OBJECTIVE: To provide references for the retail pharmacies on market competition. METHODS: The customer satisfactory idea and the customer delivered value theory were analyzed and the ways to enhance the customer delivered value were discussed. RESULTS & CONCLUSIONS: Decreasing drug price is just one among the multi-methods to enhance the pharmacy customer satisfaction. The pharmacies should analyze multi-factors influencing the customer delivered value before making correct marketing strategies.

Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

Objective To investigate the expression of aquaporin-1 (AQP1) in human peritoneum and its effect on peritoneal dialysis (PD) patients with the different peritoneal transport characteristics.Methods Peritoneal biopsies were obtained from the PD patients (n =30) at catheter insertion.Western blot and immunohistochemical staining were used to investigate AQP1 expression in peritoneal tissues.After catheter insertion,4 week,peritoneal equilibrium test (PET) was used to decide peritoneal transport characteristics.Results Western blot revealed a major band at 28 kDa band.The expression of AQP1 index was 1.49 ±0.67 in the normal subjects,and 1.61 ±0.76 in the PD patients,and there was no significant difference.Positive deposition was distributed in mesothelial cells,endothelial cells of capillaries,and small veins.The index of AQP1 expression in endothelial cells of capillaries in normal subjects and PD patients were 2.12 ±0.18,and 2.50 ±0.81,respectively,and no significant difference was found.The index of AQP1 expression in mesothelial cells of capillaries in normal subjects and PD patients were 1.95 ± 0.67,and 2.23 ± 1.07,respectively,and no significant difference was found.Among PD patients,the level of AQP1 was significantly different.Conclusions The expression of AQP1 was different in the PD patients with different peritoneal transport characteristics.In the high and high average transport groups,the level of AQP1 was lower; the low transport group was higher.It reveals that AQP1 plays a role in the pathogenesis of transcellular water transport.

Objective To evaluate the diagnostic and prognostic evaluation of Procalcitonin (PCT)levels detection for elderly patients with severe pulmonary infection.Methods 60 elderly patients with severe pulmonary infection were selected,as the infected group,wherein 45 cases with bacterial infection,15 cases with non -bacterial infections.Another 60 cases elderly patients excluded infectious diseases were selected as the control group.PCT,CRP and WBC levels in two groups were detected and compared.The infection group was randomly divided into two groups,each of 30 cases,the control group received conventional anti -infection treatment,while the observation group developed solutions to optimize antimicrobial drugs by detecting changes in PCT and CRP.Antibiotic course,antimi-crobial drug costs,superinfection and adverse reaction rates in two groups were recorded and compared.Results PCT,CRP levels and WBC in the infected group were (17.4 ±11.3)ng/mL,(43.5 ±18.7)mg/L and (10.4 ± 7.3)×109 /L,which in the control group were (0.4 ±0.2)ng/mL,(6.3 ±3.6)mg/L and (5.4 ±1.4)×109 /L,the difference was statistically significance (t =7.369,9.570,3.295,all P <0.05 ).PCT levels of bacterial infection group was (27.2 ±14.7)ng/mL,which in non -bacterial infection group was (8.2 ±2.7)ng/mL,the difference was statistically significant (t =7.369,9.570,3.295,all P <0.05).Antibiotic course,antimicrobial drug costs,superin-fection and adverse reactions in the observation group were significantly lower than those in the control group,the difference statistically significant (t =6.994,27.71,χ2 =6.171,6.984,all P <0.05).Conclusion PCT detection has an important value of infection diagnosis especially in elderly patients with severe pulmonary infection,and can be used as the basis for antibiotic treatment.

