OBJECTIVE:To analyze the current situation and developing trend of drugs used in hospitals of Guangdong Province.METHODS:The data of drugs purchased by60hospitals in Guangdong Province during the period1999～2003was collected and analysed.RESULTS&CONCLUSION:The sales volume of drugs was increasing year by year with a fast increament speed.The consumption conditions of anti-infectives,drugs for cardiovascular,digestive system and respiratory system diseases,vitamines,diuretics and dehydrants kept stable.The drugs occupying the front10places in sales volume were mainly antibiotics.The manufacture occupying the front places in sales volume were mostly joint ventures.

Our hospital changed the old dispensing mode of its outpatient pharmacy and started to dispense drugs by applying computer network techniques. At the registration area of the outpatient clinic, patient data were entered by means of the computer and the doctor entered his prescription by means of the computer; the dispensing pharmacist dispensed drugs according to the printed drug bag; the distributing pharmacist made checks according to the printed prescription by the doctor item by item and bag by bag. The new dispensing mode had the following advantages: bringing convenience to the patient, ensuring the accuracy of pricing, and shortening the drug-obtaining process; greatly cutting down on the errors occurring in the drug dispensing, distributing and obtaining process, and improving the quality of drug dispensing and distribution; effectively guaranteeing the wholeness and traceability of the prescriptions; greatly enhancing work efficiency; and bettering service manners. Surveys on the level of patients' satisfaction indicated that the level of patients' satisfaction towards the management of our hospital's pharmacy showed a year-to-year upward tendency.

Objective:To study the inhibition effects of simvastatin on cardiac hypertrophy induced by myocardial infarction,and to in-vestigate whether simvastatin prevents cardiac hypertrophy through attenuation of RhoA kinase.Methods:Male Wistar rats were divided intofourgroup(sn=8).Myocardial infarction model was established by ligation of left anterior descending coronary artery.Sham operati on group(SHAM group)and myocardidal infarction group(MI group)were gavaged with 0.9%NaCl 1ml/day,Simvastatin group(SIM group)was gavaged with simvastatin 40 mg/(kg.d).Fasudil group(F group)was injected with fasudil 7.5mg(/kg.bid)through peritoneum.At the time point of 28 ds,the ratio of LV weight to body weight(LVW/BW)and the cross-sectional area of cardiomyocytes were measured.The mRNA expression level of ROCK was detected by RT-PCR.The expression level of Phosphorylated-ERM was detected by immunohisto-chemistry and Western blot.Results:28ds after MI,the LVW/BW,the cross-sectional area of cardiomyocytes,the mRNA expression level of ROCK and the expression level of Phosphorylated-ERM significantly increased in the MI group compared with those in the SHAM group.And the indexes mentioned above significantly decreased both in the SIM group and F group compared with those in the MI group.Conclusion:Simvastatin prevents post-infarcted cardiomyocyte hypertrophy partly through inhibition of ROCK.

Hepatic cancer is currently the fifth most common malignant neoplasm in the world.Surgical resection is considered as radical treatment.Patients with hepatic cancer in middle or advanced stage according to the Barcelona clinic liver cancer staging system (BCLC) are usually with huge and (or) multinodular lesions and vascular invasion,which are not generally recommended for surgical resection because of high operative mortality,recurrence rate and dismal survival benefit.However,many centers have proved an opposite and encouraging result against the opinions above.With the development of surgical techniques and intensive medical care,the concern of high postoperative mortality for middle or advanced stage hepatic cancer patients is no longer unsolvable.Precise preoperative assessment is essential.The estimation of the liver functional reserve has developed from simple Child-Pugh score to an integrated system including computed tomography evaluation,indocyanine green clearance test,hepatic venous pressure gradient,etc.The estimation of the remnant liver volume after hepatectomy is especially important for surgical treatment for the middle or advanced stage hepatic cancer.Insufficient liver remnant was absolute contraindication for major hepatectomy because of high incidence of postoperative liver failure.In-situ liver transection with one branch of the portal vein ligation has been invented as a novel method to stimulate fast liver regeneration; by this way,a second-stepped radical resection can be performed with a plenty of liver remnant one week later.However,the reliability for hepatic cancer patients with liver cirrhosis is still unknown.Meticulous surgical procedure is another key factor for a safe major hepatectomy.Radical resection is most expected to provide better survival.The development of the technique of liver blood flow occlusion has a markedly influence on partial hepatectomy.Highly selective occlusion and even occlusion-free hepatectomy can reduce warm ischemia injury and improve postoperative survival.Anterior approach is a reasonable maneuver for huge hepatic cancer resection.Cancer thrombosis usually indicates poor prognosis,however,if en-bloc resection or separate thrombectomy can be achieved,surgical resection for the middle and advanced stage hepatic cancer still can provide a better survival benefit to this category of patient than palliative treatment as TACE.

