h specific measures of humanistic management from three aspects of the hospital service processes,making it clear the importance and significance of humanistic management in hospital service processes.

OBJECTIVE:To provide suggestions for retail drugstores on how to tackle problems of non-quality induced drug returning from customers.METHODS:Reasons why it is hard to return the already purchased drugs were analyzed based on the status quo of drug returning in retail drugstores,and some countermeasures were presented on how to reduce or avoid non-quality induced drug returning problems.RESULTS&CONCLUSION:Non-quality induced drug returning problems can be well solved in drugstores through improving pharmaceutical care level and management level.

OBJECTIVE:To provide the reference for drug stores to choose the chain mode:the direct sales or franchise.METHODS:The common modes of the drug store’chain administration and the current condition of the chain drug store industry in china were summarized;The merits&demerits of each mode and the environment,which influenced the choice of chain modes,were analyzed.RESULTS&CONCLUSION:The phenomenon can not be the proof that direct sales are better than the franchise in the market.The Chinese pharmaceutical chain enterprises should make their own choices based on the specific situation.The improved franchise mode is very competitive in the market.

Objective To investigate the values of serum vascular endothelial growth factor (VEGF) ,carcinoembryonic antigen (CEA) ,carbohydrate antigen 19-9 (CA19-9) and ferritin (SF) determination in assessing the efficacy of chemotherapy in patients with advanced gastric cancer .Methods Wedetermined the concentrations of serum VEGF ,CEA ,CA19-9 and SF for 85 patients with advanced gastric cancer ,before and after 1 cycles of chemotherapy and evaluated the the effect of chemotherapy after 2 cycle of chemotherapy .Results In effective group ,serum concentrations of VEGF ,CEA ,CA19-9 and SF significantly decreased after chem-otherapy cycle(P< 0 .05) ,serum VEGF and CEA concentrations significantly increased in progress group (P< 0 .05) ,serum VEGF ,CEA ,CA19-9 and SF concentrations in stable group and serum CA19-9 and SF concentrations in progress group did not change significantly(P> 0 .05) ,compared with those before chemotherapy cycle .Multiple regression analysis showed that serum CEA ,VEGF ,CA19-9 concentration changes correlated with chemotherapy efficiency ,while serum SF didn′t(t=1 .58 ,P=0 .119) . Conclusion Serum CEA ,VEGF ,CA19-9 concentration changes associated with gastric cancer chemotherapy efficiency ,which help predict the efficiency of chemotherapy .

Objective To investigate the combined detection of serum vascular endothelial growth factor (VEGF),squamous cell carcinoma antigen (SCC-Ag)and cytokeratin 19 fragment (CYFRA21-1)value in assessing the efficacy of chemotherapy in patients with advanced squamous cell carcinoma of the lung.Methods 60 cases of lung squamous cell carcinoma patients in January 2011 between June 2013 to be admitted to hospital were treated with gemcitabine plus cisplatin or carboplatin chemotherapy.Detected the levels of serum VEGF,SCC-Ag and CYFRA21-1 expression in 60 cases before and after 1 cycle of chemotherapy in patients using ELISA and immunoradiometric assay,and evaluated the efficacy evaluation with reference to RECIST criteria after 2 cycle of chemotherapy.Results Effective group serum VEGF and CYFRA21-1 levels were 413± 114 pg/ml and 14.7±9.6 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 272±131 pg/ml and 10.8±7.1 ng/ml,which decreased after chemotherapy (P<0.01).Progress group serum VEGF and CYFRA21-1 levels were 472±207 pg/ml and 18.9±17.6 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 537±219 pg/ml and 21.5±20.2 ng/ml,which increased after chemotherapy (P<0.01).Stable group serum VEGF CYFRA21-1 levels and were 419±246 pg/ml and 17.0±12.9 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 421±252 pg/ml and 16.8±11.7 ng/ml,which had no changes before and after treatment (P>0.05). Serum SCC-Ag levels before and after each treatment group difference was not statistically significant (P>0.05).Multiple regression analysis showed that serum VEGF,CYFRA2 1-1 levels and the efficacy of lung squamous were related changed (t=5.86,P<0.001;t=2.26,P=0.027),and there was no significant correlation between SCC-Ag levels changes and the effect of chemotherapy (t=1.52,P=0.133).Conclusion Serum VEGF and CYFRA21-1 expression level changes associat-ed with squamous cell carcinoma of the lung chemotherapy effect,which can advance understanding of the effect of chemo-therapy,combined with advanced squamous cell carcinoma detection of serum VEGF and chemotherapy assessment CY-FRA2 1-1 has a certain reference value.

