OBJECTIVE:To explore the necessity of developing pharmaceutical services on the retailed pharma?cy.METHODS:The current state of the pharmacy retailers in China and the necessity of developing pharmaceutical services on the retailed pharmacy were analyzed.RESULTS&CONCLUSION:Only through developing specialized pharmacy services actively can the pharmacy retailer strengthen their competitive ability in the pharmacy market.

Adult ; Aged ; Antipsychotic Agents ; adverse effects ; Child ; China ; epidemiology ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Dyskinesia, Drug-Induced ; drug therapy ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Prevalence

Background and purpose:Adrenal schwannoma is extremely rare, mostly benign, lack of special characteristics in clinical and imaging presentation. The aim of this study was to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of adrenal schwannoma, in order to improve the accuracy of diagnosis. Methods:The CT and MRI features of 8 patients with pathology-proven adrenal schwannoma were reviewed. Among the 8 patients, 4 patients underwent CT scanning, 3 patients underwent MR scanning, 1 patient underwent both CT and MR scanning.Results:The tumors were located at the left adrenal in 5 cases and at the right in 3 cases. Tumors showed no signs of endocrine activity in all cases. All tumors were well-circumscribed, oval or lobulated masses, 2 cases with calcification, 5 cases with cystic change, 2 cases with intratumoral hemorrhage. CT or MR enhancement showed moderate, heterogeneously delayed enhancement in 7 cases with enhanced capsule. Four cases showed rabbit tail sign.Conclusion:The imaging and pathological features of adrenal schwannoma have certain characteristics. The CT and MRI features, such as intact capsule, cystic degeneration, rabbit tail sign, calcification and progressive enhancement, are helpful to improve the accuracy of diagnosis of adrenal schwannoma.

BackgroundPterygia is a clinical common disease.A lot of surgical methods are developed to decrease the recurrence rate.Resent years,the application of fibrin glue is receiving more and more attention.Objective This study was to explore the effects of fibrin glue in decreasing inflammatory irritation and its mechanism. Methods Pterygia models were created in 12 clean rabbits by exsection of limbal tissue and topical administration of 1.25％ diluted hydrochloric acid,and then the conjunctival autograft surgery was performed in the experimental rabbits.The conjunctival flap was sutured in the left eyes,and the conjunctival wound was closed using fibrin glue in the right eyes.The operation duration for each group was documented and compared.The irritation sign was examined under the slit lamp in all the rabbits 1 week and 4 weeks respectively.The expressions of vascular endothelial growth factor (VFGF) and basic fibroblast growth factor (bFGF) proteins in the conjunctiva tissue were detected by immunochemistry,and the expressions of VFGF mRNA and bFGF mRNA in the conjunctival tissue were determined by reverse transcription polymerase chain reaction (RT-PCR).Results The operative duration was (21.3±0.2) minutes in suture group and( 10.1 ±0.1 )minutes in the fibrin glue group with a significant difference between two groups( t =102.242,P＜0.05 ).From 1 week through 4 weeks,the hyperemiain degree was obviously slight in fibrin glue group compared with suture group.Immunochemistry showed that VEGF and bFGF proteins were expressed mainly in the cytoplasm of conjunctival epithelium layer.The positive response intensity was weaker in the fibrin glue group than in suture group 1 week and 4 weeks after operation.RT-PCR revealed that the expression level of VEGF mRNA was significantly lower in fibrin glue group than in suture group,and the VEGF mRNA was gradually decreased with the time lapse ( Fgroup =174.443,P =0.000 ; Ftime =231.459,P =0.000 ).The similar outcomes were found in the expression of bFGF mRNA(Fgroup=41.727,P=0.000;Ftime=55.417,P=0.000). ConclusionsThe use of fibringluecanshortentheoperationdurationandreducepostoperationinflammatoryreaction.The downregulation of VEGF and bFGF in tissue is the possible mechanism of remitting irritation sign,which allows a reduce of the recurrence rate of pterygia.

Objective To explore the diagnostic accuracy of urine liquid-based cytology(LBC)for diagnosis of urothelial carcinoma(UC).Methods A total of 603 cases in our department from January 2005 to July 2007 were subject to urine liquid-based cytology test(LBC)and followed by histological examination.Using the histological appearance as the gold standard,the accuracy of LBC test was evaluated.Results A total of 436 cases with histological diagnoses were selected.There were 274 cases of UC and 61 cases of other malignant tumors of urinary system.The sensitivity,specificity and accuracy of urine LBC test for malignant tumors were 61.5%,86.5% and 67.1%,respectively.The positive predictive value and negative predictive value were 94.1% and 39.2%,respectively.The sensitivity of urine LBC test for UC and non-urothelial malignant tumors were 68.6% and 29.5%,respectively.The sensitivity for UC Was significantly higher than that for non-urothelial malignant tumors.The diagnostic sensitivity of urine LBC test for UC G1,G1-2;G2,G2-3 and G3 was 53.3%,74.5% and 90.6%,respectively.The diagnostic sensitivity of urine LBC was increased with the increacment of histological grade of UC.Conclusions The sensitivity of urine LBC test for high grade UC is high and has a good clinical value.However,for the diagnosis of low grade UC,the sensitivity of LBC test is low and adjuvant test is needed to improve it.

