OBJECTIVE: To explore a new hospital pharmacy management mode. METHODS: The tradition pharmacy management model undergone reformation by integrating the original outpatient pharmacy, out - patient traditional Chinese pharmacy (excluding cut crude drug section) and inpatient pharmacy into one general pharmacy. RESULTS: The operation of general pharmacy not only reduced the personnel, the storing space and the stock of drugs, but also simplified the management flow - sheet. CONCLUSION: Under permitted condition, hospitals might take into account general pharmacy management mode.

The expression of cancer gene products of insuline-like growth factor Ⅱ (IGF-Ⅱ),IGF-Ⅱ receptors (IGF-Ⅱ-R),and colony-stimulating factor 1 receptors (CSF-1-R) /c-fms in 17 cases of human primary hepatic cancer,the non-cancerous liver tissue adjacent to the cancer,and normal liver tissue was studied with immunocytochemistry (ABC),Western blot and Northern blot techniques.It was found that the expression of IGF-Ⅱ,IGF-Ⅱ-R and CSF-1-R was significantly higher in the cancers than in normal liver tissues,and the expression of IGF-Ⅱ and IGF-Ⅱ-R was higher in the non-cancerous liver tissues than in the cancers.It was noteworthy that the expression of IGF-Ⅱ in both the cancerous and non-cancerous hepatic tissues was characterized by its fetal type.However the expression of CSF-1-R was distinctly higher in the cancers than in the non-cancerous hepatic tissue.These findings,the authors believe,imply that the aberrant overexpression of IGF-Ⅱ,IGF-Ⅱ-R and CSF-l-R might be related to the mechanism of auto-crine-stimulated growtth of the cells of human primary hepatic cancer.

Objective To study the generation of metallo-β-lactamase(MBLs) and its related gene carrying situation in the clini-cal isolates of Pseudomonas aeruginosa .Methods Ceftazidime and imipenem were adopted to preliminarily screen MBLs of Pseudo-monas aeruginosa .The phenotypic confirmatory of imipenem-resistant and ceftazidime-resistant Pseudomonas aeruginosa was per-formed by using 2-mercaptopropionic acid (2-MPA) or EDTA synergy test and the MBLs genotypes of the positive strains in the preliminary screen were detected by PCR .Results The positive rate of the MBLs preliminary screen test in multi-resistant strains was 10 .9% ,and the positive rate of the MBLs in multi-resistant strains detected by CAZ/EDTA ,CAZ/2-MPA ,IMP/EDTA and IMP/2-MPA was 7 .5% ,7 .9% ,8 .8% and 9 .5% respectively .The positive rates of ipm1 and vim gene by PCR were 10 .4% and 8 .3% respectively .The strains with positive spm ,sim1 and gim were not found .Conclusion The MBLs test results detected by different methods are different ;MBLs genes carying ipm1 and vim are the main reason for carbapenem-resistant multi-drug resist-ant Pseudomonas aeruginosa in the hospital .

Objective To ascertain the significance of qualitative and quantitative detections of urine neutrophil gelatinase-associ-ated lipocalin(NGAL)in the early diagnosis of diabetic nephropathy.Methods 74 patients with diabetes mellitus were divided into the normoalbuminuria group[(DN1 ,n =26,urinary albumin excretion rate(UAER)<30 mg/24 h],the microalbuminuria group (DN2 ,n=24,UAER 30-300 mg/24 h)and the macroalbuminuria group(DN3 ,n=24,UAER>300 mg/24 h)according to the 24 h UAER,and at the same time the control group(n=25)was set up.Both the activity and levels of urine NGAL in the above groups were examined and compared.Results The activity band of urine NGAL in each group were more distinct than that of the control group(P =0.000).The NGAL activity in the macroalbuminuria group was higher than that in the normoalbuminuria group(P <0.05).No difference in the NGAL activity was found between the micro-and normal-albuminuria groups(P >0.05);the quantitative detection demonstrated that differences of the NGAL content existing between the macroalbuminuria group and the other three groups had statistical significance(P =0.000),the urinary NGAL excretion in the macroalbuminuria group was higher than that in the microalbuminuria group,normoalbuminuria group and the control group(P =0.000);No differences were found between the control group and the normoalbuminuria group and between the control group and the microalbuminuria group(P >0.05).Conclu-sion For the patients with diabetic nephropathy,the activity detection of urine NGAL is more sensitive than UAER and the NGAL quantitative detection and could become a new type index in the early diagnosis of diabetic nephropathy.

