OBJECTIVE： To discuss the problems to which clinical pharmacists should pay attention in promoting pharmaceutical care METHDOS： To summarize and analyze the present situation and existing problems in rational drug－ use and pharmaceutical care RESULTS ＆ CONCLUSION： Playing an important role in clinical treatment， clinical pharmacists should know medical knowledge well and can communicate with doctors in rational drug use， which is the prerequisite for pharmaceutic care

OBJECTIVE:To study the bio-equivalence of domestic loratadine syrup and tablets in human beings.METHODS:a dose fo40mg domestic loratadine(syrup or tablet)was given to18healthy male volunteers to a randomized crossover design.Blood samples were collected before administration and20min,40min,1hr,1.5hr,2hr,3hr,4hr,6hr,8hr,12hr,24h after administration.The concentrations of Loratadine in blood were determined by HPLC.Pharmacokinetic parameters and relative bio-availability were detected with3p97program.RESULTS:The main pharmacokinetic parameters of domestic Lortadine syrup and tablet were as follows:C max were(40.91?15.42)ng/ml and(41.57?18.68)ng/ml respectively;T max were(1.04?0.19)h and(1.19?0.25)h respectively;T 1/2 were(4.43?1.67)h and(4.21?1.49)h respectively;AUC 0～24 we_ re(127.60?46.28)(ng?h)/ml and(133.13?45.65)(ng?h)/ml respectively;AUC 0～∞ were(132.98?47.43)(ng?h)/ml and(138.16?47.26)(ng?h)/ml respectively.The relative bio-availability was(96.25?21.30)%.CONCLUSION:the do?mestic Lortadine syrup and tablet are bio-equivalent.

Ultrasonic estimation of fetal weight is important in the management o f labor and delivery. Lots of charts and formulas have been put forward in virtu e of regression methods. Artificial neural network, a kind of computer artificia l intelligence technology, can simulate human thinking based on neural structure and physiology. With the excellence in complex and non-linear information proce ssing, artificial neural network is fitter for the forecasting of fetal weight t han traditional regression methods.

OBJECTIVE: To explore the curative effect and origin of antrochoanal polyp (ACP) with various approaches. METHOD: Fifty-seven patients with ACP were included in the study. All the ACP patients were examined by preoperative endoscopy and computer tomographic (CT) scans. The patients were treated by various endoscopic approaches including endoscopic middle meatus antrostomy, inferior meatus antrostomy combined with endoscopic middle meatus antrostomy or endoscopic medial maxillectomy combined with endoscopic middle meatus antrostomy respectively. The relationship between polyp location in middle meatus and lesions in the antrum was explored during the surgery. Pathological examination was carried out and patients were regularly followed up after operation. RESULT: Fifty-seven ACP develops from antral cyst. In 22 cases of endoscopic middle meatus antrostomy, two patients relapsed. In 17 cases of inferior meatus antrostomy combined with endoscopic middle meatus antrostomy, one patients relapsed. In 18 cases of endoscopic medial maxillectomy combined with endoscopic middle meatus antrostomy, no one relapsed. CONCLUSION Our data indicated that the ACP mainly originates in antral cyst, and capsule wall herniates to middle meatus through the antral ostium. ACP are common in unilateral, rare in both sides. The endoscopic approaches of middle meatus antrostomy and inferior meatus antrostomy combined with endoscopic middle meatus antrostomy might guarantee good prognosis. If the cyst is on the anterior wall of maxillary sinus, the approach of endoscopic medial maxillectomy can obtain a better vision and completely remove the lesions.
Cysts ; surgery ; Endoscopy ; Humans ; Maxillary Sinus ; surgery ; Nasal Polyps ; surgery ; Nasal Surgical Procedures ; methods ; Tomography, X-Ray Computed

Objective To evaluate the endothelium-dependent vasodilation in children after repair for coarctation of aota (CoA). Methods A group of 20 children having undergone CoA repair between January 2010 and October 2010 in Guangzhou Women and Children′s Medical Center were include in the study , including 12 infants aged less than 6 months and 8 ones aged more than 6 months. Another 20 healthy children were enrolled during the same period as controls. All the subjects underwent monitoring of resting blood pressure and flow-mediated dilation (FMD) of the brachial artery in 4-year follow-up. Results There were no resting hypertension in all subjects , but FMD in the CoA group was higher than in the control group and so it was with the early surgery group and non early surgery group. Conclusion The surgical repair for coarctation of aorta could not cure the vascular function impairment satisfactorily , neither is the early surgery effective in alleviating the injuries in vascular endothelia.

