Objective:To understand the rules and features of consultation service of outpatients by examining the outpatient consultation in clinical pharmaceutical-care practice.Method:The 1-year clinical charts for outpatient consulta- tion were monitored.The population and disease characteristics of outpatients,consulted problems and resolutions were re- viewed,Result:The counseling patient's median age was 32.And 56.7% of the patients were females.The disease charac- teristics were influenced by the distribution of beth regional diseases and hospital departments.Neither history of adverse drug reactions nor drug quantity of each prescription had any significant influence on the patient consultation behavior.The major problem(72%)concerned about was how to use drugs properly.Conclusion:The general disease information about different ages,genders,periods are indispensable for consultant pharmacists to acquire.More considerate and initiative service for drug uses should be provided for the outpatient counseling.

A new dibenzocyclooctadiene lignan, renchangianin E (1) was isolated from the stems of Kadsura renchangiana. Its structure and stereochemistry were elucidated by spectroscopic methods, including 2D-NMR techniques.

Objective:To explore the utilization of and satisfaction at community health service between migrant and non-migrant workers in Shenzhen city. Methods: Random sampling was used and 8000 community residents in Shenzhen city were investigated, and the data was analyzed with SPSS 18. 0. Results:There was statistically signifi-cant difference on the times of seeking community health services last year between migrant workers and non-migrant workers ( P<0. 0001 ) , and the proportion of more than three times service utilization of migrant workers were greater than that of non-migrant workers. The top three elements inpluencing satisfaction at community health service between migrant and non-migrant workers were service attitude ( 73. 29% vs. 73. 46%) , technical level ( 65. 29% vs. 67. 50%), and its convenience of seeking a doctor (63. 16% vs. 64. 98%). 73. 47% of users (migrant workers:74. 16%, non-migrant workers:69. 71%) were willing to accept the system of first contact in community health in-stitutions. Conclusions:The utilization of community health service has increased since implementing the system of first contact in community health institutions. Both migrant workers and non-migrant workers were very satisfied with the community health services, and the differences on satisfaction between the two groups were not significant. It is feasible to gradually promote the system of first contact in community health institutions over China.

Objective Infliximab is a kind of recombinant human mouse chimeric anti-tumor necrosis factor monoclonal antibody. Here we aimed to examine the impact of infliximab therapy on RANK/RANKL/OPG system in the peripheral blood of rheumatoid arthritis (RA) patients. Methods Fifty patients with RA were rigorously screened and randomly divided into 2 groups. One group was treated with infliximab (3 mg/kg)and methotrexate (MTX). As control, the other group was treated with MTX alone. Infliximab was administered at weeks 0, 2, 6 and 14. The expression of RANK, RANKL mRNA in the peripheral blood, serum OPG and clinical indicators changes at week 0 and 18 were compared.x2-test or t-test were used for statistical analysis.Results After treated with infliximab, bone damage of joints were slowed down when examined by radiography in RA patients compared with the control group. And the ratio of OPG/RANKL was also decreased in RA peripheral blood (w0: 80.25;w 18: 63.2); (control group w0: 83.37; w18: 30.87)(P＞0.05). Although after the treatment with either MTX alone [w0: (238±15) pg/ml; w18: (118±10) pg/ml] or infliximab combined with MTX [(w0: (223.1±6.2) pg/ml; w18:(162.4±5.5) pg/ml], the serum levels of OPG were all decreased (P＞0.05), the level of OPG in infliximab treatment group was declined slower than those in the control group. Conclusion RA bone destruction can be inhibited by the combination therapy of infliximab and MTX. The mechanism may be partly through the RANK/RANKL/OPG system.

We retrospectively analyzed the features of the size, morphology, attenuation, the enhancement patterns, and anatomic distribution of 45 patients with mediastinal tuberculous lymphadenitis shown on contrast-enhanced multislice spiral CT (MSCT). 80% of the patients showed peripheral enhancement, and 38% of them showed multilocular appearance. deltaCT (The CT on enhanced scan minus that on the unenhanced scan) in the central area (15 +/- 12) HU was less than that in the peripheral area (27 +/- 16) HU (P < 0.01). The enlarged lymph nodes were predominantly distributed in the regions of 4R (87%), 2R (76%), 7 (73%), 10R (62%), and 4L (51%). MSCT could reveal the enhancement patterns and predominant anatomic distribution, which was of great value for the diagnosis of mediastinal tuberculous lymphadenitis.
Adolescent ; Adult ; Contrast Media ; Female ; Humans ; Male ; Mediastinal Diseases ; diagnostic imaging ; Mediastinum ; diagnostic imaging ; Middle Aged ; Radiographic Image Enhancement ; methods ; Tomography, Spiral Computed ; Tuberculosis, Lymph Node ; diagnostic imaging ; Young Adult

To determine the characteristics and regularity of multi-detector CT (MDCT) in breast cancer with skeletal thorax metastasis, we retrospectively analyzed the imaging findings of MDCT in 72 cases of breast cancer with bone metastasis before treatment. There were totally 455 metastasis involved sites. The most common metastatic site was thoracic vertebra. And the fourth left rib was most common lesion in rib metastasis. Right breast cancer was more likely to take place at the bilateral ribs (65%) and pectoral girdle (54.5%) metastasis. The lesions in 28 cases demonstrated osteolytic destruction (38.9%), while 30 cases showed osteogenic appearance (41.7%). In conclusion, the development of breast cancer with skeletal thorax metastasis has certain characteristics and regularity.
Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; diagnostic imaging ; secondary ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Middle Aged ; Multidetector Computed Tomography ; Retrospective Studies ; Ribs ; diagnostic imaging ; pathology ; Thoracic Vertebrae ; diagnostic imaging ; pathology

The purpose of this study was to evaluate the prothesis and vascular features of Debakey III aortic dissection by DSCT angiography after endovascular graft exclusion. We performed a retrospective analysis of 39 Debakey III aortic dissection patients who underwent DSCT angiography after endovascular graft exclusion. After the operations in this study, all the 39 patients had no stent fracture and migration, 15 among all the 39 had endoleaks (type I 12 patients, type II 2 patients, 1 patient had no reason), 17 had large amount of thrombosis in false lumen, and 1 had false lumen outside the stent absorbed completely. While before the operations, 15 patients had abnormal renal perfusion pre-operation, and 9 of them had recovered after the operations. And the nearer located to the initial exclusive place, the more obviously the aortic remodeling occurred. In conclusion, DSCT angiography can accurately evaluate the prosthesis and anatomic-pathologic features of Debakey III aortic dissection after endovascular graft exclusion.
Adult ; Aged ; Aneurysm, Dissecting ; diagnostic imaging ; surgery ; Angiography ; methods ; Aorta, Thoracic ; diagnostic imaging ; surgery ; Aortic Aneurysm ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Tomography, X-Ray Computed

Based on the analysis of the existing problems and implementation dilemmas in family doctor contracting and first-return-visits faced by primary medical institutions in China, the authors propose countermeasures to provide reference for managers of primary health care institutions.