AIM: To monitor the concentration of tacrolimus in whole blood in liver transplant recipients and establish an optimal therapeutic window of tacrolimus, in order to provide information for rational usage in clinic. METHODS: The whole blood concentrations of tacrolimus were measured by ELISA. The levels of tacrolimus in 1190 samples from 138 liver transplant recipients were compared and studied. RESULTS: The whole blood concentration of tacrolimus is gradually decreased with time after operation. The optimal therapeutic window of tacrolimus for liver transplant recipients was 8-15 ?g?L -1 within 1 month after operation, 6-12 ?g?L -1 from the 2nd to 3rd months, 5-10 ?g?L -1 from the 4th to 6th months and 3-8 ?g?L -1 after 6 months, respectively. CONCLUSION: It is necessary to routinely monitor blood concentration of tacrolimus. The satisfying therapeutic effects will be obtained if dosage regimens will be individualized according to optimal therapeutic window.

Objective To explore the expression and significance of hedgehog signal molecules (Ptch, Smo and Gli1 ) in pancreatic cancer. Methods Two hundred SD rats were randomly divided into DMBA group ( group A, n = 90), cyclopamine intervening group ( group B, n = 90) and control group ( group C, n = 20).For group A and B, DMBA was directly implanted into the parenchyma of the pancreas to establish the model of pancreatic cancer. The rats in group B were treated with 6.25 ml/kg cyclopamine and DMSO solution intraperitoneally daily. All rats were sacrificed four months later to observe the pancreatic tissue pathologic changes, and immunohistochemistry SP was used to detect the expression of Ptch, Smo, Gli1 protein in pancreatic cancer and normal pancreatic tissue. Results The prevalence rate of pancreatic cancer in group A was 57.5％ (46/80), the maximum size of the tumor was 0.5 ～ ＞2 cm; the prevalence rate of pancreatic cancer in group B was 17.1％ ( 14/82), the maximum size of the tumor was 0.5 ～ 2.0 cm, and the difference between the two group was statistically significant (P ＜0.05). The positive expression rate of Ptch, Smo and Gli1 protein was 82.6％, 73.9％ and 65.2％ in DMBA group, and was 50.0％, 42.9％ and 28.6％ in cyclopamine group, and the difference between the two group was statistically significant ( P ＜ 0.05 ). Ptch,Smo and Gli1 protein was expressed in normal pancreatic tissue. Conclusions Direct implantation of DMBA in the parenchyma of rat pancreas can induce pancreatic cancer with a high incidence in a short time.Hedgehog signal protein expression is significantly increased, cyclopamine can inhibit the occurrence and progression of pancreatic cancer by inhibiting Hedgehog messenger expression.

Combined with the development of modem hospital pharmacy,in light of the present condition of the continuing education for the hospital pharmacists,based on the continuing education mode and method of the affiliated provincial hospital of Anhui medical university pharmacists,from the establishment of continuing education's goal and mode,the construction of hierarchical continuing education system,and education content integration aspects,this paper expounds the role and influence of the pharmacist professional skill contest.Through pharmacist professional skill contest,pharmacist can test and evaluate the hospital pharmacist professional ability,gradually improve pharmaceutical service level and quality of pharmacists.By introducing the pharmacist professional skill contest,pharmacist can not only timely adjust the continuing education's plan and ways,better coordinate with the development of hospital pharmacists,but also provide important technical support and talent reserves for the pharmacist professional skill contest.

Missing data is a common but unavoidable issue in clinical trials. It not only lowers the trial power, but brings the bias to the trial results. Therefore, on one hand, the missing data handling methods are employed in data analysis. On the other hand, it is vital to prevent the missing data in the trials. Prevention of missing data should take the first place. From the perspective of data, firstly, some measures should be taken at the stages of protocol design, data collection and data check to enhance the patients' compliance and reduce the unnecessary missing data. Secondly, the causes of confirmed missing data in the trials should be notified and recorded in detail, which are very important to determine the mechanism of missing data and choose the suitable missing data handling methods, e.g., last observation carried forward (LOCF); multiple imputation (MI); mixed-effect model repeated measure (MMRM), etc.

