OBJECTIVE:To explore a fair,reasonable and legal management for outpatient chemical drug pharmacy.METHODS:By combining our experiences in outpatient chemical drug pharmacy of our hospital reviewing a considerable literature,the problems occurred in daily pharmacy management were analyzed,and the coping strategies such as flexible shift arrangement system,comprehensive drug control and sustained improvement etc were applied.RESULTS:The scientific management contributed to a reasonable pharmacy management,reduced error rate,ensured the drug quality,greatly shortened the dispensing time,and due to which,high-quality service was available and the allocation of human resources was optimized to some degree.Patients' satisfaction degree raised to 97.8% of Mar.2008 from 80% of Apr.2006.CONCLUSI-ON:A fair,reasonable and legal pharmacy management was achieved by means of scientific,human and standard management,accordingly,the hardware and software in pharmacy brought about a maximal efficiency and effectiveness of management.

Objective To observe the clinical efficacy of bipolar hemi arthroplasty and PFNA internal fixation for elderly patients with unstable intertrochanteric fracture.Methods The data of 79 elderly patients with unstable intertrochanteric fracture in our hospital from Au-gust 2013 to August 2014 were analyzed retrospectively.According to different surgical methods,79 cases were divided into observation group (n =40)and control group(n =39).The observation group were treated by artificially double-acting avascular replacement,and the control group received PFNA internal fixation.The operation time,intraoperatve blood soss,bedridden time,clinical effecacy and complications were recorded and observed.Results The operative time and bed time of observation group were significantly shorter than those of control group, the difference was statistically significant(P <0.05).The total postoperative complication rate of observation group was 20.00%,which was higher than 20.51% of control group,the difference was statistically significant (P <0.05).The Harris scores in observation group 3 months and 6 months after surgery were significantly higher than those in control group,the differences were statistically significant(P <0.05).Con-clusion Both artificially double-acting avascular replacement and PFNA internal fixation have a good effect on elderly patients with unstable intertrochanteric fracture.The artificially double-acting avascular replacement has the advantages of less blood loss,faster recovery and less postoperative complications,which is conducive to improving the quality of life of patients.

Objective To investigate the imaging features of hepatic epithelioid hemangioendothelioma (EHE) and to improve the level of awareness of this disease.Methods A retrospective analysis was conducted on the CT and MRI findings and the clinical data of 16 patients with liver EHE.The diagnosis was made on specimens obtained by liver biopsy or with operation.Six patients received only CT,6 only MRI,4 both CT and MRI,and 4 with DWI sequence.Results 6 of 16 patients with hepatic EHE had a solitary tumor while the remaining 10 patients had multiple tumors.CT scanning on 10 patients showed a heterogeneous mass with low density.In 4 patients,there were small calcifications in the lesions.The lesions on MRI showed a heterogeneous mass with low signal in T1WI and high signal in T2WI and DWI.In 8 patients,during enhanced scanning,the intrahepatic vein and its branches terminated at the edge of the tumor to form the lollipop sign. On the arterial phase lesions with a diameter ＞ 3 cm showed a centripetal enhancement pattern,which is similar to that of a haemangioma.Lesions with a diameter ＜ 3 cm showed ring enhancement and continuous annular enhancement in the portal venous phase and in the delayed phase.The best observation period for the number of lesions was in the arterial phase.Conclusion Hepatic EHE had certain distinct characteristics on CT and MRI,e.g.the lollipop sign,lesions with small calcification,lesions with a diameter ＞ 3 cm with a centripetal enhancement pattern,and lesions with a diameter ＜ 3 cm with continuous ring enhancement on CT scanning.These radiological features help in the diagnosis of the disease.

OBJECTIVETo investigate the reduction in residual ridges of maxillary edentulous models duplicated from old and new complete dentures using the 3-D data analysis.

METHODSTwenty-six pairs of maxillary edentulous models copied from the fitting surfaces of new and old upper complete dentures were selected for this study. The 3-D data were collected with a laser scanning system. The data were matched using Geomagic Studio 8 and Rapidform2006 software and then the fitting surfaces of new complete dentures were analyzed in comparison with old ones.

RESULTSThe total amount of morphologic change of fitting surface [(39.8+/-14.2)%] was greater than the change of width [(28.2+/-16.0)%]; the area reduction of the residual ridge in anterior region [(43.0+/-15.2)%] was larger than that in posterior region [(36.1+/-14.1)%]; and the area reduction of residual ridge in buccal aspect [(42.9+/-13.8)%] was larger than that in lingual aspect [(35.5+/-15.2)%]. All the differences were statistically significant (P<0.05).