[Objective]To Probe the causes of significant operatiive complications of ossification of posterior longitudinal ligament as well as the treatment outcomes in order to reduce the surgical morbidities and to suggest preventive measures of complications.[Method]The surgical data of 85 cases with ossification of posterior longitudinal ligament were reviewed form March 2002 to May 2006.In continuous long segment OPLL which were treated by bilaminectomy with internal fixation system;short segment OPLL which were treated by corpectomy of anterior cervical approach with bone of autograft and anterior cervical spine locking plates.[Result]Totally 66 cases were followed-up from 3 to 25 months with an average of 13 months.Complication of posteior cervical approach:8 cases with the pain of neck-shoulder,which resulted from postoperative radiculopathy and nerve root irritation or injury.Most of 8 cases were recovered in 2 to 20 weeks by conservative treatment such as antalgica,dehydration and physiotherapy.Four cases with quadriparesis or symptom deteriorate,which resulted from reperfusion injury of spine cord.Two cases were recovered by hyperbaric oxygen and medication and 1 cases recovered not enough.Two cases with posterior cervical hemotoma were caused by bleeding of smaller blood vessels and obstruction of drainage.One case of CSF leakage were cured in 3 days with cervical spinal immobilization and moderate local compressiom.Two cases of local infection were cured during 20 days with antibiotics or combined with debridement and suturing.Complications of anterior cervical approach:a cases with quadriparesis or symptom deteriorate;1 case of CSF leakage.Complications related to instruments included 1 case of titanium net subsidence and 1 case of single lateral mass screw back-out.[Conclusion]Many kinds of operative complications could occur in either anterior or posterior approach of surgery of ossification of posterior longitudinal ligament.Preoperative good preparation,intraoperative carefull operation and postoperative strengthened management are the key points to decrease and prevent operative related complications.

Objective To evaluate transcatheter thrombolysis via the small saphenous vein in the treatment for lower limb acute mix-deep venous thrombosis. Method From Jan 2005 to Mar 2007.37 patients with lower limb acute mix-DVT underwent catheter-directed thrombolysis via the small saphenous vein with urokinase(149 ±71)×104 IU continuous infusion.The venous patency score and the rate of patency improvement were observed by venograms before and after therapy.Twenty-two patients were followed up for(12 ±4)months. Results Venous patency score were significantly improved(Z=-5.330,P＜0.01).The mean rate of venous patency was 50.17%±15%,and there was no complication.Venogram on 6～12 month follow up showed a venous patency of 58%±13%(Z=-3.545,P＜0.01),and that on 13～18 months was 68%±20%(Z=-2.201,P＜0.05). Conclusion This preliminary experience suggests that catheter-directed thrombolysis via the small saphenous vein with urokinase for acute lower limb mix-DVT iS safe and effective.

Objective To explore the effects of amisulpride on the cognitive function in first-episode schizophrenia patients.Methods 64 patients in first-episode schizophrenia were divided into two groups randomly according to the method of tossing a coin,then treated with amisulpride or risperidone respectively for 12 weeks.The efficacy and adverse effect were evaluated with positive and negative scale (PANSS) and treatment emergent side effect scale (TESS) before treatment and after treatment for 2 weeks,4 weeks,8 weeks,12 weeks.Before and after treatment for 12 weeks,cognitive function of all the patients was blindly evaluated with Wechsler Scale-revised China (WMS-RC),Wisconsin Card Sorting Test(WCST) and Trail Making test A and B.Results After 12-week treatment,statistical difference was found in amisulpride(44.7 ± 6.7) and risperidone (45.2 ± 7.4) groups (P ＜ 0.01).But no statistical difference was found between the two groups (P ＞ 0.05).The cognitive function in firstepisode schizophrenia was damaged obviously.In two groups,the scores in recognize,association,comprehend,back a few and MQ of WMS and TAT-A,TAT-B were improved significantly after treatment for 12 weeks (P ＞ 0.05).These items of WCST were improved more remarkably than baseline (amisulpride (20.63 ± 13.06),(28.75 ± 15.72),(43.17 ±22.13),(3.62 ±2.21),P＜0.05; risperidone(20.41 ±13.82),(29.31 ± 16.12),(42.78 ± 21.42),(3.67 ± 2.32),P ＜ 0.05).The improvement in the scores of WCST were statistical difference compared with control group(P ＜ 0.05).But statistical difference was no found between the two groups (P ＞ 0.05).Conclusion The study shows that the cognitive dysfunction in first-episode schizophrenia can be improved by amisulpride,and the efficacy was similar with risperidone.

