OBJECTIVE:To promote the development of pharmacists' clinical thinking ability.METHODS:By analyzing the differences between physicians and pharmacists in clinical thinking together with our practical experience,we expounded the key points of pharmacists' clinical thinking,i.e.critical thinking,comprehensive thinking,evidence-based thinking,patient-cored thinking and creative thinking.RESULTS & CONCLUSION:The clinical thinking that is in line with pharmacists' characteristics should be developed with clinical pharmaceutical practice as the core and it can be achieved by enhancing pharmacists' ability to detect and solve the drug related problems.

The problems in teaching infectious disease were discussed .The measures should be taken to improve the teaching quality from the varies of aspects, such as the aim and the model of the teaching, the arrangement of curricula, the cultivation of the clinical ability, and the method of examination and the application of multi-media materials.

Objective To establish a method for the determination of bacterial endotoxin in Ilex pubescens compound injection(LPCJ) .Methods According to China Pharmacopoeia (second part,2000),interference test was carried out to detect the endotoxins in LPCJ with limulus lysate agents (?was 0.25 EU/mL).Results Inhibition action was found in bacterial endotoxin test for LPCJ and in the 10-,20-,30-and 40-fold diluted liquid of LPCJ.It was proved that the maximum noninterference concentration was the 50-fold dilution.The inspection results are the same as that of rabbit pyrogen test.Conclusion The 50-fold diluted LPCJ is suitable for the determination of bacterial endotoxin and can be used as the quality control standard for its preparation.

Objective: To study the chemical constituents from the stems of Daphne acutiloba. Methods: The constituents were separated by column chromatography and their structures were elucidated by spectral data analyses. Results: Fourteen biflavans or biflavons were isolated from the EtOAc fraction of 95% ethanol reflux extract in the stems of D. acutiloba and were identified as daphnodorin A (1), daphnodorin C (2), daphnodorin C' (3), daphnodorin F (4), daphnodorin E (5), wikstrol A (6), daphnodorin K (7), iso-chamaejasmin (8), (+)-chamaejasmin (9), daphnodorin D1 (10), daphnodorin H (11), 3-methoxyl daphnodorin H (12), daphnodorin K' (13), and daphnodorin B (14). Conclusion: All the compounds except 14 are obtained from the stems of this plant for the first time.

Mixed saponin molecules in the extraction of Panax notoginseng(PNE) can be effectively desorpted into the molecular ionization for measurement and analysis by mass analyzer from matrix assisted laser desorption ionization-time of flight-mass spectrometry(MALDI-TOF MS). The saponin samples with chromatography purity were directly analyzed by MALDI-TOF MS, which indicated that the sensitivity of the method was higher than that of RP-HPLC. A technology of MALDI-TOF MS was directly employed to analyze the saponin kinds and their relative contents in Panax notoginseng(PN) while the saponins were perfectly extracted from the Chinese traditional medicine of PN. It was indicated that there were at least 20 saponins consisting of different molecular structure and that the content of both ginsenoside Rg1 and notoginsenoside R1 in PNE was relative high. R1 saponin was extracted and identified to follow its metabolism pathway by both thin layer chromatography and MALDI-TOF MS, respectively. The saponin fingerprinting maps in PNE can be established to evaluate the quality of PE and to study both metabolism pathway and mechanism of extra minim saponins in vivo.

Objective To observe the poet-operative clinical inpact on cervical intraepithelial neoplasia surgery by Loop elcctrosurgical excision procedure(LEEP),gelatin paste to improve the healing of the Cut,prevent the post-operative bleeding,and find out effective methods of preventing LEEP complications.Methods 100 patients with cervical intraepithelial neoplasia underwent LEEP in clinic.Divide them into two groups randomly,60 patients were adopted gelatin paste post-LEEP ag the cure group.while 40 patients were adopted as control group.Observation Vaginal bleeding,infection and cervical rear in short-term.Results In 60 patients of cure group,never patients with vaginal bleeding,infection and the cut healing in the short time.In 40 patients of control group,three patients with vaginal bleeding,two patients with infection,and three patients with bad healing.The different between two group with vaginal bleeding,infection and the cut healing time was significant(P＜0.05).Condusion gelatin paste can reduce bleeding.infection and cervical repair bad cmpllcations after cervical intraepithelial neoplasia surgery by LEEP.

