Based on theories of career guidance and refined management,this paper introduced the investigation and practice of refined career planning and guidance for pharmacy graduate students in Peking University,and puts forward some ideas to improve the career planning and guidance in the future.

Objective The aim of this study was to describe the clinical and pathological features of primary biliary cirrhosis(PBC) and their correlation.Methods Liver biopsy specimens were obtained through percutaneous needle puncture from twenty four patients with PBC who had not been diagnosed or treated before.These samples were fixed in formaldehyde and embedded in paraffin for routine histological examination.Pathologic stages based on Ludwig criteria,fibrosis,portal and periportal inflammation,lymphocytic periportal piecemeal necrosis,ductular proliferation,intralobular hepatocyte necrosis,the degree of ductopenia and relevant laboratory results were recorded.Statistics method used was x2 or t-test,Mann-whitmey U nonperametric test and Pearson's or Spearman's correlation analysis.Results The pathological stages,degree of fibrosis were positively correlated with total bilirubin (TBIL) level,total bile acid (TBA),cholesterol (CHO),IgG levels,and were negatively correlated with serum albumin(ALB) level(r=-0.527,P=0.030; r=-0.503,P=0.039) ,percentage of eosinophilic cells (EOS) ( r=-0.554,P=0.021; r=-0.502,P=0.040).Lymphocytic periportal piecemeal necrosis was positively correlated with alkaline phosp-hatase (ALP),TBIL,DBIL,TBA,and also tumor necrosis factor-αt (TNF-αα) levels(r=0.617,P=0.006).Conclusion TBIL,DBIL,TBA,CHO,IgG and ALB,EOS are good surrogate markers for disease sever ity and reversibility of PBC,while ALP,TNF-Cα,TBIL,DBlL,TBA can be used as markers for disease activity.

Objective To investigate the pathological features of chronic inflammation in prostatic specimens,and study the correlation of chronic prostatic inflammation with prostate cancer and hyperplasia of prostate in the elderly.Methods The histopathologic features of prostatic specimens which were taken during prostatectomy were retrospectively observed.The inflammatory cells in partial cases were labeled by immunohistochemical markers such as CD3,CD20,CD4,CD8,CD117 and CD138,and by inflammation related factors such as nuclear factor(NF)-κB,(COX-2),tumor necrosis factor-α(TNF-α)and inducible nitric oxide synthase (iNOS).Results The chronic prostatic inflammation of different extent were found in 100 patients with prostate cancer and 76 patients with benign prostatic hyperplasia,among them 71 cases (40.3 ％) had mild chronic prostatic inflammation,80 cases (45.5 ％) had moderate chronic prostatic inflammation,25 cases (14.2 ％) had severe chronic prostatic inflammation.Inflammatory cells mainly were CD3-labeled lymphocytes,accompanied by a small amount of mononuclear cells and mast cells.Chronic prostatic inflammation was not correlated with prostatic carcinoma and its differentiation degree,benign prostatic hyperplasia,focal atrophy and its subtypes,and high grade prostatic intraepithelial neoplasia (all P＞ 0.05).There was correlation between chronic prostatic inflammation and expression of COX-2 (P＜ 0.05).Conclusions The histological chronic inflammation is common in the prostate specimens in elderly men.There are no direct correlations of prostatic inflammation with prostatic carcinomas and benign prostatic hyperplasia.Prostatic inflammation is positively correlated with the expression of COX 2,which may be associated with the activation of COX-2 pathway induced by oxidative stress.

The aim of this study was to study the synthesis of two folate conjugates and their application in the preparation of folate targeted liposome, and to investigate their targeting effect in hepatocellular carcinoma HepG2 cell line in vitro. In this study, Folate-PEG-Cholesteryl hemisuccinate(Folate-PEG2000-CHEMS and Folate-PEG4000-CHEMS)were synthesized by linking folate and cholesterol succinate with two kinds of PEG materials. Structures of Folate-PEG2000-CHEMS and Folate-PEG4000-CHEMS were characterized by 1H NMR and ultra-high resolution mass spectrometry. Calcein was selected as the model drug, and calcein liposomes FA-PEG2000-L and FA-PEG4000-L were prepared by film dispersion method using Folate-PEG2000-CHEMS and Folate-PEG4000-CHEMS, respectively. The particle size and Zeta potential of FA-PEG2000-L and FA-PEG4000-L were measured by laser particle size analyzer. The drug delivery effect of FA-PEG2000-L and FA-PEG4000-L was evaluated by cellular uptake experiment in HepG2 cell line in vitro. Flow cytometry and laser confocal scanning microscope were used to determine fluorescence in HepG2 cells in vitro. The results showed that the average particle size of calcein liposome was (205.8 ± 10.2) nm, and the Zeta potential of calcein liposome was -(1.19 ± 0.31) mV.There was no significant difference in particle size and Zeta potential between FA-PEG2000-L and FA-PEG4000-L. The fluorescence intensity of FA-PEG4000-L liposome group was about 3.6 and 3.1 times higher than that of non-targeted liposome group and FA-PEG2000-L liposome group, with statistically significant difference (P < 0.01). The drug delivery efficiency of FA-PEG4000-L group in HepG2 cells was higher than that in FA-PEG2000-L and non-targeted groups, and the results indicated that Folate-PEG4000-CHEMS can promote the uptake of liposome by HepG2 cells in vitro. All in all, Folate-PEG4000-CHEMS could be applied in the preparation of folate targeted liposome, which could promote the uptake of liposome by HepG2 cells.