CONCLUSIONSThe results of this study reveal that 3-D analysis of the whole change of the residual ridge is significant and verify that the residual ridge resorption of edentulous maxilla in three dimensions is greater in buccal aspect than in lingual aspect and greater in anterior region than in posterior region.

Aged ; Aged, 80 and over ; Alveolar Bone Loss ; etiology ; Alveolar Process ; pathology ; Denture, Complete, Upper ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged

Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.

Objective To observe the effects of hyperoxia on Notch 1 receptor of alveolar epithelial type Ⅱ cells (AEC Ⅱ), in a hetcrocellular culture of alveolar epithelial type Ⅱ cells and lung flbroblasts(LF), in order to explore Notch signaling in hyperoxic induced lung injury and thus make theoretical basis for prevention and treatment of a acute/chronie neonatal lung injury. Method Twelve Spragne Dawkey female rats with 200～220 g and 3 Spragne Dawkey male rats with 220～250 g were offered from experimental animal centre of Tongji Medical Colleege, Huazhong University of Science and Technology. The AEC Ⅱ/ LF co-culture system was established successfully. AEC H s from premature rats were randomly assigned to 2 groups: air control group and hyperoxia group. Air control group was kept in room air 50% ml/L CO2 enviromnent at 37°C, while hyperoxia group was exposed to 950 ml/L O2 + 250 ml/L CO2. Immuno-histochemistry was taken to detect Notch 1. Fluorescent quantitafive PCR was used to quantify the Notch 1 mRNA. MTT method was taken to assess cen proliferation viability.Flow eytometry double label method was used to detect cell percentages. Results In hyperoxia group:Notch 1 activation was inhibited, and Notch 1 mRNA decreased to 0.43,0.29,0.11,0.03 fold of control (95% confidence limit). AEC Ⅱ percentage descended predominantly[ 24 h hyperoxia group vs. control group: (68.92±6.88)%vs. (90.35±4.01)%, P =0.006;48 h hyperoxia group vs. control group: (38.03±3.27) vs. (61.47±4.81)%, P =0.000;72 h hyperoxia group vs. control group:(20.13±4.45)% vs. (52.05±3.35)%, P =0.000;96 h hyperoxia group vs. control group:(8.17±1.99)% vs. (52.59±2.93)%, P =0.0001 while that d AECI rised[24 h hyperoxia group vs. contrd group:(0.11±0.03)% vs. (0.01±0.01)%, P=0.006;48h hyperoxia group vs. control gnmp:(49.73±3.45)% vs. (16.13±2.13)%, P =0.000;72 h hyperoxia group vs. control group: (52.43±3.14) % vs. (5.98±0.95) %, P = 0.000;96h hyperorxia group vs. control group:(19.85±3.26)% vs. (29.03±3.16)%, P =0.007]. Comclusions Hyperoxia may inhibit Notch signaling pathway, which can weaken proliferation and disdifferentiation of AEC Ⅱ s. Investigations on how to control Notch signaling will provide fresh thoughts for alveolar epithelium repairing.

OBJECTIVE:To investigate the effects of puerarin on bone mineral density around the femoral prosthesis of el-derly women after osteoporotic fracture artificial hip joint replacement. METHODS:99 elderly women after osteoporotic fracture artificial hip joint replacement were divided into control group(49 cases)and test group(50 cases)according to random number table. Control group received conventional treatment:calcium carbonate and vitamin D3+alendronate sodium+salmon calcitonin;test group was additionally given Puerarin injection 200-400 mg dissolved in Glucose injection 500 ml intravenously,qd,on the basis of control group. A treatment course lasted for 20 d,and both groups received 2 courses of treatment. The hip joint function score and bone mineral density around the femoral prosthesis of 2 groups were observed and compared after surgery,and the oc-currence of ADR was also observed. RESULTS:3 and 2 patients withdrew from control group and test group,respectively. 18 months after surgery,the patients with hip joint function score ranged 70-79 in test group was significantly less than in control group;the rate of excellent hip joint function score in test group was significantly higher than in control group,with statistical significance (P<0.05). 15 and 18 months after surgery,bone mineral density in R1-R5 range of Gruen range in test group was slightly higher than in control group,without statistical significance(P>0.05);bone mineral density in R6-R7 range was signifi-cantly higher than control group(89.58% vs. 69.57%),with statistical significance(P<0.05). The prosthesis loosening was not found in both groups,and ADR was also not found as fever,erythra,nausea,vomiting,headache,dizziness,etc. CONCLU-SIONS:For the use of puerarin in elderly women after osteoporotic fracture artificial hip joint replacement,puerarin can increase the periprosthetic femur bone mineral density with good safety.

