OBJECTIVE:To promote the drug use in a legal way.METHODS:The legal issues were analyzed,which included standardization of specially administrated drugs,exchange or replacement of prescribed drugs,usage and dosage of prescribed drugs,informed consent of patients,etc.RESULTS&CONCLUSION:There still exist problems in clinical drug use,the relevant laws and regulations should be further standardized and identified.

As an important component of the social system, physician-patient relationship plays a guiding and fundamental role in creating a harmonious healthcare environment. However, due to certain social, ethical and moral factors, the current physician-patient relationship is not favorable, and various contradictions in physician-patient relationship are becoming barriers in building up a harmonious society. In order to enable medicine return to its "merciful" nature, restitute the respect for patients, the dignity of doctors, find the memorable warmth in the medical service world, hospitals must pay close attention to humanistic care in the management dimension in order to establish a harmonious relationship between doctors and patients.

Objective:To investigate the relation of counselors'and therapists'interpersonal personality on the ethical behavior of dual relationship.Methods:Totally 177 practitioners (21-65 years old) were investigated with 4 interpersonal personality subscales of the Chinese Personality Inventory (CPAI) and the Questionnaire of the attitude of counselors to the ethical behavior of dual relationship.Results:There were no differences of 4 dimension of interpersonal personality on the 6 items of professional relationship between higher and lower groups (Ps ＞ 0.05),but on the other 5 types of dual relations respectively,there were 6 (9％),10 (15％),12 (18％) and 21 items'(32％) score showing statistically difference (Ps ＜ 0.05).Furthermore,more items had score difference on social relationship.Conclusion:It suggests that the counselors'and therapists'interpersonal personality may be related to the ethical behavior in dual relationship.

Objective To study the effect of estrogen on myocardial injury in hypothyroidism rats and to reveal the pathology of occurrence and development of the myocardial injury in hypothyroidism rats.Methods The model of hypothyroidism rats was established by feeding propylthiouracil.The pathology of the female group ( n =40 ) and male group ( n =40 ) was observed dynamicly.The presence of myocardial apoptosis cell was demonstrated by the method of terminal deoxynucleotidyl transferase mediated dTUP nick end labeling (TUNEL).And the immunohistochemistry was used to determine the expression of Caspase-3 and Bcl-2 in the myocardial cells.Results The myocardial cell apoptosis appeared in hypothyroidism rats.With the development of the disease,the apoptosis myocardial cell was increased progressively (Female rats group:the numbers of myocardial cell apoptosis at 3,6,8,10,and 12 weeks were 16.40 ± 2.62,29.50 ± 2.67,34.50 ± 3.34,42.70 ±3.24,and 56.00 ± 2.90 respectively,P ＜ 0.05 ; Male rats group:the numbers of myocardial cell apoptosis at 3,6,8,10,and 12 week were 21.60 ± 2.67,35.50 ± 2.94,41.70 ± 2.96,46.70 ± 3.11,and 60.70 ± 3.31respectively,P ＜ 0.05 ),which indicated that estrogen may be related to myocardial cell apoptosis.Conclusion The myocardial cell apoptosis is related with the myocardial injury in hypothyroidism rats.Myocardial cell apoptosis may result in the myocardial injury.The estrogen participates in regulating apoptosis,but its function gradually weakens with the development of the hypothyroidism.

Objective To evaluate the effects of sevoflurane preconditioning on zonula occludens-1 (ZO-1) during myocardial ischemia-reperfusion (I/R) in rats in vitro.Methods Adult male Wistar rats,weighing 250-300 g,were anesthetized with intraperitoneal pentobarbital 30 mg/kg and heparinized.Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃.Eighteen isolated rat hearts were randomly assigned into 3 groups (n =6 each) using a random number table:control group (group C),group I/R and sevoflurane preconditioning group (group S).At 10 min of equilibration,the hearts were perfused with K-H solution for 110 min in group C,the hearts were perfused with K-H solution for 20 min,and then subjected to 30 min of ischemia followed by 60 min of reperfusion in group I/R,and the hearts were perfused with K-H solution saturated with 3％ sevoflurane for 15 min followed by 5 min washout,and then subjected to 30 min of ischemia followed by 60 min of reperfusion in group S.At the end of equilibration,immediately before ischemia,and at 15 and 60 min of reperfusion (T1,2),HR,left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP),+ dp/dtmax and-dp/dtmax were recorded.The development of arrhythmias was recorded during reperfusion and scored.At 60 min of reperfusion,myocardial specimens were obtained from the apex of heart for determination of the expression of ZO-1 in myocardial tissues (by Western blot) and for observation of distribution of ZO-1 and connexin43 (Cx43) (by immunofluorescence).Results Compared with group C,HR,LVDP,+ dp/dtmax and-dp/dtmax were significantly decreased and LVEDP was increased at 15 and 60 min of reperfusion,scores of arrhythmia was increased,and ZO-1 expression was down-regulated in I/R group.Compared with group I/R,HR,LVDP,+ dp/dtmax and-dp/dtmax were significantly increased and LVEDP was decreased at 15 and 60 min of reperfusion,arrhythmia was decreased,and ZO-1 expression was up-regulated in group S.ZO-1 and Cx43 were co-localized at the intercalated disk.ZO-1 was redistributed in the lateralization of the membrane and co-localized with Cx43 in group I/R.The incidence of ZO-1 lateralization was significantly decreased in group S.Conclusion The mechanism by which sevoflurane preconditioning decreases reperfusion arrhythmia is related to inhibition of down-regulation of expression and redistribution of ZO-1 and inhibition of redistribution of Cx43 in rats.

