation Wag regained.The patient has obtained the good function of foot and malleohs.The abdomen contour resumes satisfaction, and the abdominal wall competency is preserved. Conclusion Abdominal wall competency is preserved because no muscle or fascia is included.DIEP flap is so thin that not required second-stage operation for debulking.In brief,it is believed that the DIEP flap is an ideal technique for foot and malleolus reconstruction of child patients, which meets the new concept of mieresurgery.

Objective To investigate the ex tr action technique for seperating the active components in the root of Salvia mi ltiorrhizae bunge by supercritical fluid, and to analyze the extracted product s by HPLC-MS n . Methods The extraction condition s were established as follows: 950ml?L -1ethanol as the first entrainer, t he pressure of 20.0 MPa, temperature at 45 ℃, and extracting time 1 h; then 100 mL?L -1 ethanol was selected as the second entrainer, pressur e was 30.0 MPa, temperature was 65 ℃, and extracting time was 3 h. Results Compared with traditional refluxing extraction and ultrasonic extraction, supercritical fluid extraction was better and more effect ive. Conclusion Supercritical extraction is simple, highly selec tive and efficient in extracting the active components in Salvia miltiorrhizae bunge.

ObjectiveTo study the sirolimus (SRL)-associated interstitial pneumonitis,which is a severe side effect of sirolimus therapy. Methods In 7 renal grafts treated with SRL, interstitial pneumonitis (8 times) was diagnosed. One patient suffered a relapse after sirolimus treatment was given again. Two patients received de novo sirolimus treatment, and rest 5 patients were switched from a calcineurin inhibitor-containing regimen to a SRL-based protocol for various indications: chronic allograft nephropathy (n = 4) and cancer (n = 1 ). The patients presented with fever, dyspnea on exertion and the chest X-ray or computed topographic (CT) scan on admission showed bilateral mostly peripheral interstitial infiltrates. ResultsSRL was discontinued in 4 patients and the dose was reduced in the remaining 3 patients. Symptoms were improved within 3-14 days in all patients, the radiographic findings improved within 2-4 weeks, and the lesions were absorbed completely in 2-6 months.ConclusionThe frequency of interstitial pneumonitis appears to be increased in renal transplant patients receiving SRL. Discontinuation or reduced dose of SRL appears to be the safest treatment option for the patients with interstitial pneumonitis.

Objective To evaluate the value of using fluorescence in situ hybridization (FISH)technique for the detection of chromosome aberration of urine exfoliated cells for the diagnosis of bladder tumor.MethodsFISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9p16 site from 20 normal people, and to establish the threshold.The morning's first urinations were available from 75 patients with bladder cancer and 25 patients without urothelial tumor, then were detected using FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results higher than the criteria,or one probe has two or more abnormal results.Results The sensitivity of single using were 73.3％ (55/75),76.0％ (57/75),62.7％ (47/75) and 62.7％ (47/75) for the 4 probes (3,7, 17 and 9p16)respectively.The sensitivity of combined detection was 85.3％ (64/75) and specificity was 96.0％ (24/25) The sensitivity and specificity of urine cytology examination was 9.3％ (7/75) and 100％ (25/25) .The sensitivity of FISH examination was significantly higher than that of urine cytology examination (85.3％ vs 9.3％ ,x2 = 57.00, P ＜ 0.001) .Sensitivity of FISH examination was not correlated with cancer pathologic grading(low vs high : 84.2％ vs 86.5％, x2 = 0.08, P ＞ 0.05)and clinical stage (ta-tl : 82.9％, t2-t4 :87.5％, x2 = 0.32 ,P ＞ 0.05) .ConclusionFISH technique is a non-invasive and effective method for the early diagnosis of bladder tumor and is more sensitive than urine cytology.Furthermore, FISH technique can be used to predict the tumor's biological behavivor and prognosis.

Objective To use autologous costicartilage trestle to correct secondary cleft lip nasal deformity,in order to obtain a nice nose.Methods A total of 64 patients were treated,including 51 unilateral and 13 bilateral cleft lip,aged 16 to 38 years,with the average of 21 years.The deformity included cripetura columellar,flattened nasal tip,anisopleural nostril and caved nosewing.The carven costicartilage was embedded into bilateral nasal septum to form a new trestle for remodelling the shape of nose and nasal tip.Results The follow-up time was 3 months to 2 years,showing that all patients were satisfied with the outline of external nose,without infection and costicartilage revealed.Conclusions The autologous costicartilage is easy to collect without rejection reaction,and therefore it can be used in correcting secondary cleft lip nasal deformity with fair improvement of nasal outline,especially in nasal tip height.

Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DI-COM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".
Computer Systems ; Information Dissemination ; Medical Informatics ; Software

