OBJECTIVE:To explore hospital pharmacists service mode and the subject construction of hospital pharmacy. ME-THODS:Through reviewing the transformation process of hospital pharmacy and pharmacist's duty,the present structure,con-tent,working model and achievements of pharmacy in our hospital were introduced based onlarge pharmacyof taking clinical pharmacy as core,paying attention to personnel training,technical innovation,physican,pharmacist and nurse cooperation,multi-ple discipline integration,etc.;the direction of hospital pharmacy was explored. RESULTS:Many adjustments were made to facili-tate the smooth and orderly development of hospital pharmacy under the new situation,as that establish the rational drug use and quality safety system,drug supply and operation management system working mode;that the development strategy of pharmacy was identified asfocusing on the rational drug use,combining the management functionandproviding professional pharmaceuti-cal care for the clinic and patients,providing professional technical support for the hospital decision and medical management;that the construction of clinical pharmacy specialty/key discipline and drug clinical trial technology platform in accordance with the international standard and so on were lined in the project of pharmacy;that quality control circle was cited,pharmaceutical supervi-sion and pharmaceutical care were expanded to the public and the fine;that a fine,professional pharmacist team was cultured. CONCLUSIONS:The construction of future hospital pharmacy needs the concept oflarge pharmacywith multi-disciplinary inte-gration to develop towards standardization,refinement,specialization and modernization.

Objective To study the role of OIf-1/EBF associated zinc finger protein (OAZ),a transcription factor encoded by a positional systemic lupus erythematosus (SLE) candidate gene,in the function of mesenchymal stem cells (MSC) of SLE patients by silencing this gene.Methods OAZ mRNA levels of bone marrow MSC obtained from 5 SLE patients and 5 healthy controls were detected by real-time PCR.Bone marrow MSC obtained from 6 SLE patients were incubated with specific siRNAs for 3 days,then cells were harvested for OAZ measurement,Idl-3 and CCL2 mRNA levels were tested by real-time PCR,and levels of CCL2 were detected in culture supernatants using ELISA.Differences between groups were analyzed using t-test or MannWhitney test.Results ① OAZ mRNA levels of bone marrow MSC were significantly elevated in SLE patients (0.013±0.016) compared to healthy controls (0.001±0.000,P=0.009).② After OAZ silencing,the expression levels of OAZ,Id1,Id2 and ld3 mRNA were significantly decreased (△Ct 10.3±0.7,15.2±1.6,8.1±1.4,10.5±0.6 vs 8.7±0.7,14.1±1.2,7.1±1.5,9.8±0.6) (P all ＜0.05).③ Both the expression levels of CCL2 mRNA (△Ct 2.2±1.1 vs 3.0±1.1 ) and the levels of CCL2 protein in culture supernatants [(341±29) pg/ml vs (304±19) pg/ml] were significantly increased in OAZ silencing group comparing to those in the control group (P all ＜0.05).Conclusion OAZ gene expression is significantly elevated in bone marrow MSC of SLE patients.OAZ may affect autoantibody production in SLE patients by regulating CCL2 expression.

