OBJECTIVE:To provide reference for promoting the standardization construction of pharmaceutical affairs manage-ment in primary medical institutions. METHODS:Completing the survey forms was combined with field trip to investigate the phar-maceutical affairs management in 23 hospitals in Hanyang district of Wuhan,and the results were summarized and analyzed. RE-SULTS:Totally 23 survey forms were sent out,and 23 were effectively received with effective recovery rate of 100%. In the sur-veyed hospitals,3 community hospitals had no adjust management system,all community hospitals had no clinical pharmacists management system,3 community hospitals had no pharmaceutical management and pharmacotherapeutics system,the information-ization management system in hospitals below third-grade had no statistics function,5 community hospitals had no standardized cool warehouse;use rate of antibiotics in the outpatient of 13 community hospitals was more than 20%;among the 21 hospitals with special management drugs,18 hospitals below third-grade did not use the unified state identification;4 community hospitals did not train pharmacy staff every year. CONCLUSIONS:Medical institutions in Hanyang district of Wuhan,especially the commu-nity hospitals,exist some problems,including construction of pharmaceutical institutions,clinical pharmacy disciplines,equipment and facilities,management and training of pharmacy staff. It is suggested that primary medical institutions should enhance pharma-ceutical management level by expanding pharmacy staff,paying attention to the basic construction and informationization construc-tion,performing job duties,attaching importance to training and effect evaluation and focusing on the construction of clinical phar-macy disciplines.

Objective To investigate the causes of clinical misdiagnosis for gastric mucosa associated lymphoid tissue lymphoma (GMALT). Methods The clinical manifestations of and accessory examination for GMALT in 32 cases were retrospectively analyzed. Results Clinical misdiagnosis was made on 32 out of 78 cases (41%) of GMALT for a period of 5 days to 13 months. Radiographic misdiagnosis rate was 40% and endoscopic misdiagnosis rate was 37%. Conclusion The preoperative diagnosis of GMALT was difficult because the incidence of GMALT is low, the symptoms are nonspecific, and radiologic and fibergastroscopic features were very similar to those of gastric carcinoma and peptic ulcer.

Objective To study the role of soluble intercellular adhesion molecule-1 ( sICAM-1 ) in the pathogenesis of adults bronchial asthma and analyze the relationship between the level of sICAM-1 and the severity of bronchial asthma.Methods Serum levels of sICAM-1 in 134 cases with different periods of bronchial asthma patients and healthy volunteers were measured by ELISA and pulmonary functions of acute asthma patients were determined by pulmonary function analyzer. Results Serum sICAM-1 levels in 63 cases of acute asthma patients were increased significantly when compared with those in remission asthma patients and healthy volunteers and its value was increased significantly with the exacerbation of asthma;A negatively correlation between FEV1％ of pulmonary function and serum sICAM-1 level in patients with acute asthma was found in this study. Conclusion sICAM-1 was one of the important adhesion molecules in the pathogenesis of bronchial asthma. It could be used as one indicator of disease severity and guide the drug application in clinic.

Objective: To investigate constitutional and phys ical stamina status in soldiers with different adaption periods in Tibetan areas . Methods: Two hundred and eithty-two male soldiers from a barr acks at an elevation of 3 600 m were divided into 2 groups: the veteran group ( n=143) in Tibet for 1.45±0.22 year, and the recruit group (n=139) in Ti bet for 0.33±0.00 years. The test items included body weight, cirumference, st a nding long jump, chin-up, 100 m dash and 3 000 m jogging, all were evaluated ac cording to the national military standard, which were Comprehensive Evaluation o f Health in Troops, and Examination and Evaluation of the Physical Stamina of So ldiers. Results: The physical stamina indexes of both the vetera ns and the recruits were up to the national military norm on the whole, ranking as moderate. The veteran group showed no significant difference in standing long jump and 100 m dash,（P<0.05), but obvious lower level in chin-up and 3 00 0 m jogging（P<0.01）, compared with the national military norm. The recr ui t group showed significant lower level in chin-up, 100 m dash, 3 000 m jogging as compared with the national military norm（P<0.01）, and also significant lower level in chin-up and 3 000 m jogging （P<0.05 or P<0.01) as compa red with the veteran group. Conclusion: The physical stamina of both the veterans and the recruits meet the basic national military requirements , ranking as moderate. The soldiers who have been in service for over 1 year hav e better explosive force, but they need more tolerance and aerobic exercises. Th e newly recruited need more exercise to raise tolerance to the hypoxic environme nt in plateau areas so as to shorten the adaption time to high altitude.

