OBJECTIVE:To provide reference for the development of clinical pharmacists’career and the establishment of le-gal system in China. METHODS:The background,progress and situation of applying for“pharmacists’health care provider sta-tus”in the United States were introduced. The reasons for achieving provider status in California,Washington,and Oregon were summed up in aspects of politics,economics and education. The chance and challenge for achieving provider status at federal level were also discussed. Based on the development of clinical pharmacists in China,the suggestions were put forward for the improve-ment of legal system of clinical pharmacists in China. RESULTS & CONCLUSIONS:“Health care provider status”in the United Stated were recognised by 3 states with local developed economics,high-level education,and collective efforts of pharmacy organi-zations. Multiple national pharmacy organizations as American Pharmacists Association,American Society of Health-System Phar-macists and American Pharmacy College Society are working together toward provider status at the federal level. Our country should pay attention to related legal system construction,establish perfect and definite clinical pharmacists legal system as soon as possible to provide legal guarantee for career development of clinical pharmacists in China.

Objective To investigate the feasibility o f endoscopic resection of parathyroid adenoma. Methods Endoscopi c parathyroidectomy by anterior chest approach was performed in 5 patients with parathyroid adenoma. Results The operation was successfully ac complished in all the 5 patients, requiring no conversions to open surgery. The operating time was 120~150 min (mean, 130 min), and the intraoperative blood los s, 5~15 ml (mean,10 ml). No postoperative complications such as hemorrhage, hoar seness, choke, subcutaneous emphysema and effusion, or infection were seen. All the patients were followed for 6~24 months(mean,14 months), with satisfactory cu rative and cosmetic results. Conclusions Endoscopic resection for parathyroid adenoma gives reliable curative effects and excellent cosmetic o utcomes.

Objective To assess the usefulness of the MSCTA with 3D reconstruction to epigastric tumors in interventional treatment.Methods MSCTA were performed in 27 cases of epigastric tumors before and after interventional treatment.3D reconstruction were taken for blood vessels with technique of MIP(maximum intensity projection)and VRT(volume rendering technique).Results 42 times MSCTA and 3D reconstruction were performed in 27 cases of epigastric tumors.We discovered 5 feeding arteries with mutation in abdominal cavity,7 collateral branches formed after embolization and 2 abnormal courser of celiac artery.The display of vasculative with MSCTA was better than that of DSA.Conclusion 3D-MSCTA for epigastric tumors not only can show directly and clearly the stereo-anotomic images of the tumor feeding vessels but also provide guidance for planning the treatment.

Objective To observe the effects of different anesthetic solutions on postoperative cognitive function and serum S100β protein levels.Methods A prospective randomized controlled trial was conducted. Ninety patients necessary to perform off-pump coronary artery bypass grafting (op-CABG) in Tianjin Chest Hospital from November 2013 to July 2014 were enrolled. They were divided into three groups by random number table: P1, P2 and P3 groups, 30 cases in each group. The anesthesia was maintained with propofol by target-controlled infusion (TCI) in all the patients in the three groups, and the respective dosages were < 2.0μg/mL, 2.0 - 3.0μg/mL and > 3.0 - 4.0μg/mL. The operation time, anesthesia time, dosages of propofol and the incidence of postoperative cognitive dysfunction (POCD) were compared among the three groups. At the following times: before induction of anesthesia (T0), completion of anesthesia induction (T1), after tracheal intubation (T2), skin incision (T3), 1 hour after operation (T4), 2 hours after operation (T5) and the end of operation (T6), the narcotrend index (NTI) and hemodynamic levels were observed; the serum S100β protein levels were measured at the following times: before induction of anesthesia (Ta), 2 hours after operation (Tb), the end of operation (Tc), postoperative 6 hours (Td) and postoperative 24 hours (Te).Results There were no significant differences in operation times and anesthesia times among three groups (allP > 0.05); dosages of propofol in P2 and P3 groups were obviously higher than those of P1 group (mg: 1 746.3±43.9, 2 332.7±42.8 vs. 968.5±35.6, bothP < 0.05), and the incidences of POCD in P2 and P3 groups were lower than that in P1 group (10.00%, 6.67% vs. 33.33%, bothP < 0.05). With the extension of anesthesia time, the level of NTI was gradually declined in each group, in P3 group, it was occasionally increased at T6, and beginning from time point T1 afterwards, the NTI levels were lower than those of P1 and P2 groups at all the time points (allP < 0.05); the mean arterial pressure (MAP) in the three groups had a tendency of firstly going down and then increasing, and the inflection point being at T2, in P1 group, the elevation of MAP level persisted to T4, and it began to decline at T5, while in P2 and P3 groups, the levels started to decline at T4; the heart rate (HR) in three groups showed a tendency of firstly going up and then declining, and the inflection point being at T3; until T6, in P3 group, MAP and HR were all lower than those of P1 and P2 groups, the differences being statistically significant [MAP (mmHg, 1 mmHg = 0.133 kPa): 74.9±8.3 vs. 85.3±11.2, 84.2±10.1;HR (bpm): 74.1±4.2 vs. 80.9±8.1, 78.7±7.9, allP < 0.05]. The serum S100β protein levels of three groups at Tb began to be obviously higher than those at Ta, and reached the peak points at Tc, then the levels started to decline until Td, and the levels at Te was approximately close to those of Ta, but the serum S100β protein levels in P2 and P3 groups were lower than that in P1 group, the differences being statistically significant (mg/L: 1.05±0.22, 1.04±0.21 vs. 1.33±0.22, bothP < 0.05).Conclusion Application of propofol by TCI 2.0 - 3.0μg/mL for maintenance of anesthesia can achieve the satisfactory depth of anesthesia, and it not only can reduce the effects on hemodynamics, but also can decrease the serum S100β protein level and the incidence of POCD.