Testing of hypothesis was affected by statistical analysis set division which was an important data management work before data base lock-in. Objective division of statistical analysis set under blinding was the guarantee of scientific trial conclusion. All the subjects having accepted at least once trial treatment after randomization should be concluded in safety set. Full analysis set should be close to the intention-to-treat as far as possible. Per protocol set division was the most difficult to control in blinded examination because of more subjectivity than the other two. The objectivity of statistical analysis set division must be guaranteed by the accurate raw data, the comprehensive data check and the scientific discussion, all of which were the strict requirement of data management. Proper division of statistical analysis set objectively and scientifically is an important approach to improve the data management quality.

Objective To analyze the investigation results of an acute respiratory infection outbreak caused by adenovirus and provide scientific information for the prevention and control of congener public health emergencies .Methods A case‐control study was performed with grades and gender as matching factor ,all cases and selected controls were investigated with the same question‐naire .Results A totul of 47 cases were diagnosed in the outbreak ,no death ,the attack rate was 8 .88% ;the main clinical symptom was fever and 27 .7% of the cases became pneumonia .The case‐control study analysis demonstrated that with close contact to cases or not(χ2 =7 .96 ,P<0 .05) ,contact time (χ2 =7 .95 ,P<0 .05) ,hand washing habits (χ2 =25 .92 ,P<0 .05) and with or without the habit of cleaning snivel by hand directly (χ2 =22 .78 ,P<0 .05) were statistically different between cases and controls .Conclu‐sion long‐time contact to cases maybe the main risk factor for the adenovirus infection ,especially the contact manner were sharing the same desk or playing together .A good health habit of washing hands often and no cleaning snivel by hand directly were impor‐tant protective factors .Thus ,strengthening the training of health habit and awareness is the important preventive measure for re‐spiratory infectious diseases .

Objective To investigate the effect of femoral head replacement for the treatment of intertrochanteric frac -tures among elderly patients .Method There were 38 cases that received intertrochanteric fracture hemiarthroplasty and 35 patients were treated with open reduction and dynamic hip screw ( DHS) plate internal fixation .After follow-up, their opera-tion duration,blood loss, postoperative drainage flow , postoperative ambulation time , hospitalization time were compared according to the Harris score to assess the effect of postoperative follow-up.Results After the mean follow-up time of 18 months (12 to 36 months),the hemiarthroplasty group was superior to the open reduction and DHS plate fixation group ,as shown by the earlier postoperative ambulation time , fewer complications , and better fracture reduction , with an excellent rate of 94 .7%.Conclusion For patients with intertrochanteric fractures , hemiarthroplasty surgery is effective and can re-duce the incidence of postoperative complications .

At present, studies on traditional Chinese medicine (TCM) properties are mostly restricted to a single or two kinds of medicinal properties, but deviated from the holism of the theoretical system of TCMs. In this paper, the characteristics of pharmacological effects of different property combinations of TCMs distributing in the stomach meridian were take as the study objective. The data of properties of TCMs distributing in the stomach meridian was collected from the Pharmacopoeia of the People's Republic of China (2005). The data of pharmacological effects of TCMs distributing in the stomach meridian was collected from all of literatures recorded in Chinese Journal Full-text Database (CNKI) since 1980, Science of Chinese Materia Medica (Yan Zhenghua, People's Medical Publishing House, 2006) and Clinical Science of Chinese Materia Medica (Gao Xuemin, Zhong Gansheng, Hebei Science and Technology Publishing House, 2005). The corresponding pharmacological effects of property combinations of TCMs distributing in the stomach meridian was mined by the method of association rules. The results of the association rules were consistent with the empirical knowledge, and showed that different medicinal property combinations had respective pharmacological characteristics, including differences and similarities in pharmacological effects of different medicinal property combinations. Medicinal property combinations with identical four properties or five tastes showed similar pharmacological effects; whereas medicinal property combinations with different four properties or five tastes showed differentiated pharmacological effects. However, medicinal property combinations with different four properties or five tastes could also show similar pharmacological effects. In this study, the medicinal property theory and the pharmacological effects of TCMs were combined to reveal the main characteristics and regularity of pharmacological effects of TCMs distributing in the stomach meridian and provide a new way of thinking and method for revealing the mechanism action of TCMs distributing in the stomach meridian and discovering the pharmacological effects of TCMs distributing in the stomach meridian.
Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Humans ; Meridians ; Stomach ; drug effects ; Stomach Diseases ; drug therapy

