OBJECTIVE:To provide reference for the development of clinical pharmacists’career and the establishment of le-gal system in China. METHODS:The background,progress and situation of applying for“pharmacists’health care provider sta-tus”in the United States were introduced. The reasons for achieving provider status in California,Washington,and Oregon were summed up in aspects of politics,economics and education. The chance and challenge for achieving provider status at federal level were also discussed. Based on the development of clinical pharmacists in China,the suggestions were put forward for the improve-ment of legal system of clinical pharmacists in China. RESULTS & CONCLUSIONS:“Health care provider status”in the United Stated were recognised by 3 states with local developed economics,high-level education,and collective efforts of pharmacy organi-zations. Multiple national pharmacy organizations as American Pharmacists Association,American Society of Health-System Phar-macists and American Pharmacy College Society are working together toward provider status at the federal level. Our country should pay attention to related legal system construction,establish perfect and definite clinical pharmacists legal system as soon as possible to provide legal guarantee for career development of clinical pharmacists in China.

Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class (EC) and control class (CC), with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students (88%) were inter-ested in the new course, 91 students (91%) thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC:44 students (88%) thought that the new course could increase interests of clinical question;43 students (86%) thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students (80%) thought that the new course could strengthen the communication between doctors and patients; 42 students (84%) thought that the new course could widen the minds in diagnosis and treatment;45 students (90%) thought that the new course could enhance the ability of dialectical thinking;while in CC, the proportions of the above issues were 24(48%), 23(46%), 26(52%), 25(50%) and 26(52%) (all P<0.05). Furthermore, there were statistical difference in auerage scores bertween EC and CC [(86.26 ±5.72) vs. (77.00 ±6.16)] (P=0.000). Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.

Objective To investigate the expressions of IL-8,MCP-1 and MIP-1? and their biological significance in pancreatic carcinoma and chronic pancreatitis, and investigate the relationships of their expressions in pancreatic cancer tissues.Methods Immunohistochemical method of avidin-biotin complex was used to examine surgically removed specimens from 51 cases of pancreatic carcinoma and 10 cases of chronic pancreatitis. Results The positive rates of expression and the scorings of IL-8,MCP-1,MIP-1? were significantly higher in pancreatic carcinoma than that in chronic pancreatitis(P

This study was aimed to explore the relationship between the Shen-Gui-Fang(SGF) formula of different proportions and treatments for diseases with the method of bibliometrics. A total of 49 formulae of SGF from ancient books of traditional Chinese medicine (TCM) were retrieved and the database was established in order to analyze the origin of herbal medicine and the relationship with the ratio of the key medicinal material, as well as the treatment for major diseases. The results showed that 49 SGF formulae were mainly used in the treatment of internal disorders for 16 times (32.65%), gynecological disorders for 17 times (34.69%) and pediatric disorders for 8 times (16.32%). Guistanded forAngelica sinensis. There were 3 types ofShen, which werePanax ginsengfor 40 times,Codonopsis pilosulafor 8 times, andSophora flavescensfor 1 time. The ratio betweenP. ginsengandA. sinensiswas less or equal to 1. The ratio betweenC. pilosulaandA. sinensiswas usually more than 1. The formulae with the highest frequency were in the treatment of internal medicine and gynecological diseases. Statistical analysis was used to find the application features and rules of the combination ofP. ginsengandA. sinensisin SGF formula, in order to provide theoretical evidences and references for clinical medication selection and new medication research.

A method was developed for the determination of tetrodotoxin in marine organisms by high perfor-mance liquid chromatography-mass spectrometry with immunoaffinity column. The samples were extracted with 1% acetic acid methanol solution and diluted with phosphate buffer at pH 7-8. After cleaned up by immuno-affinity column, the samples were analyzed by LC-MS/MS and quantitatively determined by external standard method. The chromatographic separation was performed on an ACQUITY UPLC BEH Amide column with gradient elution by using acetonitrile and 5 mol/L ammonium acetate solution containing 0. 1% formic acid as mobile phase. Detection was carried out by electrospray positive ionization mass spectrometry in the multiple reaction monitoring mode. Linear ranges of TTX was in the range of 0. 3 -20. 0 μg/L with correlation coeffi-cient more than 0. 997. The quantification limit of the method was 0. 3 μg/kg. The recoveries of standard addition for tetrodotoxin were 88. 7%-102. 3%, and the relative standard deviation was 2. 0%-6. 4%. The method could be used to identify and quantify tetrodotoxin in marine organisms with satisfactory reproducibility and sensitivity.

Objective To investigate the clinical efficacy of acupuncture plus TDP in treating stageⅡ-Ⅲ pressure sore.Methods Thirty-three patients with pressure sore meeting the inclusion criteria were randomly allocated to treatment and control groups, 17 cases each. Both groups were first given routine clean care. The control group received routine surgical asepsis dressing change and the treatment group, fire needling, surrounding electroacupuncture and TDP irradiation to the affected part. The pressure sore area was observed and the PUSH score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups of patients. Results The total efficacy rate was 88.0% in the treatment group and 71.0% in the control group; there was no statistically significant difference between the two groups (P>0.05). The total efficacy rate was 88.0% in the treatment group and 71.0% in the control group; there was no statistically significant difference between the two groups (P>0.05). The cure and marked efficacy rate was 58.8% in the treatment group and 23.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post- treatment difference in the pressure sore area in the two groups at one, two and three weeks after treatment (allP<0.05). There was a statistically significant difference in the pressure sore area between the two groups at two and three weeksafter treatment (bothP<0.05). There was a statistically significant pre-/post-treatment difference in the PUSH score in the two groups at two and three weeks after treatment (bothP<0.05). There was a statistically significant difference in the PUSH score between the two groups at three weeks after treatment (P<0.01).Conclusions Acupuncture plus TDP can markedly relieve the clinical symptoms and accelerate the sore healing in treating stageⅡ-Ⅲ pressure sore.

