Objective To investigate the relationship between gastroesophageal flap valve (GEFV) and reflux esophagitis(RE).Methods We analyzed 239 cases of RE diagnosed by endoscopy in our hospital from January 2007 to December 2009.RE was classified by Los Angeles classification system and GEFV by Hill system.The association of GEFV with RE was analyzed.Results The overall incidence of abnormal GEFV was32.9% (316/960) and that of RE was 24.9% (239/960).The incidence of severe RE ( grade C and D) in abnormal GEFV group was significantly higher than that in normal GEFV group (23.1% vs.2.4% , P = 0.000).RE grades were positively correlated with GEFV grades (r = 0.308, P = 0.000 ).The incidence of abnormal GEFV in RE patients was higher than that in non-RE (65.3% vs.22.2% ,P = 0.00 ).In terms of gender, there were more males than females in both RE group (63.6% vs.36.4% ) and abnormal GEFV group (60.1% vs.39.9% ).Additionally, incidence of RE increased with age, i.e.positively correlated with age (r=0.214,P =0.000).The incidence of abnormal GEFV also increased significantly in those over 30 years old, i.e.positively correlated ( r = 0.129, P = 0.000).Conclusion There is correlation between GEFV abnormality and RE.GEFV provides useful information for assessment and prediction of the reflux status of the patients.

Objective: To study correlation among serum levels of lipoprotein a[Lp(a)], uric acid (UA) and cardiac function in patients with acute myocardial infarction (AMI) complicated diabetes mellitus (DM).Methods: A total of 70 AMI+DM patients were enrolled as AMI+DM group, 60 pure AMI patients were enrolled as pure AMI group, 60 pure DM patients were enrolled as pure DM group, and 60 healthy people were selected as healthy control group.According to NYHA cardiac function class, AMI+DM patients were divided into class I~II group (n=58) and class III~IV group (n=12);according to their prognosis, they were divided into no cardiovascular event group (n=54) and cardiovascular event group (n=16).Serum Lp(a) and UA levels were measured in all group, and their correlation were analyzed.Results: Serum Lp(a) and UA levels of AMI+DM group were significantly higher than those of healthy control group, pure AMI group and pure DM group, and those of pure AMI group and pure DM group were significantly higher than those of healthy control group, P<0.01 all;Pearson compared with class I~II group, there were significant rise in serum levels of Lp(a)[(183.28±19.96) mg/L vs.(335.65±22.71) mg/L]、UA[(287.45±21.82) μmol/L vs.(437.79±26.72) μmol/L]in class III~IV group (P<0.01 both);compared with no cardiovascular event group, there were significant rise in serum levels of Lp(a)[(220.75±25.72) mg/L vs.(423.97±30.81) mg/L]and UA[(308.49±21.82) μmol/L vs.(442.97±29.75)μmol/L]in cardiovascular event group, P<0.01 both;Pearson correlation analysis indicated that serum Lp(a), UA levels were significant positively correlated with cardiac function class (r=0.410, 0.412, P<0.05 both), and serum Lp(a) level was significant positively correlated with UA level (r=0.496, P=0.023) in AMI+DM patients.Conclusion: Serum Lp(a), UA levels are closely correlated with cardiac function in AMI+DM patients, which can be used as indexes diagnosing and monitoring disease progress.

Objective To diagnose limb-girdle muscular dystrophy type 2A(LGMD2A)using Western blot with micro-sample.nethods Skeletal muscle specimens of 73 cases of progressive muscular dystrophy with prominent proximal muscle involvement were obtained by open biopsy,and underwent histochemical,immunohistochemical stains with anti-dystrophin-N,C,R,α,β,γ,δ-sarcoglycan,dysferlin,caveolin-3 monoclonal antibodies.Twenty-nine cases were excluded with deficiency of dystrophin,sarcoglycans,dysferlin and caveolin-3,then Western blot and immunoreaction were performed with anti-calpain-3,caveolin-3 monoclonal antibodies.Results Ten cases with LGMD2A were diagnosed,all presenting muscle weakness of the proximal limb and elevated creatine kinase in vacant levels.and electromyography showed myogenic change.Histochemical stains showed variation in fiber size,different extent of degeneration,regeneration and necrosis,increased connective tissue elements,while lobulated fibers presented in 6 cases.Immunohistochemical stains identified dystrophin,sarcoglycans,dysferlin and caveolin-3 expressed normal in muscle fibers.Western blot,compared with the control,confirmed that the bands at 94 000 were absent(8 cases)or partly(2 cases)deficient:The additional bands at 30 000expressed weakly;The bands at 22 000 were normal.Conclusion Western blot analysis with microspecimen of skeletal muscle is an effective modality to diagnose LGMD2A,and is suitable to diagnose the sub-type of LGMD in clinic.