Objective Even after successful surgical repair,patients with coarctation of the aorta (CoA) are at high risk of long-term morbidity and mortality due to cardiovascular events,which is probably related to persistent arterial disfunction during long-terr follow-up after operation,The aim of the study was to explore the alterations of vascular structure and function in children with successfully repaired CoA in the short-and mid-term follow-up.Methods A cohort of 20 children who underwent CoA repair between January 2010 and October 2010 in Guangzhou women and children's Medical Center was studied.There were 14 males and 6 females in CoA group,which comprised 6 patients with isolated CoA,14 patients with CoA associated with intracardia anomalies,whose median age of operation was 4 months (rang from lmonth to 10.0 years).And 20 patients with isolated ventricular septal defect (VSD) were included as VSD group during the same time,with 12 males and 8 females,whose median age of operation was 5 months (rang from 1 month to 12.0 years).Resting blood pressure,flow-mediated dilation (FMD) of the brachial artery,carotid intima-media thickness (IMT) were compared in CoA group and VSD group,including preoperative media data and follow-up of 1 month,6 months and 1 year.In addition,as comparison to the operation group,20 health children with normal echocardiographic findings,whose median age was 5 months (rang from 3 month to 10.0 years),were selected as health group for the 1-year following up.None of them had obesity,hyperlipidemia,diabetes mellitus,metabolic diseases or systemic inflammatory disease.Results As a result of the datas before operation and those I month,6 months and 1 year after operation,all children were normotensive at rest.In the same period,Carotid IMT in CoA group[(0.47 ± 0.10)mm,(0.49 ±0.10) mm,(0.57 ±0.07)mm,(0.61 ± 0.07) mm]was significantly thicker than that in VSD group[(0.41 ±0.11) mm,(0.43 ±0.11)mm,(0.51 ±0.08) mm,(0.55 ±0.08) mm](P＜0.05) and health group[(0.40 ±0.09) mm,(0.42 ±0.11)mm,(0.50 ±0.08) mm,(0.57 ±0.08) mm](P ＜0.05),Brachial artery FMI in children with CoA[(5.4,6 ±1.51)％,(5.71 ±1.88)％,(5.42±1.69)％,(5.27±1.02)％]was significantly lower than that in the VSD control group[(6.69±1.45) ％,(6.66±1.21)％,(6.81 ±1.03)％,(6.43±1.34)％](P＜0.05) and health group[(6.59 ±1.84)％,(6.84±1.41)％,(6.91 ±1.31)％,(6.56±1.62)％](P＜0.05).Significant difference could not be found in neither the IMT nor the FMI between the VSI control group and health group in 4 period respectively,P ＞ 0.05.Conclusion Children after successful coarctation repair have abnomal structural and functional properties of the aorta above the place of coarctation even their blood pressure at rest is normal.These results confirm that the alterations in mechanical properties of carotid arteries as well as the generalized endothelial dysfunction in children with coarctation of the aorta are persistent,which can not be prevented or reversed by surgical repair,and which may partly explain the high incidence of cardiovascular disease observed in their adulthood and reduced life expectancy,furtherly supporting the claim that coartation of the aorta is a systemic vascular disorder which needs long-term follow-up of vascular function.

OBJECTIVETo discuss the key role of various mode of circulation assist in the radical operation of retro-peritoneal malignancy with the inferior vena cava thrombotic involvement.

