Objective:To explore the feasibility of pharmacy trusteeship in Shanghai medical institutions to provide useful informa-tion for the reform of medicine without added profit and pharmacy transition to clinical pharmacy. Methods: On-site investigation of seven hospitals and one famous drug retail company in Shanghai was performed combined with the communication with relative person-nel and non-random sampling questionnaire survey on the staff of pharmacy. Statwing software was used in the statistical analysis of the data. Results: A total of 93 valid questionnaires in the study were taken back. Although one hospital has achieved great progress in pharmacy trusteeship, most of respondents had negative attitudes and the common thought was that pharmacy trusteeship did more harm than good to the development of clinical pharmacy at present. Conclusion: As a consequence of drug zero interest policy and clinical pharmacy development, pharmacy trusteeship should be explored and attempted. The duties and responsibilities of all parts in pharma-cy trusteeship should be definite in law in order to standardize drug retail market and protect the interests of patient.

60 mm Hg and PaCO2

Objective To study the effect of noninvasive pressure venrilation(NIPPV) on the treatment of acute exacerbarions of chronic obstructive pulmonary disease(COPD) with typeⅡrespiratory failure. Methods 46 cases of COPD were selected to treat with NIPPV in our hospital from 2001 January to 2005 May. The data in arterial blood gas(pH,PaO2,PaCO2),the course of disease in the hospital,the rate of endotracheal intubation, the mortality of the patients in NIPPV were analyzed and compared with those of the patients without NIPPV treatment before. Results The datas in arterial blood gas had been imprived significantly in NIPPV after 24h.The couse of disease in hospital was significantly shkrter,and the rate of endotracheal intubation and mortality of the patients was significantly lower in NIPPV than those in no NIPPV. There was remarkably difference between two groups. In NIPPV, the rate of endotracheal intubation were significantly lower in light and moderate trspiratkry failure than those in severe respiratory failure(P

BACKGROUND:Preliminary experiments have reported the influence of serum and nerve growth factor on olfactory ensheathing cells proliferation in vitro, but there are less studies concerning choice of serum concentration and growth time for in vitro culture of olfactory ensheathing cells.
OBJECTIVE:To find out the influence of different blood serum concentration and growth time on olfactory ensheathing cells from the olfactory mucosa of adult rats based on the growth curve of olfactory ensheathing cells.
METHODS:The olfactory ensheathing cells from the olfactory mucosa of adult rats were separated, culture and identified in vitro. Sulforhodamine B and microplate reader were employed to measure absorbance values and plot growth curve of olfactory ensheathing cells.
RESULTS AND CONCLUSION:When cultured for the same time in blood serum of different concentrations, absorbance values, especial y in the groups 10%, 20%, 30%, 40%, tended to increase with time except the 0%group. When cultured in the same serum for different time, absorbance values increased within the first 9 days, then promoted rapidly in the groups 10%, 20%, 30%, 40%at 13 days, entered the plateau phase at 19 days, and decreased at 23 days;meanwhile, in the other groups (50%, 60%, 70%, 80%, 90%) the absorbance values peaked at the 13th day and then decreased gradual y. These findings indicate that different serum concentrations and different growth time in vitro affect cellgrowth and survival of olfactory ensheathing cells significantly, which should be ful y considered when cells are cultured in an in vitro condition.

Objective To evaluate the efficacy and safety of caspofungin in the treatment of invasive fungal disease (IFD) in advanced age patients. Methods A retrospective analysis of the clinical data was conducted. IFD patients who had received caspofungin treatment in elderly wards were included. Results From January 2007 to August 2009, 29 IFD patients aged 80-100 years (mean 89 ) were treated with caspofungin. Except that one patient dead on the first drug administration day, there were 28 evaluable patients, 13 were cured (46.4%), 6 were markedly improved (21.4%), 3 progressed (10.8%) and 6 dead (21.4%). The overall effective rate was 67. 8%. Of 13cured patients, 12 were Candida bacreremia, 1 was Candida albicans disease of lung. Of 6 dead patients, 2 were Candida bacteremia, 1 was Candida albicans disease of lung and 3 was suspected of lung IFD. One patient performed that alanine aminotransferase was increased, considering drug-related impairment of liver function. Conclusions Caspofungin is effective and safe in the treatment of IFD in advanced age patients.

Objective:To explore the expression of R-spondin family in colorectal cancer tissues and adjacent tissues,and to evaluate its relationship with clinic-pathological stage.Methods:A total of 64 samples of colorectal cancer tissues and adjacent tissues were collected from the patients,who received radical surgery in Xiangya Hospital,Central South University between January 2014 and August 2014.The mRNA and protein expression levels of R-spondin 1-4 and β-catenin in the colorectal cancer tissues and adjacent tissues were detected by qRT-PCR and immunohistochemistry.The relationship between the expression level of R-spondin 1-4 and the clinic-pathological factors were analyzed to explore the correlation between the expression level of R-spondin 1-4 and β-catenin in colorectal cancer.Results:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 were elevated in the colorectal cancer tissues (P＜0.05).The mRNA and protein expression levels of R-spondin 2-4 were increased in the colorectal cancer tissues than those in the normal tissues (P＜0.05),but there was no significant difference between the colorectal cancer tissues and adjacent tissues (P＞0.05).The expression level of R-spondin i was positively correlated with the nuclear expression of β-catenin in the colorectal cancer tissues (r=0.6307,P＜0.05).Conclusion:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 are significantly elevated in the colorectal cancer tissues.R-spondin 1 may play a role in promoting carcinogenesis by regulating the activity of β-catenin in the downstream of Wnt signaling pathway.

