Objective To explore the changes of placental growth factor (PLGF) in patients with acute coronary syndrome (ACS).Methods One hundred and twelve patients were divided into four groups according to clinical data and coronary angiography:non-coronary artery disease (non-CAD) group (27 cases),stable angina (SA) group (28 cases ),unstable angina (UA) group (29 cases) and acute myocardial infarction (AMI) group (28 cases).Fifty-seven patients with ACS were divided into single lesion group (19 cases),twice lesion group ( 16 cases) and triple lesion group (22 cases) by coronary angiography,and 0-7 scores group (23 cases),8-15 scores group (27 cases) and 16-32 scores group (7 cases) by Jenkins scores.The serum PLGF levels of all the cases were determined on admission.The serum PLGF levels of 40 cases receiving percutaneous coronary intervention (PCI) were determined at 30 min before operation,the first and second day after operation.Results The serum PLGF levels of AMI group and UA group were (38.33 ±10.14) ng/L and (37.44 ± 13.32) ng/L respectively,which were significant higher than that of SA group [(20.90 ± 3.88) ng/L] and non-CAD group [(20.34 ±4.53) ng/L](P＜ 0.01),and there was no significant difference between AMI group and UA group,SA group and non-CAD group (P ＞0.05).There was no significant difference in the serum PLGF level among triple lesion group,twice lesion group and single lesion group (P ＞ 0.05 ).There was no significant difference in the serum PLGF level among 0-7 scores group,8-15scores group and 16-32 scores group (P ＞ 0.05).The serum PLGF level of patients receiving PCI on the first day after operation [ (32.03 ± 7.41 ) ng/L] was significantly higher than that before operation [ (23.86 ± 6.91 ) ng/L](P＜ 0.05 ),and on the second day after operation the serum PLGF level [ (29.37 ± 6.99) ng/L] was less than that on the first day after operation,showing a fall tendency(P＞ 0.05).Pearson correlation analysis showed that the serum PLGF levels in patients with ACS were not related with cardiac troponin T and creatine kinase isozyme-MB (r =-0.158,P=0.421;r =0.302,P=0.118).Conclusion The serum PLGF level of ACS patients is an inflammatory marker reflecting coronary atherosclerotic plaque destabilizing or plaque ruptured,and may also play an important role in early diagnosis of the borderline case of ACS.

Objective To assess the estimated 10-year risk of stroke among hypertensive outpatients known with diabetes from cardiovascular clinics of 36 tertiary hospitals in China and to analyze the characteristics of the risk factors and the 10-year risk of stroke between the southern and the northern patients.Methods A multi-center prevalence survey was conducted from October 2011 to June 2012.Hypertensive outpatients known with diabetes were enrolled from cardiovascular clinics of 36 tertiary hospitals in China.A total of 15 914 outpatients were included in the final analysis.The 10-year probability of stroke was evaluated by the Framingham stroke risk profile.According to the 10-year probability of stroke,patients were divided into low risk (≤ 5％),medium risk (6％ ～9％) and high risk (≥10％).Results (1) Of all the hypertensive outpatients known with diabetes,the mean age was (64.6 ± 10.1) years and the mean systolic pressure was (138.7 ± 19.3) mmHg(1 mmHg =0.133 kPa).Among them,7.4％ with atrial fibrillation,11.2％ with left ventricular hypertrophy,57.2％ with cardiovascular diseases,17.1％ smokers and 37.0％ using mono-hypoglycemic agent.The southern patients who were older with more smokers had higher proportions of men and left ventricular hypertrophy,lower Levels of systolic blood pressure,and lower proportions of other cardiovascular diseases than those of the northern patients (all P ＜ 0.05).(2) The mean 10-year probability of stroke was (20.9 ± 16.2) ％.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients [(22.4 ± 17.1)％ vs (19.7 ± 15.2)％] (P ＜ 0.01).After adjusted by age and sex,the southern patients still had a higher mean 10-year probability of stroke (P ＜0.05).(3) All the patients had 7.7％ with low risk,17.4％ with medium risk,and 74.9％ with high risk.The southern patients had lower proportions of low and medium risk than those of the northern patients (6.7％ vs 8.4％,15.5％ vs 18.9％),but had a higher proportion of high risk than that of the northern patients (77.7％ vs 72.7％,all P ＜ 0.01).Conclusions Among the hypertensive outpatients known with diabetes from the cardiovascular clinics of our study,most of them were at the 10-year high risk of stroke.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients.

