OBJECTIVE:To promote the improvement of the quality of pharmaceutical care.METHODS:Patients’com_ plaints in2003～2004in the pharmacy department of our hospital were analyzed and the related information was considered in the formulation of countermeasures.RESULTS&CONCLUSIONS:Giving consideration of patients'complaints that served as information resources in pharmaceutical management can promote a steady improvement of the quality of pharmaceutical care.

With the continuous improvement of people's living standard, more and more people are in pre-diabetes state. Pre-diabetes is the key to the development of diabetes, and early intervention can reduce the incidence of diabetes, and prevent transforming pre-diabetes to diabetes in order to maintain the health status of the patient. By retrieving the Chinese Biomedical Literature Database of nearly five years on pre-diabetes intervention literature, it was found that traditional Chinese medicine interventions in pre-diabetes have a relatively new understanding. Through the traditional Chinese medicine, acupuncture, acupoint massage, and combine traditional Chinese and western medicine, medicinal food, eight brocade etc intervention therapy in patients with pre-diabetes, the occurrence and development of diabetes and its complications can be effectively prevented.

Objective To study the ultrasonic features and outcomes of VACTERL association fetuses. Methods From Jan 2003 to Sep 2013 in Shenzhen Maternity&Child Healthcare Hospital there were 55 fetuses diagnosed as VACTERL association, the prenatal ultrasonographic characteristics and outcomes were summarized. Results Ultrasonography showed that the incidence of 6 VACTERL association anomalies were:vertebral defects were 45.5%(25/55), anal atresia were 30.9%(46/55), cardiac malformations were 81.8%(45/55), tracheoesophageal ifstula/esophageal atresia were 32.7%(18/55), renal anomalies were 60.0%(33/55) and limb anomalies were 83.6%(17/55). All the 55 fetuses had 3 or more VACTERL association malformations and the characteristic ultrasonic features were as follows:(1) There were 39 cases (70.9%, 39/55) co-occur with three VACTERL malformations, the more common malformations were limb anomalies (33/39), cardiac malformations (31/39) and renal anomalies (21/39). (2) There were 13 cases (23.6%, 13/55) co-occur with four VACTERL malformations, the more common malformations were cardiac malformations (11/13), limb anomalies(10/13), renal anomalies (9/13) and tracheoesophageal ifstula/esophageal (8/13). (3) There were 3 cases (5.5%, 3/55) co-occur with ifve VACTERL malformations, they were all with anal atresia, cardiac malformations, renal anomalies and limb anomalies (3/3), and two were co-occur with vertebral defects (2/3). (4) No fetus co-occur with six VACTERL malformations. There were 29 cases (52.7%, 29/55) co-occur with other malformations, of which 21 cases (38.2%, 21/55) with single umbilical artery. All the 55 cases underwent labor induction. The results of postmortem appearance of 55 cases and autopsies of 9 cases were all consistent with prenatal ultrasound scan. Conclusions Fetuses with VACTERL association had characteristic prenatal ultrasound imaging, multiple malformations can be found and limb anomalies, cardiac malformations and renal anomalies are more common. Scanning the fetal structures from higher incidence to lower incidence of VACTERL association can be helpful to improve the diagnostic coincidence rate of VACTERL association. Prenatal ultrasound diagnosis of VACTERL association can provide guidance for clinical obstetrical management.

Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image(CDFI) when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses,15 cases with cystic-solid mixture masses,4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration (PS) were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

Objective To investigate the therapeutic effect,safety and its prognostic factors of capecitabine as maintenance treatment agent for prolonging the PFS of patients with recurrent and metastatic breast cancer after they received combination chemotherapy.Methods From January 2011 to June 2013,38 cases with recurrent and metastatic breast cancer were collected in the department of medical oncology of the First Hospital of Lanzhou University.All the 38 patients received NX scheme (vinorelbine combined capecitabine chemotherapy),and some patients among of them had stabile disease after chemotherapy and were administered X scheme (capecitabine,twice a day,2 000 mg/m2 daily,withdrawal for 7 days after a consecutive intake of 14 days,21 days as a cycle,at least 2 cycles) until disease progressed or toxicity could not be tolerated.Adverse reactions and PFS were observed and recorded.Single factor chi square test and multivariate COX proportion hazard model were used to evaluate the relationships between clinic features and RR,PFS.Results The overall response rate (CR + PR) was 55.26％ (21/38),clinical benefit patients rate (CR + PR + SD) was 84.2％ (32/38),with 4 patients of CR (4/32),17 patients of PR,11 patients of SD,6 patients of PD.Thirty-two no progressived patients were administered capecitabine until PD.The median PFS was 10.0 months.Stratification analysis showed that patients whose Karnofsky (KPS) ≥80 had an average PFS of 14.1 months,while an average PFS of 6.8 months for patients whose KPS ＜ 80,with a statistical significance (x2 =6.251,P =0.000).Cox proportion hazard model also showed that age (RR =3.561,95％ CI:1.372-5.216,.x2 =4.025,P =0.031),menopausal status (RR =1.895,95 ％ CI:1.124-4.452,x2 =5.725,P =0.048),KPS score (RR =4.553,95％ CI:1.131-7.703,x2 =11.205,P =0.005),the number of metastasis (RR =5.781,95％ CI:2.321 ～11.243,x2 =3.925,P =0.011) were important prognostic factors for the patients with breast cancer.Major treatment-related adverse reaction was grade Ⅰ-Ⅱ hand-foot syndrome.One patient discontinued treatment because of grade Ⅲ hand-foot syndrome.Conclusion Capecitabine as maintenance treatment can significantly prolong the PFS of patients with recurrent and metastatic breast cancers at remission or stable stage after combination chemotherapy with a better tolerance.Age of patients,menopausal status,KPS score,the number of metastasis are the prognostic factors for the efficacy of NX-X regimen.

