OBJECTIVE:To survey the implementation of pharmaceutical care in various levels of medical institutions in Shanghai and introduce the foreign experience in order to find out defect and orientation in the field of pharmaceutical care in China. METHODS:The pharmaceutical care practices of clinical pharmacists in sampled hospitals were surveyed using questionnaire in order to survey the status quo of the implementation of clinical pharmacy projects in various levels of hospitals in Shanghai. The focused projects were evaluated to analyze the advantage and disadvantage of pharmaceutical care provided by clinical pharmacists in various levels of hospitals and orientation of pharmaceutical care in the future. RESULTS:Medical care and pharmaceutical care in China which were different from foreign model of pharmaceutical care with community pharmacy as main model presented multi-level operating model. The scales of pharmacy in China were ranged from community-based health service station to grade A class three hospital according to the rank of hospital. CONCLUSION:The development of pharmaceutical care in China requires clinical pharmaceutical staff overcome the difficulty and strive to make innovation.

Today, the direction of litigation reformation is changing trial pattern to be trial-centered and making the trial substantialized. Under this background, the relevant provisions have been launched from the supreme people's court and other departments to make sure that the forensic expert will appear in court and accept cross-examination, and this phenomenon should be normalized and substantiated. In order to ensure the expert opinion can be fully and effectively cross-examined, the medico-legal expert should fulfill obligations, such as respect for the court, answer questions honestly and explain expert opinions. We find that some problems show up in this process: the rate of forensic expert appearing in court is low; the legal nature of expert opinion is not clear; the requirements are not clear;the conflict between forensic expert opinion and other forms of expert evidence, including auxiliary expert, is very clearly. Based on this situation, the author give some suggestions to the forensic expert: keep on learning to improve professional skill; improve the legal knowledge; pay attention to practice and strengthen the ability of expression.

Velpatasvir is a new generation of NS5A inhibitors, and combined with marketed sofosbuvir, compound tablets Epclusa was obtained and approved by FDA in June, 2016, which is used for the treatment of adult patients infected with chronic hepatitis C vi-rus ( HCV) with all genotypes. The mechanism of action, pharmacodynamics, pharmacokinetics, clinical trials and safety of Epclusa were reviewed in this article.

OBJECTIVE:To study the preparation and quality control methods of Tinidazole rod(TR) and observe its clinical therapeutic efficacy.METHODS:To determine the content of Tinidazole by ultraviolet spectrophotometry and observe the clinical therapeutic efficacy in 45 patients with periodontitis.RESULTS:The average recovery of Tinidazole was 99.06%(RSD=1.03%).The effective rate of TR in treating periodontitis was 93.33%.CONCLUSION:The preparation of TR is reasonable in technology,stable in quality,feasible in quality control and reliable in therapeutic efficacy.It is worth popularizing the application of this preparation.

Objective Established the model of atherosclerosis (AS) cells.To explore Hydrogen sulfide donor (NaHS) in atherosclerosis model by oxidized low density lipoprotein (ox-LDL) induced of the NF-κBp65 factor expression.MethodsApplication concentration of 80ug/mL ox-LDL induced liver cancer cell HepG2 cells AS model, set up a control group and treatment group (10μmol/L、15μmol/L、30μmol/L、100μmol/L、500μmol/L、1000μmol/L), to observe hydrogen sulfide this cell model of the cell proliferation activity and the determination of TNF-α and IL-10 factors of the expression, through the RT-qPCR and Western-blot method for determining the expression of the NF-κBp65 expression situation.ResultsAt 24h the ox-LDL induced a large number of red-stained granules, free cholesterol and total cholesterol in HepG2 cells increased, and free cholesterol content was more than 50% of total cholesterol in HepG2 cells, indicating that AS cell model was established successfully.CCK8 method of cell proliferation activity test results showed that the NaHS in 30umol/L, duration of 48 h when the largest cell proliferation activity.The TNF-α cytokine by ELISA method for testing the results showed that the treatment group in 15umol/L and 30umol/L concentration compared with the control group decreased significantly (P<0.05), while the expression of IL-10 increased significantly (P<0.05), with statistical significance.RT-qPCR and Western-blot method results show that the NF-κBp65 factor expression significantly reduced compared with control group (P<0.05), with statistical significance.ConclusionH2S play a protective role in atherosclerotic lesions by reducing the NF-κBp65 factor expression, and provide a valuable reference for the development and clinical treatment of H2S donor-type drugs.