OBJECTIVE:To improve the hospital workflow and efficiency in temporary drug purchase approval process. METHODS:The approval function for temporary drug purchase was introduced into office automation(OA)system in our hospi-tal,and the effects were evaluated. RESULTS:According to ensuring the administrative approval process,system function permis-sion assignment and approval process design in temporary drug purchase in our hospital,functions for approving temporary drug purchase were established in OA system. It achieved convenient,efficient,timely,networking and paperless approval work,as well as standardized record,checking out at any time and automatic statistics for drug purchase. CONCLUSIONS:Introducing tem-porary drug purchase approval function into hospital OA system can simplify workflow,provide better service for clinic,and pro-mote development of hospital pharmacy management.

Objective To investigate the chemical constituents of marine sponge Mycale sp.collected from the South China Sea.Methods The ethyl acetate extract of the marine sponge Mycale sp.was separated and purified by repeated column chromatography on silica gel, Sephadex LH-20 and reversed-phase high-performance liquid chromatography (RP-HPLC).The structures of these compounds were identified by means of various modern spectroscopic techniques and comparison with their physicochemical properties to reported data.The tumor cell growth inhibitory activities of these compounds against human breast cancer cell lines MCF-7 and human lung cancer cell lines PC9 were tested by Cell Counting Kit-8 (CCK-8) method.Results Ten compounds were isolated and identified as cyclo-(Pro-Ile)(1),cyclo-(Pro-Leu)(2),cyclo-(Ile-Leu)(3),cyclo-(Phe-Pro)(4),cyclo-(Phe-Val)(5),cyclo-(Phe-Leu)(6),cyclo-(Phe-Ile)(7), 2′-deoxythymidine (8), thymine (9), 5-hydroxy-3,4-dimethyl-5-pentyl-2(5H)-furanone (10).These compounds showed weak tumor cell growth inhibitory activities toward cells MCF-7 and PC9 in vitro.Conclusion Compounds 1, 2, 4, 5, 6, 7 and 10 were isolated from the sponge Mycale sp.for the first time.It is the first time to report the antitumor activity evaluation for compounds 1~10.

OBJECT IVE To e stablish the method for simultaneous determination of levetiracetam and carbamazepine concentrations in human plasma. METHODS After plasma samples were precipitated with methanol ，using carbamazepine-D 10 as the internal standard ，the concentrations of levetiracetam and carbamazepine were determined by high performance liquid chromatography-tandem mass spectrometry （HPLC-MS/MS）. The determination was performed on XBridge BEH C 18 column with methanol-0.1％ formic acid as mobile phase （gradient elution ）at the flow rate of 0.35 mL/min. The column temperature was set at 40℃，and sample size was 2 μL. With electrospray ion source，a multiple reaction monitoring mode was used for positive ion scanning；the detected ion pairs for quantitative analysis were m/z 171.3→126.3（levetiracetam），m/z 237.1→194.1（carbamazepine）， 247.1→204.1（internal standard ）. RESULTS The linear range of the concentrations of levetiracetam and carbamazepine were 0.5-50 and 0.2-20 μg/mL（r＝0.997 3 and 0.998 5），respectively；the lower quantitative limits were 0.5 and 0.2 μg/mL，respectively. RSDs of intra-day and inter-day were all no more than 10.00％. RE of intra-day and inter-day were within ±4.00％；the average extraction recoveries rate were 95.60％-105.00％；the average internal standard correction matrix factors were 98.40％-110.00％； RSDs of stability tests were all not higher than 5.60％. The concentrations of levetiracetam and carbamazepine in the plasma of 22 patients measured by this method were 3.36-40.90 and 3.64-9.93 μg/mL，respectively. CONCLUSIONS The established method for determining the concentration of levetiracetam and carbamazepine in human plasma is f ast，sensitive，accurate and stable ，and can be used for the monitoring of plasma concentration and pharmacokinetic study in epilepsy patients.

