Objective To investigate the effects of various dose of atorvastatin on intima-media thickness (IMT) of carotid and endothelial function in elderly patients with type 2 diabetes mellitus (T2DM).Methods One hundred and seventy-two elderly patients with T2DM were divided into three groups by random digits table method.Group A (63 cases) was treated with atorvastatin 10 mg/d,while group B (54 cases) was treated with atorvastatin 20 mg/d and group C (55 cases) was treated with atorvastatin 40 mg/d for 12 months.The serum levels of lipid,high-sensitive C reactive protein (hs-CRP),IMT of carotid and endothelial function were measured before and after treatment of 6,12 months.Results There were no significant differences in the levels of lipid,hs-CRP,IMT of carotid and endothelial function among three groups (P ＞0.05).The levels of total cholesterol (TC),triacylglycerol (TG),low density lipoprotein cholesterol and hs-CRP were decreased and high density lipoprotein cholesterol was increased after treatment of 6,12 months in three groups (P ＜ 0.05).The levels of TC,TG and hs-CRP after treatment of 12 months in group C were lower than those in group A and group B [(3.52 ± 0.55) mmol/L vs.(4.45 ± 0.71),(4.31 ± 0.75) mmol/L,(1.20 ±0.12) mmol/L vs.(1.64 ±0.18),(1.51 ±0.17) mmol/L,(4.22 ±0.28) mg/L vs.(5.34 ± 0.48),(5.02 ± 0.44) mg/L],and there were significant differences (P ＜ 0.05).IMT of carotid,Crouse scores of plaque and the incidence of carotid plaque after treatment of 12 months in group C were lower than those before treatment [(0.84 ±0.07) mm vs.(1.07 ±0.10) mm,(4.03 ± 1.14) scores vs.(4.34 ± 1.18) scores,41.8％(23/55) vs.78.2％(43/55)],and there were significant differences (P ＜ 0.05).The levels of endothelin and thromboxane B2 were markedly decreased in group C after treatment of 12 months [(68.48 ± 9.35) ng/L vs.(90.07 ± 10.19) ng/L,(80.08 ± 14.27) ng/L vs.(104.77 ± 12.36) ng/L],while the levels of nitric oxide and 6-Keto-PGF1α were increased [(72.28 ± 9.40)μ mol/L vs.(61.88 ± 10.01) μ mol/L,(72.39 ± 8.67) ng/L vs.(54.92 ± 10.78) ng/L],and there were significant differences(P＜0.05).After treatment of 12 months,the levels of endothelium-dependent dilation were significantly increased in three groups (P ＜ 0.05).The levels of endothelium-independent dilation in group B and group C were significantly increased after treatment of 12 months [(11.12 ± 1.00) ％ vs.(6.38 ± 0.49) ％,(13.43 ± 1.11) ％vs.(6.39 ± 0.52)％],and there were significant differences (P ＜ 0.05).Conclusion Combined with hypoglycemic treatment,atorvastatin may delay the progress of carotid atherosclerosis and improve the endothelial function in elderly patients with T2DM.

Objective To investigate whether switching anti-hypertensive medication to bedtime could improve blood pressure control in non-dipper patients with refractory arterial hypertension.Methods 30 patients (as observation group) with refractory arterial hypertension and non-dipper pattern on ambulatory blood pressure monitoring were shifted all non-diuretic anti-hypertensive drugs from morning to evening.22 patients with similar characteristics and no changes in the therapeutic regimen formed the control group.Results After 12 weeks treatment,the changes of 24h average systolic/diastolic blood pressure,average diastolic blood pressure during the day and the average diastolic blood pressure at day/nigh were-(2.8 ± 4.2)/-(2.1 ± 3.4)mm Hg,(-1.1 ± 3.1)mm Hg and (-6.3 ±5.9)/(-4.3 ±5.7)mm Hg,respectively.The decrease of mean systolic blood pressure and mean diastolic blood pressure in the observation group were significantly larger than those in the control group(all P ＜0.05).The circadian blood pressure profile changed from non-dipper to dipper in 6 cases in the observation group and no changes were observed in the control group(x2 =4.974,P =0.0263).There was also no difference between two group in terms of untoward reaction.Conclusion In non-dipper patients with refractory arterial hypertension,changing the timing of anti-hypertensive medication to the evening could improve blood pressure control aud help the abnormal circadian blood pressure profile recover to the normal.

Objective To realize the safe work of hospital network and ensure the veracity and reliability of the hospital information system (HIS). Methods The network malfunctions and cause of HIS since from its beginning were analyzed by making full use of statistical graph and summarized the factors of affecting HIS safety. The safety complications of HIS were rebuilt by using collecting cluster server, double-redundant design of switchboard, the installation of firewall, installing anti -virus software,etc. The strict safety regulations were established and operation levels of technical personnel were enhanced. Results The hospital runs smoothly, no major network malfunction comes to true repeatedly. Conclusion The HIS safety is realized by attaching importance to the safety and strengthening the input.