Objective To investigate the prevalence and severity of malnutrition in patients with stable chronic obstructive pulmonary disease (COPD) , analyze serum levels of myostatin, tumor necrosis factor alpha (TNFα) and C reactive protein (CRP) , and investigate the relationship between serum myostatin and malnutrition in COPD. Methods Seventy-one patients with stable COPD and 60 age-matched healthy volunteers were recruited in this study. Pulmonary function was tested in all of the subjects and the severity of malnutrition was evaluated by a multiple-parameter malnutritional index (MNI). Based on the MNI scores, patients with COPD were divided into group Ⅰ (MNI≥5 score) and group Ⅱ (MNI ＜ 5 score) , the former represents the patients with severe or very severe malnutrition while the latter represents the patients with mild or without malnutrition. Serum concentration of myostatin, TNFα and CRP were measured by enzyme-linked immunosorbent assay. Results The MNI score was significantly elevated in patients with COPD [(7. 75 ±3. 86)score] compared with the controls [(1. 13 ±0. 96)score; P＜0.001],and 55 patients (77%) in COPD group Ⅰ showed MNI ≥ 5 (9. 30 ± 3. 01) score. Serum myostatin concentration was significantly elevated in COPD group Ⅰ [(12. 18 ±4. 76)μg/L] than in COPD group Ⅱ [(9. 73 ±2.85) μgL] and controls [(7.93 ±2.35) μg/L], with each P ＜ 0.001. Serum TNFα concentration was also significantly elevated in patients with COPD compared with the controls (P ＜ 0. 001).Pearson correlation analysis showed that serum myostatin levels were significantly correlated with MNI scores (r = 0. 438, P - 0. 000) and TNFa levels (r = 0. 234, P = 0. 041) in COPD group (combined group I and Ⅱ) while MNI scores were correlated inversely with BMI in COPD group (r = - 0. 530, P = 0. 000) . After stratified with subgroups, the correlation between myostatin levels and MNI scores was more significant and the correlation coefficient was higher (r =0.464, P =0.000) in COPD group I patients. Moreover,myostatin levels were inversely correlated with BMI (r = - 0. 287, P = 0. 034) and forced expiratory volume in one second of the predicted value (r = - 0. 264, P = 0. 049) in COPD group I patients. Conclusions Malnutrition commonly and substantially exists in patients with COPD; serum myostatin concentration is significantly elevated and is correlated with the severity of malnutrition in the patients. The elevation of serum myostatin may contribute to malnutrition in COPD patients.

The application of robotic surgery can provide solutions to the many drawbacks of traditional laparoscopic surgery.Robotic surgery is a feasible and safe procedure for patients with gastrointestinal tumor.It can harvest adequate lymph node with low postoperative morbidity.Longer follow-up and further raudomized clinical trials are needed to validate the utility and efficacy of this technology in the field of gastrointestinal surgery.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Laser Therapy ; Male ; Middle Aged ; Urination Disorders ; therapy

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Animals ; Child ; Female ; Furunculosis ; therapy ; Humans ; Male ; Middle Aged ; Young Adult

