OBJECTIVE:To discuss the way to improve the service quality of outpatient pharmacy.METHODS:The pharmaceutical work in the outpatient pharmacy was optimized applying the theory of system engineering.RESULTS:The working efficiency and service quality of outpatient pharmacy were improved significantly.CONCLUSIONS:The theory of system engineering lay a focus on the optimal holistic effect of the system.Excellent results were achieved on the same objective conditions,when the stable quality of drugs,intensive scientific management,coordinating the exterior and interior relationships and reasonable usage of workers were considered as the elements of the system.

Objective: To compare the effects of engine-driven rotar y nickel-titanium(ni-ti) file and stainless steel hand K-file (ss-K-file) in posterior teeth’s root canal preparation. Methods: 118 root c anals of 45 cases were instrumented with ni-ti file (ProFile)by crow-down te chnique and 127 root canals of 49 cases were treated with ss-K-file by step- back technique respectively. The incidence of pain after preparation and the res ults of obturation were observed. Results:Total pain incidence i n ni-ti file preparation group and in ss-K-file group was 20.00% and 46.94% respectively (P

Objective To detect fat emboli in cardiac chamber of the patients undergoing total knee arthroplasty(TKA) by transesophageal echocardiography(TEE), and to discuss the relevant clinical value.Methods Eleven female patients with 12 osteoarthritis(OA) knees were underwent TKA. According to whether using tourniquet or not,12 knees were divided into 2 groups at random:tourniquet-related group (6 knees) and control group(6 knees). Echo intensity and ultrasonic characteristics of fat emboli in cardiac chamber were studied dynamically by multiplane TEE in various periods of the whole operation. Results All of the patients were implanted knee prostheses successfully. In different periods of TKA, fat emboli appeared as isoechoic or hyperechoic particles, which were found in right atrium, but nothing could be found in left heart. The imaging of the particles was flowing with duration time of 10～600s, like dots, lines, "moving star" or "shower". While femur expanding(0～3mins),the particles in right atrium and ventricle became more and more, and the echo intensity became significantly higher than those in other periods. After releasing tourniquet(0～5mins),most particles with highest echo intensity were observed in right heart,showing like "snowstorm" in tourniquet-related group, and more emboli were still detected at the end of monitoring (10 min after releasing tourniquet) by TEE,compared to the control group. No patient suffered from fat embolism syndrome(FES) with clinical manifestation. Conclusions Fat emboli in cardiac chamber can be observed sensitively by real-time TEE dynamically during TKA. It should be encouraged and promoted to analyze ultrasonic characteristics to facilitate the early detection, early diagnosis and early clinical intervention for the subclinical type of FES.

We set up the characteristic medical psychology teaching mode based on the talent training objectives for three-year clinical medical majors and the requirements of the course qualification exam.The mode includes the basic psychological and clinical psychological teaching content system based on cases and tasks.Case-based teaching and Problem-based learning were used and research report and net exam were employed as main assessment methods.Online teaching resources were explored through establishing excellent course website,medlical psychology website and psychological test web

OBJECTIVE:To establish the optimal technical condition for the extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription with supercritical CO2 fluid(SFE-CO2).METHODS:The technical condition for the extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription were optimized using L9(34)orthogonal design table with extraction pressure,the extraction temperature,the pressure and temperature of separator Ⅰ as factors and with the yield of the volatile oil as index.RESULTS:A highest extraction yield of volatile oil from the volatile herbs of Huoxiang zhengqi prescription was achieved(2.057%)under an optimal technical condition as follows:with extraction pressure at 25 MPa,the extraction temperature at 30 ℃,the pressure for separator Ⅰ at 9 MPa and the temperature of separator Ⅰ at 45 ℃.CONCLUSION:Extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription by SFE-CO2 is characterized by high extraction yield,stable,pure operation,safe,and by which the biological activity of the volatile oil can be maintained,thus it is a potential extraction and separation method.

The functional experimental teaching reform plays a very important role in raising the teaching resources,consummating the experimental teaching management system,enhancing the student to practice the ability and so on and has obtained the good effect.But it also faces some problems waiting urgently to be solved and further perfected,to which this article has made the analysis and the discussion from the management science angle.The goal lies in deepening the educational reform in functional experiment unceasingly to provide the model.

Objective To investigate the effect of Zhuang medicine acupuncture on brainstem auditory evoked potential (BAEP) in patients with posterior circulation ischemic vertigo (PCIV).Methods Eighty-five PCIV patients were randomly allocated to a treatment group of 45 cases and a control group of 40 cases. The control group received conventional basic therapy and the treatment group, Zhuang medicine acupuncture in addition. The peak latencies (Pg) of BAEP waveⅠ ,Ⅰ andⅠ and the interpeak latencies (IPg) of waveⅠ-Ⅰ,Ⅰ-Ⅰ andⅠ-Ⅰ were compared between the two groups after treatment.Results There were statistically significant post-treatment differences in waveⅠ andⅠ Pg and waveⅠ-Ⅰ andⅠ-Ⅰ IPg between the treatment and control groups (P<0.05).Conclusions Zhuang medicine acupuncture plus medication is an effective way to treat PCIV. It can improve BAEP indicators in the patients.

