OBJECTIVE: To discuss the way to evaluate outpatient prescription in medical institutions according to Prescription Administrative Policy so as to provide reference for the practice of prescription evaluation system. METHODS: 500 outpatient prescriptions from April 16 to April 20 in 2007 in our hospital were sampled randomly for an evaluation in respect of drug utilization, prescription behavior, pharmaceutical care level etc. RESULTS & CONCLUSIONS: To evalnation from The prescriptions involved use of injections and of antibacterials, prescribed drugs were covered in "national essential drugs" , prescriptions with general name, the knowledge of patients on the administration and dosage were drectively.It is supply reference for the prescription evaluation system.

Objective:To investigate outpatient's medicine knowledge and satisfaction degree and analyze their correlation.Method:150 outpatients,their doctors and pharmacists were investigated with a fieldwork method.Patients' medical knowledge and satisfaction degree were measured with a quantitative scale table,and their correlation was calculat- ed with a linear regression method.Result:Almost all the doctors and pharmacists could provide their patients with their guidance about medicines,which focused on drug dosage and taking ways.Fewer than 20% patients could take medical ad- vice of potential risks and notice of taking medicine.A significant correlation was shown between patient's medical knowl- edge and satisfaction degree(r=0.76).Conclusion:More guidance from doctors and pharmacists should be provided for outpatients.The medical knowledge learned by patients could influence patient's satisfaction degree significantly.

Objective To investigate the effect of high concentration hydrogen gas on neurons in the rat hippocampus CA1 region during global cerebral ischemic/reperfusion injury (GCIR) Methods Four-vessel occlusion was used to establish rat model with GCIR injury. One hundred and five healthy male Sprague-Dawley rats were randomly divided into sham operation group(SH group, n = 15), model group(4-VO group, n = 45) and treatment group(4-VO+H2 group,n = 45). After 72 h and 9 d reperfusion, hippocampal CA1 region pyramidal neurons in every group were detected with Nissle staining , immunohistochemical neuron-specific nuclear protein (NeuN), specific protein antibody microglial cells (Iba1) staining and the relationship of position between neurons and microglia was observed through fluorescence double staining. We used Morris water maze to test the space orientation ability and the learning and memory ability in rats after 9 d reperfusion. Results Compared with those of 4-VO group,the neurons of hippocampus CA1 region were closer to normal in 72 h and 9 d in 4-VO+H2 group and neuron form and the number of neuron survival were increased significantly (P < 0.05);immunohistochemical staining showed that the number of neuron survival in 4-VO+H 2 group was obviously higher than that in 4-VO group (P < 0.05) and the number of microglia in 4-VO group was obviously higher than that in 4-VO+H2 group (P < 0.05). Water maze experiment showed that the swimming time in quadrant Ⅳ in 4-VO+H2 group was longer than that in 4-VO group (P < 0.05). Conclusion Inhalation of high concentration hydrogen gas has prominent protective effect on neurons of rat hippocampal CA1 region during reperfusion. The mechanism may be related with inhibiting the microglia excitation and activation during GCIR.

OBJECTIVETo observe the influence of borneol, a traditional Chinese medicine, on the concentration of ceftriaxone in the rat brain striatum and evaluate the relativity.

METHODThe sample of cerebrospinal fluid in the rat brain striatum was collected via brain microdialysis technology, and then the contents of ceftriaxone in standard preparation and sample were detected by high efficiency liquid chromatography combined with diode array detector respectively and analyzed statistically. The concentration of ceftriaxone in rat brain striatum in the ceftriaxone + Borneol group was compared with that in the ceftriaxone-only group.

RESULTThe concentration of ceftriaxone in the rat brain in the ceftriaxone + Borneol group (13.01-4.43 mg x L(-1)) is significantly higher than that in the ceftriaxone-only group (2.41-0.94 mg x L(-1)).

CONCLUSIONBorneol can promote ceftriaxone through blood-brain barrier, and increase the concentration thereof in striatum.

2-Pyridinylmethylsulfinylbenzimidazoles ; pharmacokinetics ; Animals ; Blood-Brain Barrier ; Bornanes ; pharmacology ; Ceftriaxone ; pharmacology ; Chromatography, High Pressure Liquid ; Corpus Striatum ; drug effects ; metabolism ; Drug Combinations ; Male ; Medicine, Chinese Traditional ; Microdialysis ; Neostriatum ; drug effects ; metabolism ; Rats ; Rats, Wistar

