OBJECTIVE:To discuss about the feasibility and importance of the Obtaining Outside Resources Strategy of pharmaceutical enterprises in our country and to provide theoretic basis and practical direction.METHODS:To expound the new opportunity which this strategy would bring in and to theoretically analyse the reason and effect of practicing it.RESULTS&CONCLUSION:Obtaining Outside Resources Strategy could effectively raise the market competition power of pharmaceu?tical enterprises,but there exist strategical risks as well.

This paper reports the post-operative care of 41 patients with Chiari malformation associated with syringomyelia. The nursing points included postoperative vital signs monitoring,management of the body posture and incision,observation of complications. Among these patients,21 of them had cerebrospinal fluid leakage,3 of them had cranial nerve palsy,a patient suffered from acute respiratory arrest caused by brainstem edema. Patients recovered and discharged after active appropriate treatment and care.

The analgesic, sedative and convulsive effects of procaine were determined by animal experiments. The analgesic ED50 of procain were 21.7mg/kg or 52.8ug/ each (iv or icv, hot plate) and 29.2mg/kg or 52.2ug/ each (iv or icv,electral stimulation) in mice.Procaine In subthreshold dose had additive hypnotic effect of phenobarbital in mice and rabbits, but could not de crease spontaneous activity in mice.The convulsive ED50 of procaine were 13.5mg/kg (iv) or 2.4mg/each (icv) in rabbits.There was no influence on the righting reflex in all the experiment animals when iv or icv procaine was given alone.These results suggest that the analgesic and sedative effects of procaine are weak, but may be potentiated when administered concomitantly With other potent drugs.

The interaction between sodium oxybate and ketamine were studied in conscious animals. Sodium oxybate increased the LD_(50) of ketamine, increased the incidence of sleep caused by ke tamine and prolonged the sleep duration and potentiated analgesic action of ketamine. Sodium Oxybate didn't effect the respiratory and circulatory function in rabbits. The results showed sodium oxybate po tentiated the anesthetic action of ketamine and reduced the side effect of ketamine. So It is suggested that sodium oxybate has the anesthetic synergism with ketamine in animals.

Objective To evaluate the magnetic resonance angiography(MRA) in senile lower extremity arterial disease and to compare the diagnostic value of two dimensional time of flight(2D TOF) with three dimensional contrast enhancement(3D CE) technique. Methods Seventy patients with a mean age of 75 years underwent MRA for suspected acute or chronic lower extremity arterial disease. MRA was performed with a 1 5 T MR scanner and Gd DTPA was used by manual injection in 3D CE MRA. Among 52 patients examined with 2D TOF MRA, 18 of them underwent an additional 3D CE MRA, 32 patients took Doppler ultrasound examination, and 4 patients received emergency operation. Results In all 70 patients, 52 showed atherosclerotic stenosis disease, 17 atherosclerotic occlusive disease (4 of them were verified by emergency operation) and one patient atherosclerosis with aneurysmal dilatation. A total of 997 vessel segments were shown on MRA images and 600 of them were abnormal including 486(81%) mild to moderate stenoses, 114(19%) severe stenoses and 451 curved arterial segments. In 32 patients who underwent Doppler ultrasound, the diagnosis and its grading based on MRA was well correlated with that from Doppler ultrasound (coincidence rate was 91% and 96% respectively). A total of 764 suprapopliteal and 125 infrapopliteal arteries were depicted by 2D TOF MRA (visibility was 99% and 40% respectively). In 18 patients who received additional 3D CE MRA, totally 306 arteries were depicted on MRA (visibility 100%). Doppler ultrasound showed 40 segments with arterial calcification and 32 atherosclerotic plaques. Conclusions MRA is quite useful in detecting lower extremity arterial disease because of its noninvasion and convenience. The results derived from MRA are well correlated with that of Doppler ultrasound and clinical outcome. 3D MRA is superior to 2D TOF MRA in image quality, accuracy and time efficiency and is best for emergency case. Pitfalls of MRA such as overestimation in the severity of the disease and the long scanning time of 2D TOF must be taken into consideration .