Objective To compare the differences of prescription pattern, adverse events, economic burden and drug-use adherence between preferred mood stabilizers and preferred antipsychotics in patients with bipolar disorder. Methods We investigated 240 cases of patients with bipolar disorder from 39 mental health institutions in 11 cities in Hebei province. The self-made questionnaire was used to investigate the demographic information, disease characteris-tics, prescription pattern and medical expense. The clinical global impression scale-severity of illness (CGI-SI) was used to assess the disease severity. The treatment emergent symptom scale (TESS) was used to assess the adverse drug reac-tions. The medication adherence rating scale (MARS) was used to assess drug therapy compliance in patients. Results One hundred fifty-two patients (63.3%) used antipsychotics as the first choice (antipsychotics group), 88 patients (36.7%) used mood stabilizers as the first choice (mood stabilizers group). The number of patients in-patient (90.1%vs. 76.1%), patients with psychotic symptom (27.0%vs. 11.4%), incidences of adverse events (46.1%vs. 31.8%), drug daily cost (me-dians 12.00 yuan vs. 8.37 yuan) and drug total cost (medians 344.61 yuan vs. 144.64 yuan) were larger in antipsychotics group than in mood stabilizers group (P<0.05). There was no significant difference between two groups in pattern of pre-scription, severity of adverse events and total scores of MARS (P>0.05). Conclusion The bipolar disorder patients more frequently use antipsychotics as the first choice in Hebei province. The use of antipsychotics does not alter the combina-tion medication pattern. In addition, antipsychotics cause a higher incidence of adverse events and heavier economic bur-den compared with mood stabilizers, suggesting that mood stabilizers should be the first choice to bipolar disorder.

Objective To study the bone turnover and its related molecular mechanism in STZ-induced diabetic rats. Methods Of 30 male SD rats studied, 15 were induced diabetics by intravenous injection of streptozotocin (50 mg/kg)and fed for 8 weeks. After the sacrifice of both the diabetic and control groups, serum Ca, P, alkaline phosphatase (ALP), and osteocalcin were determined, and 24 h urinary Ca and urinary cross-linked N-telopeptide of type Ⅰ collagen (NTx)and creatinine (Cr)ratio were also determined. The left tibia was dissected for bone histomorphometry analysis. Right femur and lumbar vertebrae (L1-L4) were reserved for bone mineral density (BMD) determination. The right tibia was separated for the study of bone tissue RANKL/osteoprotegerin, Core binding factor 1 (Cbfa1) ,osterix and osteocalcin mRNA level which was performed by real-time quantitative reverse transcription polymerase chain reaction assay. Results No significant difference was found in serum Ca, P, and ALP levels between 2 groups of rats. ST-Z-induced diabetic rats were characterized by extreme hyperglycemia, marked weight loss, polyuria, and hypercalciuria. A low-turnover osteopenia was evidenced in diabetic rats by decreased BMD in both femur [(0. 099±0.013) vs (0. 139 ± 0.013 g/cm~3) , P < 0.01] and lumbar vertebrae [(0. 107±0.011)vs (0. 149±0.009) g/cm~3, P<0.01] , reduced serum osteoealcin level [a marker of formation, (3.03±0.52) vs (6. 18±0.71) ng/ml ,P<0. 01]) ,decreased urine NTx/Cr ratio [(5. 67±0.86) vs (5.23±0.98) nmol/g Cr, P<0. 05], decreased trabeeular volume and thickness, and reduced bone label surface and bone formation rate [(0. 44±0. 11) vs (0. 78±0. 14) μm/d,P<0. 01] by bone dynamic study. The RANKL/ osteoprotegerin [(0.57±0.11)vs (0.89±0.13) ,P<0.01] ,osterix [(1.93×10~(-4)±0.65×10(~-4))vs (4.19×10~(-4)± 0.71×10~(-4)) ,P<0.01] ,Cbfa1 [(26.68×10~(-4)±6.53×10~(-4))vs (37.21×10~(-4)±7.14×10~(-4)) ,P<0.01] ,and osteocalcin [(2.25×10~(-4)±1.19×10~(-4))vs (3.43×10~(-4)±1.63×10~(-4)) ,P<0.01] mRNA expressions were declined in the bone tissue of the tibia in the ST-Z-induced diabetic rats, as compared with the control. Conclusion A low-turnover osteopenia is evidenced in STZ-induced diabetic rats by significant decrease of both osteoclastic marker(RANKL/ osteoprotegerin)and osteoblastic marker (osterix ,Cbfa1 ,osteocalcin)mRNA levels in tibia.

