Drug addiction is a chronic relapsing brain disease. Repeated drug exposure can cause neuroadaptations in major brain circuitries,leading to compulsive drug consumption behav-ior and relapse after abstinence.Many studies have found that intercellular signaling cascades mediated central nervous system remodeling in the rewarding circuitry and addiction associated neuroplasticity of learning and memory are important molecular mechanism of drug addiction.Studies show that extracellular sig-nal-regulated kinase (ERK)is associated with drug-mediated psychomotor activity,rewarding properties and relapse of drug seeking behaviors.Therefore,this article has reviewed the role of ERK signaling pathway in drug addiction.Research on the role of ERK signaling pathway in drug addiction will provide im-portant theoretical foundation for in-depth understanding of the molecular mechanism of drug addiction and shine a light on new molecular targets and treatment strategies for drug addiction.

Objective To shorten the time of drug reception for ward areas and improve the overall satisfaction level towards the hospital. Methods The process of drug reception for ward areas was optimized by means of information technology and through business process reengineering. Results The time of drug reception for ward areas was effectively shortened and work efficiency and the overall satisfaction level were improved. Conclusion Using information technology and implementing business process reengineering are effective measures that can be taken by hospitals to improve efficiency and satisfaction level.

AIM: To study the effect of the processing on the contents of nuciferine and quercetin existed in lotus leaf(Nelumbo nucifera Gaertn).METHODS: Nuciferine and quercetin were allowed for the markers and its contents were assayed by HPLC.Marker constituents were compared among raw herb,carbonizing by stir-frying and carbonizing by calcining.RESULTS: By means of carbonizing processing,nucifering content of lotus leaf reduced to 99.25% and 99.23% compared with the unprocessed lotus leaf,quercetin content of lotus leaf increased to 608.56% and 643.85% compared with the unprocessed lotus leaf.CONCLUSION: The heating processing has remarkable effect on the contents of nuciferine and quercetin in Nelumbo nucifera Gaertn.

Objective To explore the clinical significance of coagulation factor and fibrinolytic indexes in viral hepatitis and pregnant hepatitis. Methods 142 inpatients with viral hepatitis classified into five subgroups (acute hepatitis; mild chronic hepatitis; chronic moderate/severe hepatitis; cirrhosis and severe hepatitis),and 35 cases of pregnant hepatitis were measured eight indexes of FV:C、FVⅡ:C、FX:C、PL:A、t-PA:A、PAI:A、D-D和FDP respectively and the results were compared with that of 90 cases from normal control group and 32 cases of normal pregnant women. Results Compared with control, plasma FV: C increased evidently in acute hepatitis (P

Under the principle of giving priority to patient care, efforts were made to expand the functions of HIS in the dispensary of the ward areas. Using HIS to automatically create and print drug-dispensing labels that fit in with clinical needs and thus realizing paperless dispensation in the dispensary of the ward areas could not only reduce errors but also improve work efficiency and service quality. Medication records created automatically with HIS, in the process of which clinical data were automatically entered, were easy to use and provided complete and timely information, thus setting up a sound platform ofr the delivery of pharmaceutical service. A quantitative system for personnel appraisal and control was also established. Hence the enhancement of work efficiency and control level.

Objective To develop an HIS-based electronic medication record. Methods With the aid of the Windows 2000 platform, the clinical data of the patients from the relevant branch systems of HIS was loaded into the medication record management system by using PowerBuild, and then correlative data were processed and corresponding functions were appended. Results An HIS-based electronic medication record was successfully developed. Easy to operate and providing clinical pharmacists with full and accurate clinical data, it could be used both forprospective analyses and retrospective studies. Conclusion As a new mode of medication records, it has sound application prospects in hospitals with good hospital information systems.

Objective To study the impact of narrow band ultraviolet B (NB-UVB) irradiation on the expression of T helper 17 (Thl7) and CD4,CD25 and regulatory T (Treg) cells and their related cytokines transfor-ming growth factor beta 1 (TGF-β1) and interleukin-6 (IL-6) to further clarify how NB-UVB treatment helps patients with psoriasis vulgaris.Methods Ninety patients with active stage and stationary stage psoriasis vulgaris (45 cases each) were treated with NB-UVB for 8 weeks.Fifty healthy persons were used as normal controls.Peripheral blood levels of Th17 and Treg were measured by flow cytometry.An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of TGF-β1 and IL-6 before and after treatment.Clinical efficacy was evaluated in terms of the area of psoriasis and severity index (PASI) scores.Restlts Before treatment,the patients showed significantly higher levels of Thl7 cells in their peripheral blood than the controls.Their ratios of Th17 to Treg cells and their serum levels of IL-6 were also significantly higher.The percentage of Treg cells and the serum level of TGF-β1 were significantly lower in the patients.After the NB-UVB treatment,the Th17 cells,the ratio of Th17 to Treg cells and IL-6 had all decreased significantly.The percentage of Treg cells and TGF-β1 levels were significantly high-er compared with before phototherapy.The total effectiveness rate was 86.7％,and the average PASI scores had de-creased significantly.The PASI scores were positively correlated with the percentage of Th17,the Th17 to Treg ratio,and the serum level of IL-6,and negatively correlated with the percentage of Treg cells and TGF-β1.Conclusion The imbalance between Th17 and Treg cells and their cytokines may play an important role in the pathogenesis of pso-riasis.NB-UVB is able to significantly down-regulate the levels of Th17,IL-6 and the progression of Treg levels and TGF-β1 expression.It can regulate the balance between Thl7and Treg cells,which may be one of the mechanisms of NB-UVB treatment for psoriasis.The clinical data demonstrate that NB-UVB treatment is a safe and effective therapy for psoriasis vulgaris.

