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.

Objective To compare the clinical response with etoricoxib 60 mg once daily with diclofenac sodium tablet 75 mg two times daily in the treatment of osteoarthritis of the knee or hip joint.Methods A 4-week multicenter,randomized,double-blinded and active comparator-controlled clinical trial was performed during January 2005 and June 2005 in 6 medical centers in China.Eligible patients (≥40 years old Chinese patients with osteoarthritis of the knee and hip) were randomized (1:1 ratio) to receive etoricoxib 60 mg once daily (n=90),or diclofenac sodium 75 mg twice daily (n=90).Primary efficacy end point is the change of WOMAC (Western Ontario and McMaster Universities osteoarthritis index) pain subscale from baseline to 4 weeks; non-inferiority bounds were pre-defined [if the upper bound of 95％ confidence interval (CI) for the difference is less than 10 mm on a 100-mm VAS WOMAC pain subscale] for the comparison of the change between the two groups.The secondary efficacy endpoints include WOMAC physical function subscale,WOMAC stiffness subscale,patient's global assessment of response to therapy (PGART),investigator's global assessment of disease status (IGADS),discontinuation due to lack of efficacy and rescue paracetamol tablet count.Safety was assessed by physical examination,adverse experience reported,and laboratory safety data.Results C6mpared to baseline,the changes of WOMAC pain subscale after 4 weeks treatment were statistically significant (P＜0.01) in both groups (etoricoxib group:51±16 vs 21± 19; diclofenac sodium group:53±16 vs 22±19).There was no difference in the change of WOMAC pain subscale between the two groups.The change in WOMAC stiffness subscale,WOMAC physical function subscale,PGART and IGADS in both groups were statistically significant (P＜0.01),but there was no difference between treatment groups according to the pre-defined non-inferiority criteria.No drug related serious adverse events were observed during the study.The difference in drug-related adverse event incidence between the two groups was not statistically significant.Etoricoxib and diclofenac sodium were generally safe and well tolerated.Conclusion Etoricoxib 60 mg administered once daily is efficacious and shows clinical efficacy notinferior to that of diclofenac sodium 75 mg administered twice daily for the treatment of osteoarthritis.Etoricoxib 60 mg administered once daily for 4 weeks is generally safe and well tolerated.

Vinflunine tartrate-loaded liposomes (VT-L) with two drug-to-lipid ratios were prepared by pH gradient method. Vesicle size and zeta potential were determined by the Zetasizer Nano ZS. Entrapment efficiency was evaluated by cation exchange resin centrifugalization method. The toxicity and tumor inhibition to nude mouse administrated by VT-L with different drug-to-lipid ratios were investigated and compared with the vinflunine tartrate injection (VT-I). The results showed that the mean particle size, zeta potential and entrapment efficiency of the VT-L with drug-to-lipid ratios of 1 : 5 and 1 : 10 were 124.6 nm and 128.3 nm, -25.3 mV and -22.8 mV, 94.46% and 97.31%, respectively. The VT-L with two different drug-to-lipid ratios has significantly higher anti-tumor effect to nude mouse transplanted human non-small cell lung carcinoma A549 and lower toxicity than VT-I. While there were no significant differences in anti-tumor effect and toxicity between VT-L with two different drug-to-lipid ratios.

Objective To compare the ventilatory effects between three-way laryngeal mask airway (TLMA)and tracheal catheter (TC) on hemodynamics, respiratory function and stress responses on patients during bronchoalveolar lavage (BAL). Method Forty patients scheduled for BAL under general anesthesia were divided (stratified sampling) into either TLMA group (group T,n = 20) or TC group (group C, n = 20) according to the stratified sampling principle. SpO2, SBP, DBP and HR were measured in 5 min after entering the operating theater (To), just before inserting TLMA or TC(T1), immediately after inserting TLMA or TC(T2) ,3 min(T3), 5 min(T4), 10 min(T5)after mechanical ventilation, 10 min(T6),20 min(T7), 30 min(T8)during the course of BAL,immediately after extubating TLMA or TC (T9)and 3 min after extubating TLMA or TC (T10). The tidal volume (VT), peak inspiratory airway pressure (Ppeak) and end expiratory CO2 pressure(PETCO2)were recorded at T2,T4,T6,T7, T8, T10. The venous blood samples were taken at T0, T2, T3, T4, T6, T9, T10 for the measurements of epinephrine(AE), norepinephrine(NE)and dopamine (DA) levels with high performance liquid chromatography.Data were dealt with SPSS version 10.0 statistic software. The variables of hemodynamics and stress responses were analyzed with ANOVA of repeating test data. P ＜ 0.05 means the difference in statistical significance. Results In group C, SBP, DBP and HR were significantly higher than those in group T at T2 ,T3 ,T9 (P ＜ 0.05). In group C, the levels of Ppeak were significantly higher than those in group T at T6 ,T7 ,T8 (P ＜ 0.05), and the concentrations of AE, NE and DA were also significantly higher in group C than those in group T at T2, T3 and T9 (P ＜0.05). Conclusions Ventilation with TLMA in patients during BAL is better than TC in respects of keeping stable ventilation, stable hemodynamics and producing less stress responses.