OBJECTIVE： To standardize the management of temporary drug purchase， and to provide reference for drug selection in Hospital Pharmaceutical Administration and Drug Treatment Committee （Pharmaceutical Association）. METHODS： Clinical pharmacists set up drug quantitative scoring table according to the 10 attributes of drugs as effectiveness， safety， economy， etc. 15 temporary purchased drugs submitted by departments in Oct. 2018 were graded according to the rules of the scoring table， and the evaluation results were fed back to Pharmaceutical Association. A retrospective evaluation of 20 temporary purchased drugs which were discussed at the Pharmaceutical Association from Jul. to Sept. 2018 was made according to previous approval model without using drug quantitative scoring table. The effect of pre-intervention was evaluated after using drug quantitative scoring table. RESULTS： Among 15 temporary purchased drugs， 2 of them scored below 60， and the unqualified rate was 13.3％. It suggested that 2 drugs could not be discussed at the meeting. Among 20 temporary purchased drugs that have been discussed at the meeting， 9 of them scored below 60， with the unqualified rate of 45.0％， suggesting that 9 drugs may have wasted the workload of the Pharmaceutical Association. CONCLUSIONS： Drug quantitative scoring table can play a pre-intervention role in the scoring of temporary purchased drugs to a certain extent. At the same time， the table can also be used as a relevant reference for hospital drug evaluation. It is helpful to optimize hospital drug use list and improve the level of rational drug use in clinic.

ObjectiveTo characterize the changes of metabolites of Blumea balsamifera in the process of sweating by non-targeted metabolomics， and to investigate the influence of sweating processing on the constituents of B. balsamifera. MethodsUltra performance liquid chromatography-quadrupole/electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap-MS） metabolomics was used to identify the metabolites in no sweating group（F1）， sweating 2 d group（F2） and sweating 4 d group（F3）， the differences of metabolites between the groups were compared by principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）， and differential metabolites were screened according to the variable importance in the projection（VIP） value>1 and P<0.05， and the pathway enrichment of the differential metabolites was analyzed by Kyoto Encyclopedia of Genes and Genomes（KEGG）. ResultsThe results of PCA and OPLS-DA showed a clear distinction between the three groups of samples， indicating significant differences in the compositions of the three groups of samples. A total of 433 differential metabolites were screened between the F1 and F2， with 154 up-regulated and 279 down-regulated， the significant up-regulated metabolites were tangeritin， 5-O-demethylnobiletin and so on， while the metabolites with significant down-regulation included alternariol， fortunellin， etc. A total of 379 differential metabolites were screened between the F2 and F3， with 150 up-regulated and 229 down-regulated， the significant up-regulated metabolites were isoimperatorin， helianyl octanoate and so on， and the significant down-regulated metabolites were hovenoside I， goyasaponin Ⅲ， etc. KEGG pathway enrichment analysis showed that tyrosine metabolism， isoquinoline alkaloid biosynthesis， phenylalanine， tyrosine and tryptophan biosynthesis， tryptophan metabolism， valine， leucine and isoleucine biosynthesis， pantothenate and coenzyme A biosynthesis may be the key pathways affecting metabolite differences of B. balsamifera after sweating treatment. ConclusionSweating can reduce the content of endophytic mycotoxins in B. balsamifera and has a great impact on the synthesis and metabolic pathways of total flavonoids and auxin. This study can provide a reference for the process research on the sweating conditions of B. balsamifera.