BACKGROUND:In recent years, there are many animal studies and osteoblast studies on the anti-osteoporotic effects of puerarin, a kind of phytoestrogen. But few of them are reported on the effects of puerarin on osteoblasts in older patients with osteoporosis. OBJECTIVE: To observe the influence of puerarin on the proliferation ofin vitro cultured osteoblasts from older female patients with osteoporosis. METHODS:The older female patients with osteoporotic femoral neck fractures who underwent artificial femoral head replacement were included in this study. The femoral neck cancelous bone removed during the operation was colected. Primary cancelous bone osteoblasts were cultured using explant culture method. The cels were sub-cultured to the required amounts. Osteoblasts from the control group were cultured with culture medium without puerarin. Osteoblasts from the 0.01, 0.1, and 1 μmol/L puerarin groups were cultured with culture medium containing the corresponding concentrations of puerarin. After in vitro co-culture with different concentrations of puerarin for 1, 3, 5 days, the proliferation of osteoblasts was observed. RESULTS AND CONCLUSION:With the increase in the concentration of puerarin, the proliferative activity of
osteoblasts constantly increased at different time points (P < 0.05). At 3 days of culture, cel absorbance value in each group reached the peak level. These results suggest that 0.01, 0.1, 1μmol/L puerarin promotes the proliferation of osteoblasts in older patients with osteoporosis in a concentration-dependent manner.

Objective To explore the effect of macrolide antibiotics(erythromycin) on tumor necrosis factor(TNF)-α and interleukin(IL)-8 in hyperoxia-induced lung tissue of premature newborn rats,and to study the intervention effect of erythromycin on hyperoxia-induced lung injury.Methods One-day old preterm Sprague Dawley rats were randomly divided into four groups by random number table method:air + sodium chloride group,air + erythromycin group,hyperoxia + sodium chloride group,hyperoxia + erythromycin group.Hyperoxia groups were continuously exposed to oxygen (oxygen ＞ 0.85) and air group in room air.After 1,7,14 days of exposure,the preterm rats of four groups were sacrificed,whole lung of these rats were isolated,the lung histological changes were observed by hematoxylin-eosin staining,TNF-α and IL-8 in pulmonary tissue homogenate were detected by ELISA.Results The results showed that:(1) Compared with air + sodium chloride group,TNF-α and IL-8 expression in hyperoxia + sodium chloride group were significantly increased(P ＜ 0.05) after 1,7 days of exposure [1 d:TNF-α:(16.163 ± 0.574) ng/ml vs.(21.923 ±2.066) ng/ml,IL-8:(18.214 ±3.649) ng/ml vs.(23.546 ± 5.240) ng/ml ;7 d:TNF-α:(15.940 ±0.821) ng/ml vs.(19.688 ±0.764) ng/ml,IL-8:(18.541 ± 4.114) ng/ml vs.(24.255 ±4.692) ng/ml],in particular,TNF-α expression appeared to increase earlier,their expression became significantly weak in 14 days (P ＜ 0.05).(2) Compared with hyperoxia + sodium chloride group,TNF-α and IL-8 expression in hyperoxia +erythromycin group became significantly weak after 1,7,14 days of exposure(P ＜0.05) after the intervention of erythromycin [1 d:TNF-α:(21.923 ± 2.066) ng/ml vs.(18.903 ± 1.851) ng/ml,7 d:IL-8:(24.255 ±4.692) ng/ml vs.(23.508 ±3.543) ng/ml,14 d:TNF-α:(16.443 ±5.466) ng/ml vs.(14.453 ±0.963)ng/ml],but their expression became weaker in 14 days than that in 1,7 days.Conclusion The release of inflammatory mediators TNF-α and IL-8 induced by oxidation outbreak participates in the development of hyperoxia induced lung injury,erythromycin may regulate immune function,inhibits the levels of oxidant-mediated TNF-α and IL-8 induced by oxidation outbreak,and alleviate hyperoxia lung injury in premature rats.

Objective To build the indicators system for clinical pathway management as required by clinical pathway control.Methods An indicators system was proposed by means of evidence-based review,focus group discussions,and ratings of the indicators' importance by doctors and nurses.A multidisciplinary panel of 60 experts from across the country were selected.A 3-round Delphi survey was made on the proposed indicators.The weights of the indicators were established by analytical hierarchy process (AHP).The response rate,Cronbach's α,and the authority coefficient of experts were used as a measure of reliability.Results The response rates of the 3 rounds were 85％,70％,and 94％; the experts authority coefficient was 0.80.The ccoefficient of variation falls with the rising number of consultations.The Kendall's W ranged from 0.40 to 0.83.Following the 3 rounds,consensus was achieved among experts as such a system comprising three first-level,9 second-level,and 36 third-level indicators.Conclusion The expert consultation has achieved reliable results.The established indicators system can serve as a useful instrument for standardized development of clinical pathways management and constant improvement.