Objective To study the distribution of polycyclic aromatic hydrocarbons (PAHs)on different diameter atmospheric particulates in winter and summer respectively. Methods Atmospheric particulates in the atmosphere of Hengyang urban districts were collected using DFJ-1 model five-stage classification air sampler in the winter and summer. The contents of PAHs on different diameter atmosphere particulates were detected by GC-MS. Results The PAHs were found on different diameter atmosphere particles. The PAHs contents in the atmosphere in the winter and summer were 161.42?140.72 ng/m3. 52.3% and 63.3% PAHs distributed in the fine partioulates with dicameter ≤2.0 ?m in the summer and winter. Conclusion The PAHs contents in the atmosphere during winter were higher than that during summer,and the PAHs were mainly distributed in the fine particulates with diameter≤2.0 ?m. The distribution characteristics of different kinds of PAHs on different diameter atmospheric particulates were not unanimous. The distribution of PAHs in winter changed significantly.

OBJECTIVE:To discuss the approach of drug pricing by applying the pharmacoeconomics evaluation.METHODS:Theory deductions together with demonstration analysis were performed based on the theory of pharmacoeco-nomics.RESULTS:In drug pricing for new drugs,the pharmacoeconomic evaluation should be conducted with suitable ref-erence drugs and suitable reference prices as references,meanwhile based on the results,the reported costs-based price should be reevaluated and adjusted accordingly.CONCLUSION:The rationality of drug pricing can be effectively improved through pharmacoeconomics evaluation.

Objective To investigate the curative effect of surgery,radiotherapy and photodynamic therapy combined with chemotherapy on early glottic carcinoma and prognostic factors.Methods Clinical data of 122 cases of early glottic carcinoma with Tis ~T2 N0 M0 were analyzed retrospectively.Small doses of chemotherapy applied to single drug cisplatin (according to the surface area of 50 mg/m2 ).83 patients underwent surgical treatments combined with chemotherapy,20 cases accepted radiotherapy combined with chemotherapy and 19 cases accepted photodynamic therapy combined with chemotherapy. Results The 3 and 5 years overall survival rates (overall survival,OS ) of surgery group,radiotherapy group and photodynamic group were 92.7%,93.8% and 89.5%,89.5% and 84.4% ,89.5%,respectively.The 2-year disease free survival rate (disease-freesurvival,DFS)were 87.6%,79.4%,78.6%,respectively.The 2-year local control rate(local control,LC)were 91.9%,84.4%,83.0%, respectively.27 cases suffered from tumor recurrence or metastasis,15 cases in the surgery group,3 cases in the radiotherapy group and 5 cases in the photodynamic group,among them 19 patients accepted salvage surgery.Multifactor retrospective analysis indicated anterior commissure invasion (P=0.047),clinical stage(P =0.018)and KPS score before treatment(P =0.001)were independent adverse prognostic factors for OS.Anterior commissure invasion(P=0.027)and differentiation degree(P=0.041)were adverse prognostic factors for DFS.Anterior commissure invasion was also poor prognostic features for LC(P=0.047).Conclusion Radiotherapy and photodynamic therapy combined with chemotherapy may be the first or very important treatment on early stage glottic squamous cell cancer(Tis ~T2N0M0 ).High preservation rate of laryngeal function with radiotherapy and photodynamic therapy combined with chemotherapy can significantly improved quality of life of patients.Curative effect of three groups was similar,and three kinds of curative methods achieved good effect.KPS score before treatment,glottis impair and differentiation degree were the main adverse prognostic factors for early stage glottic carcinoma.

ObjectiveTo assess the value of intraoperative cholangiography(IOC) for detecting bile duct injury during laparoscopic cholecystectomy.Methods31 cases of bile duct injuries were reviewed regarding the site of injury,mechanism,time of diagnosis,and the place of IOC was evaluated.ResultsBile duct injuries resulted from misidentification in 19 cases.In 12 of these 19 cases,the diagnosis was made by IOC.Primary laparoscopic repair or open repair and T-tube drainage solved the problem without postoperative complications.However,in 3 of the above 19 cases the result of IOC was misinterpreted and in 4 of the above 19 cases IOC was not performed.Two of the 7 patients had aberrant bile duct injuries, in all of them the diagnoses were delayed.There were two cases in which bile duct injury developed after an IOC.ConclusionsCorrect interpretation of IOC enables detecting bile duct injury caused by intraoperatively misidentification and consequent morbidity.