The combination of medicinal properties refers to expression forms of elements with active properties combined according to a specific sequence. The mode of medicinal property combination refers to the compatible relationship multiple medicinal property combinations. In this paper, based on the mode, safflower, Taohong Siwu decoction, Xuefu Zhuyu decoction and Buyang Huanwu decoction were taken for example to study the characteristics of the compatibility among single herb, herbal pairs and prescriptions. The authors discovered the similarities and differences among them, interpreted the self-similarity in medicinal property combinations of traditional Chinese medicines, and analyzed the compatible relationship among multiple medicinal property combinations, so as to bring forth new ideas in discovering the correlation between the compatibility study mode of traditional Chinese medicines based medicinal property combinations and the efficient compatibility of medicinal property combination.
Drug Combinations ; Drug Prescriptions ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional

Objective To investigate the correlation between genetic polymorphisms of glutathione S-transferases (GSTs) and ulcerative colitis (UC) in Hubei Han population. Methods Genetic polymorphisms of GSTM1 and GSTT1 of 270 patients with UC (UC group) who were admitted to the Zhongnan Hospital, People's Hospital of Wuhan University, Tongji Hospital and Union Hospital of Huazhong University of Science and Technology from August 2002 to December 2009 and 623 healthy people ( control group) were detected by restriction fragment length polymorphism-polymerase chain reaction. All UC patients were allocated to distal UC group (n= 229) and extensive UC group (n =41 ) according to the location of the lesions; and all UC patients were also allocated to mild-moderate group (n = 237) and severe group (n = 33 ). The genetic polymorphisms of GSTP1 of these patients and healthy people were detected by polymerase chain reaction. The genotypes of GSTM1, GSTT1 and GSTP1 were also detected. GSTM1 and GSTT1 containing small DNA segments ( 157 bp and 480 bp) were defined as GSTM1 (+) and GSTT1 (+), otherwise, GSTM(-) and GSTT1 (-), respectively. All data were analyzed by chisquare test. Results The frequencies of GSTM1(-), GSTT1(-) and GSTP1 (Val/Val) were 70.7% (191/270),64.8% (175/270) and 48.9% (132/270) in the UC group, and 41.7% (260/623), 47.2% ( 294/623 ) and 34.3% (214/623) in the control group, with a significant difference between the two groups (x2 = 63. 404,22. 320, 25. 384, P ＜0.05 ). The frequencies of GSTT1 (-) and GSTP1 (Val/Val) were 71.6% (164/229) and 57.6% (132/229) in the distal UC group, which were significantly higher than 31.7% (13/41) and 29.3%( 12/41 ) in the extensive UC group ( x2 = 24.528, 9.609, P ＜ 0.05 ). The frequencies of GSTM1 (-) were 65.1%(149/229) in the distal UC group and 56.1% (23/41) in the extensive UC group, with no significant difference between the two groups ( x2 = 1. 210, P ＞ 0.05 ). The frequencies of GSTT1 (-) and GSTP1 ( Val/Val ) were 71.6%(164/229), 31.7% ( 13/41 ) in the distal UC group and 57.6% ( 132/229), 29.3% ( 12/41 ) in the extensive UC group, with a significant difference between the two groups ( x2 = 24. 528, 9. 609, P ＜ 0. 05 ). There was no significant difference in the frequencies of GSTM1 (-), GSTT1 (-), GSTP1 (Val/Val) in the mild-moderate group and the severe group( x2 = 0. 623, 1. 884, 3. 403, P ＞ 0. 05 ). Conclusions Variant genotypes of GSTs are significantly correlated with UC in Hubei Han population. The severity of UC may not be correlated with variant genotypes of GSTs.