OBJECTIVE:To discuss the management tactics and developmental prospects of fair-price drug stores in China.METHODS:To analyze the advantages and disadvantages of fair-price drug stores and countermeasure.RESULTS&CONCLUSION:Development of fair-price drug stores need not only support of governments but also the improvement of drug and service quality by strengthening physical distributions,renewing management methods and bringing up specialists.

Objective To study the role of Th1/Th2 cytokine profile in the pathogenesis of recurrent genital herpes (RGH), and to find out the relationship between Th1/Th2 cytokines. Methods A two-colour immunofluorescent staining of cell surface antigen and intracellular cytokines (IL-2、 IL-10、 IL-12、 IFN－? and TNF－? ) in CD3＋ T-lymphocytes of 20 patients with RGH with flow cytometric analysis were performed. Results Compared to controls, patients with RGH showed a decreased number of CD3＋ T cells（ P0.05） . Conclusions RGH patients seem to have a predominance of Th2 cytokine profile, which may play an important role in the pathogenesis of RGH.

Objective To study the role of Th1/Th2 cytokine profile in the pathogenesis of recurrent genital herpes (RGH), and to find out the relationship between Th1/Th2 cytokines. Methods A two－ colour immunofluorescent staining of cell surface antigen and intracellular cytokines (IL－ 2、 IL－ 10、 IL－ 12、 IFN－ γ and TNF－ α ) in CD3＋ T－ lymphocytes of 20 patients with RGH with flow cytometric analysis were performed. Results Compared to controls, patients with RGH showed a decreased number of CD3＋ T cells（ P0.05） . Conclusions RGH patients seem to have a predominance of Th2 cytokine profile, which may play an important role in the pathogenesis of RGH.

Objective To assess the effect of immunosuppression conversion from cyclosporine(CsA) to tacrolimus(FK506) on progression of chronic allograft nephropathy(CAN).Methods A retrospective study was performed in 36 cyclosporine treated renal transplant recipients.Patients were included if they were biopsy-proven CAN and they were converted from cyclosporine to tacrolimus due to CAN.The FK506 dose was 1/50 to 1/100 of the cyclosporine's and the dose was adjusted according to the trough level of tacrolimus,body weight of the patient and the situation of CAN.Other immunosuppressive agents kept unchanging.Serum creatinine and FK506 trough level were monitored after conversion.Fasting blood triglyceride,total cholesterol and glucose were determined at baseline and 6th month after conversion to tacrolimus.Results After switching over to FK506 for 6 months,there was a significant improvement in function of renal allograf(P

Objective To detect cytokine levels secreted by CD3 + T cells and monitor the Th cell im-balance in the patients with condyloma acuminatum(CA).Methods The peripheral blood lymphocytes were isolated and stimulated prior to analysis.Cytokine detection was performed using monoclonal antibodies,which were fluorochrome-conjugated for easier direct manipulation in flow cytometry analysis.The results were pre-sented as cytograms showing dual staining of lymphocytes.Results The levels of IL-2,IL-12,IFN-?and TNF-?produced by Th1cells decreased,while the level of IL-10produced by Th2cells had no significant change in CA patients in comparison with healthy controls.Conclusions There is Th1/Th2imbalance in CA patients with a decline of Th1type cytokines.The Th1/Th2imbalance might be the mechanism that HPVs es-cape from immunosurveillance in CA patients.

Objective To study the diagnosis and treatment of the severe pulmonary infection in the patients after kidney transplantation. Methods The clinical data of 26 patients with severe pulmonary infection following kidney transplantation were analyzed retrospectively. Results Microorganisms were isolated and identified in 22 patients out of 26 kidney transplantation patients with severe pulmonary infection. The main etiological pathogens according to their frequency and type were: bacteria (15 cases, including Escherichia coli, Aerobacter cloacae, Klebsiella fredlanderi, Enterococcus faecalis, Staphylococcus epidermidis, etc.), fungi (12 cases, Fermentum, Blastomyces albicans, Candida tropicalis, Aspergillus, etc.), and cytomegalovirus (10 cases). 46.15% (12/26) of patients were infected with one kind of microorganism, and 53.85% (14/26) of patients were mixed infection. In 73.1% (19/26) of patients the pulmonary infection occurred during 1-6 months after renal transplantation. Among 26 patients, 12 developed ARDS, and 4 patients gave up therapies due to high expenses. With energetic treatment, 18 patients (81.82%) were cured and 4 died. Conclusions Intensive care and active measures should be given in the treatment of severe pulmonary infection after kidney transplantation. Early diagnosis, administration of broad-spectrum and combined use of antibiotics, the early identification of pathogens, enforcement in systemic support, including correction of immunosuppression, the timely use of mechanical ventilation to correct hypoxia, are the key treatment strategies for a successful result.

Objective To investigate Shuxuening injection combined with deproteinized extract of calf blood on serum IGF-1, IL-1 and ICAM-1 level in patients with cerebral infarction recovery stage.Methods 120 patients with cerebral infarction were collected.According to the different drug treatment, 60 cases in each group were given corresponding drug treatment, on the basis of control group, the calf blood extract injection was given in experimental group.After the end of treatment, all patients blood rheology, IGF-1, IL-1 and ICAM-1 levels were tested.Results Compared with control group, the indexes of the patients in experimental group improved more significantly, whole blood viscosity, red blood cell pressure volume, platelet aggregation rate decreased significantly(P<0.05); serum IGF-1 levels in experimental group decreased significantly(P<0.05).The levels of serum IL-1, ICAM-1 in experimental group decreased significantly(P<0.05).Conclusion Shuxuening injection combined with deproteinized extract of calf blood can significantly reduce serum IGF-1, IL-1 and ICAM-1 levels in patients with cerebral infarction recovery stage, improve blood flow, reduce blood viscosity.