Objective To evaluate the effect of the clinical nursing path integrated with the holistic nursing on advanced schistosomiasis patients with ascites. Methods A total of 226 advanced schistosomiasis patients with ascites were randomly di?vided into a control group and an experimental group (113 cases each group). The subjects in the experimental group were nursed by the clinical nursing path integrated with the holistic nursing,while those in the control group were nursed only by the holistic nursing. Then the clinical relevant indexes of the two groups were observed,and the quality of life of the patients before and after hospital discharge was assessed. Results The improvement rate,satisfaction degree,and awareness rate of health knowledge of the patients in the experiment group were 93.8%,100%and 97.4%,respectively,which were significantly higher than those of the control group(all P<0.05). The mortality rate and the complication rate of the patients in the experimental group were 0 and 2.7%,respectively,which were significantly lower than those of the control group(both P<0.05). In addi?tion,the average hospitalization days and the hospitalization cost of the experiment group were(12.2 ± 0.7)d and(4 725.0 ± 310.1)Yuan respectively,which were less than those of the control group(both P<0.01). When 6 months after the discharge from hospital,the quality of life of the patients in the experimental group in various fields was significantly better than that of the control group(all P<0.05). Conclusions The clinical nursing pathway integrated with holistic nursing can effectively improve the improvement rate and decrease the mortality of the advanced schistosomiasis patients with ascites;meanwhile,it can short?en the hospitalization time and save the hospitalization cost. Therefore,this nursing model is suitable for popularization and ap?plication in the treatment and nursing work of the advanced schistosomiasis assistance.

Objective To summarize and analyze prenatal ultrasound and postnatal autopsy ifndings in fetuses with urorectal septum malformation sequence (URSMS). Methods An analysis of prenatal ultrsound ifndings and postnatal autopsy features was performed on eleven cases of fetuses with URSMS that were identiifed by ultrasonography at Shenzhen Maternity&Child Healthcare Hospital in the period of January 2003 to December 2012. Results Prenatal ultrasonography showed a large abdominal cystic mass concomitant with imperforate anus in eleven fetuses with URSMS. The cyst contained unilocular or bilocular cystic structures in two fetuses, and trilocular cystic structures in nine fetuses. The cyst was demonstrated as clear acoustic transmission in three fetuses and unclear in eight fetuses. Out of them, seven fetuses had kidney abnormalities, six had ascites, and three had enterolithiasis. The associated systemic abnormalities included tethered cord in two fetuses, single umbilical artery in two fetuses, sacrococcygeal dysplasia in one fetus, and myocardial noncompaction in one fetus. 21-trisomy was found in one fetus by chromosome examination. Eleven cases were all identiifed as female fetuses by autopsy ifndings, including a single perineal opening and ambiguous genitalia with clitoral hypertrophy and labial fusion. The internal genital abnormalities included double vagina or longitudinal vaginal septum in nine fetuses, double uterus or uterus bicornis in ten fetuses and vaginal dysplasia in one fetus. Conclusions URSMS is a complex congenital malformation, which includes abnormalities of the urinary system, reproductive system and gastrointestinal track. An abdominal cystic mass visualized by prenatal ultrasonography might be the distinctive lesion in female with URSMS, and have an important diagnostic value. The kidney abnormalities and ambiguous genitalia can contribute to the diagnosis of URSMS.