Objective To investigate the clinic pathologic features of young patients with renal malignant tumour by comparing with older patients. Methods The clinical data of 83 younger adults(age,≤40 years) with renal cell carcinoma and 703 cases of older renal cell carcinoma (age＞40 years)was analyzed and compared retrospectively. All of the patients were surgically treated between 1986and 2007. Results Among patients with symptoms, younger female patients were more likely to have abdominal pain(12/27, 44.4% vs. 154/703, 21.9%)and mass (2/27, 7.4% vs. 154/703,1.3%)than older (P＜0.05). The older groups were more likely to have dear cell carcinoma than in the younger(501/703, 71.3% vs. 47/83, 56.6%)(P＜0.05). The rate of PRCC has the trends to be higher in young patients than that in older patients (21/83, 25.3% vs. 118/703, 16.8%) (P=0.054),especially in male patients (17/56, 30.4 %) (P=0.011). The rate of MFH and leiomyosarcoma was significantly higher in young patients than that in older patients (6/83, 7.2% vs. 12/703,1.7%) (P＜ 0.05), especially in female patients (4/27,14.8%). Younger male patients were more likely to have a higher incidence of small tumors (T≤4 cm)(24/56,42.9 % vs. 173/703,24.6 % )(P＜0.05)and a lower incidence of big RCC(T＞7 cm) than older patients(12/56,21.4% vs. 295/703,42.0%) (P＜0.05). Conclusion Younger female renal cell carcinoma patients tends to have worseprognosis than older patients, while younger male patients have better prognosis due to different pathology.

Objective To improve the knowledge,diagnostic level on concealed penis in children,and explore the operative treatment methods of concealed penis.Methods Ten children with concealed penis were reviewed retrospectively in the First Hospital of Jilin University from Jun.2005 to Jul.2007.Patients were 6-12 years old.Penis length was 1.2-2.6 cm.Patients growthing and micturition were normal,the results of androgne and estrogen examination were normal.The etiology was simple obesity in one case,fiber streak of penis sarcolemma in 9 cases.The clinical symptoms and signs,diagnosis and operative method were analyzed.Results The diagnosis of 10 children were correct,and all patients were treated by Devine's operation and 10 cases patients had healed in one stage.There was no vessel,nerve and urethra injury during the operation.The length of penis was 3.0-5.5 cm,average in 3.6 cm after operation.Followed up 3 months to 2 years,10 children's phimosis were removed,the micturition were normal;the appearance of penis was also satisfactory after operation.One patient with under-developed penis had a amelioration after treatment with HCG postoperatively.The penis contour was dissatisfactory in 1 obesity patient,but it was ameliorated gradually while growing up.Conclusions The correct diagnosis and differential diagnosis are very important for operative treatment depend on the different etiology and pathologic changes of concealed penis.Suitable operation can extend the length;moreover,ameliorate the symptom of micturition and the appearance of the penis.