Objective To investigate the detection rate and possible factors of hyperhomocysteinemia(HHcy) in children with chronic kidney disease(CKD).Methods The clinical data of children with CKD between July 2012 and September 2016 in the Department of Pediatrics,Peking University First Hospital were retrospectively collected.The homocysteine(Hcy) level of patients were measured.The other data included the general information,diagnosis and laboratory test results.Results Seventy-six pediatric patients with CKD were enrolled including 49 boys and 27 girls.The average age of the patients was (9.9±3.4) years old.The main cause of the patients in the study was primary glomerulopathy(48.7%,37/76 cases),and the rest were congenital and inherited glomerular diseases(36.8%,28/76 cases),secondary glomerular diseases(9.2%,7/76 cases)and renal tubular diseases(5.3%,4/76 cases).Fifty patients (65.8%,50/76 cases) had normal level of Hcy which was 10.40(7.30,11.62) μmol/L.Twenty-six patients(34.2%,26/76) were detected with HHcy whose Hcy level was 17.93(16.76,24.11) μmol/L.The detection rate of HHcy in CKD stage 1,stage 2,stage 3,stage 4 and stage 5 was 13.9%(5/36 cases),22.2%(2/9 cases),50.0%(4/8 cases),57.1%(4/7 cases) and 68.8%(11/16 cases) respectively,and the detection rate increased with CKD stages and the difference was statistically significant (χ2=17.574,P<0.001).The level of Hcy was 10.05(7.04,12.47) μmol/L,11.75(10.78,16.44) μmol/L,13.73(10.09,18.23) μmol/L,15.81(11.12,20.71) μmol/L and 17.39(11.86,24.76) μmol/L in CKD stage 1,stage 2,stage 3,stage 4 and stage 5,respectively.The Kruskal-Wallis test revealed that the distribution of homocysteine in CKD stages had statistically significant difference(P=0.001).Multiple linear regression model showed that creatinine clearance was an independent predicator of HHcy.Conclusions In this study of the CKD patients,the detection rate of HHcy was high and increased with the progression of CKD.HHcy is mainly influenced by creatinine clearance in CKD.The level of Hcy should be monitored regularly in children with CKD and HHcy should be treated with proper measures.

A method was developed for the determination of tetrodotoxin in marine organisms by high perfor-mance liquid chromatography-mass spectrometry with immunoaffinity column. The samples were extracted with 1% acetic acid methanol solution and diluted with phosphate buffer at pH 7-8. After cleaned up by immuno-affinity column, the samples were analyzed by LC-MS/MS and quantitatively determined by external standard method. The chromatographic separation was performed on an ACQUITY UPLC BEH Amide column with gradient elution by using acetonitrile and 5 mol/L ammonium acetate solution containing 0. 1% formic acid as mobile phase. Detection was carried out by electrospray positive ionization mass spectrometry in the multiple reaction monitoring mode. Linear ranges of TTX was in the range of 0. 3 -20. 0 μg/L with correlation coeffi-cient more than 0. 997. The quantification limit of the method was 0. 3 μg/kg. The recoveries of standard addition for tetrodotoxin were 88. 7%-102. 3%, and the relative standard deviation was 2. 0%-6. 4%. The method could be used to identify and quantify tetrodotoxin in marine organisms with satisfactory reproducibility and sensitivity.