Xuanwei district in Yunnan Province of China has pretty high incidence of lung cancer in China, even a- round the world. Studies have shown that there exists a close relationship between lung cancer and local indoor air pollution caused by Bituminous coal. Considering that the indoor air pollution in Xuanwei District is caused by "open fireplace", an indoor air pollution simulation system was designed, and an F344 rats lung damage model was estab- lished for this indoor air pollution fireplace. The model is based on indoor air pollution simulation system with signal multiplexer control and multi-channel acquisition, and mining PID algorithm was used for polynomial fitting to each test point, and a relatively constant PM2. 5 air pollution status was simulated. The results showed that the system could simulate a variety of states of air pollution, provide a new test method for evaluation of human injury caused by indoor air pollution and a new idea for the study of the incidence of lung cancer in Xuanwei district and other places.
Air Pollution, Indoor ; analysis ; Animals ; China ; Coal ; adverse effects ; Humans ; Incidence ; Lung ; drug effects ; pathology ; Lung Neoplasms ; epidemiology ; Models, Biological ; Particulate Matter ; analysis ; Rats ; Rats, Inbred F344

Objective To explore the ultrasonographic and CT imaging features of predominantly cystic thyroid carcinoma (PCTC).Methods The retrospective analysis was performed on 30 cases of thyroid carcinoma with predominantly cystic composition confirmed by pathololy in the General Surgery Department of the First Affiliated Hospital of China Medical University from Jan.2011 to Dec.2016.The distribution of their solid portion's ultrasound characters including the eccentric configuration,irregular margin and increased vascularity were observed in all PCTCs.The CT images of 9 cases were analyzed,and the distribution of their solid portion's CT characters including irregular margin,uneven enhancement and papillary structure were observed in 9 PCTCs.Results In the ultrasound images of 30 PCTCs' whole shapes,26 cases (86.7％) showed oval and 24 cases (80.0％) showed smooth margin.26 cases (86.7％) showed eccentric configuration,20 cases (66.7％) showed rich blood flow and 19 cases (63.3％) showed irregular margin in the solid portion's ultrasound image.Only 7 cases(23.3％) showed microcalcification.Every ultrasound image of 30 PCTCs showed at least one or more of the three ultrasound characters,including eccentric configuration,irregular margin and increased vascularity.In the solid portion of 9 PCTCs,7 cases (77.8％) showed irregular margin,6 cases (66.7％) showed uneven enhancement and 6 cases(66.7％) showed papillary structure in the CT image,and every one of them showed at least one or more of the above 3 CT characters.Conclusion When the solid portion of predominantly cystic thyroid nodule appears to have some suspicious malignant characters in the image of ultrasound or CT,we should be vigilant that the nodule may be malignant.

Single-cell sequencing (SCS) sequences the genetic information of a single cell to better understand the differences amongst cells and reveal the unique changes of each cell type. The specific analysis of cell subsets at the single-cell level can accurately evaluate tumor cells and microenvironment cells to reveal the complexity of molecular components and the difference from the corresponding components in non-malignant tissues. Lymphoma is highly heterogeneous, some have unknown pathological types, etiology and poor prognosis. SCS is helpful to clarify the molecular mechanisms of lymphomagenesis and pathological staging, and guide clinical practice. This article reviews SCS and its application in lymphoma.

BACKGROUND:The alteration of miR-146a-3p level is a common event in the pathogenesis of most neurological diseases,and the specific mechanism of miR-146a-3p regulation of astrocytes has not been studied. OBJECTIVE:To verify that miR-146a-3p regulates astrocyte proliferation,migration and apoptosis through insulin-like growth factor 1. METHODS:12 SD rats were divided into a sham operation group and a spinal cord injury group,with six rats in each group.RNA sequencing analysis was performed on the spinal cord tissues of all groups 2 weeks after surgery to screen out the differential genes(log2FC>2),and to select spinal cord injury-related genes(Score>20)in the Genecards database,and then to predict the target genes of miR-146a-3p by Targetscan.The intersection of three gene sets was obtained to screen out insulin-like growth factor 1 as one of the important target genes.qPCR,western blot assay and immunohistochemistry were performed to analyze the expression level of insulin-like growth factor 1 in spinal cord tissues.The primary astrocytes were divided into NC group,NC-mimics group and miR-146a-3p mimics group.Annexin-V/PI staining was used to detect cell apoptosis.CCK-8 assay was used to detect cell proliferation.Transwell assay was used to detect cell migration ability. RESULTS AND CONCLUSION:The expression of miR-146a-3p in the spinal cord tissue of the spinal cord injury group was lower than that of the sham operation group(P<0.05).The expression of insulin-like growth factor 1 in the spinal cord tissue of the spinal cord injury group was higher than that of the sham operation group(P<0.05).Compared with the NC group and NC-mimics group,the apoptotic rate of astrocytes was increased(P<0.01);the proliferation of astrocytes was decreased(P<0.01)and the number of migration was decreased(P<0.01)in the miR-146a-3p mimics group.To conclude,the expression of miR-146a-3p decreased and the expression of insulin-like growth factor 1 increased in spinal cord tissue after spinal cord injury.miR-146a-3p targeted regulation of insulin-like growth factor 1 in astrocytes,inhibited the proliferation and migration of astrocytes and promoted their apoptosis.