Objective To explore the protective effect of in-taking high concentration hydrogen gas on neurons and dendritic spines in hippocampus CA1 region of rats after globe cerebral ischemia/reperfusion (I/R) injury and its mechanism.Methods Four-vessel occlusion (4VO) was used to establish the models of global cerebral I/R injury in rats.One hundred and twenty healthy male Sprague-Dawley rats were randomly divided into 3 groups using a random number table:sham-operated group (inhaled 67％ N2 and 67％ O2,n=40),model group (inhaled 67％ N2 and 67％ O2 during reperfusion,n=40),and treatment group (inhaled 67％ H2 and 67％ O2 during reperfusion,n=40).After 72 h,5 and 9 d reperfusion,neuron-specific nuclear (NeuN) protein expression in the pyramidal neurons of the hippocampal CA1 region was detected with immumohistochemical staining and the positive cells were counted.And the contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in serum were tested with colorimetry.Water maze test was used to measure the spatial orientation and memory function and Golgi staining to detect the number of dendritic spines in neurons 9 d after reperfusion.Results (1) Immunohistochemical staining of NeuN results showed that as compared with those in the model group,the neurons ofhippocampus CA1 region were significantly closer to normal with relatively intact structure,and the number of positive neurons was significantly increased in the treatment group 72 h,5 d,and 9 d after reperfusion (P＜0.05).With the reperfusion time being prolonged,the number of NeuN stained positive neurons at different time points of reperfusion in model group was gradually decreased (P＜0.05),and the numeric of the NeuN stained positive neurons at different time points of reperfusion in treatment group was slightly declined without significant difference (P＞0.05).(2) The serum SOD activity in the treatment group was significantly higher than that in the model group and sham-operated group (P＜0.05),while the MDA content in the treatment group was significantly lower than that in model group 72 h,5 d,and 9 d after reperfusion (P＜0.05).And with the reperfusion time being prolonged,the SOD activity at different time points of reperfusion showed no significant difference among the difference groups (P＞0.05).But the MDA content at different time points ofreperfusion between model group and treatment group was significantly different (P＜0.05);with the reperfusion time being prolonged,the MDA content was gradually decreased in both groups.(3) Nine d after reperfusion,water maze test found that the incubation period of treatment group was significantly shorter than that of model group (P＜0.05);the IV quadrant swimming time of space exploration in the treatment group was significantly longer than that in the model group (P＜0.05).(4) Golgi staining showed that the complexity of the neuronal dendrites branch and the number of dendritic spines of neurons in the hippocampal CA1 region of treatment group were increased than those in the model group;high-power oil microscopy indicated that the density of dendritic spines in the treatment group was significantly higher than that in the model group (P＜0.05).Conclusion In-taking of high concentrations hydrogen gas during reperfusion can definitely protect neurons in hippocampal CA1 region after globe cerebral I/R injury,and improve learning and memory function,whose mechanism may be related to hydrogen protecting the structure and function of neurons and dendritic spines,and inhibiting oxidative stress to reduce oxidative damage.

Objective To compare volar plating and nonoperative treatment for senile comminuted fractures of the distal radius. Methods From October 2012 to June 2015, 46 senile comminuted fractures of the distal radius ( AO types B and C ) were treated surgically or conservatively. Twenty old patients were managed by open reduction and fixation with a volar locked plate. They were 7 men and 13 women, with an average age of 67. 9 ± 10. 7 years, including 7 cases of AO type 23-B and 13 cases of AO type 23-C. Twenty-six patients were managed with closed reduction and plaster cast. They were 8 men and 18 women, with an average age of 66. 2 ± 11. 5 years, including 10 cases of AO type 23-B and 16 cases of AO type 23-C. The 2 groups were compared in terms of follow-up time, union time and wrist functional scores and complica-tions. Results There was no significant difference between the 2 groups in follow-up time ( P > 0. 05 ) . Fractures in the 2 groups all united about 11 weeks after surgery. According to Dienst scoring for reduction, the volar plating group had 13 excellent cases, 4 good ones, 2 fair ones and one poor case, with an excellent to good rate of 85. 0％ while the nonoperative group had 5 excellent cases, 10 good ones, 5 fair ones and 6 poor ones, with an excellent to good rate of 57. 7％. A significant difference was shown between the 2 groups ( P <0. 05 ) . At final follow-ups, the volar plating group had significantly lower Gartland & Werley wrist functional score ( 2. 16 ± 1. 82 ) and complication rate ( 30. 0％, 6/20 ) than the nonoperative group [ 6. 62 ± 3. 78 and 53. 8％( 14/26 ) , respectively ] ( P <0. 05 ) . Conclusion In treatment of senile comminuted fractures of the distal radius, volar locked plating may lead to better functional recovery and fewer complications than nonoper-ative management. However, one should take full account of the physical condition and preference of the patient when surgery is chosen.