Objective Acute respiratory dysfunction (ARD) can occur after aortic surgery with the use of cardiopulmonary bypass and deep hypothermic circulation arrest, but relatively little is known about acute respiratory dysfunction in the patients with type A aortic dissection. This study aims to analyze the independent risk factors of acute respiratory dysfunction after A type aortic dissection surgery and to assess possible prevention and treatment option in the future. Methods Clinical data of the 252 patients including 193 male patients and 59 female patients who underwent type A aortic dissection surgery from February 2009 to October 2010 were collected. The mean age was 47 years. Postoperative acute respiratory dysfunction was defined as oxygenation impairment (PaO2/FiO2 ＜ 150) that occurred within 72 h of surgery except pleural effusion, cardiogenic pulmonary edema, pneumonia, pulmonary embolism and haemato-/ pneumothorax. There were 187 acute A type aortic dissection patients and 65 chronic type A aortic dissection patients. Clinical characteristics including age, gender, weight, height, history of hypertension, history of smoking, preoperative complications such as preoperative shock and acute renal failure, pericardial effusion, previous cardiac surgery, time from event to surgery, malperfusion syndrome, cardiopulmonary time, cross-clamp time,deep hypothermia circulation arrest time, surgical procedure, duration of intensive care unit stay and postoperative complications including tracheotomy, dialysis dependent renal failure and hospital mortality were gathered. Arterial blood analysis, chest X ray, ventilator parameters, number of blood transfusion and flood balance were assayed after operation. All the factors were evaluated by means of univariate and multivariate logistic regression analysis to identify relative risk factors of ARD. Results Acute respiratory dysfunction occurred in 32 (12.7% ) patients. The in-hospital mortality was significant difference between acute respiratory dysfunction group and non- acute respiratory dysfunction group (P ＜ 0.05). The value of BMI, incidence of acute aortic dissection, preoperative SBP level, cardio-pulmonary bypass time, aortic clamp time and total arch replacement in acute respiratory dysfunction group were significantly higher than the values in non- acute respiratory dysfunction group. Multivariate Logistic regression analysis showed blood transfusion more than 10 units and cardio-pulmonary bypass time more than 160 minutes were independent risk factors of early stage acute respiratory dysfunction after type A aortic dissection surgery.Conclusion Acute respiratory dysfunction after type A aortic dissection was a severe early stage postoperative complication and was associated with in-hospital mortality. The patients in acute aortic dissection were prone to have acute respiratory dysfunction. The independent risk factors of acute respiratory dysfunction included blood transfusion more than 10 units and cardio-pulmonary bypass time more than 160 minutes.

Objective Patients in the intensive care unit (ICU) are at high risk for multi-organ failure and death. Few well-established scoring systems have been used in the cardiac surgery. We try to identify a feasible score system for the risk assessment after CABG. Methods 1028 consecutive patients who had received CABG and staying in a single cardiac postoperative intensive care unit of Anzhen hospital were enrolled in the prospective study between October of 2007 and May of 2008 and assessed daily with three score systems, the multiple organ dysfunction score (MODS), the sequential organ failure assessment (SOFA) and our postoperative score for cardiac surgery (PSCS). Four new variances were added to PSCS system, which were Euroscore, IABP, ECMO and dialysis. Euroscore was considered as a preoperative factor which provided the preoperative information of the patient. IABP and ECMO were considered as assistant factors to support circulatory system. The dialysis was also considered as an assistant factor to support renal system. The differences with the respects of sensitivity and specificity among the three systems were compared with Hosmer-Lemeshow goodness-of-fit and receiver operating characteristic (ROC)curve. Results The new variances added to PSCS system were shown to be associated with mortality in a multivariate logistic regression analysis. The EXP(B) value for Euroscore was 3. 803, the EXP(B) value for IABP was 1. 645, the EXP(B) value for ECMO was 3.803, and the EXP(B) value for dialysis was 1.605. In discrimination analysis, ROC values of the operative day score were 0.602 for MODS, 0.571 for SOFA, and 0. 821 for PSCS; ROC values of the maximum score were 0.847 for MODS, 0.830 for SOFA, and 0.929 for PSCS; ROC values of the maximum score during the first 3 days were 0.838 for MODS, 0.814 for SOFA, and 0.919 for PSCS; score changes of ROC value between the third day and the first day were 0.767 for MODS, 0.779 for SOFA, and 0. 780 for PSCS. In calibration analysis, we compared the x2 values, P values and overall corrected percentage of the three different systems. x2 values of the three systems were 6. 763 for MODS, 4. 101 for SOFA, and 1.687 for PSCS; P values of the three systems were 0.454 for MODS, 0. 848 for SOFA, and 0. 975 for PSCS; overall corrected percentages of the three systems were 98.1%, 98%, and 98.3% respectively. Conclusion The sensitivity and specificity of PSCS were superior to MODS and SOFA in predicting death risk after CABG.