METHODS>From the June 1999 to the March 2001, 6 patients with retro-peritoneal malignancy with thrombosis involving the inferior vena cava, were completely resected with various mode of circulation assist.

RESULTSAll the patients operated have good outcomes and follow-up (1 - 20 months) except one death 1 month after operation.

CONCLUSIONAccording to the various types of tumor thrombi, individualized and technically feasible circulation assist mode should be utilized to achieve the satisfactory outcomes.

Aged ; Assisted Circulation ; Humans ; Male ; Middle Aged ; Retroperitoneal Neoplasms ; blood supply ; surgery ; Surgical Procedures, Operative ; Vena Cava, Inferior ; surgery

Objective: The goal of this research was to understand the demographic distribution and related factors of non-marital and non-commercial heterosexual transmission (non-commercial transmission) for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). Methods: Data related to HIV/AIDS infected by non-marital heterosexual transmission and whose present address was in Qian Dongnan, were collected from Information System on the HIV/AIDS Prevention and Control. Information included demographic characteristics, the members of non-marital sex partners, transmission path, detection source, CD4⁺T lymphocyte level, et al. cases belong to homosexual history, injective drug use or non-classified non-marital heterosexuality transmission were excluded, totally collect HIV/AIDS 919 cases. Multivariate logistic regressions were used to analyze potential factors associated with non-marital and non-commercial heterosexual transmission. In addition, in March and June 2017, using a convenience sampling, we conducted one-to-one interviews among 10 HIV/AIDS who were infected by non-marital heterosexuality and had non-marital and non-commercial heterosexual experience in Kaili Center for Disease Control and Prevention. The content of the interview included basic information, sexual orientation, the main place of making friends and sexual behavior, attitude to commercial heterosexuality and non-martial and non-commercial heterosexuality and so on. Results: Out of the 919 cases, 645 (70.2%) were male, the proportion of non-commercial transmission was 55.06% (506). The proportion of female HIV/AIDS with non-commercial transmission was 84.7% (232), which was higher than male (42.5%(274)) (χ²=138.35, P<0.001). The proportion of Han HIV/AIDS with non-commercial transmission was 61.5% (275), which was higher than other religion (52.2%(412)) (χ²=6.32, P=0.012). The proportion of HIV/AIDS with non-commercial transmission who had 0-5 non-marital sexual partners was 58.8% (498), which was higher than who had>5 non-marital sexual partners (11.1%(8)) (χ²=61.10, P<0.001). The proportion of HIV/AIDS with non-commercial transmission who lived mobile was 72.9% (94), which was higher than who lived fixedly (52.2%(412)) (χ²=19.34, P<0.001). Qualitative interviews results revealed that the age of the respondents were 22-69. Respondents whose ages are in 22-34 were more likely to use mobile phone (4/10) and respondents whose ages are in 35-69 were less likely to look partners through party and the context of working. Conclusion The proportion of cases being infected by non-marital and non-commercial heterosexual transmission in Qian dongnan was higher than general national levels. The characteristics of sex, marriage status, migration, vocation, the members of non-marital sex partners were significant differed between commercial heterosexual transmission and non-marital and non-commercial heterosexual transmission.