Objective To understand the clinical characteristics of pediatric patients who developed H1N1 influenza A virus-associated pneumonia during the outbreak of H1N1 influenza A in Shanghai. MethodsA dcscriptivc study was done to analyze the clinical and epidemiologic characteristics of 30 hospitalized children who developed complicated pneumonia caused by H1N1 influenza A virus infection in 2009 in Shanghai. The comparison of medians was done using rank sum test and comparison of rates was done using exact chi-square test. Results Among thirty pediatric patients with H1N1 influenza A virus-associated pneumonia, the median age was 5.9 years old, five cases (16.7 %) had pre-existing medical conditions. Twenty cases (66.7 % ) had been exposed to the classmates or family membcrs with fever. All cases had fever and cough. Eleven cases (36.7 %00 ) had tachypnca and ten (33.3%) had wheeze. Eleven cases (36.7%) showed white blood cell (WBC)＜4.0 × 109/L and 2 (6. 7%) had thrombocytopenia. All patients had bilateral or unilatcral patchy infiltrates in the lung indicated by chest X-ray and four (13. 3%) had extensive infiltrates with the evidence of pulmonary edema. One (3. 3%) critically ill child with pneumonia, chest computed tomography scan revealed lung fibrosis 3 months and 9 months after illness onset. Three(10. 0%) cases had pneumomediastinum and subcutaneous emphysema. Six cases (20. 0%) were complicated with acute respiratory failure, three (10. 0%) with acute asthmatic attack and one (3. 3%) with encephalitis. All patients were treated with oseltamivir plus antibiotics and four required mechanical ventilation. All patients survived. The median duration of fever in group with oseltamivir given within 2 days of fever onset was statistically shorter than that in group with oseltamivir given 2 days after fever onset (2 days vs 5 days, Z= -8. 015, P<0. 01). Conclusions Both pre-school age and schoolage children may develop complicated severe respiratory diseases after H1N1 influenza A virus infection. Early initiation of oseltamivir may shorten the duration of fever and reduce the occurrence of severe complications.

Objective To compare the early results of total knee arthroplasty using high flexion (HF) versus standard posterior-stabilized (PS) prosthesis tibial insert. Methods From February 2005 to July 2008, 203 patients (216 knees) underwent total knee arthroplasty using Genesis Ⅱ prosthesis and were randomly distributed into group A (98 patients with 107 knees, HF insert) or group B (105 patients with 109 knees, PS insert). There were no significant differences between the two groups in the preoperative Knee Society score (KSS) knee score, KSS function score, and range of motion. They were followed-up for 1 year and compared using KSS knee score, KSS function score and range of motion. Results 91 patients (98 knees)were followed up in group A, and 94 patients (96 knees) were followed up in group B. The postoperative knee active range of motion was 121.1°±6.9° in group A, and was 118.6°±8.1° in group B. The improvement of knee active range of motion was 17.1°±13.3° in group A, and was 16.1°±18.8° in group B. The postoperative range of passive motion of group A and group B were 127.2°±7.1° and 121.0°±7.8° respectively. The postoperative KSS knee score was 86.9±7.6 in group A, and was 87.5±6.8 in group B. The postoperative KSS function score was 91.2±8.7 in group A, and was 90.1±9.3 in group B. The range of passive motion of groupA was better than that of group B (P ＜0.05). There were no significant differences between the two groups in other aspects. Complications include deep vein thrombosis (DVT), 4 patients in group A and 3 in group B,wound fat liquefaction, 3 patients in group A and 5 in group B, synarthrophysis, 2 patients in group A and 3 in group B. Conclusion This prospective randomized clinical trial demonstrates no differences between PS and HF in early clinical outcomes, except the range of passive flexion.

Clinical data of 53 patients (69 knees), who were treated at the Division of Joint Surgery, Department of Orthopaedics, Changzheng Hospital from January 1998 to December 2006, were retrospectively analyzed. These patients suffered from wound-healing complications following total knee arthroplasty. Wound skin problems included skin flare, disruption of wound, local hematoma, skin necrosis and deep infection. Local wound care was performed in 58 knees, debridement and secondary closure in 6 kness, and primary management of the soft tissue defect was achieved with local muscle flaps in 3 knees, with the fasciocutaneous flap in 1 knee, and with fasciocutaneous flap and skin grafting in 1 knee. Mean follow-up was 1.9 years. All wound was healed well. It is indicated that corresponding management should be used for treating wound-healing complications following total knee arthroplasty.