Objective To explore the feasibility,the safety,D2 lymph node dissection and clinical outcomes of laparoscope-assisted radical gastrectomy lot advanced gastric cancer.Methods The clinica data of 47 cases with advanced gastric treated with laparoscope-assisted radical gastrectomy were analyzed retrospectively.Results Laparoscope-assisted radical gastrectomy,proximal gastrectomy in 25 cases,distalgastrectomy in 11 cases,total gastrectomy in 10 cases;46 were performed Laparoscope-assisted surgery radical gastrectomy successfuly,and the other one was converted to abdominal opening.The average operative time for proximal gastrectomy,distal gastrectomy,and total gastrectomy was(220±55)min,(284±37)min,and (330±50)min,respectivel.The average blood loss in proximal gastrectomy,distal gastrectomy,and total gastrectomy was(150±87)ml,(120±70)ml,and(330±50)ml respectively.The average time of proximal gastrectomy for gastrointestinal function recovery,for the patients to stand up,and for the postoperative hospital stay was(5.1±0.5)d,(3.2±0.8)d and(9.0±1.5)d.The average time of distal gastrectomy for gastrointestinal function recovery,for the patients to stand up,and for the postoperative hospital stay was (4.0±0.8)d,(3.2±1.5)d and(9.0±2.0)d.The average time of total gastrectomy for gastrointestinal function recovery,for the patients to stand up,and for the postoperative hospital stay was(4.1±0.8)d,(3.2±0.8)d and(9.5±2.0)d.The mean total number of retrieved lymph nodes was(21.95±9.88),and the lengths of proximal and distal margins to the tumor were(6.41±2.13)cm and(6.22±1.98)cm respectively.No postoperative deaths or anastomtic fistulas were found.Its short-term outcomes were satisfactory.Conclusion Laparoscope-assisted radical gastrectomy with D2 lymphadenectomy is safe,feasible,which achieves adequate cancer clearance,but the long-term outcome is needed to be observed.

Objective Folate receptors ( FRs) , overexpressed on the surface of a variety of tumor cells , are potential targets for tumor targeting therapy .This study aimed to prepare an FR-mediated drug nanocarrier with folate conjugated pullulan acetate ( FPA) to target chemotherapeutic agents to FR-overexpressed tumor cells and investigate its tumor-suppressing effect in vitro. Methods The cytotoxicity of epirubicin-loaded FPA nanoparticles ( FPA/EPI NP) against HepG2 and Hela cells was evaluated by MTS assay.The HepG2 and Hela cells were divided into five groups to be treated with NPs (NP control), chlorpromazine, chloro-quine, amiloride, and folate, respectively, followed by detection of the fluorescence intensity by flow cytometry . Results FPA/EPI NP was successfully formulated into NPs , with the mean particle size of (268.5 ±12.0) nm, by dialysis with an almost spherical shape . The drug-loading rate and entrapment rate of FPA/EPI NP were (6.45 ±1.04) and (72.45 ±11.50) %, respectively.The survival rates of the HepG2 and Hela cells were both >95%after 24 hours of incubation with FPA NP at 5, 40, 200, 400 and 1000μg/mL and 90.0%after 72 hours.The survival rates of the HepG2 cells treated with 5, 40, 200, 400 and 1000μg/mL FPA/EPI NP for 24 hours were (92.3 ±5.2), (70.4 ±4.6), (50.0 ±4.0), (41.1 ±4.1) and (27.0 ±3.6) %, respectively.Compared with the NP control group, the Hela cells of the chlorpromazine , amiloride and folate groups showed a significantly lower rate of NP uptake (P<0.05), and so did the HepG2 cells pretreated with chlorpromazine or amilo-ride (P<0.05).At 72 hours, the half maximal inhibitory concentrations (IC50) of FPA/EPI NP against HepG2 and Hela cells were 168 and 105μg/mL, respectively . Conclusion Clathrin-mediated endocytosis and macropinocytosis are involved in the internaliza-tion of FPA/EPI NP in HepG2 cells, while clathrin-and FR-mediated endocytosis in that of Hela cells .FPA NP may serve as a new drug carrier for tumor-targeted therapy .

Objective To observe the effect of buyanghuanwu decoction on expression of immunoreactive protein and mRNA of NMDA receptor 2B subunit in rats hippocampal with vascular dementia to investigate the mechanism of buyanghuanwu decoction. Methods One hundred and forty-four rats were randomly divided into 4 groups: sham-operated group, VD model group,nimodipine group and buyanghuanwu decoction treatment group. The rats models of vascular dementia were built up by four vessels occlusion method. VD rats were treated with in-tragastrical buyanghuanwu decoction suspension (50 pharmacognostic g·kg-1·d-1) and nimodipine suspension (20 mg·kg-1·d-1) for 30 days. The learning and memory abilities were evaluated by Morris water maze tests. The change of NR2B protein in hippocampal of each group of rats were measured with immunohistochemistry and Western blot techniques and the expression of NR2B mRNA in hippocampus were observed by real-time fluorescence quantitative PCR techniques. Results Water maze tests,compared with sham-operated group((24. 18 ± 7.90)s,(7.99 ±1.32)/min) ,the escape latency(51. 25 ±18.28)s to explore the extension and the average spatial probe number ((5. 26 ±0. 74)/min) reduced in VD model group (P < 0. 05). Buyanghuanwu decoction ((25.91 ±9.56)s,(7. 52 ± 1. 27)/min) had significantly improved the above-mentioned rat model of learning and memory performance (P<0.05). There was no significant difference among sham-operated group,nimodipine group and buyanghuanwu decoction treatment group (P>0. 05). Similarly,as compared rats with sham-operated group(0.71 ±0.13), (5887 ±501), the expression of NR2B protein (0. 33 ± 0. 06) and its mRNA(593 ±53) were apparently decreased in VD rats (P< 0.05). The expression of NR2B protein(0.66 ±0. 11) and its mRNA (5692 ±482) in neuron of hippocampus were increased by buyanghuanwu decoction compared with the model group (P < 0. 05), and no difference was discovered between sham operation group and nimodipine group (P > 0.05).Conclusions Buyanghuanwu decoction improves the learning and memory abilities in VD rats, the therapeutic mechanism was concerned with lessening the injury of neurons on CA1 field in hippocampus and promoted the expression of NR2B protein and its mRNA.