Objective To investigate CT and MRI features of giant cell tumor of the skull.Methods CT and MRI features of 5 patients with giant cell tumor of the skull with histopathologically confirmed were analyzed retrospectively.Plain CT scanning was performed in all 5 patients.Plain MRI,contrast-enhanced MRI and HRCT scanning with facial nerve and auditory ossicle chain computer reconstruction were performed in 3 patients with giant cell tumor of temporal bone.Results Tumor occured unilateral in all cases,4 cases on the right side,1 case on the left side.CT scan showed a wide range of expanding destruction without sclerotic border,residual bone septum and bone cladding, On MRI, tumor signal variable;tumor appeared hypo-isointense on T1WI and heterogeneous hyperintense with hypointense rim on T2WI.CE-MRI: solid part of tumor show heterogeneous enhancement.Conclusion CT features of giant cell tumors of the skull was wide range of expanding destruction, residual bone septum and bone cladding.On T2WI, low signal in the rim of tumor was the disease characteristic imaging finding;Auditory ossicle chain and facial nerve CPR reconstruction made prepare for preoperative evaluation of otosteon and facial nerve,to provide more accurate image information for clinical treatment strategies.

Objective To evaluate the clinical efficacy of mini-invasive multichannel drainage in the treatment of hypertensive cerebral hemorrhage combined with severe ventricular hemorrhage. Methods The clinical data of 76 patients with hypertensive cerebral hemorrhage combined with severe ventricular hemorrhage were analyzed. They were divided into observation group and control group by random digits table method with 38 cases each. The patients in observation group were performed intracranial hematoma catheterized drainage combined with ventricle drainage under CT positioning, and the patients in control group were performed small bone window craniotomy combined with ventricle drainage. The conditions related to surgery and prognosis were compared between 2 groups. Results The operation time, blood loss and hospital stay in observation group were (46.2 ± 25.2) min, (35.4 ± 18.1) ml and (15.2 ± 2.5) d, and those in control group were (108.5±32.5) min, (112.5 ± 35.2) ml and (18.5 ± 3.2) d, there were statistical differences between 2 groups (P<0.01). Two cases died perioperatively in each group. The Glasgow outcome score (GOS) 1 month after operative in observation:9 patients were 5 scores, 19 patients were 4 scores, and the rate of better prognosis was 73.68%(28/38);in control group: 8 patients were 5 scores, 18 patients were 4 scores, and the rate of better prognosis was 68.42% (26/38). There was no statistical difference between 2 groups (χ2 = 0.256, P = 0.613). Conclusions Mini-invasive multichannel drainage is a safe and effective method for hypertensive cerebral hemorrhage combined with severe ventricular hemorrhage, and has the minimal invision.

Objective To analyze age-related changes in fractional anisotropy(FA) in sub-regions of corpus callosum on diffusion tensor imaging(DTI).Methods DTI was obtained from 171 healthy individuals(80 men,91 women; age 12 to 73 years; median age 44 years).All the subjects were stratified into the following seven age groups(10-19,20-29,30-39,40-49,50-59,60-69,70-79 years).Corpus callosum was divided into 5 subregions(Ⅰ-Ⅴ region).DTI FA values of sub-regions of corpus callosum were measured.Mean FA values changes in corpus callosum sub-regions with advancing age were evaluated with hierarchical polynomial regression analyses.Results The mean FA value in the Ⅴ region was the highest within the same age group.The corresponding values from group 1 to 7 were 0.77±0.06,0.80±0.03,0.79±0.03,0.79±0.03,0.78±0.03,0.77±0.03,0.77±0.03,respectively.The mean FA value in the Ⅲ region was the lowest within the same age group.The corresponding values from group 1 to 7 were 0.51 ±0.08,0.59± 0.06,0.59±0.06,0.56±0.07,0.55±0.07,0.52±0.07,0.43±0.07,respectively.The change of FA values in subregions of the corpus callosum on DTI followed an inverted U-shaped curve with advancing age(ROI1-ROI5,R2=0.162,0.214,0.164,0.098,0.070,respectively,all P＜0.05).FA peak appeared at 20 to 30 years old in all regions.Conclusions The study demonstrated age-related changes in FA value in sub-regions of the corpus callosum on DTI as following a curve,reflecting the age-related changes of physiological processes,which could serve as a basis for corpus callosum research.

