To cultivate more excellent pharmacists, ensuring patients rational drug use, standardiza-tion training of hospital pharmacists in Beijing has been carried out since 2000, and the wonderful effect has been achieved. The teaching methods mainly include centralized training model, small lectures, practice teaching and self-study. The training teaching content mainly includes prescription audit, drug dispensing and management as well as the pharmaceutical care. In this paper, based on the analysis of the status quo, it is recommended that detailed training formulate, teaching methods and content of the second stage of the training about the training management policy, and the clinicians teaching should be added to the contents of teaching. The thought moral qualities, laws and regula tions, as well as academic and research training should also be added to the teaching content.

Objective To use autologous costicartilage trestle to correct secondary cleft lip nasal deformity,in order to obtain a nice nose.Methods A total of 64 patients were treated,including 51 unilateral and 13 bilateral cleft lip,aged 16 to 38 years,with the average of 21 years.The deformity included cripetura columellar,flattened nasal tip,anisopleural nostril and caved nosewing.The carven costicartilage was embedded into bilateral nasal septum to form a new trestle for remodelling the shape of nose and nasal tip.Results The follow-up time was 3 months to 2 years,showing that all patients were satisfied with the outline of external nose,without infection and costicartilage revealed.Conclusions The autologous costicartilage is easy to collect without rejection reaction,and therefore it can be used in correcting secondary cleft lip nasal deformity with fair improvement of nasal outline,especially in nasal tip height.

ObjectiveTo study the sirolimus (SRL)-associated interstitial pneumonitis,which is a severe side effect of sirolimus therapy. Methods In 7 renal grafts treated with SRL, interstitial pneumonitis (8 times) was diagnosed. One patient suffered a relapse after sirolimus treatment was given again. Two patients received de novo sirolimus treatment, and rest 5 patients were switched from a calcineurin inhibitor-containing regimen to a SRL-based protocol for various indications: chronic allograft nephropathy (n = 4) and cancer (n = 1 ). The patients presented with fever, dyspnea on exertion and the chest X-ray or computed topographic (CT) scan on admission showed bilateral mostly peripheral interstitial infiltrates. ResultsSRL was discontinued in 4 patients and the dose was reduced in the remaining 3 patients. Symptoms were improved within 3-14 days in all patients, the radiographic findings improved within 2-4 weeks, and the lesions were absorbed completely in 2-6 months.ConclusionThe frequency of interstitial pneumonitis appears to be increased in renal transplant patients receiving SRL. Discontinuation or reduced dose of SRL appears to be the safest treatment option for the patients with interstitial pneumonitis.

Objective To evaluate the value of using fluorescence in situ hybridization (FISH)technique for the detection of chromosome aberration of urine exfoliated cells for the diagnosis of bladder tumor.MethodsFISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9p16 site from 20 normal people, and to establish the threshold.The morning's first urinations were available from 75 patients with bladder cancer and 25 patients without urothelial tumor, then were detected using FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results higher than the criteria,or one probe has two or more abnormal results.Results The sensitivity of single using were 73.3％ (55/75),76.0％ (57/75),62.7％ (47/75) and 62.7％ (47/75) for the 4 probes (3,7, 17 and 9p16)respectively.The sensitivity of combined detection was 85.3％ (64/75) and specificity was 96.0％ (24/25) The sensitivity and specificity of urine cytology examination was 9.3％ (7/75) and 100％ (25/25) .The sensitivity of FISH examination was significantly higher than that of urine cytology examination (85.3％ vs 9.3％ ,x2 = 57.00, P ＜ 0.001) .Sensitivity of FISH examination was not correlated with cancer pathologic grading(low vs high : 84.2％ vs 86.5％, x2 = 0.08, P ＞ 0.05)and clinical stage (ta-tl : 82.9％, t2-t4 :87.5％, x2 = 0.32 ,P ＞ 0.05) .ConclusionFISH technique is a non-invasive and effective method for the early diagnosis of bladder tumor and is more sensitive than urine cytology.Furthermore, FISH technique can be used to predict the tumor's biological behavivor and prognosis.

Objective To investigate the feasibility and the preliminary curative effect of the deep inferior epigagtrie perforator(DIEP)flap for child's foot and malleolus reconstruction.Methods A series of 5 child patients were treated with DIEP flap from August to December in 2007.All of them had foot and malleolus defects secondary to traumatic injuries and significant exposure of the tendons and skeleton.The maximum defect Wag 17 cm×6 em in size,the minimum defect Was 11 cm x 6 cm in size.In 2 eases,suture the inferior epigastric artery(vein)to the anterior tibial artery(vein).In 1 case,suture the inferior epigagtric artery(vein)to the dorsal artery (vein)of foot.In 2 cases,suture the inferior epigastric artery (vein)to the posterior tibial artery(vein).The minimum flap in size was 12 cm×7 cm.The maximum flap in size was 18 cm×7 cm.The donor site of the DIEP flaps Wag always closed primarily.Results Donorsite and receptor-site weIe primary healing in all patients.The mean follow-up was 3 months(range from 1to 5 months),all flaps survived with excellent color and quality,and no extremely fat contour.In 4 cases,a protective sensation Wag regained.The patient has obtained the good function of foot and malleohs.The abdomen contour resumes satisfaction, and the abdominal wall competency is preserved. Conclusion Abdominal wall competency is preserved because no muscle or fascia is included.DIEP flap is so thin that not required second-stage operation for debulking.In brief,it is believed that the DIEP flap is an ideal technique for foot and malleolus reconstruction of child patients, which meets the new concept of mieresurgery.