Objective To evaluate the effects of sevoflurane preconditioning on wnt/glycogen synthase kinase-3 beta (GSK-3β)/β-catenin signaling pathway during myocardial ischemia-reperfusion (I/R) injury in rats in vitro.Methods Ault male Wistar rats,weighing 220-280 g,were heparinized and anesthetized with intraperitoneal 3％ pentobarbital 30 mg/kg.Their hearts were rapidly excised and perfused in a langendorff apparatus with oxygenated (95％ O2-5％ CO2) K-H solution at 37 ℃.After 15 min of equilibration,36 isolated hearts were randomly divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),group I/R and sevoflurane preconditioning group (group SP).After 30 min of equilibration,the hearts were continuously perfused for 150 min in group S.The isolated hearts were subjected to 30 min of ischemia followed by 120 min of reperfusion.In SP group,the hearts were perfused for 15 min with K-H solution containing 2.4％ sevoflurane,followed by 5 min washout before reperfusion.At the end of equilibration and 30 min of reperfusion,HR,left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP) and ± dp/dtmax were recorded.The severity of arrhythmias was assessed during reperfusion.At 60 min of reperfusion,3 hearts in each group were chosen for measurement of expression of wnt3a,phosphor-GSK-3β (p-GSK-3β) and β-catenin (by Western blot).At 120 min of reperfusion,6 hearts in each group were chosen for determination of myocardial infarct size by TTC staining.Results Compared with group S,HR,LVDP,+dp/dtmax and -dp/dtmax were significantly decreased,and LVEDP was increased at 30 min of reperfusion,arrhythmia scores and the percentage of myocardial infarct size were increased,and the expression of wnt3a,p-GSK-3β and β-catenin was down-regulated in I/R group.Compared with group I/R,HR,LVDP,+dp/dtmax and-dp/dtmax were significantly increased,and LVEDP was decreased at 30 min of reperfusion,arrhythmia scores and the percentage of myocardial infarct size were decreased,and the expression of wnt3a,p-GSK-3β and β-catenin was up-regulated in group SP.Conclusion Sevoflurane preconditioning attenuates myocardial I/R injury by activating wnt/GSK-3β/β-catenin signaling pathway in isolated rat hearts.

Objective The differential diagnosis of female precocious puberty (PP) and premature breast development (PT) was made by ultrasound and related hormone levels,so as to provide the basis for clinical diagnosis.Methods In this study,from 2015 to 2016 due to early breast enlargement (age ＜ 8 years) to our hospital pediatric patients with children,according to the diagnostic criteria were divided into PP group and PT group.Ultrasonography was performed on all patients and graded according to the criteria.At the same time,the levels of clinical and hormones were compared between the two groups.ROC analysis was used to identify the significant differences.Results In this study,a total of 60 cases of female children,including PP and PT children were 30 cases.Ultrasonic breast grading was positively correlated with age,BA,BD,LH level,FSH level and E2 level,but there was no correlation between BA/CA.There was no statistical difference between the breast ultrasound and the breast diameter (P ＜ 0.05).The levels of LH and FSH,basal LH/ FSH,LF and FSH peak and LH/FSH peak in the PP group were significantly higher than those in the PT group (P ＜ 0.05).The ROC analysis found 100％ sensitivity and 85％ specificity for LH/FSH peak ＞0.25 for diagnosis of PP,with a 72％ sensitivity and a specificity of 65％ for basal LH ＞ 0.1 mIU/ml.The SHBG level was the only one that did not overlap [PP:80.6 (62.3-95.4) vs PT:114.5 (107.6-121.5)].There was no significant difference in kisspeptin,leptin and neurokinin B between the two groups (P ＞ 0.05).Conclusion Breast ultrasound by grading and measurement of breast buds can be effective in evaluating the development of female precocious puberty breast development,but can not identify PP and PT.The study found that SHBG concentration and peak ratio of LH/FSH can effectively identify PP and PT,but kisspeptin,neurokinin B and leptin is not enough to identify PP and PT.

