This paper summarizes the main achievements and the existing problems of clinical pharmacy in China since establishing the discipline. The cause which accounts for the occurrence of these problems is briefly analysed. On the basis, we suggest the way to develope clinical pharmacy in the future. The following three topics are discussed in detail:establishing related rules and regulations, trainning qualified personnel, and encouraging pharmaceutists to contact clinical work.

Ten cases of gastrointestinal adenocarcinomas were histochemically investigated for their lectin receptors by avidin-biotin-peroxidase complex (ABC) method. Results showed that gastric adenocarcinomas expressed more types of lectin receptors than large bowel adenocarcinomas. Positive rates of G1c/Man-and GlcNAc-specific lectin receptors in those tumors were higher than those of Gal/GalNAc- and Fuc-specific lectin receptoes. From the stomach to rectum, the spectrum of the lectin receptors in pericarcinomatous tissues gradually changed from the gastric type to rectal type. The expression of lectin receptors in gastrointestinal adenocarcinomas was obviously different from that in their corresponding pericarcinomatous tissues. The increase and decrease of lectin receptor expression, the appearance and disappearance of some types of lectin receptors as well as the change of the receptor distribution are indirectly regulated by cellular genome.

Glycophorin A(GPA)of human erythrocyte membrane is closely related with the invasion of erythrocytes by Plasmodium falciparum. Under the condition of the in vitro culture, the effects of GPA, anti-GPA-IgG, ?1-acid glycoprotein, wheat germ agglutinin, etc. on the invasion of erythrocytes by Plasmodium falciparum were observed in the research. The results showed that the combination of GPA with Plasmodium falciparum merozoites has high specificity, high affinity and a tendency to saturation, and produces specific biological effects. These confirm for the first time from the characteristics of the ligand-receptor interaction that GPA is a recptor recognized and bound by Plasmodium falciparum merozoites.

Wheat germ agglutinin(WGA)with a higher activity of hemagglutination was purified from wheat germ by a modified method of ovomucoid-Sepharose 4B affinity chromatography.The average yield of purified WGA from 100g wheat germ acetone powder was 58.74?6.56mg. WGA showed a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis with an apparent molecular weight of 34400.The specific haptens of WGA- were N-acetylglucosamine and sialic acid.

The high affinity interaction of avidin-biotin in immunoenzyrnatic techniques has provided a simple and sensitive method to localize antigens in formalin-fixed and paraffin-embedded tissues.The distribution of lectin receptors in primary hepatocellular carcinoma, int-ahepatic cholangiccarcinorria an.i cavernous hemangi-oma was studied for the first time by avidin-biotin-peroxidase complex (ABC) method.The results show that the method was simple, highly sensitive, and had gcod reproducibility and specificity as well as higher value of practical use.

Receptors of wheat germ agglutinin (WGA) in liver tumors, such as hepatocellular carcinoma (HCC), intrahepatic cholangiocellular carcinoma(ICC) and so on, were histologically localized by avidin-biotin-peroxidase complex (ABC) method. Normal, cirrhostic and pericarcinomatous liver tissues were used as controls. The result showed that WGA receptors in HCC were irregularly distributed, which was significantly different to the band-like distribution of WGA receptors in the controls and to the distribution in ICC. After the treatment with neuraminidase, the distributions of WGA receptors changed apparently. It is suggested that the characteristics of WGA receptor distributions in cells could be helpful to the diagnosis and differential diagnosis of liver tumors.

OBJECTIVE: To provide reference for the further implementation of national essential drug system in China. METHODS: The establishment of national essential drug system in China was reviewed to find out the problem in the implementation process. Related solutions were proposed. RESULTS & CONCLUSION: The implementation of essential drugs in China demand clarifying the legal status of essential drugs, strengthening popularity of essential drugs, improving awareness of medical staff and the public about essential drugs. Moreover, patients can be benefited in the medical institutions where essential drug system has been carried out to improving the dependence of the public to essential medicines.

目的观察多功能微晶疤痕治疗仪配合曲安缩松局部注射治疗瘢痕疙瘩的疗效。方法 80例瘢痕疙瘩患者随机分为多功能微晶疤痕治疗仪配合曲安缩松瘢痕组织内注射组与单纯曲安缩松注射组各40例,比较两组的疗效。结果多功能微晶疤痕治疗仪配合曲安缩松局部注射的疗效明显优于单纯曲安缩松注射(P<0.01)。结论多功能微晶疤痕治疗仪负压探头能软化瘢痕,利于曲安缩松药物充盈,从而使其更好地发挥抑制成纤维细胞增生的作用。