Objective To observe the effects of electro-acupuncture on the expression and inhibition of DNA binding protein 2 (Id2) and myelin basic protein (MBP),and to explore the mechanism of remyelinization after compressive spinal cord injury (CSCI) in rats.Methods Fifty-four SD rats were randomly divided into a control group and a treatment group,and each was further subdivided into 3 time point subgroups:3,7 and 14 days.There were 9 rats in each subgroup.The CSCI models were made with a self-designed method.The acupuncture points Jiaji (EX-B2),bilateral Zusanli (ST36) and Taixi (KI3) were selected for treatment.Electro-acupuncture (continuous wave,2 Hz,1.5 V)was applied to the bilateral Zusanli (ST36) and Taixi (KI3) points.The control group received the injury but no treatment.The changes in the ultrastucture of the nerve fibers＇ white matter were de-termined by transmission electron microscopy (TEM).The alterations in the expression of MBP and Id2 were observed by double labeled immunofluorescence and Western blotting on the 3rd,7th and 14th day after the injury.Results TEM showed that the myelin sheaths in the control group had degenerated,swollen,and even broken down after CSCI.Changes to the myelin sheaths in the treatment group were milder than those in the control group.The immunofluorescence results showed the amount of Id2-immunoreactive oligodendrocytes in the control group to be (20 ±2) on the 3rd day after CSCI,becoming (16 ± 1) on the 14th day.The differences among the 3 control subgroups were not statistically significant.The amount of Id2-immunoreactive oligodendrocytes in the treatment group was (13 ± 1) on the 3rd day,reaching a minimum the 14th day.The differences among the 3 treatment groups were statistically significant.The differences compared with the control group at the same time points were also statistically significant.Western blotting showed that the expression of Id2 in the contrast and treatment groups was (1.12 ±0.12) and (0.67 ±0.01) respectively on the 3rd day after CSCI,and both decreased with time.The expression of Id2 in both groups reached their minima ((0.86 ±0.02) and (0.25 ±0.01) respectively) on the 14th day.The difference between the treatment groups and the contrast group was statistically significant at each time point.The expression of MBP in the contrast and treatment groups at day 3 was (0.44 ± 0.02) and (0.67 ± 0.04) respectively,and these increased with time.The expression of MBP in both groups peaked at the 14th day (at (0.95 ± 0.04) and (1.74 ± 0.09) respectively).These differences were again statistically significant.Conclusion Electro-acupuncture can regulate the expression of Id2 and MBP after CSCI.The down-regulation of Id2 which controls MBP negatively and the up-regulation of MBP may contribute to remyelination in the injured spinal cord.

Objective To observe the curative effect of warm needling therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine on patients with scapulohumeral periarthritis and its effects on immunoglobulin IgA, IgG and IgM;To explore the mechanism. Methods Ninety patients with scapulohumeral periarthritis were randomly divided into needle with medicine group, needle group and medicine group, 30 cases in each group. Patients in the needle with medicine group were treated with needle warming therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine, patients in the needle group were treated with needle warming therapy, patients in the medicine group were treated with kidney-supplementing and blood-activating Chinese herbal medicine, 30 days for medicine and every other day for acupuncture. Five time acupuncture was one course of treatment, and patients were treated for 3 courses. Shoulder pain index was evaluated, and the levels of IgA, IgG and IgM was determined before and after 3 courses treatment. The total curative effect of the three groups were compared. Results The total effective rates for needle and medicine group, needle group and medicine group were 93.33% (28/30), 73.33% (22/30), 66.67% (20/30), respectively, with statistical significance between needle and medicine group and the other two groups (P<0.05),without statistical significance between needle group and medicine group (P>0.05). There was statistical significance between the shoulder indexes before and after treatment of the three groups (P<0.05). Before treatment, the levels of IgA, IgG and IgM of all three groups increased significantly compared with the normal reference values (P<0.05). After treatment, the levels of IgA, IgG and IgM were reduced significantly in three groups after treatment (P<0.05), the levels of IgA, IgG and IgM in the needle and medicine group were significantly lower than those in the other two groups (P<0.05). Conclusion The curative effect of needle warming therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine was better than alone needle warming therapy or kidney-supplementing and blood-activating Chinese herbal medicine. This combined therapy could significantly improve the symptoms of patients, reduce the levels of IgA, IgG and IgM, regulate the body immune function, which is probably one of the mechanisms in the treatment of scapulohumeral periarthritis.

Objective To investigate the association of restriction fragment length polymorphisms (RFLP) in p.S267F of SLC10A1 gene with clinical outcomes of hepatitis B virus (HBV) infection. Methods Clinical data of 1 268 patients with HBV infections admitted in Public Health Clinical Center Affiliated to Fudan University during July 2014 and February 2015 were collected.Polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP) method was used to genotype the p .S267F of SLC10A1 gene in all patients, and the potential association between variants in p .S267F of SLC10A1 gene and the clinical outcomes of HBV infection was analyzed .Results Among 1 268 patients with HBV infections, 1 226 were of genotype CC, and 42 were of genotype CT, so the variation rate in p.S267F was 3.31%(42/1 268).Compared with patients with genotype CC , patients with genotype CT had a higher incidence of acute HBV infections (13.6%vs.28.6%,χ2 =19.819, P<0.05) and a lower incidence of HBV-related liver cirrhosis or hepatocellular carcinoma (13.9% vs.4.8%, χ2 =18.945, P <0.05). Conclusion RFLP in p.S267F of SLC10A1 gene may be associated with chronicity and aggravation of HBV infection, and genotype CT is possibly a protective factor .

Interferon and nucleotide/nucleoside analogues are currently widely used in the management of chronic hepatitis B virus ( HBV) infections, but are facing problems such as poor sustained virologic response, low HBsAg clearance rate and a high risk of recurrence after drug withdraw.Exploring new target of anti-HBV agent has become a hot topic in recent years.This paper reviews the research progress on new anti-HBV targets and related drugs.