Signaling pathways such as MAPK and P13K have been confirmed to be important in the mechanism of tumor genesis, development, prevention and treatment. Thyroid hormone (TH) and its receptor (TR) can affect the pathways resulting in inhibition of tumor growth and metastasis, thus they have gradually become the focus of recent research. However, numerous studies showed that TR gene mutation was often observed in a variety of cancers and resulted in the deregulation of TH/TR mediated downstream pathways, and TR gene mutation became an causative agent to activate downstream proto-oncogene. Recent studies showed that TH/TR might play a role in the regulation of β-catenin degradation, the knowledge of which allows us not only to further understand the function of TR gene in the inhibition of tumor development, but also provide a theoretical basis for the continuous activation of downstream proto-oncogene by TR mutation. To study the downstream pathway of TR gene could eventually guide the clinician and provide a new theoretical basis for cancer prevention and molecular target gene therapy.

Objective To analyse the economies of scale in public hospitals in Zhejiang Province. Methods One hundred and twenty-five public hospitals in Zhejiang Province with qualification no less than class two level two were selected as sample hospitals. Douglas production function was employed to analyse the relationship between investment and output in sample hospitals between 2004 to 2006, with two types of production models established by medical service and incomes in hospitals as dependent variables. Results From 2004 to 2006, the medical service and incomes of sample hospitals were in line with economies of scale. The production increase rate was higher than investment increase rate. The medical service, incomes, total assets and number of staff in class three hospitals were higher than those in class two hospitals (P =0.000). Conclusion Economies of scale is the ultimate incentive to continuous outstretch for hospitals. Hospitals should rationally control the scale so as to avoid problems in medical service caused by overstretch.

OBJECTIVE: To optimize the therapeutic regimen for acute cerebral infarction for clinical reference. METHODS: Medical records of patients in who acute cerebral infarction occurred for the first time in a hospital during 2003～2006 were analyzed statistically in respect of drug use. RESULTS: In terms of DDDs, dehydrants, diuretics, platelet aggregation inhibitors, promoting cerebral circulation agents and supportive drugs took the lead in this hospital. The DDDs of drugs used for complications in descending order were antiinfectives, hypotensors, and drugs for heart diseases. CONCLUSION: The drugs used for inpatients with acute cerebral infarction varied in kinds; therefore, clinical choice of drugs and the rationality of drug use remain to be further studied.

OBJECTIVE:To explore the method of pharmaceutical care which influence the effect of the treatment for diabetes mellitus at home. METHODS:163 patients with diabetes mellitus in community who received treatment at home were selected, and then randomly divided into control group (58 cases),family visit group (51 cases) and group education group (54 cases);control group were given pharmaceutical intervention with traditional dispensing window;family visit group received door-to-door service or telephone follow-up service;group education group were given collective education and interactive way. The latter two groups were all given regular drug education,and the advisory desk was set up and provided consulting services about medication knowledge. RESULTS:After providing pharmaceutical care,the regular medication rate of 3 groups were 43.1%,64.8% and 78.4%;medication adherence were 51.7%,70.4% and 82.4%;the rates of blood glucose at target level were 29.3%,48.1% and 54.9%;the rates of glycosylated hemoglobin at target level were 13.7%,31.5% and 31.4%,ADR occurance rates were 31.0%, 13.0%,5.9%. These index of family visit group and group education group were all better than those of control group significantly (P<0.05). CONCLUSIONS:Humane pharmaceutical care can improve the quality and effect of the treatment for diabetes mellitus.

AIM: To recognize the importance of ADR monitoring of drugs available on the market from PPA Event. MET- HODS: With reviewing relevant literatures and scanning relevant network stations. we summarlzed the importance of moni- toring ADR of drugs available on the market and signiticance of creating a perfect evaluation mechanisms and systems of ADR monitoring for those drugs. and analysed several method of ADR monitoring and points for attention Finally. we gave several suggestions about enhancing ADR monitoring .RESULTS& CONCLUSION:ADR events can be effectively pre- vented by perfect evaluation mechanisms and ADR monitoring systems of drugs available on the market.

OBJECTIVE:To investigate the methods of calculating pediatric dose of medication.METHODS:The validity of several methods of calculating pediatric dose of medication was evaluated by statistical methods and demonstration analysis,and the expression of the pediatric dosage of administration in drug instruction was discussed.RESULTS&CONCLUSION:There exist improper medical manipulation in the rational use of medicines in pediatrics,uniform criterion and calculation are lack for measuring age groups in pediatrics,aseries of integrated and uniform criteria to determine the safe dosage for child are needed.

0.05),but adverse reaction in TPM group was lighter.Conclusion TPM treated on PHN is effective and safe with good tolerance.