Objective To investigate the relationship between dynamic changes of plasma D-dimer and survival rate of the esophageal carcinoma patients pre-and post-operation.Methods 30 cases of normal control group,160 cases of esophageal cancer group( including operation cases n =112),with the gold standard method for the determination of plasma D-dimer.Results There was a link between the level of D-dimer,TNM staging,lymph node metastasis and tumor size in esophageal carcinoma patients.Compared with the preoperation,the plasma D-dimer is significantly elevated 2 years later( t =7.35,P ＞ 0.05 ).Conclusion Before or after the operation,dynamic changes of plasma D-dimer had a relationship with short-term survival rate.

ObjectiveTo evaluate the value of serum galactomannan platelia aspergillus kit in the diagnosis and treatment of invasive fungal infection(IFI) patients. MethodsA total of 178 serum samples from 74 high risk patients were collected. ELISA assay was used to detect the level of GM antigen. Refer to domestic IFI diagnostic criteria, 16 patients include the proven cases and probable cases were defined as study group, while 29 patients of improbable cases defined as control group. Fourflod table was founded,by which the sensitivity,specificity,positive predictive value, negative predictive value of this GM test were calculated. Meanwhile, a total of 53 patients received antifungal therapy which divided into GM-positive group(21 patients with I≥0. 5) and GM-negative group(32 patients with I ＜0. 5). The therapeutic effect comparison of two groups was made according to curative effect criterion. ResultsAccording to the certainty level of IFI diagnosis, 1,9,10 and 4 patients were identified as GM positive in proven, probable,possible and improbable IFI groups respectively. The prevalence of GM in these 4 groups was 50％ ,64％ ,34％ and 14％ ,respectively. The sensitivity and specificity of galactomannan ELISA assay were 63％ ,86％ respectively. The positive and negative predictive values were 71％ and 81％ respectively. The diagnose accordance rate was 78％, the Younden index was 0. 49. The efficacy of fluconazole in GM-positive patients was significant lower than in GMnegative patients( x2 =4. 95 ,P ＜0. 05) ,while The efficacy of non-fluconazole drug was superior to that in GM-negative patients( x2 =4. 88,P ＜ 0. 05). After antifungal therapy, the GM value of GM-positive patients decreased significantly( t =2. 13 ,P ＜0. 05). ConclusionThe galactomannan ELISA assay with high specificity, could be helpful in diagnosis and choicing effective anti-fungi drug in clinic.

Objective: To investigate the effects of psycholog ical factors on treatment and outcome of patients with high altitude pulmonary e dema(HAPE). Methods: In the present study, one hundred and fifty -two patients with HAPE were tested by hospital anxiety and depression scale. Results: The results showed that there were 61 patients (40.13%) with anxiety and 29 patients (19.08%) with depression. The important factors on mental state of patients were preventive education, the first time suffering HA PE, characters of patients, degree of the disease and the medical fee, the less w ere age, sex, occupation and education of patients. Duration of rales of lung an d course of illness were significantly prolonged in HAPE patients with mental di sorders compared to the patients without mental disorder. Conclusion:The study suggests that anxiety and depression might aggravate the state of HAPE.

OBJECTIVETo assess the role of oxidative metabolism and nitric oxide synthesis for elucidating their pathophysiological mechanisms in a Tibetan patient with essential hypertension.

METHODSThe serum levels of total superoxide dismutase (T-SOD), malondialdehyde (MDA), total antioxidant capacity (T-AOC), nitric oxide (NO) and nitric oxide synthase (NOS) were assayed in sixty native Tibetans (thirty hypertensive patients and thirty healthy volunteers as control).

RESULTSThe levels of T-SOD, T-AOC, NO and NOS were significantly lower in the patient group than in the control group (P < 0.01); MDA was significantly higher in the patient group than in the control group (P < 0.01). The level of MDA had a strong negative correlation with T-SOD, T-AOC, NO and NOS (r = -0.82, -0.76, -0.79, -0.73, respectively, P < 0.001 for all).

CONCLUSIONTibetan patients with essential hypertension (EH) may have underlying oxidative metabolism dysfunction and depressed NO synthesis, both responsible for the hypertensive process.

Adult ; Altitude ; Endothelium, Vascular ; physiology ; Female ; Humans ; Hypertension ; etiology ; Male ; Middle Aged ; Nitric Oxide ; biosynthesis ; Oxidation-Reduction ; Tibet