Objective To evaluate the value of elastic strain ratio (SR) in ultrasound guided fine needle aspiration (US-FNA) of thyroid nodule.Methods A total of 222 thyroid nodules from 216 patients were reviewed and analyzed by Logistic regression of clinical data,2D ultrasound,and SR.The odds ratios of variables in the equation were compared to assess various variables,especially of SR in the diagnosis.The sensitivity,specificity,and accuracy of the SR method,US-FNA method,and combined method were calculated.Results Three statistically significant features finally entered the Logistic regression model,followed by SR,echo,and age according to the odds ratio.The sensitivity,specificity,and accuracy of the SR method,US-FNA method and combined method were 85.4％,82.1％,83.3％ ; 91.5％,82.1％,85.6％ ; 97.6％,94.3％,95.5％ respectively.Conclusions SR＜0.5 is the most important risk factor in differential diagnosis of thyroid malignant nodules from benign nodules.SR raises the sensitivity,specificity,and accuracy of US-FNA method and plays an important role in diagnosing thyroid nodules via US-FNA.

Aviation ; Humans ; Physical Fitness ; Resistance Training ; Schools ; Students

We designed a locator for puncture under CT examination.Thirty-three patients of both sexesaged 16-76 yr weighing 46-80 kg undergoing bilateral thoracic or lumber sympathetic nerve block under CT examination were enrolled in this study.One side was punctured under the guidance of the locator,while the other side was punctured by conventional technique.The time consumed during puncture,CT scan adjusting time,the deviation of the needle from the targets and the incidence of puncture complications were recorded.The results showed that compared with the conventional technique,with the locator the time consumed during puncture was significantly shorter,the number of attempts and the deviation of the needle from the target were significantly reduced.The procedure was successfully performed on both side in all patients without serious complications such as hemothorax and pneumothorax.

This study was purposed to investigate the amplification of CD3(-)CD56(+)NK cells in umbilical cord blood and their change of immunophenotype and cytotoxicity after stimulation with IL-2 and IL-15. Mononuclear cells were isolated from umbilical cord blood and cultured in serum-free medium supplemented with IL-2 or (and) IL-15 for 14 d. The subset level of CD3(-)CD56(+)NK cells and expression of CD16, CD62L, NKG2A, NKG2D, NCR44, NCR46, granzyme B and perforin were analyzed by flow cytometry. The cytotoxicity of NK cells to K562 was detected by WST-1 method. The results showed that NK cells stimulated with IL-2, IL-15 and IL-2/IL-15 were amplified by 10.78 ± 2.51, 10.42 ± 3.72, and 10.54 ± 6.24 times respectively after 14 d, there was no statistically significant difference between these three groups. The expression of CD16 decreased obviously in NK cells after amplification; there was significant difference between IL-2 and IL-15 groups. The expression of CD62L was not changed statistically after stimulation with cytokines, the IL-2 down-regulated the expressions of NKG2A and NCR46, while IL-15 showed the opposite effect. IL-2 or IL-15 displayed upregulation effect on the expression of NKG2D, perforin and NCR44, but there was statistically significant difference between effects of these two cytokines. IL-15 up-regulated the expression of granzyme B on NK cells. The cytotoxicity of NK cells stimulated and amplified by cytokines significantly increased, but there was no statistically significant difference between IL-2 and IL-15. It is concluded that IL-2 or IL-15 can effectively amplify umbilical cord blood NK cells under serum-free conditions. Although the immunophenotype associated with NK cells function showed different characteristics between them, however, cytotoxicity of NK cells increased obviously after amplification and there is no statistically significant difference between effect of these two cytokines, their synergistic effect is not obvious. The cytotoxicity of NK cells is the result from combined effect of all active molecules.
Cells, Cultured ; Cytotoxicity, Immunologic ; drug effects ; Fetal Blood ; cytology ; Flow Cytometry ; Humans ; Immunophenotyping ; Interleukin-15 ; pharmacology ; Interleukin-2 ; pharmacology ; K562 Cells ; Killer Cells, Natural ; drug effects

OBJECTIVETo determine the outcome of hepatic venousaplasty and transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of the Budd-Chiari syndrome with occlusion of the hepatic veins.

METHODSFifty patients of the Budd-Chiari syndrome with occlusion of the hepatic veins (23 males and 27 females, with a mean age of (39 ± 11) years) were elected for venousaplasty or TIPS. The average of Child-Pugh scores was 9.6 ± 2.6. Three patients had a acute course of the disease, while 47 patients had a subacute or a chronic course of the disease. The clinical presentation was ascites in all 50 cases, with concomitant upper gastrointestinal bleeding in 10 patients, hepatorenal syndrome in 4 patients and impaired liver function in all patients. Hepatic venousplasty was performed for 12 patients with occlusion of hepatic venous. Hepatic and inferior caval venousplasty were performed for 6 patients with occlusion of hepatic and inferior caval vein. TIPS was performed for 13 patients with occlusion of small hepatic vein. Modified TIPS was performed for 19 patients with extensive occlusion of hepatic vein.

RESULTSThe procedure of treatment was successfully performed in all patients. The shunt reduced the portosystemic pressure gradient from (41 ± 10) to (27 ± 6) cmH2O (1 cmH2O = 0.098 kPa, t = 20.20, P = 0.001) and improved the portal flow velocity from (14 ± 10) to (52 ± 14) cm/s (t = 15.02, P = 0.001) after TIPS or modified TIPS. Clinical symptoms and the biochemical test results improved significantly during 3 weeks after hepatic venousplasty and shunt treatment. During the hospitalization, the death occurred in 1 case due to hepatic failure and the acute occlusion of shunt was treated with secondary intervention in another case. The mean follow-up was (82 ± 46) months. The revisions of shunt with TIPS were needed in 2 patients and the inflation of stenosised hepatic vein in another 2 patients during the follow-up. All patients were still observed.

CONCLUSIONHepatic venousaplasty and TIPS provide an excellent outcome in patients of Budd-Chiari syndrome with occlusion of the hepatic veins.

Adult ; Angioplasty ; Budd-Chiari Syndrome ; surgery ; Female ; Hepatic Veins ; surgery ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; methods ; Retrospective Studies ; Treatment Outcome