OBJECTIVE:To provide reference for improving the pharmacy self-taught undergraduate course system in general universities in China. METHODS:According to comparative study and researching related literatures,the situation of pharmacy self-taught undergraduate course system in general universities in China was analyzed,and reform ideas and programs were present-ed. RESULTS & CONCLUSIONS:Based onchemistry-biology-psychology-society-medicine-pharmacyin the overall framework of pharmacy undergraduate self-examination course system,it was designed with target of cultivating applied talents;related con-tents in public basic courses,humanities basic course and professional ethics course should throughout the whole teaching process;professional main course should be pharmaceutical knowledge-based,supplemented by medical related courses;the school should set vocational elective course to reform based on combining with the own teaching research direction,characteristics and career ori-entation of different self-taught students. The reform can develop applied talents with ability and political integrity,which meets the needs of social development.

Recently, dry powder inhalation (DPI) has become a hotspot in the research area of pulmonary drug delivery (PDD). With the development of drug micronization technology and the emergence of innovative inhaler device, DPI has now been widely applied. This article introduces the formulation composition of DPI, which consists of micronized drug particles, carrier and inhaler device, and the formulation factors of influencing the aerosolizing and deposition properties are emphatically reviewed.

Changhai hospital begins to practice resident standardization training.This article introduced the basic instance of it, analyzed and summarized the experiences and problems in the process.At last we give some advices to improve the job of resident standardization training.

Early diagnosis and early thrombolysis may have a better prognosis in patients with ischemic stroke.The benefits from the development of modem magnetic resonance imaging techniques in this field have received great attention,and it directly guides the 'management of the acute ischemic stroke,This article briefly reviews diffusion-weighted imaging,perfusion- weighted imaging and MR spectroscopy analysis that are more commonly used in current clini- cal practice.

China ; Occupational Exposure ; prevention & control ; Risk Assessment ; Workplace

OBJECTIVE To investigate the reasons of infusion reaction. METHODS The liquid and disposable infusion tubes were tested by limulus amebocyte lysate(LAL).Blood samples were collected when infusion reaction occurred and the bacteria in blood culture were detected. RESULTS A total of 58 cases of infusion reactions within two years were from clinical department.LAL of liquid infusion was positive in 5 cases.Two isolations were identified from liquid infusion respectively.LAL was negative and no isolation for the unsealed bottle of liquid drugs with same batch number.LAL was negative for samples of same lot infusion tubes.The main drugs caused infusion reaction were refined medical herbs,large molecule substance,blood products and the medicine contained potassium ion.53.4% infusion reactions occurred in autumn.The seniles had high incidence.Bacteria were isolated from 5 patients in blood culture after liquid infusion. CONCLUSIONS More than one reason that cause infusion reaction.It is important to reduce incidence of infusion reaction through quality control of infusion tubes and aseptic process in infusion.

Background and purpose:Many patients may suffer from acute pain after radical mastectomy un-der general anesthesia. This article aimed to investigate the effect of intercostal nerve block coupled with general anes-thesia on analgesia after radical mastectomy for breast cancer.Methods:Ninety-six patients underwent modiifed radical mastectomy for breast cancer were randomized with random number into group C (intercostal nerve block coupled with general anesthesia) and group G (general anesthesia), with 48 patients in each group. Group C received intercostal nerve block by ultrasound before general anesthesia. Group G received only general anesthesia. The induction of general an-esthesia was the same between the two groups. During the surgery, 10 μg sufentanil was given to the patient if heart rate or blood pressure were 20% higher than baseline. After surgery, sufentanil was given if VAS score exceeded 0 point. The perioperative amount of sufentanil was recorded. VAS scores were recorded respectively on 2 (T1), 12 (T2) and 24 h (T3) after surgery. The incidence of postoperative nausea and vomiting was also observed.Results:Sufentanil amount used intra- and post- operation were signiifcantly lower in group C [(25.2±3.5) and (3.3±1.2) μg] than that in group G [(40.5±4.3) and (8.4±2.2) μg] (P<0.01). The VAS scores on 2, 12 and 24 h after surgery in group C(0.45±0.15,1.75±0.08 and 2.05±0.12), were signiifcantly lower than those in group G (4.32±0.21, 4.88±0.13 and 4.78±0.16) (P<0.01). The incidences of nausea and vomiting on 2 and 24 h after surgery in group C (6.25% and 16.66%) were signiifcantly lower than those in group G (20.8% and 41.66%). There was no adverse complication related with intercostal nerve block in group C.Conclusion:Intercostal nerve block coupled with general anesthesia plays an important role in preemptive analgesia for patients undergoing modiifed radical mastectomy for breast cancer, which may improve postoperative pain control and reduce the usage of opioids and incidence of nausea and vomiting. Intercostal nerve block under ultrasound is quite safe and effective for patients.