Objective To detect whether there is neurotropism following end-to-side neurorrhaphy by means of the neuron retrograde tracing technique. Methods Forty female Sprague-Dawley rats were randomly divided into 4 groups: tracing main branch of musculcutaneous nerve(MC) of end-to-side group, tracing MC main branch of normal group, tracing MC motor branch of end-to-side group and tracing MC motor branch of normal group.In two end-to-side groups, the MC was transeeted, then an 1 mm epineukral window was created on the ulnar nerve. Distal end of MC nerve was sutured to the windowed ulnar nerve by means of end-to-side neurorrhaphy.In two normal control groups, MC and ulnar nerves were just exposed. Five months post operation, by means of retrograde Fluoro-Gold neuron tracing technique,the number of C5～ T1 anterior horn motoneurons and dorsal root ganglion sensory neurons of all groups were counted. Results In two tracing MC main branch groups: the motor neuron counts in end-to-side group was 245.2 ± 93.8, the motor neuron counts in normal group was 846.7 ± 264.8, and counts of end-to-side group was 30.0% of the normal control group (P＜ 0.01). The sensory neuron counts in end-to-side was 434.7 ± 160.4, the sensory neuron counts in normal group was 1545.2 ± 287.4, and counts of end-to-side group was 28.1% of the normal control group (P ＜ 0.01). The per-centage of motor neuron in end-to-side group was 0.36 ± 0.09, there was no difference between end-to-side group and normal control group(P＞ 0.05). In two tracing MC motor branch groups: the motor neuron counts in end-to-side group was 72.3 ± 35.3, the motor neuron counts in normal group was 189.7 ± 57.0, and counts of end-to-side group was 38.1% of the normal control group (P ＜ 0.01). The sensory neuron counts in end-to-side was 110.8 ± 52.5, the sensory neuron counts in normal group was 157.9 ± 50.0, and counts of end-to-side group was 70.2% of the normal control group (P ＞ 0.05). The percentage of motor neuron in end-to-side group was 0.40 ± 0.14, the difference between end-to-side group and normal control group was signifieant(P ＜ 0.01 ). Conclusion Neurotropism in collateral spouting after end-to-side neurorrhaphy is not significant.

Objective To investigate the changes of serum levels of sex hormone binding globulin (SHBG),free testosterone index (FTI) and insulin resistance; and to investigate the relationship among them and prevalence of gestational diabetes mellitus (GDM) and hypertensive disorder complicating pregnancy (HDP) in polycystic ovarian syndrome (PCOS) women during pregnancy. Methods Serum samples of 32 PCOS women and 32 non-PCOS women were collected during their gestational age from 12 to16 weeks.Serum levels of total testosterone,SHBG and insulin were detected.Free testosterone index (FTI) and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.Risk factors of GDM and HDP were analyzed by stepwise logistic regression.Data of two groups were compared with t test or Chi square test. Results Serum fasting insulin [(8.0±1.5) mU/L vs (7.1±1.5) mU/L,t=2.32,P＜0.05],FTI [0.96 (0.52-1.41) vs 0.61 (0.40-0.79),t=3.02,P＜0.05],HOMA-IR levels [1.53±0.32 vs 1.36±0.36,t=2.04,P＜0.05] and total testosterone [2.95 (1.61-4.40) nmol/L vs 2.15 (1.50-2.80) nmol/L,t=2.55,P＜0.05] were higher in PCOS group than in control group; and SHBG level [325 (312-355) nmol/L vs 360 (347-373) nmol/L,t=4.13,P＜0.05] was lower in PCOS group than in control group.Cesarean section rate (84％ vs 50％,x2 =8.58,P＜0.01) and HDP incidence (25％ vs 3％,x2=4.65,P＜0.05) were higher in PCOS group than in control group. SHBG level [(293 ±42) nmol/L] of PCOS women who complicated with GDM (n=6) was significantly lower than that [(333±40) nmol/L] of those who did not (n=26),t=2.22,P＜0.05.Serum total testosterone [(4.34±1.29)vs (2.49±1.44) nmol/L,t=3.23,P＜0.05] and FTI [1.42±0.52 vs 0.81±0.59,t=2.61,P＜0.05] were significantly higher in PCOS women complicated with HDP (n=8) than those of the PCOS women who did not (n=24).Stepwise logistic regression analysis showed that SHBG was the risk factor of GDM (OR=0.98,95％CI:0.96～1.00,P＜0.05); FTI was the risk factor of HDP in PCOS women (OR=5.53,95％CI:1.20～25.61,P＜0.05). Conclusions FTI and SHBG levels could be predictors for GDM and HDP in PCOS women during their pregnancies.

Minimally invasive techniques for venous operation have evolved over the last decade and revolutionized the management of venous disease especially for venous varicosity of lower extremity. Endoscopic, endovascular and mechanical methods including transilluminated powered phlebectomy, endovenous laser occlusion,radiofrequency endovenous occlusion, subfascial endoscopic perforator ligation, endovenous vascular sclero-therapy, and percutaneous venous valvular bioprosthesis have supplanted the longstanding traditional procedures. For comprehension, these techniques decrease the number and size of incisions, operative and recovery time; and furthermore increase the efficient rates.

Objective To study the effect of blood transfusion on earthquake injuries with crush syndrome in WenChuan earthquake.Methods The amount of red blood cell suspension given to the earthquake victims were studied. The transfusion effect, Hb concentrations, and capillary hemorrhage of tissues of the injuries were also observed.Results Two victims, who underwent amputation surgery and cerebral hemorrhage operation, received a relatively small amount of transfusion, and showed a good transfusion effect and prognosis. While the other 6 victims, who underwent amputation surgery, surgical debridement, or continuous renal replacement therapy, received a large amount of blood, and showed a bad transfusion effect and prognosis.Conclusion The amount of blood transfusion in patients with crush syndrome was correlated negatively with the outcome.

This paper elaborates on the significance of'birth,growth,transformation,harvest,store'from the theory of TCM fi ve elements.Then it mainly discusses the harmonious development of five aspects of TCM science in research,education,market,hospitals and infrastructure from the view of respective functions of'birth,growth,transformation,harvest,store'and the TCM idea that conforming to certain climate can help people keep healthy.Finally,the paper indicates that it is necessary for the government to guide and adjust the development of TCM in different stage from a dynamic view.