Objective:To investigate the correlation of red blood cell distribution width-to-platelet ratio (RPR) with clinical features and prognosis of patients with multiple myeloma (MM).Methods:The clinical data of 137 patients with MM who were admitted to the Affiliated Hospital of Xuzhou Medical University from April 2013 to July 2019 were collected. The receiver operating characteristic (ROC) curve was used to determine the best cut-off value of RPR. According to the best cut-off value of RPR, the patients were divided into high RPR group and low RPR group, and the differences in clinical characteristics and prognosis between the two groups were analyzed.Results:The best cut-off value of RPR was 0.10, and according to the best cut-off value, the patients were divided into high RPR group (RPR ≥ 0.10, 52 cases) and low RPR group (RPR < 0.10, 85 cases). There were statistical differences between the high RPR group and low RPR group in the proportion of patients between different stratification of Durie-Salmon (DS) staging ( χ2 = 17.110, P < 0.01), International Staging System (ISS) staging ( χ2 = 10.817, P = 0.001), red blood cell distribution width standard deviation(RDW-SD) ( χ2 = 26.937, P < 0.01), hemoglobin ( χ2 = 17.140, P < 0.01), lactate dehydrogenase (LDH) ( χ2 = 7.926, P = 0.005), erythrocyte sedimentation rate (ESR) ( χ2 = 9.513, P = 0.002), β 2-microglobulin (β 2-MG) ( χ2 = 7.726, P = 0.005), and bone marrow plasma cell ratio (BMPC) ( χ2 = 6.621, P = 0.010). The overall response rate (ORR) in the low RPR group was higher than that in the high RPR group [82.4% (70/85) vs. 71.2% (37/52)], but the difference was not statistically significant ( χ2 = 2.366, P = 0.124). The deep remission rate in the low RPR group was higher than that in the high RPR group [56.5% (48/85) vs. 19.2% (10/52)], and the difference was statistically significant ( χ2 = 18.327, P < 0.01). The results of multivariate analysis showed that the albumin, RPR and degree of remission were independent influencing factors for the overall survival (OS) of newly treated MM patients (all P < 0.05). Conclusion:MM patients with elevated peripheral blood RPR have shorter OS time, and RPR may be one of the indicators for evaluating the prognosis of MM.

Objective:To analyze the diagnosis and surgical treatment of high-risk anomalous aortic origin of coronary artery (AAOCA).Methods:This is a retrospective case series study. From January 2016 to July 2023, 24 cases of high-risk AAOCA underwent surgical treatment in Department of Cardiac Surgery, Guangdong Provincial People's Hospital. There were 18 males and 6 females, operatively aged ( M (IQR)) 13 (26) years (range: 0.3 to 57.0 years). They were confirmed by cardiac ultrasound and cardiac CT, all of which had anomalous coronary running between the aorta and the pulmonary artery. There were 15 cases of the right coronary artery from the left aortic sinus of Valsalva, 6 cases of left coronary artery from the right aortic sinus of Valsalva, 3 cases of the sigle coronary artery. Only 3 patients had no obvious related symptoms (2 cases were complicated with a positive exercise stress test and 1 case with other intracardiac malformations), 21 cases had a history of chest tightness, chest pain, or syncope after exercise. Three patients suffered syncope after exercise and underwent cardiopulmonary resuscitation (2 cases were treated with an extracorporeal membrane oxygenerator (ECMO)). The gap from the first symptom to the diagnosis was 4.0 (11.5) months (range: 0.2 to 84.0 months). The detection rate of coronary artery abnormalities suggested by the first cardiac ultrasound was only 37.5% (9/24). Seven patients were complicated with other cardiac diseases (4 cases with congenital heart defects, 2 cases with coronary atherosclerotic heart disease, 1 case with mitral valve disease). Results:All 24 patients underwent surgical treatment (23 cases underwent abnormal coronary artery unroofing, 1 case underwent coronary artery bypass grafting), and 5 patients underwent other intracardiac malformation correction at the same time. There were no death or surgery related complications in the hospital for 30 days after the operation. A patient with preoperative extracorporeal cardiopulmonary resuscitation was continuously assisted by ECMO after emergency AAOCA correction and had complications such as limb ischemia necrosis and renal dysfunction after the operation. During the follow-up of 2.2 (3.3) years (range: 1 month to 7.2 years), one patient who previously underwent percutaneous transluminal coronary angioplasty with a stent implant experienced significant postoperative symptomatic relief, and the other discharged patients had no related symptoms.Conclusions:The accurate rate of initial diagnosis for high-risk AAOCA is still low, but the risk of cardiovascular accidents is high. For sports-related chest pain and other symptoms, more attention should be paid to the detection of AAOCA, especially for adolescents. Exercise stress testing can be helpful in evaluating the cardiovascular risk of asymptomatic AAOCA. Instant surgical treatment can achieve satisfactory curative effects.