Objective To explore the practicality and feasibility and evaluation of the team based learning method (TBL) combined with the clinical pathway leaning method (CP) in clinical teaching of department of gynecology and obstetrics. Methods Toltally 40 clinical specialist interns selected for the study were randomly divided into two groups (each 20) respectively, using TBL com-bined with CP teaching method and traditional teaching method, and to make analysis and comparisons on the above two teaching methods. Differences were compared with t testing. Meanwhile, a question-naire survey was carried out among students of TBL combined with CP teaching group for qualitative analysis of the implementation effect of TBL combined with CP pedagogy. (Qualitative analysis is the medical students' evaluation of teaching effect, without further statistical processing). Results The professional test results of TBL combined with CP teaching team were superior to the traditional teach-ing group [(83.95 ±7.63) vs. (72.00 ±5.26)] and the difference was significant by paired t tests and analysis (t=5.063,P<0.05). The knowledge contest results of TBL combined with CP teaching team were superior to the traditional teaching group(90 vs. 85,95 vs. 75,85 vs. 70). TBL combined with CP method has been recognized by 90% medical students and they think that most of their quality has been further improved. Conclusions TBL combined with CP method for the clinical teaching of de-partment of gynecology and obstetrics is practical and feasible, and should be widely applied.

Objective To investigate the effect of double lumen tube applied in the simple negative pressure drainage.Methods Forty cases were divided into two groups by a random table method,with 20 cases in each group. The double lumen tube was used in observation group while the normal gastric tube was used in control group,then the indexes on the drainage effect and wound healing were quantized and analyzed.Results In the observation group,one case suffered obstruction at 2 -4 days,1 case after 4 days of treatment,the obstruction rate was 10%.In the control group,two cases suffered obstruction at 2 -4 days,and 2 cases after 4 days of treatment,the obstruction rate was 25%.There was significant difference between two groups(χ2 =9.212,5.021,P =0.027,0.032).There were two cases of delayed healing and 17 cases with effective in the observation group,but 8 cases delayed healing and 11 cases with effective in the control group,there was statistically significant difference (χ2 =5.833,4.800,P =0.016, 0.028).Conclusion Double lumen tube can delay the occurrence time and reduce the occurrence rate of obstruction in simple negative pressure drainage,which promotes wound healing,and it is worth popularizing and using clinically.

Objective To evaluate the performance and clinical utility of Verigene gram-negative blood culture ( BC-GN ) assay for a rapid identification of gram-negative bacteria and resistance genes . Methods Non-repetitive blood culture samples containing gram-negative bacteria were collected from inpa-tients in the Second Affiliated Hospital of Zhejiang University School of Medicine from June to October , 2013 .BC-GN assay was performed to identify the species and genetic resistance determinants of gram -nega-tive bacteria directly from the positive blood culture bottles .VITEK MS and the VITEK 2 Compact were used for species identification and antimicrobial susceptibility test , the results of which were considered as gold standards.The resistance genes were further validated by PCR amplification and sequencing analysis .A comparison of the results and time between the BC-GN assay and routine methods was conducted . Results The detection range of BC-GN assay almost covered all of the common gram-negative bacteria .BC-GN assay showed an advantage of high accuracy in the identification of Escherichia coli (13/13), Klebsiella pneumoniae (19/24), Klebsiella oxytoca (9/9), Pseudomonas aeruginosa (39/39), Serratia marcescens (4/5), Enterobacter spp.(6/8), Citrobacter spp.(11/11), Proteus spp.(6/6) and Acinetobacter spp. (24/24) with an overall accuracy of 94.24%for the identification of mono-microbial blood culture samples . Moreover , BC-GN assay accurately identified all of the bacteria and resistance genes from the two multi -mi-crobial samples .Species identification and resistance profiles could be 42 hours earlier available by using BC-GN assay than those by using routine methods .Conclusion BC-GN assay could simultaneously and ac-curately identify bacteria and resistance determinants from blood cultures within 2 hours.More time for clini-cally effective therapy could be achieved by using BC-GN assay for the reduction of mortality associated with bloodstream infection .