Objective To study the effects of quercetin(QUE) on proliferation of rat glioma C6 cell line in vitro.Methods The cells were divided into 5 treatment groups(10,25,50,75 and 100 ?mol?L~(-1) QUE),blank control and menstruum control group.The rat C6 cells were cultivated to 1?10~6?mL~(-1) in the RPMI 1640 medium,then added into 96 holes board with various doses of QUE by 3 holes per group,and MTT assay was used to observe the proliferation of the cells treated for 24,48 and 72 h.The change of cell cycle was also observed by flow cytometry(FCM) after the cells were treated with 50 and 100 ?mol?L~(-1) QUE for 48 h.The changes of the protein P53 and Bcl-2 of C6 cells treated with 50 ?mol?L~(-1) QUE for 48 h were detected by immunocytochemical methods.(Results With) the augmentation of QUE and the extension of the treated time,the C6 cell growth was inhibited,the A values decreased and the cell number in G_0/G_l phase was increased,the cell numbers in S and G_2/M phases were cut down,and the decreased expression of Bcl-2 protein and the increased expression of P53 protein were also observed after treatment with QUE.Conclusion Inhibitory effect of QUE on C6 cell line is proved to be dependent on the treated time of the drug and the dose of QUE,and the induced apoptosis of C6 cells is implemented by the means of up-regulation of P53 protein expression and down-regulation of Bcl-2 protein expression.

Objective To investigate the effect of small dose of dexmedetomidine on the development of postoperative nausea and vomiting in the patients undergoing laparoscopic gynecologic surgery.Methods A total of 207 patients,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic gynecologic surgery under general anesthesia,were randomly divided into either dexmedetomidine group (group D,n=103) or control group (group C,n=104) using a random number table.Before induction of anesthesia,dexmedetomidine 0.1 μg/kg was injected intravenously over 1 min in group D,while the equal volume of normal saline was given instead in group C.At 20 min before the end of surgery,dexmedetomidine 0.04 μg/kg was injected intravenously over 30 s in group D.For the patients requiring patient-controlled analgesia (PCA),PCA solution contained sufentanil 125 μg in 125 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 8 min lockout interval and background infusion at a rate of 1 ml/h.Pethidine was used for PCA after surgery in the patients who did not require PCA.Numeric rating scale scores were maintained ＜4 after surgery.Sufentanil 3 μg was injected intravenously as rescue analgesic in postanaesthesia care unit (PACU).The occurrence of nausea and vomiting was recorded within 0-1 h,1-6 h,6-12 h,and 12-24 h periods after surgery.The occurrence of hypotension and bradycardia during surgery,emergence time,Ramsay sedation score on admission to PACU,requirement for sufentanil as rescue analgesic in PACU,requirement for PCA and antiemetics,and occurrence of somnolence and shivering were recorded.Results Pethidine was not given in the patients who did not require PCA in the two groups.Somnolence and shivering were not found in the two groups.Compared with group C,the incidence of bradycardia was significantly increased,the requirement for antiemetics in PACU and incidence of nausea and vomiting within 1 h after surgery were significantly decreased (P＜0.05),and no significant change was found in the emergence time,Ramsay sedation score,requirement for sufentanil as rescue analgesic,requirement for PCA and total incidence of postsurgical nausea and vomiting in group D (P＞0.05).Conclusion For the patients undergoing laparoscopic gynecologic surgery,small dose of dexmedetomedine can only decrease the development of nausea and vomiting in the early postsurgical period (in PACU),and does not influence the recovery from anesthesia.

Objective To develop a set of indicators for measuring the performance of China's Healthcare Improvement Initiative.Methods Such methods as literature review,expert consultation and onsite preliminary experiment were used,to study and demonstrate the indicators,the evaluation framework,the weight,evaluation indicators,and evaluation standards.Results The final evaluation indicators for medical institutions included nine class-1 indicators,29 class-2 indicators,and 56 class-3 indicators;those for healthcare administrations included six class-1 indicators,nine class-2 indicators,and 13 class-3 indicators.Conclusions The system takes into full account the special nature of healthcare,and mission of the Initiative,as the well as the quality,safety,efficiency and equity of healthcare,to make the system scientific and operational.

Objective To explore the CT and MR imaging characteristics of intracranial melanomas. Methods CT and MRI characteristics in five patients admitted to our hospital from June 1993 to June 2000 and diagnosed as intracranial melanomas were retrospectively analyzed. Results There were two cases of primary melanoma and three cases of secondary melanoma. All the cases were examined by CT. The lesions presented as high density in 4 cases, and low density in only 1 case. Four cases were examined by MRI. Short T 1 and short T 2 signals were found in 3 cases, and slightly long T 1 and short T 2 signal was found in 1 case. Conclusion There are some special characteristics of melanomas on the MR imaging, which are helpful to ensure the diagnosis and distinguish the primary melanomas from secondary melanomas.