Long non-coding RNAs(LncRNAs) refer to such a kind of RNAs which possess none or very few open reading frames,thus could only encode none or little protein.Recent studies suggest that LncRNAs tissue-specially expressed in several human cancers,and might play a key role in the diagnosis and prognostic of these malignant neoplasms.

Objective To explore the correlation between adenoid hypertrophy and secretory otitis media.Methods The cases of adenoid hypertrophy were screened and selected by nasopharyngeal lateral X ray.We chose 58 normal children after the clinical examination as control group.In accordance with the degree of adenoid hypertrophy,they were divided into three groups:the normal group,middle-grade and high-grade groups of adenoid hypertrophy with the association between the degree of adenoidal hypertrophy and the incidence rate of secretory otitis media analyzed.Results There was no difference in the incidence rate of secretory otitis media between the normal and middle-grade groups.The incidence rates of secretory otitis media were significantly different between the normal and high-grade groups(P＜0.01).Conclusion The incidence of secvetory otitis media and the degree of adenoid hypertrophy showed positive correlation.The greater is the size of adenoids, the severer is the degree of obstruction of the nasopharyngeal cavity and the higher is the incidence of secretory otitis media.

Bronchial Diseases ; diagnosis ; surgery ; Bronchoscopy ; Child ; Humans ; Tuberculosis ; diagnosis ; surgery

Primary ciliary dyskinesia (PCD) is an autosomal recessive or x-linked disorder of cilia structure and (or) function, with a morbidity of 1:10 000–1:50 000 from foreign reports, while epidemic data of PCD in China is not available yet. PCD is due to cilia biallelic gene mutations leading to impaired tissue structure and organ function. Clinical phenotypes include chronic infections of the respiratory tract, fertility problems, disorders of organ laterality, etc, and the percent age of Kartagener syndrome is about 50%. The frequently used diagnostic methods are nasal NO examination, high-speed video microscopy, electron microscopy, genetic tests, chest high-resolution computed tomography and spirometry at present. Each method has its highlights and disadvantages, meanwhile, effective diagnostic algorithm and therapeutic protocols are needed for further research.

Objective To investigate the suitable mode of induced termination of pregnancy at second trimester for women with scarred uterus.Methods A retrospective study was performed in 120 cases of second trimester pregnant women with scarred uterus,who requested termination of pregnancy in Department of Obstetrics,Ruijin Hospital of Shanghai Jiaotong University from January 2010 to July 2016.The indications of termination of pregnancy were fetal anomaly,serious pregnant complication,intrauterine fetal deaths and personal factors.The interval time of previous operation to this pregnancy were recorded.It was ＜ 2 years in 35 cases and ≥2 years in 85 cases.The patients with normal hepatic function began to take mifepristone combined with ethacridine lactate (group A,62 cases).The method of mifepristone combined with misoprostol was used in the patients who failed to amniotomy to inject ethacridine lactatebecause of oligohydramnios or small gestational age (group B,58 cases).The detail information of every patient was recorded,including age,gestational weeks,gravidity,parity,the mode of previous operation,previous operation time and indication,the mode of induced labor inthis pregnancy,the interval time from administration to uterine contraction,delivery or not and the interval time from induction to delivery,postpartum hemorrhage,the successful rate of induce labor,and placental retention ratio.Results (1) It had no significant difference between groups A and B in age,gravidity,parity and the interval time of previous operation to this pregnancy (P ＞ 0.05).There was significant difference between two groups in gestational weeks of induction (P ＜0.01).(2) It had no significant difference between two groups in successful rate of induction and postpartum hemorrhage (P ＞ 0.05),but the time from induction to regular uterine contractionand delivery in group B was significant shorter than that of group A (P ＜ 0.01).The rate of delivery with 24 hours in group B was 89.66％.It was significant higher than that of group A (22.58％,P ＜0.01).(3) The rate of retained placenta in group A (19.23％,10/52) was significant lower than group B (4g.7g％,20/41),but the ratio of residual of placenta and membranes in group A (75％,39/52) was significant higher than that of group B (48.78％,20/41).It was no significant difference between the over 2 years group and the less 2 years group in the incidence rate of complications including placental retention,residual of placenta and membranes and postpartum hemorrhage.It had no significant difference between two groups in incidence of severe pain (P ＞ 0.05).Conclusions Both of methods of mifepristone combined with misoprostol and the mifepristone combined with ethacridine lactate are feasible to induce second trimester termination of pregnancy for women with scarred uterus.