One hundred patients were diagnosed with coronary heart disease through dual-source CT coronary angiography (DSCTA) in our hospital,including 53 cases aged ≥60 y (elderly group) and 47 cases ＜60 y (middle-aged group).The curved-planar reconstruction (CPR),maximal intensity projection (MIP) and other post-processing reconstruction techniques were used to evaluate the indicators and differences of coronary stenosis ≥ 50％ ; the X-ray coronary angiography (CAG) findings were regarded as the gold standard.The evaluable rates of coronary arteries through DSCTA were 97.0％ and 98.6％ for two groups (P ＞0.05).The positive rate of coronary artery stenosis ≥ 50％ in elderly group was higher than that of middle-age group ( 12.6％ vs 9.0％ P ＜0.05 ).The rates of multi-vessel disease in elderly group (28.3％ ) was also significantly higher than that of middle-age group (6.4％,P ＜0.05 ).The sensitivity,specificity,positive predictive value and negative predictive value in evaluation of coronary artery stenosis ≥ 50％ for elderly patients were 92.3％,98.0％,88.0％ and 98.9％ respectively; those for middle-aged patients were 96.0％,99.0％,90.6％ and 99.6％ respectively ( P ＞0.05 ).DSCTA imaging provides an effective screening and evaluation method for coronary heart disease in elderly and middle-aged patients.

Objective To evaluate the diagnostic value of one-stop cardiac CT (stress dynamic CT-MPI combining with CTA) in CAD. Methods Thirty patients underwent CCTA combined with stress dynamic CT-MPI and stress SPECT-MPI including 16 patients underwent ICA were retrospectively enrolled. All procedures were performed within 2 weeks without related treatment. CT-MPI and SPECT-MPI were evaluated visually and MBF was quantified according to dynamic CT-MPI which was compared through paired t test. The diagnostic value of CT-MPI for myocardial ischemia was evaluated with SPECT-MPI as the reference standard. The consistency between the two techniques was determined by Kappa test. With SPECT combined with ICA as the reference standard, we evaluated the value of CT-MPI and its combination with CCTA in the diagnosis of CAD with hemodynamic stenosis. Results On stress CT-MPI, 19 of 30 patients and 52 segments were evaluated with myocardial perfusion defects. There was a significant difference in MBF values between normal[(117.61±29.82)ml·100 ml-1·min-1] and hypoperfused [(80.60±22.15)ml·100 ml - 1 · min - 1] segments (t=15.764,P<0.001). With SPECT as reference standard, the sensitivity, specificity were 94.12% (32/34), 95.80% (456/476) on the vessel basis. The Kappa value of the two examinations was 0.772(P<0.001). As for the 16 patients who also underwent ICA, 15 patients with 22 vessel-areas had hemodynamic stenosis on CT-MPI. Compared with SPECT combined with ICA, the sensitivity, specificity for detecting hemodynamic stenosis were 92.31% (12/13), 71.43% (25/35) for CT-MPI;100%(13/13), 51.43%(18/35) for CTA and 92.31%(12/13), 82.86%(29/35) for CT-MPI combined with CTA, respectively. Moderate correlation was observed between the combination of CT-MPI and CCTA and reference standard (r=0.690,P<0.001). Conclusion Stress dynamic CT-MPI can detect myocardial perfusion defects and hemodynamic changes and improves the diagnostic ability of functional stenosis of CAD combined with CTA, which can finally achieve the one-stop mode of cardiac CT in CAD.

Objective To investigate the resistance of Acinetobacter baumannii to clinical common antibiotics and new drug tigecycline. Methods Six hundred and two Acinetobacter baumannii isolates were collected from 2008 to 2009 in four teaching hospitals in Zhejiang province. Agar dilution method was used to detect the resistance of 13 clinical commom antibiotics, polymyxin B and tigecycline. Homology analysis of 24 multi-drug resistant Acinetobacter baumannii strains was used to investigate the relationship of each strain with the method of pulsed field gel electrophoresis. Results From 2008 to 2009, the Acinetobacter baumannii isolates of four teaching hospitals in Zhejiang province were mainly isolated from respiratory specimens with the number of 277 (86.0%) strains in 2009, the number of blood samples decreased from 15 (5.4%) strains in 2008 to 5 ( 1.5% ) strains in 2009, and there were no obvious change in other specimens. Acinetobacter baumannii strains were resistant to 13 clinical common antibiotics at different degree, fluctuated from 35.0% to 85.0%. Compared with the resistance in 2008, levofloxacin and tobramyxin decreased 0. 9% and 9.0% in 2009, respectively. However, the resistance of other antibiotics increased at different degree, the resistance of ceftriaxone and cefepime increased about 10.0%, and the resistance of imipenem and meropenem increased to 74.2% (239/602) and 70.8% (228/602) in 2009,respectively. Acinetobacter baumannii showed high resistance to tigecycline with the percent of 78.9% (475/602), while it was only 3.7% (22/602) for polymyxin B. There were six cloning types among the 24 Acinetobacter baumannii isolates, and the most common type was type A with the percent of 50%.Conclusions The resistance of tigecycline makes the situation of nosocomial infectious more serious. It is necessary to control the transmission of multi-drug resistant Acinetobacter baumannii immediately.