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.

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 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 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 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 explore the clinical value of serum CA125 and HE4 combined with transvaginal color Doppler(TVCD)examination in early screening of ovarian cancer among high-risk populations.Methods The included research subjects were divided into 3 groups:100 cases in the healthy group,80 cases in the high-risk group and 32 cases in the ovarian cancer group.The serum CA125 and HE4 levels and ultrasonic scores were compared among 3 groups.Results The HE4 and CA125 levels and ultrasound scores in the ovarian cancer group were significantly increased compared with the other two groups,the difference was statistically significant(P＜0.01);the positive detection rate of CA125 plus HE4 levels combined with ultrasonic examination in the high-risk group was higher than that of other detection method(P＜0.05);the sensitivity and specificity of CA125+HE4 combined with vaginal ultrasound screening were obviously higher than those of other screening method,the difference was statistically significant(P＜0.05);the specificity of HE4 was significantly higher than that of CA125,but its sensitivity was lower than that of CA125(P＜0.05).Conclusion CA125 and HE4 combined with TVCD is helpful for early screening of ovarian cancer in high-risk populations,easy to save medical cost and improves its detection rate.

Multimedia is widely used in dermatology teaching.Some problems are analyzed in this article,such as the problem of communication between teachers and students,teaching contents,teaching methods and multimedia making.Methods to solve these problems are also suggested.

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.

Background and purpose:In recent years, many studies have showed that elemene liposome is widely used in the treatment of digestive tract tumors, malignant pleural effusion and ascites. This study combined in vitro and in vivoexperiments to observe the inhibitory effect of elemene liposome on the growth of human gastric cancer and the HGC-27 cell line.Methods:In order to screen the optimum concentration of elemene liposome, machine vision automatic live cell observation analysis system (Cell-IQ) was applied to detect the best inhibitory effect on human gastric cancer cell line HGC-27, and the lfow cytometry was applied to further detect the apoptosis of HGC-27 treated with elemene liposome. The model of human gastric cancer peritoneal metastasis in nude mice was established to investigate the intervention of elemene liposome and cisplatin (DDP) on peritoneal cancer index (PCI). CD31 marker of tumor microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) in tumor tissues were investigated to explore the mechanism underlying the inhibitory effect on peritoneal metastasis of HGC-27 cells in nude mice.Results:Cell-IQ analysis showed that the inhibitory effect of elemene liposome on HGC-27 presented in a positive concentration-dependent manner, which could not be further enhanced when the concentration exceeded 100 μg/mL with the best reaction time between 4 and 19 hours. Flow cytometry showed that the early apoptosis rate was 45% in the elemene liposome group and only 0.019% in the control group. The early apoptosis rate was signiifcantly higher in treatment group than that in control group (P<0.05). PCI was signiifcantly lower in the group treated with elemene liposome plus DDP than that in control group (P<0.05) in the peritoneal metastasis of gastric cancer nude mice model. The expression of CD31-MVD and VEGF was not signiifcantly different between the treated and control groups (P>0.05).Conclusion:Elemene liposome can inhibit human gastric cancer cells at the optimal concentration of 100 μg/mL with the best reaction time between 4-19 hours. Elemene liposome has a clear preventive effect on peritoneal metastasis of human gastric cancer in nude mice. Induction of apoptosis in gastric cancer cells may be the main mechanism underlying the inhibitory effect of elemene liposome on human gastric cancer cells.