OBJECTIVE:To improve the management on drug supply in our hospital by using the Six sigma method. METHODS: The quality control of the management on drug supply is achieved by practicing the five steps of Six sigma: concept, measurement, analysis, improvement and control. RESULTS & CONCLUSIONS: Six sigma method did effectively bring down the defect rate of drug supply from 6.66% before the introduction of the method to 0.59% after and raise the degree of satisfaction to the work of medicine provision from 80% before the introduction of the method to 95% after.

OBJECTIVE: To implement scientific drug control in inpatient dispensary by means of “Army No.1” system and to establish digitalized drug quality control system. METHODS: The “Army No.1” network system was put into wide operation in our hospital to establish interconnection among doctor workstation, nurse workstation and pharmacy workstation. Hence, the central dispensing mode was established. RESULTS: The operation of Army No.1 system not only relieved the workload of both clinic and pharmacy, increased whose working efficiency and transparency but also reduced overstock and run-off of drugs and enforced drug monitoring; meanwhile it facilitate the carrying out of pharmaceutical care and evaluation of drug utilization. CONCLUSIONS: Central dispensing mode in inpatient dispensary drug control by means of “Army No.1” system is advisable and which deserves generalization.

AIM: To observe the effects of norepinephrine (NE) on the cardiopulmonary and lung injury in goats with acute respiratory distress syndrome (ARDS) induced by endotoxin. METHODS: A model of septic ARDS was induced by intravenous infusion of low dose endotoxin in six goats. Then 40?10~ -6 NO inhalation was applied to the animals. After 30 min, combined intravenous infusion of NE at concentration of 0.5 mg?kg~ -1 ?min~ -1 was conducted. The dynamic changes in gas exchange and hemodynamics were measured with the aid of Swan-Ganz catheter. Arterial blood gas analysis before and after the onset of ARDS, 30 min after NO inhalation and combined NE was detected. Histology of the lung was also observed. RESULTS: Inhalation of NO rapidly reduced mean pulmonary arterial pressure (MPAP), increased PaO_2, decreased P_ (A-a) O_2 and Qs/Qt in septic ARDS goats. These decrease and increase were more significant than those in NO inhaled alone when animals received NE. The combination of NO inhalation and NE injection resulted in increase in mean arterial pressure. NO inhalation did not ameliorate lung injury and combined NE intravenous injection ameliorated lung injury. CONCLUSION: Injection of low dose norepinephrine improves the beneficial effects of inhaled nitric oxide on lung gas exchange and ameliorates lung injury in goats with acute respiratory distress syndrome induced by endotoxin.

OBJECTIVE:To establish quality control system by using modern scientific idea and advanced method in in?patient pharmacy.METHODS:Under the situation o f running authentication of ISO9001quality control system in our department,inpatient pharmacy should take the patients as focus to offer good and normative services to patients and clinical departments and continue to make our work better.RESULTS&CONCLUSION:Implementation of ISO9001quality control system has standardized the management of quality of inpatient pharmacy as well as increased the patients'satisfaction.And satisfactory social and economical benefits have been obtained and self-perfect and continuous improvement have been realized in the inpatient pharmacy.

OBJECTIVE:To improve hospital's drug control level.METHODS:Quantized medicine provision management aims like stock limit,conformity rate of object-account of single category,medicine loss,mistake rate of recipe preparation,etc.were made and enforced.RESULTS:Through the above aims,medicine stock has been reduced effectively;the conformity rate of object-account has been increased;the medicine loss and incidences of mistakes in recipe preparation have been decreased.CONCLUSION:Working out feasible medicine provision management aims is an effective way to strengthen drug control.

OBJECTIVE:To carry out the ISO9001standard quality control system in the department of pharmacy.METHODS:The procedures and methods of PDCA cycle(Plan-Do-Check-Action)were applied to our department's ISO9001quality authentication standardization.RESULTS:The application of PDCA cycle-based ISO9001standards proved to be successful in the standardization of our department.CONCLUTION:The ISO9001quality authentication following the PDCA cycle is effective.

Objective To investigate the relationship between the delivery gestational age, birth weight and fidgety movement. Methods 81 infants in fidgety movement phase were divided into preterm group and full-term group according to their delivery gestational age, into <2500 g group and ≥2500 g group according to their birth weight. The number of different kinds of General Movements (GMs) was compared.The correlation between birth weight, delivery of gestational age and GMs was analysed. Results The number of fidgety movement was more in the full-term group than in the preterm group (P=0.001), while the number of absence of fidgety movement was significantly less (P=0.003). The number of fidgety movement was more in the ≥2500 g group than in the <2500 g group (P=0.001), the number of absence of fidget movement was significantly less (P=0.003). The GMs was correlated with birth weight and delivery gestational age. Conclusion Premature and low birth weight are the risk factors for abnormal fidgety movement.