Objective To investigate the clinical effect of fissure for ligamentum teres hepatic (LTH) approach in hepatectomy.Methods The method of cross-sectional study was adopted.The clinical data of the 85 patients undergoing hepatectomy through fissure for LTH approach who were admitted to the West China Hospital of Sichuan University from February 2009 to December 2013 were collected.Among all the 85 cases, there were 61 of hepatocellular carcinoma, 12 of intrahepatic bile duct stones, 6 of bile duct cellular carcinoma and 6 of metastatic hepatic carcinoma.The operations involved dissecting fissure for LTH, dealing with portal vein, hepatic artery and bile duct inside the fissure, lowering the hepatic portal, mutilating hepatic parenchyma, and undergoing the hepatic left lateral lobectomy, left hemihepatectomy, mesohepatectomy, hepatic left and/or right trisegmentectomy.Operation method, operation time, volume of intraoperative blood loss, intraoperative blood transfusion, postoperative drainage-tube removal time and complications were recorded.The follow-up including recurrence and metastasis of tumor and survival of patients was conducted by outpatient examination and telephone interview up to August 2015.Measurement data with normal distribution were presented as (x) ± s.Measurement data with skewed distribution were presented as M (range).The survival rate was caculated by Kaplan-Meier method.Results The 85 cases of hepatectomy were successfully completed through fissure for LTH approach, including 19 cases of hepatic left lateral lobectomy (9 with hepatocellular carcinoma, 6 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 20 cases of left hemihepatectomy (8 with hepatocellular carcinoma, 5 with intrahepatic bile duet stones, 4 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 5 cases of left hemihepatectomy + caudate lobectomy (3 with hepatocellular carcinoma, 1 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma), 14 cases of meso-hepatectomy (14 with hepatocellular carcinoma) and 27 cases of hepatic left and/or right trisegmentectomy due to hepatocellular carcinoma (15 of hepatic left trisegmentectomy and 12 of hepatic right trisegmentectomy).No perioperative death occurred.The median operation time was 280 minutes (range, 95-430 minutes).The median volume of intraoperative blood loss was 450 mL (range, 200-3 200 mL).There were 18 cases of intraoperative blood infusion.The postoperative peritoneal drainage-tube removal time was 3 days (range, 2-5 days).Eleven patients with postoperative complications recovered after symptomatic conservative treatment, including 6 with lung infection, 4 with peritoneal effusion and 1 with abdominal infection.There was no case of intra-abdominal bleeding, bile leakage or hepatic failure.No patient died within 1 month after operation.Seventy-nine patients were followed up for a median time of 38 months (range, 18-53 months) with a follow-up rate of 92.9％ (79/85).The 1-year overall survival rate and l-year disease-free survival rate were 79.0％ and 65.0％, and the 3-year overall survival rate and 3-year disease-free survival rate were 56.0％ and 34.0％, respectively.Conclusion Hepatectomy through fissure for LTH approach is safe, effective and easily operable, with a good short-term outcome.

Objective To analyze the pathogen distribution and drug resistance in the patients with urinary system infection in our hospital so as to provide the basis for prevention and treatment of urinary system infection .Methods 259 strains of pathogenic bacteria cultured and isolated from the midstream urine were performed the bacteriologic identification and the drug susceptibility testing ,Escherichia coli and Klebsiella pneumoniae were performed the extend‐spectrum β‐lactamase (ESBLs) producing testing . Results Among 259 strains of bacteria ,187 strains 72 .2% (187/259) were Gram negative stains ,43 strains 16 .6% (43/259) were Gram positive stains and 29 strains 11 .20% (29/259) were fungi .Gram negative stains were dominated by Escherichia coli (139 strains) and Klebsiella pneumoniae (22 strains) .The detection rates of ESBLs‐producing Escherichia Coli and Klebsiella pneumoni‐ae were 55 .4% (77/139) and 45 .4% (10/22) .The drug susceptibility testing results showed that Gram negative stains were sus‐ceptible to both imipenem and meropenem (100% ) and Gram positive stains were susceptible to vancomycin ,teicoplanin and linezol‐id (100% ) .Conclusion Gram negative bacilli are the main infectious pathogens in urinary tract infection and Escherichia coli is the most common pathogen .No vancomycin‐resistant Gram positive cocci is found .Rationally selecting antibacterial drugs according to the drug susceptibility testing results has great significance in the therapy of urinary tract infection and the control of drug‐resistant bacterial strains .

Objective To investigate the clinical feature,diagnosis and therapy of isolated Langerhans cell histiocytosis(histiocytosis X) with unusual localization.Methods A case of isolated Langerhans cell histiocytosis of the infundibulum was reported.The endocrinic tests,imaging,immunohistochemical and pathological examinations of this case were detected.Through literature review,the pathological and clinical feature,diagnosis,therapy of isolated Langerhans cell histiocytosis of the infundibulum were overviewed.Results Magnetic resonance imaging(MRI) of the brain showed a 9 mm homogeneously enhancing mass in the region of the infundibulum.No other lesion was found in other organ systems.The patient underwent an occupying lesion resection of the infundibulum via right pterion approach.Langerhans cell histiocytosis was diagnosed through pathologic analysis.She was on hormone replacement therapy and close follow-up visit postoperatively.Conclusion Isolated Langerhans cell histiocytosis of the infundibulum in adult is extremely rare.Understanding of this disease should be improved to avert misdiagnosing.