Objective To explore the relationship between transforming growth factor-β1 (TGF-β1) and obesity-related glomerulopathy (ORG),and to analyze the possible mechanism for ORG and the new approach to its treatment.Methods Based on their body weight,30 SD rats were randomly divided into 2 groups : the normal control group (15 rats) fed with common food and the ORG model group (15 rats) fed with fat-enriched diets.The rats were sacrificed at the end of the 8th week,and their kidneys were taken out.Immunohistochemistry was used to detect TGF-β1 protein expression.Real time (RT)-polymerase chain reaction (PCR) was used to extract and detect the expression of TGF-β1 mRNA,and Western blot was applied to examine the expression of TGF-β1 protein.The findings were analyzed by using SPSS 13.0 software.Results Compared with the control group, qualitative TGF-β1 expression in ORG model group were significantly increased detected by immunohistochemistry mainly in renal tubules and interstitium.The average absorbance value of the control group and the model ORG group was 0.040-0.013,0.171 ± 0.084, respectively.The difference was statistically significant(P ＜ 0.05).The expression of TGF-β1 mRNA detected by RT-PCR was also increased compared with that of the control group(4.4 vs 0.6).The difference was statistically significant(P ＜ 0.05).The protein expression of TGF-β 1 examined by Western blot showed that it was more than that in the control group(4.3 vs 0.4).The difference between the control group and ORG model group was statistically significant(P =0.002).Conclusions The expression of TGF-β 1 in kidneys of ORG model rats increased, which not only indicates it can participate in ORG's occurrence and development, but also provide the basis to find out the mechanism and the approach to treatment.

Objective To assess the health-related quality of life in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods The patients were collected from the outpatient department,a tertiary hospital in ShaanXi Province.The demographic characteristics such as age,gender,weight and height were collected.Spirometry was performed for every patient after salbutamol 400 μg was inhaled.6-minute walk test was done according to the guidelines which developed by American Thoracic Society in 2002.Four questionnaires,including COPD Assessment Test (CAT),Clinical COPD Questionnaire-week Version (CCQ),St George's Respiratory Questionnaire for COPD Patients (SGRQ-C) and Chronic Respiratory Questionnaire-Self Administered Standardized Activities-First Administration Version (CRQ-SAS),were answered by every participant.Results Totally 90 participants were enrolled between September 2013 and September 2014.75 cases(83.3％) were male and 70 cases (77.8％) were smokers or ex-smokers,the mean age was (67.8±9.7)years,and the mean educational history was (8.9±3.0)years.The mean body mass index was (23.3 ± 3.6) kg/m2,and the mean post-brochodilator FEV1 was (51.2 ± 18.7) ％ predicted.The average 6-minute walk distance was (424.5 ± 99.1) meters.The average scores of CAT and CCQ were(20.4±6.9) and (2.4±0.8),respectively.The mean SGRQ-C score was (38.5 ± 16.2).The symptoms,activity and impacts average scores of SGRQ-C were (64.3± 18.8),(45.1 ±21.3) and (25.7 ± 16.1).For CRQ-SAS,the average scores of dyspnea,fatigue,emotional function and mastery were (2.9±1.3),(2.9±1.1),(3.0±1.1) and (2.9±1.1),respectively.There was a weak correlation between FEV1 and each questionnaire scores.There was a moderate correlation between 6-minute walk distance and SGRQ-C,CCQ and CRQ-SAS.However,there was a weak correlation between CAT and 6-minute walk distance.For 6-minute walk distance,activity score of SGRQ-C,impacts score of SGRQ-C and history of coronary artery disease were independent influencing factors.For BODE index,activity and impacts score of SGRQ-C were independent influencing factors.Conclusions CAT,CCQ,SGRQ-C and CRQ-SAS are suitable to assess health-related quality of life for elderly patients with stable COPD,among four questionnaires,SGRQ-C is the best one.

Objective To understand the clinical characteristics of staphylococcal bloodstream infection in patients with secondary immunodeficiency,as well as the distribution and drug resistance of Staphylococcus aureus (SAU)and coagulase negative Staphylococcus (CNS).Methods A total of 101 patients with Staphylococcus isolated from blood sample were retrospectively reviewed in our hospital.The patients were classified into a group with secondary immunodeficiency and another group with normal immune function as control group.SPSS 18.0 statistical software was used to analyze the data,and compare the two groups of patients in terms of clinical characteristics,pathogens,antibiotic resistance,etc.Results All the 70 patients with staphylococcal bloodstream infection and secondary immunodeficiency had various degrees of fever except 2 cases (temperature < 36 ℃).Chills and shiver were reported in 30.0% of the patients,and migratory lesions in 15.5% of the patients.Lungs were the most common site of infection.About 11.4% of the patients complicated with septic shock.The case strains of SAU,of which 18 (43.9%)strains were MRSA,CNS 29 (41.4%)strains,of which 24 (82.8%)strains were MRCNS.In the control group,26 (83.9%)strains of SAU were identified,of which 11 (42.3%)strains were MRSA,and all the 5 (16.1%)strains of CNS were identified as MRCNS.The incidence of CNS infection in the patients with secondary immunodeficiency was significantly different from that in the control group (P =0.013).All the MRS strains were multidrug-resistant organism (MDRO)except one strain of Staphylococcus intermedius .The staphylococcal strains isolated from the patients with secondary immunodeficiency showed high rate of resistance to penicillin (100%), clindamycin (73.0%), erythromycin (90.0%)and gentamycin (61.0%).No strain was found resistant to tigecycline,linezolid or vancomycin.The resistance rate did not show significant difference between the patients with or without secondary immunodeficiency. Conclusions The clinical characteristics of staphylococcal bloodstream infection in the patients with secondary immunodeficiency are similar to the patients without secondary immunodeficiency,except higher incidence of septic shock and death,but the incidence of CNS infection is relatively higher,MDRO is more prevalent.Antimicrobial agents should be prescribed in clinical practice according to disease conditions and the result of antimicrobial susceptibility testing.