Objective To study the relationship between cellular immunity in vivo,humoral immunity and different iodine intakes in patients with hashimoto thyroiditis(HT).Methods Seventy-six HT patients were divided into two groups acconding to the median of urine iodine (MUI =491.20 μ g/L):HT I group (urine iodine≥MUI) with 37 cases and HT Ⅱ group (urine iodine ＜ MUI) with 39 cases.And 49healthy persons were selected as control group.The level of free three triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),thyroglobulin antibody (TGAb),thyroid peroxidase antibody (TPOAb),thyroid hormone receptor antibody ( TRAb ),tumor necrosis factor-alpha ( TNF- α )of all groups were detected.Results The levels of FT3 and FT4 in HT I group [ (2.67 ± 1.93 ),( 4.22 ± 3.77) pmol/L ]and HT Ⅱ group [ ( 3.19 ± 1.63 ),( 5.99 ± 3.97 ) pmol/L ] were significantly lower than those in control group [(5.30± 1.10),(16.50 ±2.70) pmol/L] (P ＜ 0.01).The levels of TNF-α in HT I group [(6.14 ± 1.83)ng/L] and HT Ⅱ group [ (6.09 ± 1.50) ng/L] were both obviously higher than that in control group [ ( 1.90 ±0.60) ng/L] (P ＜ 0.01 ).The levels of FT3 and FT4 were lower and TNF α was higher in HT I group than those in HT Ⅱ group,but there was no statistically significance (P ＞ 0.05 ).The positive rate of TPOAb,TGAb in HT I group [97.3％(36/37),81.1％(30/37)] and HT Ⅱ group [89.7％(35/39),74.4％(29/39)]were significantly higher than those in contnol group [ 18.4％(9/49),12.2％(6/49 ) ] (P ＜ 0.01 ).There was no statistically difference of the positive rate of TPOAb,TGAb and TRAb between HT I group and HT Ⅱ group (P ＞ 0.05).While the percentage of patients with high titer of TPOAb and TGAb in HT I group was higher than that in HT [Ⅱ group,and there was statistical difference(P ＜ 0.05 ).The level of TRAb in HT I group was higher than that in HT Ⅱ group [ ( 1.25 ± 0.14) mU/L vs.( 1.16 ± 0.21 ) mU/L ],but there was no significant difference (P ＞ 0.05).Correlated anlysis showed that FT3 was negatively correlated with TGAb and TPOAb (r =0.342,-0.397,P ＜0.05),and TNF-αwas positively correhted with TGAb and TPOAb (r =0.405,0.561,P ＜ 0.05).Conclusions High iodine intake influences the autoimmune mechanism of HT patients.The iodine intake should be limited in HT patients.

Objective To study the clincial effectiveness and safety of endoscopic sphincteropapillotomy combined with balloon dilation for decompensated cirrhosis accompanied with choledocholithiasis.Methods Data of 79 cases of decompensated cirrhosis patients with choledocholithiasis who underwent limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD,the ESBD group) and 42 cases who underwent endoscopic papillary balloon dilation(EPBD,the EPBD group)were retrospectively analysed and compared for complete stone clearance rate,one-time stone clearance rate and complications.Results The rate of complete stone clearance and one-time stone clearance were 94.9％ (75/79) and 77.2％ (61/79)in ESBD group,and those were 88.1％ (37/42) and 59.5％ (25/42) in EPBD group respectively.The rate of complete stone clearance was a little higher in ESBD group than that in EPBD group.In ESBD group,ERCP-related bleeding occurred in 3 patients (3.8％),post-ERCP hyperamylasemia in 3 (3.8％)and post-ERCP pancreatitis in 2 (2.5％) ; while in EPBD group,post-ERCP hyperamylasemia occurred in 8 patients(19.0％),post-ERCP pancreatitis in 6(14.3％) and ERCP-related bleeding did not occur.There were no significant difference in ERCP-related bleeding between ESBD group and EPBD group (P =0.551).However,the rates of post-ERCP pancreatitis and hyperamylasemia in ESBD group were significantly lower than those in EPBD group(P ＜ 0.05).Conclusion ESBD is a safe and effective procedure for choledocholithiasis accompanied by decompensated cirrhosis,with several advantages over EPBD in terms of higher one-time stone clearance rate,reduced risk of post-ERCP pancreatitis and hyperamylasemia,and without noticeable increase in the risk of bleeding related to ERCP.

Objective To optimize the effective methods of isolation,purification,culture in vitro and identification of SD rat ovarian granulosa cells,to research the effects of Oviductus Ranae on the proliferation of rat ovarian granulosa cells by CCK-8,and to contrastively analyze the best optimal action concentration and time of serum contsining Oviductus Ranae on granulosa cells to lay the foundation for further in vitro experiment.Methods Nonage SD rats aged 25 d were selected and intraperitoneally injected by pregnant mare serum,then killed after 48 h.Ovarian granulosa cells were collected and cultured in the DMEM-F12 culture solution.The hematoxylin & eosin(HE) staining and immunofluorescence technique were used to identify the ovarian granulosa cells.Twen ty-five SD rats were randomly divided into the normal control group,positive medicine control group,and low,middle and high do ses Oviductus Ranae groups.Blood was collected and serum was separated after 7 d mediaction gavage.The volume percent of 10 ％,20％,40％,80％ serum in each group was added into the in vitro medium system of ovarian granulosa cells culture.Then the cell proliferation situation at 24,48,72 h in each group was measured by CCK-8.Results Oviductus Ranae significantly increased the proliferation ability of granulosa cells in a certain dose-dependent relation.With the increase of Oviductus Ranae concentration con centration,its.proliferation ability was gradually increased,after 48 h action,which in the Oviducthus Ranae-Comtaining serum group with the volume fraction of 20％ was most significant (P＜0.05).Conclusion Establishing in vitro cultural method of rat o varian granulosa cells is conductive to further research the action and mechanism of Oviductus Ranae on ovary.