Objective To investigate the expressions of IL-8,MCP-1 and MIP-1? and their biological significance in pancreatic carcinoma and chronic pancreatitis, and investigate the relationships of their expressions in pancreatic cancer tissues.Methods Immunohistochemical method of avidin-biotin complex was used to examine surgically removed specimens from 51 cases of pancreatic carcinoma and 10 cases of chronic pancreatitis. Results The positive rates of expression and the scorings of IL-8,MCP-1,MIP-1? were significantly higher in pancreatic carcinoma than that in chronic pancreatitis(P

This study was aimed to explore the relationship between the Shen-Gui-Fang(SGF) formula of different proportions and treatments for diseases with the method of bibliometrics. A total of 49 formulae of SGF from ancient books of traditional Chinese medicine (TCM) were retrieved and the database was established in order to analyze the origin of herbal medicine and the relationship with the ratio of the key medicinal material, as well as the treatment for major diseases. The results showed that 49 SGF formulae were mainly used in the treatment of internal disorders for 16 times (32.65%), gynecological disorders for 17 times (34.69%) and pediatric disorders for 8 times (16.32%). Guistanded forAngelica sinensis. There were 3 types ofShen, which werePanax ginsengfor 40 times,Codonopsis pilosulafor 8 times, andSophora flavescensfor 1 time. The ratio betweenP. ginsengandA. sinensiswas less or equal to 1. The ratio betweenC. pilosulaandA. sinensiswas usually more than 1. The formulae with the highest frequency were in the treatment of internal medicine and gynecological diseases. Statistical analysis was used to find the application features and rules of the combination ofP. ginsengandA. sinensisin SGF formula, in order to provide theoretical evidences and references for clinical medication selection and new medication research.

Objective:To analyze the advantages of IPSA combined with increasing cervical center dose in intracavitary and interstitial brachytherapy (IC/IS) for locally advanced cervical cancer.Methods:A total of 46 stage Ⅱ B cervical cancer patients with, local lesion size≥5 cm after 45 Gy/25f external intensity-modulated radiotherapy (IMRT) were recruited. Uterine tandem and needles were implanted, CT was performed, and then HR-CTV, rectum, bladder, sigmoid colon and the area of cervix increased dose (HR-cervix) were delineated, IPSA was used for optimization. According to whether the dose of HR-cervix was increased or not, all patients were divided into IC/IS+ HR-cervix group (group A) and IC/IS group (group B). The differences in dosimetric parameters were compared between two groups. Results:The relative uterine tandem dwell time was significantly extended in group A ( P<0.001). In group B, the V 150% and V 200% volumes of HR-cervix were increased from 63.94% and 30.80% to 91.54% and 64.06%. The D 90% and D 100% in group A were significantly lower than those in group B (both P<0.05). There was no statistical difference in organ at risk (OAR) dose. Conclusion:IPSA combined with increasing cervical center dose can meet the HR-CTV D 90% dose requirement, normal tissue dose limits, and can escalate the doses to local areas of the cervix.

Mussel adhesive proteins have attracted increasing interests for their potential use as environmentally friendly bioadhesives in medicine and aqueous conditions. In this study, surface coating analysis, quartz crystal microbalance (QCM), cell and bone tissue adhesion and cytotoxicity assay were used to study the properties of the Perna viridis foot proteins (Pvfp) extract as bioadhesive. The results of coating ability on various materials and QCM analysis revealed that Pvfp extract has comparable or superior adsorbtion ability to that of Cell-Tak (the naturally extracted MAP mixture from Mytilus edulis, and has been commercialized), and also, the cell adhesion ability of Pvfp extract was stronger than that of Cell-Tak and poly-L-lysine. No cytotoxicity was detected using human HeLa and 293T cells. Furthermore, broken bones of mouse could be stuck together by use of Pvfp extract. In bulk-scale adhesion tests, Pvfp extract showed much greater tensile strength than did fibrin glue for conglutinating poly (vinl chloride) sticks and for binding together pig's femur segments. These results suggested that Pvfp extract be an efficient cell and tissue adhesive in biotechnological application and it might be a potential bioadhesive in medical practice.
Animals ; Bone Cements ; isolation & purification ; Bone and Bones ; drug effects ; HeLa Cells ; Humans ; Mice ; Perna ; chemistry ; Proteins ; isolation & purification ; pharmacology ; Swine ; Tissue Adhesives ; isolation & purification