Objective Backgrounds and Objectives Skeletal muscle dysfunction is an important systemic manifestation of several diseases such as chronic obstructive pulmonary disease and chronic heart failure.Quadriceps function assessment was used in majority of the studies for assessment of peripheral skeletal muscle function as it is readily accessible and is a primary locomotor muscle.Appropriate evaluation of the prevalence and severity of quadriceps dysfunction relies on the proper control data from the age-matched normal subject.So,the present study was aimed to measure the quadriceps function in healthy elderly,to investigate the multiple factors related to quadriceps functions,and to establish the normal ranges for quadriceps functional performance in healthy elderly.Methods Sixty healthy volunteers were recruited for the study.Quadriceps function was assessed by measurement of the following 3 items:maximum of twitch tension (TwQmax) induced by magnetic stimulation of femoral nerve,maximal volitional contraction (QMVC),and endurance time.The intensity and frequency of quadriceps exercises were quantified with physical activity (PA) scores by using a special PA questionnaire.Anthropometric measurements such as height,weight and mid-thigh muscle mass (MTMC) were measured in all of the subjects.Multiple regression models were developed by stepwise method to determine the independent factors respectively contributing to the quadriceps functional performance.Results Quadriceps functional tests results showed that the data of the three items fit normal distributions in both female and male subjects,and the gendcr-related difference was observed in quadriceps strength,with TwQmax and QMVC being significantly decreased in female than in male subjects.The mean values and normal ranges for TwQmax,QMVC,and endurance time were [13.86(10.53-17.65)] kg,[42.06(34.45-49.67)] kg,and [81.08(58.52-103.66)] second,respectively,in male subjects; and they were [7.41(6.02-9.52)] kg,and [29.40(24.66-33.82)] kg,and [83.44 (60.81-106.67)] second,respectively,in female subjects.Stepwise regression correlation analysis showed that QMVC was related with sex,PA scores and weight (R2=0.61,P＜0.01) ; endurance time was predicted by PA scores,MTMC,body weight and sex (R2 =0.58,P ＜0.01) ; and TwQmax was predicted by sex,height and PA scores (R2 =0.67,P＜0.01).Conclusions Our study results demonstrate that quadriceps functional performance fits normal distributions in healthy elderly,and that quadriceps function is related to multiple factors such as subjects' sex,muscles exercises,weight,height,muscle mass,and etc,with muscles exercises being the most significant one,except of gender.We conclude that muscles exercises take a very important role in muscles functional performance in healthy elderly.

Objective: To investigate the clinical characteristics, microsurgery feasibility and postoperation comprehensive treatment strategy of callosal gliomas, so as to improve the prognosis of patients. Methods: The clinical manifestations, diagnoses, microsurgical approaches, chemotherapy and radiotherapy, and prognoses of 82 callosal gliomas patients, who were treated in our hospital during January 1995 and December 2007, were retrospectively analyzed. The optimal surgical approach and resection strategies were chosen preoperativety according to the imaging features of tumors. Resections were performed and the navigational orientation was used during operation in 8 cases, type-B ultrasonic supervision was used in 4 cases, and cavitron ultrasonic surgical aspirator (CUSA) was used in 5 cases. Patients with tumors above grade U underwent chemotherapy (temposide + semustine) and radiotherapy designated individually according to the pathological grades and involvement of gliomas. The follow-up study was conducted by telephone, mail or outpatient department visits. Results: The clinical manifestations of the 82 patients included headache and vomiting (n=44), epilepsy (n=16), mental symptoms (n=12), and mild plasy (n=20). Resections were performed via the longitudinal fissure approach in 44 cases, via the transcortical approach in 24 cases, and via the longitudinal fissure and transcortical combined approach in 5 patients; 7 patients received stereotactic biopsy and 2 patients only received chemotherapy and radiotherapy. Six patients had tumors found in the rostrum of corpus callosum, 36 in the genu of corpus callosum, 30 in the body of corpus callosum, and 10 in the splenium of corpus callosum. Total surgical resection was performed in 45 cases, subtotal in 13 cases, and partial in 15 case. Pathological findings confirmed astrocytoma in 48 cases, oligodendroglioma in 11 cases, ependymoma in 2 cases, and glioblastoma in 19 cases. The follow-up of 61 patients indicated that 89% patients survived for over 1 year, 71% survived for over 2 years, 62% survived for over 3 years and 39% survived for over 5 years, with a median survival time being 47 months and the longest survival time being 140 months. COX regression analysis found that elder age, higher pathology grade and incomplete resection were associated with poor prognosis. Conclusion: The callosal gliomas locate at especial position, and the anatomic characteristic, adjacent structure, blood supply should be fully understood before operation. Accurate surgical approaches assisted by appropriate therapeutic strategies can improve the prognosis of the patients. The longitudinal fissure approach is commonly used. The proficient microsurgical technique combined with navigation and type-B ultrasonic can improve the resection outcome and prognosis of patients.