Objective This research examined the effect ofmicrobubble contrast agent plus ultrasound on the permeability of blood-brain barrier,and explored whether it affects the efficacy of chemotherapeutic drugs on cerebral glioblastoma.Methods Wistar rats were divided into three groups to find the optimal concentration of ultrasonic contrast agent.To identify the best ultrasound mode that affected the permeability of blood brain barrier,we employed transmission electron microscopy for study of brain ultrastructure.Western blotting was used to detect the tight junction protein claudin-5.Evans blue staining of brain tissues was utilized to identify the best ultrasonic contrast agent concentration and mode.Rat glioma cells (line 9L) were injected into Wistar rats.After temozolomide chemotherapy,the tumor size was measured and the tumor marker GFAP in serum was detected by ELISA.Results The best contrast agent concentration which increases permeability of BBB in rats was found to be lml/kg and the best ultrasound mode was intermittentlytriggered pulses lasting for 10min (with interval was set at 400ms).More Evans blue passed the blood-brain barrier in ultrasonic cavitation effect group than in control group (P＜0.05).After temozolomide chemotherapy,more tumor marker GFAP was detected in ultrasonic cavitation effect group than in control group (P＜0.05).Conclusion The permeability of BBB was increased and more temozolomide went through BBB when the rats were subjected to intermittently triggered ultrasonic pulses and were injected at contrast agent at lml/kg,which could help to achieve better therapeutic efficacy for glioblastoma.

OBJECTIVE:To provide reference for improving pharmaceutical care in the hospital. METHODS:A total of 712 clinical pharmacists were selected from 38 third grade class A hospitals in 17 provinces and cities by convenient sampling to investi-gate the ability of pharmacectical care and influantial factors. Single and multiple factor Logistic regression analysis were conducted for the results. RESULTS:The single factor analysis showed that there was significant difference in the communication between clinical pharmacists and patients or medical staffs,the listening attitude of the patients,attitude towards job prospects,understand-ing about the connotation of clinical pharmacy,the timeliness of drug supply,smoothness degree of channel,the timeliness of coordi-nation,smooth development of pharmaceutical care(P<0.05). The multiple factor analysis showed that due to good communication with the doctor [OR=1.819,95%CI(1.469,2.253)],pharmacists could understand definition and connotation of pharmaceutical care [OR=2.263,95%CI(1.722,2.973)],and the male pharmacists [OR=0.558,95%CI(0.382,0.813)] with positive attitude to the pharmacists [OR=1.506,95%CI(1.309,1.733)] believed to provide good pharmaceutical care. CONCLUSIONS:This investigation can reflect the present situation of hospital pharmaceutical service in China to a certain extent. It is suggested to improve pharmaceuti-cal care ability of pharmacists through strengthening resource disposition and the cooperation between physicians and pharmacist.

Objective To investigate the expression of chemokine ligand 2 (CCL2)in chronic uric acid nephropathy(CUAN)and its diagnostic values in kidney damage.Methods 29 patients with CUAN[male 23,female 6,age (44.4 ±8.8)years old ]and 35 health individuals[male 27,female 8,age (40.6 ±7.8 )years old ]were involved in this study.Serum and peripheral blood mononuclear cells were isolated from peripheral blood.CCL2 was assayed by ELISA,and CD +45 /CD +14 monocytes were analyzed by flow cytometry.Liver &kidney functions,lipids and glucose were detected by automatic biochemistry analyzer.Results Serum CCL2 in group of CUAN and health con-trols were 456.2(202.6 -594.9)pg/mL and 245.0(132.2 -544.5)pg/mL,respectively(F =4.915,P =0.030). Percentages of monocytes in each group were 7.4%(5.6% -8.7%)and 6.1%(4.7% -7.9%),(F =8.891,P =0.004).Pearson analysis found that levels of CCL2 positively correlated with percentages of monocytes,serum uric acid and creatinine in CUAN group(r values were 0.535,0.584 and 0.012;P values were 0.003,0.001 and 0.012, respectively),but there was no correlation with urea and retinol binding protein(r value were 0.145 and 0.746,P val-ues were 0.453 and 0.453).Conclusion Hyperuricaemia may directly contribute to elevate levels of CCL2 and facilitate monocytes release into inflammation part to induce kidney damage.