This study was aimed to establish a HPLC method for the determination of isogarcinol. Daojin Inertsil WP300 C18 (4.6 mm× 150 mm, 5μm) was employed with methanol and water (75?25) as the mobile phase. The flow rate was 1.0 mL·min-1. The column temperature was set at 40°C. The detection wavelengthγ was set at 277 nm. The results showed that the linear range of isogarcinol was 0.005 7-0.039 9μg. The average recovery rate was 99.58%. The relative standard deviation (RSD) was 1.25%. The contents of isogarcinol inGarcinia mangostana,Garcinia oblongifolia,Garcinia oligantha,Cratoxylum cochinchinense andCalophyllum membranaceum were 0.285%, 0.199%, 0.857%, 0.161% and 0.006%, respectively. Isogarcinol was not detected inCratoxylum formosum orCalophyllum inophyllum. It was concluded that the method was convenient, accurate with high sensitivity, good stability and repeatability. It can be used for determination of isogarcinol content in Chinese herbal medicine.

Objective To investigate the relationship between abnormal metabolism of aggrecan and joint destruction in patients with rheumatoid arthritis (RA).Methods 140 RA patients with duration less than 24 months were enrolled into this study.The study also included 100 normal controls and 95 patients with other rheumatic diseases.Three monoclonal antibodies (5D4,7D4 and BC-3) of aggrecan were used to detected aggrecan catabolic fragments in serum of RA patients and the other two groups of controls by enzyme linked immunosorbent assay (ELISA),and the correlation of aggrecan catabolic fragments with joint damage were analyzed.Sharp evaluation of hand joints in RA patients were performed at baseline and after one year follow-up.Calculating the area under the receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity of aggrecan catabolic fragments detected in serum of RA patients.Results Both levels of 5D4 fragment and BC-3 fragment of RA group were higher than those of normal control [5D4 of RA:(5.8±2.1) ng/μl,normal control:(2.2±1.3) ng/μl;BC-3 of RA:(11.1±3.4) ng/μl,normal control:(5.0±2.1) ng/μl,F=38.65,24.07,P＜0.001).There was no difference in 7D4 fragment among three groups (F=0.589,P=0.478).Both two fragment levels of RA patients with anti-CCP positive were greater than those patients with anti-CCP negative [5D4:(5.6±1.3) ng/μl vs (4.4±1.1) ng/μl,F=21.23,P＜0.01;BC-3:(12.2±3.9) ng/μl vs (9.3±2.8) ng/μ1,F=27.14,P＜0.01].Linear Regression showed that serum fragments detected by 5D4 and BC-3,and anti-CCP positive were risk factors for Sharp deterioration after one year follow-up.The sensitivity and specificity of combined detection of two aggrecan fragments in serum of RA patients for the prediction of joint Sharp were 56.5％ and 84.2％ respectively.Positive predictive value and negative predictive value are 74.3％ and 70.6％.respectively.Application of areas of ROC to identify the best evaluation of Sharp was 0.798.Conclusion There is positive correlation between aggrecan catabolic fragments in serum and joint Sharp evaluation of RA patients.Detection of aggrecan catabolic fragments in RA patients may predict early joint destruction.

Objective To study the Diagnosis and treatment of thyroglossal duct cyst or fistula. Methods The clinical data of 67 patients with thyroglossal duct cyst or fistula treated by surgery were analyzed retrospectively. Results The diagnosis rate preoperatively was 92.5% and the accuracy diagnosis rate by B type ultrasonography was 96.1%; all cases were treated by operation, of them, 14 cases underwent simple cyst resection, 12 with resection of partial periosteum of hyoid and 41 with resection of middle segment of hyoid( Sistrunk's operation ). 54 cases were followed up, recurrence in cases with cyst was 4 of 43 (9.3%) and recurrence in cases with fistula was 2 of 11(18.2%)respectively. Conclusion Ultrasonography shows certain characteristics and clinical value to diagnose and distinguish thyroglossal duct cyst. Postoperative recurrence is due to the selection of operation procedures and control of infection of focus. The Sistrunk's operation properly performed previou to cyst infection should reduce recurrence rate markedly.