Objective To observe the matching between the straight short femoral cephalomedullary nail (PFNA-Ⅱ) and the femoral anterior bow in Chinese patients with intertrochanteric fracture. Methods A retrospective study was performed to analyze the postoperative lateral X-rays of 158 patients with intertrochanteric fracture who had been treated by PFNA- Ⅱ between August 2009 and December 2010.They were 35 men and 123 women,with a mean age of 77.2 years.The relationships between the distal tip of the medullary nail and the anterior cortex of the femur were observed according to a self-designed 6-grade scale (grade 0:central location of the nail tip in the medullary canal; grade 1:deviated location without contact with the cortex; grade 2:contact＜ 1/3 cortex thickness; grade 3:contact ＞ 1/3, ＜ 2/3 cortex thickness; grade 4:contact ＞ 2/3 cortex thickness; grade 5:perforation; posterior deviations in grades 1 to 5 presented as minus).The theoretical distance was measured as if the anterior protrusive nail tip had been placed back to the central axis.The degree of the curvature and its corresponding radius were calculated by the geometric method. Results Of the 158 patients,the distal tip of PFNA- Ⅱ was located centrally along the axis of femur canal in 30 cases(19.0％ ),posteriorly to the central axis in 10 cases(6.3％ ),and anteriorly to the central axis in 118 cases (grades 1 to 3; 74.7％ ),of which 55 cases experienced irritation caused by the contact between the distal tip and the anterior cortex (grades 2 to 3％ ).The mean theoretical distance needed to put back the nail tip to the canal central axis was 1.42 ± 0.18 mm in the 17 cm nails,1.77 ± 0.39 mm in the 20 cm nails,and 2.46 ±0.20 mm in the 24 cm nails.Their corresponding curvature arcs were 2.51° ±2.40°,2.13° ± 1.65° and 2.09° ± 0.98°,and their curvature radii were 1483 ± 818 mm,2329 ± 1293 mm,and3710 ± 1957 mm,respectively. Conclusions There is a significant mismatch between the current short straight celphalomedullary nail (PFNA- Ⅱ) and the femoral anterior how in Chinese population.A curvature design is needed for the short cephaiomedullary nails to match the femoral anterior how of Chinese population.

Objective To investigate the clinical value of serum endocan and procalcitonin (PCT) in early diagnosis and prognosis evaluation of sepsis.Methods The patients with systemic inflammatory response syndrome (SIRS,n = 26) and sepsis (n = 78) admitted to intensive care unit (ICU) of the Third Hospital of Hebei Medical University from December 2014 to December 2016 were enrolled. According to the severity of disease, the sepsis patients were divided into general sepsis group (n = 20), severe sepsis group (n = 24), and septic shock group (n = 34). The cases were divided into survival group (n = 55) and non-survival group (n = 23) according to 28-day mortality. The serum endocan, PCT, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and sequential organ failure assessment (SOFA) score were recorded when the patients were admitted into ICU. The differences in endocan, PCT, APACHE Ⅱ, SOFA score between SIRS and sepsis groups and within sepsis subgroups were compared. Spearman correlation analysis was used to analyze the correlation between the indexes of sepsis patients. Receiver operation characteristic curve (ROC) was used to evaluate the value of endocan and PCT for the diagnosis and prognosis of sepsis.Results ① Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in the sepsis group were significantly higher than those in the SIRS group [endocan (μg/L): 4.28 (10.64) vs. 1.03 (0.69), PCT (μg/L): 3.94 (10.75) vs. 0.43 (0.39), APACHE Ⅱ:18.81±9.17 vs. 9.35±3.78, SOFA: 9.00 (7.20) vs. 4.50 (1.50), 28-day mortality: 29.49% vs. 11.54%, allP < 0.01]. The area under the ROC curve (AUC) of endocan, PCT, APACHE Ⅱ, SOFA score for sepsis diagnosis were 0.887, 0.842, 0.822, 0.835, respectively. When the cut-off value of endocan was 1.26μg/L, the sepsis diagnostic sensitivity was 87.2% and specificity was 81.8%. When the cut-off value of PCT was 0.75μg/L, the sepsis diagnostic sensitivity was 85.9% and specificity was 81.8%. ② With the severity of the disease increased, the index showed an increasing trend in patients with sepsis. Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in septic shock group were significantly higher than those in severe sepsis group or general sepsis group [endocan (μg/L): 13.02 (6.70) vs. 3.33 (3.05), 1.60 (0.98); PCT (μg/L): 8.10 (17.68) vs. 5.47 (8.92), 1.57 (2.78); APACHE Ⅱ: 25.00 (9.50) vs. 18.00 (9.00), 9.50 (5.75); SOFA: 13.00 (4.50) vs. 8.00 (3.00), 5.00 (3.50); 28-day mortality: 52.94% vs. 20.83%, 0%; allP < 0.01]. There was a significantly positive correlation between endocan, PCT, APACHE Ⅱ, SOFA, indicating that the endocan and PCT can be used to assess the severity of sepsis. ③ Serum endocan, PCT, APACHE Ⅱ and SOFA score in non-survival group were significantly higher than those in the survival group [endocan (μg/L): 15.05 (9.23) vs. 2.32 (4.81), PCT (μg/L):18.40 (16.99) vs. 3.10 (6.67), APACHE Ⅱ: 28.13±7.56 vs. 14.91±6.64, SOFA: 14.70±3.65 vs. 7.38±3.26, allP < 0.01]. The AUC of endocan, PCT, APACHE Ⅱ, SOFA score for the prediction of non-survival sepsis were 0.915, 0.763, 0.899, 0.930. When the cut-off value of endocan was 4.37μg/L, the septic death prediction sensitivity was 95.7% and specificity was 70.9%. When the cut-off value of PCT was 7.68μg/L, the septic death prediction sensitivity was 65.2% and specificity was 78.2%.Conclusions Serum endocan is more clinically valuable than PCT in early diagnosis and prognosis assessment of sepsis.