Objective:To explore the predictive value of computed tomography (CT) texture analysis for the recurrence in children with acute pancreatitis (AP).Methods:The clinical diagnostic test was conducted. The clinical data of 56 children with primary AP who were admitted to Wuhan Fourth Hospital from January 2016 to January 2018 were collected. There were 13 males and 43 females, aged from 3.5 to 13.0 years, with a median age of 5.5 years. Based on follow-up in other hospitals, 20 children with recurrence of AP were allocated into recurrence group, and 36 children without recurrence were allocated into non-recurrence group. All the 56 children underwent abdomen plain and enhanced CT scan within 24 hours after first admission. Observation indicators: (1) comparison of clinicopathological features between two groups of children with AP. (2) comparison of CT texture parameters between two groups of children with AP. (3) diagnostic efficacy of clinical features and CT texture parameters. Follow-up using outpatient reexamination and telephone interview was conducted to detect recurrence of AP up to February 2020. The duration of follow-up required more than or equal to 24 months. The Shapiro Wilk test was used to analyze normality of measurement data. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M (range) or M ( P25, P75), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U test. Clinical parameters and CT texture parameters with statistical differences were multivariate analyzed using the Logistic regression model. Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive efficacy of parameters for recurrence of AP. Results:(1) Comparison of clinicopatholo-gical features between two groups of children with AP: cases with or without complications were 14 and 6 for the recurrence group, versus 7 and 29 for the non-recurrence group, showing a significant difference between the two groups ( χ2=14.021, P<0.05). Cases with minimal, moderately severe or severe disease (severity of disease) were 2, 5, 13 for the recurrence group, versus 19, 11, 6 for the non-recurrence group, showing a significant difference between the two groups ( Z=5.414, P<0.05). (2) Comparison of CT texture parameters between two groups of children with AP: the energy value in the arterial phase on CT examination was 0.186(0.174,0.206)for the recurrence group and 0.413(0.405,0.425) for the non-recurrence group, showing a significant difference between the two groups ( Z=9.413, P<0.05). The energy value and entropy value in the venous phase on CT examination were 0.084(0.078,0.092) and 0.961(0.210,1.720) for the recurrence group, versus 0.135(0.124,0.156) and 0.372(0.210,0.535) for the non-recurrence group, showing significant differences between the two groups ( Z=4.763, 7.243, P<0.05). (3) Diagnostic efficacy of clinical parameters and CT texture parameters: results of multivariate analysis showed the complications, severity of disease, energy value in the arterial phase on CT examination were related factors for recurrence in children with AP, energy value and entropy value in the venous phase on CT examination were related factor for recurrence in children with AP ( odds ratio=0.874, 0.765, 0.837, 0.902, 0.813, 95% confidence interval as 0.802?0.985, 0.581?0.914, 0.753?0.897, 0.862?0.948, 0.765?0.873, P<0.05). Results of ROC analysis showed that that areas under curve (AUC) of complications, severity of disease in the clinical parameters were 0.734 and 0.832, the AUC of single CT texture parameter was 0.811?0.867, the AUC of clinico-pathological parameters combined with CT texture parameters was 0.882. Conclusion:CT texture analysis can early and non-invasively predict the recurrence of AP in children, and the combination of clinicopathological parameters with CT texture parameter has a better predictive efficacy.

Objective To analyze risk factors in order to predict the in-hospital mortality of patients with se-vere acute pancreatitis (SAP), especially the factor of total cholesterol. Method Factors for predicting in-hospi-tal mortality were evaluated retrospectively from the clinical data collected from 338 SAP patients of Tianjin Nankai Hospital between January 1999 and December 2008 according to the Guidelines for for clinical diagnosis and classi-fication of Acute Panereatitis set by the Society of Chinese Medical Association in 2003. The patients were treated with intensive care, blood routine examination, blood biochemical test and even computed tomography within 24 hours after admission. The patients were divided as per outcome into deceased and survivor group. All patients were admitted within 72 hours after the onset of symptoms. The Off-square test was used for univariate analysis and multivariate test was performed by logistic regression. Results Compared with TC≤3.67 mmol/L, when the TC was between 3.67 -4.37 mmol/L, OR was 0.664 (P = 0.412), while TC was between 4.37 mmol/L and 5.23 mmol/L, OR was 0.144 (P =0.021).The OR was 1.013 (P =0.018) when TC was ≥5.23 mmol/L. The variation of serum TC levels was accompanied with the changes of C-reactive protein (CRP). When the CRP was ≥170 mg/L, OR was 7.074 (P =0.031). When the serum ALB≤30 g/L, OR was 7.224 (P =0.029).Conclusions The CRP, ALB, TC can be used for early predicting the in-hospital mortality of SAP patients. TC is a protective factor when it was between 4.37 mmol/L and 5.23 mmol/L, while it is a risk factor when ≥5.23 mmol/L or≤3.67 mmol/L. CRP> 170 mg/L or ALB < 30 g/L increases the probability of fatal outcome. Low level of albumin is a stronger predictor than the high level of CRP. Moderate elevation of TC level seems to in-crease the resistance to inflammation and hence improving the survival rate of patients with SAP and reducing the in-hospital mortality.