ObjectiveTo summarize prenatal ultrasound image features of Cantrell′s syndrome (Cantrell′s pentalogy).MethodsFrom January 2007 to December 2013 in Shenzhen Maternity & Child Healthcare Hospital, there were twenty cases diagnosed and conifrmed by postmortem as Cantrell′s syndrome. The prenatal ultrasound image features and outcomes were analyzed.ResultsAmong the twenty cases, eighteen were singleton and two were twins with the other normal fetus. Prenatal ultrasound image: two obvious ultrasound image features of ectopic heart and hight omphalocele (seventeen cases) or gastroschisis (three cases) were appeared in prenatal ultrasound of twenty cases. Fourteen cases were complete ectopic heart (Ectopic heart was located within the omphalocele in one case, ectopic heart was completely exposed in amniotic lfuid in thirteen cases), six cases were incomplete ectopic heart, three cases were ventricular septal defect in which one was associated with pulmonary stenosis, two cases were single atrium and single ventricle in which one was associated with a single arterial trunk, one case was tetralogy of Fallot, and six cases were without signiifcant heart abnormalities. Associated with other abnormalities: seventeen cases were associated with other abnormalities in twenty cases, in which eleven cases were spinal abnormalities, nine cases were umbilical cord abnormalities (short umbilical cord in six cases, single umbilical artery in two cases, short umbilical cord associated with single umbilical artery in one case), ifve cases were neurological abnormalities (exencephalia in four cases, encephalocele in one case), four cases were limb abnormalities, three cases were cheilopalatognathus, one case was giant bladder. Three cases weren′t associated with other abnormalities. Nuchal Translucency: in eight cases, nuchal translucency were measured in early pregnancy. Nuchal translucency of ifve cases were thick, one case was cervical hygroma in one of the two twins. Chromosome examination results: only three cases had chromosome examination in twenty cases, in which one case was trisomy 21, another two were chromosome normal. Fetal outcome and examination results: in twenty cases, one of the two twins can′t survive after birth, and the other one of two twins was reduced in intrauterine, so the specimen could not be obtained. Eighteen cases of singleton underwent labor induction. The results of postmortem appearance (nineteen cases) and autopsies (ifve cases) were all consistent with prenatal ultrasound scan.ConclusionsEctopic heart and hight omphalocele or gastroschisis appearing at the same time was the characteristic of Cantrell′s syndrome in prenatal ultrasound and other abnormalities may be part of the Cantrell′s syndrome spectrum. It is beneift to detect and diagnose Cantrell′s syndrome by prenatal ultrasound in the ifrst trimester.

Objective To assess the value of prenatal sonographic diagnosis on fetal agenesis of corpus callosum(ACC). Methods A retrospective study was on prenatal sonographic findings of 10 cases with ACC malformation and their abnormalities in central nervous system (CNS) or extra-CNS.Results The special sonographic findings established the diagnosis of ACC malformation in all 10 cases,with 7cases diagnosed absence agenesis. Among all patients with ACC,6 cases were accompanied with abnormalities in extra-CNS,8 in CNS and 5 in both. Conclusions Prenatal ultrasonography plays a vital role in accurate diagnosis on fetal ACC. Attentions should be paid to the indirect encephalic features and complicated abnormalities so as to make accurate and prompt diagnosis.

Objective To investigate the clinical value of acoustic radiation forcs impulse (ARFI)in quantitative evaluating placental elasticity.Methods The study population included 487 normal pregnant women,and ARFI generated shear wave velocity (SWV)was measured.On the basis of gestational ages, placental sites and sampling depths in region of interest (ROI),the normal population was divided into different groups.One-way analysis of variance was used to compare the discrepancy on the SWV values amomg the nomal placental sites or the sampling depths in ROI.Pearson correlation coefficient were used to assess the possible relationships between the normal placental SWV values and the different gestational ages or the placental grades.A total of 5 1 cases were diagnosed with severe preeclampsia,among them 25 cases were categorized as severe preeclampsia with fetal growth restriction (FGR).The placental SWV values were measured and compared with those of the normal population.The pathological examinations were performed on 50 normal and 5 1 abnormal placentas.Results Basing on the placental sites,the normal population were divided into three groups:anterior wall,lateral wall and posterior wall groups.Compared with the posterior wall group,the placental SWV values in the anterior wall or lateral wall group significantly decreased (P <0.05).No statistical significant difference was found between the anterior wall group and the lateral wall group.Basing on the distance from the sampling depths to the probe (range from 2 to 7.99 cm,and each additional 1 cm corresponding a group),the normal population were divided into six groups.There was statistical significant difference for the placental SWV values between the two groups of distance in the range of 2.0 to 5.99 cm and 6.0 to 7.99 cm (P <0.05).There was no statistical significant difference between the other two groups.The mean SWV value was (0.78±0.08 m/s)in the normal group. No significant relationships were found between the placental SWV values and the gestational ages of the normal population.However the placental SWV values were significantly related to the placental grades.For the placental SWV values,there was statistical significant difference between the normal group and the abnormal group (P <0.05).No statistical significant difference was found between the severe preeclampsia group and the severe preeclampsia with FGR group.The pathological examinations also showed significant changes in the abnormal group.Conclusions ARFI may quantitatively analyze the placental elasticity and make a difference between nomal and abnormal placenta.