Objective To investigate the ex tr action technique for seperating the active components in the root of Salvia mi ltiorrhizae bunge by supercritical fluid, and to analyze the extracted product s by HPLC-MS n . Methods The extraction condition s were established as follows: 950ml?L -1ethanol as the first entrainer, t he pressure of 20.0 MPa, temperature at 45 ℃, and extracting time 1 h; then 100 mL?L -1 ethanol was selected as the second entrainer, pressur e was 30.0 MPa, temperature was 65 ℃, and extracting time was 3 h. Results Compared with traditional refluxing extraction and ultrasonic extraction, supercritical fluid extraction was better and more effect ive. Conclusion Supercritical extraction is simple, highly selec tive and efficient in extracting the active components in Salvia miltiorrhizae bunge.

Objective To investigate the incidence of infection and the effect of anti-infection prophylaxis in renal transplanted patients after Basiliximab induction therapy. Methods A total of 204patients who have received renal transplantation and Basiliximab induction therapy from January 1,2001 to December 31, 2010 in our hospital have been retrospective analysed in this study. These patients were divided into a prophylaxis group (118 cases) with Ganciclovir + Sulfadiazine +Trimethoprim therapy and a control group (86 cases) without any anti-infection prophylaxis.Furthermore, 440 transplanted patients in the same peroid without any induction therapy were also analysed. They were also devided into two groups: an anti-infection prophylaxis group (206 cases)and a control group (234 cases) without any anti-infection prophylaxis. Results In the prophylaxis group with Basiliximab induction therapy, there were 23 patients (19. 5 %, 23/118)experienced hospitalization due to infection, 3 cases (13. 0 %,3/23) among them were severe infection, and 3patients (13.0 %, 3/23) died from vital infection. In the non-prophylaxis control group with Basiliximab induction therapy, 27 patients (31.4 %, 27/86) had infection complication, 7 patients (25.9 % ,7/27) among them were severe infection, and 4 patients(14. 8 % ,4/27)died. The incidence of infection between the above two groups is significantly different (P＜0. 05). In the prophylaxis group without induction therapy, the incidence of infection was 15.0 % (31/206), there were no severe infection cases but 7 patients (22. 6 %, 7/31) died from infection. In the non-prophylaxis control group without induction therapy, the incidence of infection was 12. 8 % (30/234), 3 cases among them were severe infection(10. 0 %,3/30)and 5 patients died from infection (16. 7 %, 5/30).The incidence of infection in Basiliximab induced patients without anti-infection prophylaxis is significantly higher than that in patients without induction therapy and anti-infection prophylaxis (31.4 % vs. 12.8 %,P＜0.01). Conclusion Basiliximab induction therapy increased the risk of infection, but not the rate of mortality. It is necessary to give anti-infection prophylaxis in renal transplanted patients with Basiliximab induction therapy.

Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.

Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DI-COM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".
Computer Systems ; Information Dissemination ; Medical Informatics ; Software

Objective To observe the effect of buyanghuanwu decoction on expression of immunoreactive protein and mRNA of NMDA receptor 2B subunit in rats hippocampal with vascular dementia to investigate the mechanism of buyanghuanwu decoction. Methods One hundred and forty-four rats were randomly divided into 4 groups: sham-operated group, VD model group,nimodipine group and buyanghuanwu decoction treatment group. The rats models of vascular dementia were built up by four vessels occlusion method. VD rats were treated with in-tragastrical buyanghuanwu decoction suspension (50 pharmacognostic g·kg-1·d-1) and nimodipine suspension (20 mg·kg-1·d-1) for 30 days. The learning and memory abilities were evaluated by Morris water maze tests. The change of NR2B protein in hippocampal of each group of rats were measured with immunohistochemistry and Western blot techniques and the expression of NR2B mRNA in hippocampus were observed by real-time fluorescence quantitative PCR techniques. Results Water maze tests,compared with sham-operated group((24. 18 ± 7.90)s,(7.99 ±1.32)/min) ,the escape latency(51. 25 ±18.28)s to explore the extension and the average spatial probe number ((5. 26 ±0. 74)/min) reduced in VD model group (P < 0. 05). Buyanghuanwu decoction ((25.91 ±9.56)s,(7. 52 ± 1. 27)/min) had significantly improved the above-mentioned rat model of learning and memory performance (P<0.05). There was no significant difference among sham-operated group,nimodipine group and buyanghuanwu decoction treatment group (P>0. 05). Similarly,as compared rats with sham-operated group(0.71 ±0.13), (5887 ±501), the expression of NR2B protein (0. 33 ± 0. 06) and its mRNA(593 ±53) were apparently decreased in VD rats (P< 0.05). The expression of NR2B protein(0.66 ±0. 11) and its mRNA (5692 ±482) in neuron of hippocampus were increased by buyanghuanwu decoction compared with the model group (P < 0. 05), and no difference was discovered between sham operation group and nimodipine group (P > 0.05).Conclusions Buyanghuanwu decoction improves the learning and memory abilities in VD rats, the therapeutic mechanism was concerned with lessening the injury of neurons on CA1 field in hippocampus and promoted the expression of NR2B protein and its mRNA.