OBJECTIVE: To discuss the strategy of commodity circulation of our pharmaceutical wholesale enterprises in new period. METHODS: To describe the present conditions of pharmaceutical wholesale enterprises:high cost and low beneficial result.To discuss the need of commodity distributing of pharmaceutical manufacturers and retails.To analyses the status of wholesale enterprises in supply chain.RESULTS & CONCLUSION: Our pharmaceutical wholesale enterprises must develop their commodity distributing strategy on the basis of the status of wholesale enterprises in supply chain.

Objective To explore the tubal patency after laparoscopic salpingotomy and embryo removal for tubal ectopic pregnancy. Methods A retrospective analysis was made on 28 patients receiving laparoscopic salpingotomy at other hospitals from September 2013 to September 2014.Within their 6 postoperative months, these patients were given hysterosalpingography in this gynecological minimally invasive center to evaluate the tubal patency. Results There were 6 cases of ipsilateral tubal patency (21.4%) and 22 cases of tubal obstruction or dropsy (78.6%), while 19 cases of contralateral tubal patency (67.9%) and 9 cases of tubal obstruction or dropsy (32.1%).Bilateral tubal embryo removal was carried out in 3 cases, with hysterosalpingography showing bilateral tubal obstruction in 2 cases and bilateral tubal dropsy in 1 case.One patient had ipsilateral tubal obstruction after tubal embryo patency and developed contralateral tubal patency after conservative treatment.Follow-up of the 28 cases for 6-15 months showed 4 cases of intrauterine pregnancy, 4 cases of examination of ovulation, 7 cases of preparation of assisted reproduction, 3 cases of laparoscopic salpingoplasty 1-2 months after hysterosalpingography, 1 case of endocrine regulation monitoring ovulation, 1 case of abnormal uterine bleeding 13 months later ( hysteroscopic examination showed endometritis and diagnostic curettage found proliferative phase endometrium that consistent with the menstrual cycle), and 8 cases without further treatment. Conclusion Laparoscopic salpingotomy for tubal ectopic pregnancy does not improve patient’ s tubal patency.

Objective To introduce practice efficacy and achievement of medical waste management project in medical institutions.Methods Twenty pilot medical institutions in 6 provinces and 1 520 extended medical institutions in each provinces (municipality, city) in China were selected to perform medical waste management project, the current situation of medical waste management in China was explored to develop a new feasibility plan and practice.ResultsCatalogue of medical waste classification (revised manuscript) and Medical waste classification collection list) were formulated, which enhanced supervision ability of medical and health administration on medical waste management.Medical waste management training system was established, best available techniques/best environmental practices(BAT/BEP)for medical waste management were achieved, cooperation and promotion ability of medical waste management project was strengthened.Conclusion Medical waste management project has made great achievements since it is implemented in medical institutions, the achievement can be used as reference for medical waste management in China.

With the popularization of rehabilitation and the development of the physiotherapy, some chronic diseases do not only mean the history of the patients, but also the objects of physiotherapy. The exercises will affect the cardiopulmonary function of the patient, and result in a high risk of accident. This article would review the risk factors and risk management in physiotherapy for chronic diseases.

Objective To research etomidate or propofol in the whole intubation during the induction of elderly coronary heart disease autonomic nervous system function. Methods Ninety patients undergoing abdominal surgery patients with coronary heart disease were randomly divided into etomidate group (E group, 45 cases) and propofol group (P group, 45 cases). In pre-anesthesia, after the induction of anesthesia and after intubatiou with power spectral analysis of heart rate variability (HRPSA) observed in patients with heart rate variability (HRV) changes. Results After the induction of anesthesia, the low frequency(LF)[(316±301) ms2/Hz] end total power(TP)[(756±535) ms2/Hz] decreased significantly in E group(P<0.05) and LF, high frequency (HF), LF/HF ratio(LF/HF)and TP decreased significantly in P group [ (187±168) ms2/Hz, (89±48)ms2/Hz, 2.3±1.6 and (616±462) ms2/Hz] (P<0.05). The duction degree of LF, HF, TP and LF/HF in E group was more significant than that in P group (P<0.05). After intubation, LF, HF, LF/HF and TP increased significantly in both groups and no significant difference of HRV was observed between the two groups (P>0.05). Conclusions Propofol decreases the activity of autonomic nervous system, wherea etomidate produces minimal changes under anesthesia induction in elderly coronary heart disease patients.There is no remarkable difference in cardiovasological changes induced by etomidate and propofol during tracheal intubation.