Objective To study the genes of a carbapenem-resistant Klebsiella pneumoniae strain isolated from a patient. Methods The antibiotic sensitivity test of a multidrug-resistant Klebsiella pneumoniae strain was done according to K-B and MIC method. Metallo-β-lactamase was detected by Modified Hodge Test and EDTA-disk synergy test. Both nine genes encoding β-lactamases, including blaKPC, blaIMP , blaVIM , blaSME , blaCTX-M , blaSHV, blaDHA , blaACT, Class Ⅰ integrase and Class Ⅰ integron were detected by PCR. Positive products were sequenced. Results The Klebsiella pneumoniae was resistant to carbapenems, cephalosporins, cefoxitin, ampicillin and trimethoprim/sulfamethoxazole. Only susceptible to aztreonam, gentamicin, tobramycin, amikacin, ciprofloxacin and levofloxacin. The blaIMP-1 and Class Ⅰ integron were positive. The blaIMP gene was identified by PCR and DNA sequencing confirmed that the gene belong to IMP-1 type Metallo-β-lactamase gene. The strain also carried Class Ⅰ integron and IMP-1 was located in Class Ⅰ integron 5'. Conclusions It is the first detection of IMP-1 Metallo-β-lactamase in Klebsiella pneumoniae. The production of IMP-1 carbapenemase is the main mechanism of carbapenem-resistant in Klebsiella pneumoniae, and multidrug resistance is related to ClassⅠ integron.

Objective:To determine blood magnesium and urinary magnesium in children with asthma exacerbation and discuss the relationship between the magnesium level and children with asthma attack. Methods:The observation group include 90 children who were 0~6 years old with asthma exacerbation that admission to our hospital since May 2008 to May 2012. The control group was 100 children with the same age to the observation group to accept the health examination. Every child in two groups were taking venous blood of 2ml and 24h urine samples. Record the amount of urine at the same time. Using automatic biochemical analyzer to detect the serum magnesium concentration and urinary magnesium concentration. Results: The urinary magnesium concentration of observation group was obviously lower than control group (t=8.52, P<0.001);the serum magnesium concentration of two groups had no significant difference (t=2.21, P>0.05). Conclusion:Children with asthma in acute attack stage with magnesium deficiency. Urinary magnesium concentration determination is simple, and it is a effective method that can be used to judge whether there is magnesium deficiency. Serum magnesium concentration cannot be used as a reliable indicator of magnesium ion balance.

About half of the world population and more than 90% of rural households in the developing countries still use unprocessed biomass fuels (wood, dung and crop residues) as the fuels. These substances, burning in the open fire or in the simple stoves, can cause indoor air pollution and the pollutants exposure in women and children is more serious. Biomass smoke contains lots of toxic and harmful substances which may impact the health of human. This article presented a recent research progress in the indoor air pollution and health effects caused by combustion of biomass fuels in China and in the world.

OBJECTIVE:To provide some suggestions for reference in establishment of clinical pharmacist institution in China.METHODS:Through analysing the present policy,mechanism,education,social psychology and law,the difficulties confronting us in establishment of clinical pharmacist institution were discussed.RESULTS&CONCLUSION:It needs to improve the mechanism in many aspects and to intensify the reform continuously in the process of establishing clinical phar-macist institution.

OBJECTIVE:To study the characteristics of doctors'behavior in clinical pharmaceutical service in hospi?tal.METHODS:Using statistical method,the doctors at their posts in nationwide scope were sampled and investigated by question-naires.RESULTS&CONCLUSION:Hospital doctors have a relatively vague cognizance of clinical pharmacists'work and they are cautious about clinical pharmaceutical service.They admit that they have requirements of clinical pharma?ceutical service,but at the same time they doubt of the pharmacists'capability,and they are just willing to accept the service selectively.

OBJECTIVE:To study the behavioral characteristics of nurses(or chief nurses)in the clinical pharmacy ser?vices.METHODS:Statistical method like questionnaires was used to investigate the clinical nurses(or chief nurses)nationwide at random.RESULTS&CONCLUSION:The nurses(or chief nurses)had positive attitudes towards clinical pharmacy services and thought highly of the clinical pharmacists'work both inwardly and outwardly.There is a great need for the knowledge of the pharmacy administration method in the clinical pharmacy services.

OBJECTIVE:To prepare hydroxycamptothecin sustained-release tablets and to optimize its preparation technology and formulation.METHODS:The preparation technology and formulation were optimized by orthogonal experiment taking the type of excipient polylactic acid (A),tabletting pressure (B),ratio of HCPT to PLA (C) as factors with the deviation degree of the accumulative release percentage as evaluation index.Then the optimized results were verified.RESULTS:The optimal technology and formulation were as follows:A was PLA (20 000),B was 250 N,C was 1∶5.The deviation degree of the formulation was verified to be 2.963.CONCLUSION:The hydroxycamptothecin sustained-release tablets prepared in optimized preparation technology and formulation are up to the standard on preparation.