Objective To evaluate the effect of performance evaluation on pharmacy management at hospitals run by Beijing Municipal Administration of Hospitals.Methods Analysis of performance evaluation indexes,and retrospective analysis of drug use indexes of the recent three years since the initiation of performance evaluation at the hospital.Results Continuous performance management has significantly boosted indexes of hospital pharmacy management. For example in 2014, medicine proportion at municipal hospitals accounted for 41.55%.Conclusion Awareness of rational drug use at hospitals has significantly strengthened, and the pharmacists played a positive role in upgrading pharmacy.Performance evaluation promotes Beijing ’s municipal hospitals to put their pharmacy management on a scientific and standardized track.

Objective: To establish the determination for 5 HMF in Glucose Injection containing the extract of Radix Salviae Miltiorrhizae. Methods: Using HPLC with Hypersil ODS [4.6mm(i.d)?250mm] column, methanol 0.5% acetic acid as a mobile phase and detection wavelength at 284nm. Results: The peak of 5 hydroxymethylfurfural was separated from the peak of Danshensu. Conclusion: The method is simple, sensitive and accurate with a good reproducibility and can be used as the quality control for Glucose Injection containing the extract of Radix Salviae Miltiorrhizae.

Objective: To establish the method of purifying astragaloside. Methods: Astrageloside was determined by HPLC fingerprinting to compare macroporous resin absorbing method with extraction refine by n butyl alcohol. Results: The HPLC fingerprints of each method were difference. Conclusion: AB 8 macroporous resin is better than the others for purifying astrageloside.

ObjectiveTo explore the proliferation of human degenerate nucleus pulposus and annular fibrosus cell in vitro and compare the different biological behavior between the two kinds of cell after degeneration,and provide the new theoretical basis for the prevention and treatment of degenerative disc disease.MethodsThe samples of intervertebral disc tissue were collected from patients with lumbar disc herniation.The degree of degeneration was assessed by the pathological diagnosis and degenerate nucleus pulposus and annular fibrosus cell were cultured by enzymatic digestion and identified.In each case,the control groups of the nucleus pulposus cells and annulus fibrosus cells were cultured to the fifth generation.The inoculation density of cells was 1×105.The cell morphology of each generation was observed,while the proliferation of cells was detected by flow cytometry after 48h culture with the same conditions.ResultsThe degenerate nucleus pulposus cell and annular fibrosus cell were in good condition in vitro.The percentages of S phase cell and proliferation index (PI) were both on the rise with the subculture.The PI of nucleus pulposus cells reached the peak in the 3rd generation; The PI of annulus cells was the highest in the generation 5.The proliferation activity of degenerate nucleus pulposus cell in 2～4 generations was higher than the degenerate annular fibrosus cell within the same generations (P＜0.05).ConclusionDifferent proliferative characteristics of the degenerate nucleus pulposus and annular fibrosus cell confirmed that the disc degeneration is reversible.The response mechanisms to the degenerate micro-environment are completely different in vivo and affects the entire disc degeneration progress.

In this study, the virtual simulation tutoring system was applied to the teaching of dental residents in the standardized training stage for the first time, including the curriculum preparation, curriculum design and teaching practice. Through the practice of the preparation of class Ⅱ holes and the tooth preparation of PFM (porcelain fused to metal) by the dental residents in the virtual simulation teaching system, the teaching arrangement of three courses as one term was explored. Each course adopted the matching interactive teaching mode. Finally, the transcripts would be given by the virtual simulation teaching system to comment and summarize. This study has laid a foundation for future promotion of virtual simulation teaching system in the standardized training stage of stomatology residents and found a new direction for improving the proficiency and accuracy of residents' clinical operation skills.

The ability of clinical teachers plays a key role in residents standardized training. The teachers should fully understand the relevant policies and improve the awareness of resident standardized training. The construction of clinical teaching ability is the essential ability for clinical teachers and is the focus of the teacher training, which can guarantee to guide the improvement of residents' clinical thinking ability and the training of their clinical skills. Establishing teacher training system, making a suitable train-ing plan, selecting applicable training content and participating in various types of teacher training should effectively improve the comprehensive teaching ability of clinical teachers for resident standardized training.