Objective To explore the application value of single-port inflatable mediastinoscopy combined with laparoscopy in the radical resection of esophageal cancer.Methods The retrospective descriptive study was conducted.The clinicopathological data of 27 patients who underwent single-port inflatable mediastinoscopic and laparoscopic radical resection of esophageal cancer in the General Hospital of Ningxia Medical University between September 2016 and April 2018 were collected.The surgical operators were divided into neck operation group and abdomen operation group.A "Y" tube was used to inflate the abdomen and mediastinum simultaneously with CO2,and the gas pressure was 12-16 mmHg (1 mmHg =0.133 kPa).Bilateral exchange free and join forces with the esophagus and xiphoid process operating small incision,the severed esophagus cardia;residual stomach was made into a 3-5 cm tubular stomach and was sutured at the top point;at the same time,esophagus was brought up from the neck,with a pouch suture between upper esophageal and stapling head;the tubular stomach through mediastinum-esophagus bed was pulled to the left neck and then gastroesophageal anastomosis manually or instrument was performed.Observation indicators:(1) surgical and postoperative recovery;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to May 2018.The measurement data with normal distribution were represented as x-±s.The measurement data with skewed distribution were described as M (range).Results (1) Surgical and postoperative recovery:all the 27 patients underwent successful single-port inflatable mediastinoscopic and laparoscopic radical resection of esophageal cancer,with complete tumor resection and without conversion to open surgery.There was no arrhythmia or myocardial ischemia through intraoperative electrocardiography.Among 27 patients,5 had intraoperative rupture of the pleura and 3 stopped intermittently inflation with CO2 due to obvious hemodynamic changes.The operation time and volume of intraoperative blood loss were (121±21)minutes and (100± 30)mL.Twenty-seven patients had no thoracic incision,obviously decreased postoperative pain and out-of-bed activity at day 1 postoperatively.The volume of postoperative mediastinal drainage was (40± 10)mL.The mediastinal drainage-tube was removed at 1 week after regular food intake.Of 27 patients,5 with pleural effusion were cured by puncture drainage;2 were complicated with anastomotic leakage,1 of them with a small amount of subcutaneous gas under neck incision at 12 days postoperatively was cured spontaneously through oral food intake,without special treatment,and the other had a small amount of subcutaneous gas under neck incision after solid food intake at 1 month postoperatively and then was cured after 1-week fluid food intake;1 with anastomotic stenosis was improved after dilation treatment.The squamous cell carcinoma was confirmed by postoperative pathological examination,without cancer cell infiltration in the upper and lower margins.The numbers of mediastinal lymph node dissected,abdominal lymph nodes dissected and positive lymph node,postoperative pathological staging and duration of hospital stay were respectively 9.5±2.2,8.2±2.5,1 (range,0-12),T1-3N0-1M0 and 13 days (range,11-21 days).(2) Follow-up and survival situations:27 patients were followed up for 1-20 months,with a median time of 10 months.During the follow-up,there was no recurrence or metastasis and death.Conclusion The single-port inflatable mediastinoscopy combined with laparoscopy in the radical resection of esophageal cancer is safe and effective,and it is especially suitable for patients with partial respiratory failure and closed thoracic cavity.

By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course， this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects： academic frontier， social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine， as the frontier of the discipline， historical accumulation， educational philosophy and professional skills， provides for the Doctor-patient Communication course， and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation， realizing the coordination of medical education and competency orientation， adapting to the psychological and social increase， the change of people and health， and promoting the reform of the supply side of medical talents.

TORCH, which is considered as a series of pathogens, including the Toxoplasma gondii, Rubella virus, Cytomegalovirus or Herpes simplex virus, often infects the pregnant women to induce the the fetus or newborn infection by transplacental infection or exposure to contaminated genital tract secretions at delivery. Increasing evidence have been confirmed that the infection of TORCH may cause the miscarriage, premature birth, malformed fetus, stillbirth, intrauterine growth retardation, neonatal multiple organ dysfunction and other adverse pregnancy outcomes. For most TORCH-infections cases may lacking the effective treatments during pregnancy, and it is important to achieve the effacing monitoring of TORCH infections before and during pregnancy. The laboratory testing of TORCH has the great significance. However, the consensus opinions still need to improve the the standardization of TORCH testing process and the correct interpretation. Based on the characteristics of the TORCH detection method, this article gives a consensus opinion on the standardized detection and clinical application of TORCH from the laboratory perspective according to the characteristics and types of infection of different pathogens.

Objective: To analyze the genotypes, amino acid vatiations and molecular epidemiological characteristics of respiratory syncytial virus (RSV) infection in pediatric patients in Gansu province for the future research. Methods: A total of 4 556 respiratory tract specimens were colleted from pediatric patients under 10 years of age in five cities in Gansu from 2012 to 2017. These specimens were tested for RSV and its subtypes.The coding region of the RSV G gene was amplified using reverse transcription-polymerase chain reaction (RT-PCR) and sequenced for RSV positive specimens. Sequences were edited using DNA Star software. Sequence alignment and phylogenetic trees were built by MEGA 6.0 software. Results: Out of 4 556 specimens, 1 135 (24.91%) were positive for RSV, totally 216 G protein sequences were obtained. RSV A isolates were clustered into three genotypes: NA1、NA3 and ON1. The nucleotides and amino-acid homology was 84.9%-100% and 77.3%-100%, respectively. The nucleotides and amino-acid homology between this study and prototype long strain was 81.2%-83.3% and 74.1%-88.0%. RSV B isolates were clustered into only BA9 one genotypes. The nucleotides and amino-acid homology was 97.7%-100% and 95.8%-100%, respectively. The nucleotides and amino-acid homology between this study and prototype CH18537 strain was 84.9%-85.7% and 77.9%-80.1%. Conclusions The genetic characteristics and the amino-acid changes were analyzed systematically using data of RSV G gene collected from 2012 to 2017 in Gansu province in this study. These data were used for analyses of the etiology, control and prevention of RSV infection.