Objective To analyze the clinical characteristics of dopa-responsive dystonia (DRD). Methods The clinical characteristics and the causes of misdiagnosis in 15 patients with DRD were reviewed retrospectively.Results 4 male and 11 female patients were investigated in this study. The age at DRD onset was from 3~25 years old,the average age was 11.7 years old.The courses ranged from 2 to 29 years and the average was 12.1 years. The symptoms in female patients often aggravated during gravidity and delivery. Main clinical features included gait irregularity, postural instability and tremor, with marked diurnal fluctuation. The disease may be misdiagnosed as cerebral palsy, idiopathic torsion dystonia, essential tremor, parkinson's disease, neurosis and so on. All the patients in this study improved obviously in 2 weeks after therapy with low dose of Madopar, and recovered in 2~4 years of follow up.Conclusions Clinical diversity and diurnal fluctuation are the characteristics of DRD. Early trial treatment with low dose of Levodopa should be highly recommended for the generalized dystonia in children and untypical adults.

Objective To discuss the mechanism and prevention of bile duct injury in laparoscopic cholecystectomy (LC). Methods Twenty-six cases with bile duct injuries in this study were evaluated retrospectively regarding their location, mechanism, time of detection, repairment and outcome, and the role of intraoperative cholangiography (IOC) in preventing bile duct injury. Results Among a total of 26 cases there are duct injury due to misidentification 15 cases,( IOC detected the misidentification of bile duct injuries intraoperatively 10 cases, clipping the common duct 3 cases, duct thermal injuries 4 cases and duct lacerations 4 cases, Conclusion Duct injury due to misidentification was the main type of bile duct injury in LC, Correct interpretation of IOC will detect the duct injury intraoperatively and prevent the severe consequence. Meticulous dissection and exposure of the junction of distal common hepatic duct, proximal common bile duct, and proximal cystic duct, and safe hemostasis in Calot triangle are the important measures to prevent bile duct injury in LC.

Objective: To investigate the frequency , distribution and features of lymph node metastasis in lung cancer, and to provide evidence for lymph node dissection. Methods: 348 patients with lung cancer were retrospectively studied, all patients received R_3 surgery plus systemic lymph node dissection according to the mapping system developed by Naruke. Results: Total 3 689 groups of lymph nodes were dissected . The metastatic rates of N_1 and N_2 were 23.4% and 16.5%, respectively. N_1 or N_2 metastasis was not found in Tis tumor. There was a significant difference of N_2 metastasis rates between squamous cell carcinoma and adenocarcinoma in T_1 or T_2 tumor (P

Objective To evaluate the efficacy of Chinese botulinum toxin A(CBTX-A)injection in the treatment of motor tics in patients with tic disorder.Methods Twenty-five patients(20 male,5 female)were treated with CBTX-A in the sites of their most problematic motor tics.Before treatment the data of Yale Global Tic Severityb Scale(YGTSS)was collected.All patients were assessed at least 3 times after 1 week,4 weeks and within 12-month period.At each visit the following data were collected:YGTSS,Jankovic clinical rating scale,time to response,duration of response,global impression of changes by patients,presence of premonitory sensory tic component and side effects.Results Total number of treatment sessions was 29.The mean response time was 5.0 days.The mean duration of response was 4.6 months.The mean peak effect response in Jankovic clinical rating scale was 3.4.Based on YGTSS,62.1% (18/29)was rated as marked improvement,34.5%(10/29)as moderate improvement and only 3.4% (1/29)as no effect.85.7%(18/21)patients had less premonitory sensation symptoms(mean benefit 72.4%(20%-100%)).Weakness in the site of injection and rash were the main side effect. Conclusion CBTX-A is an effective and safe treatment for motor tics associated with tic disorder.

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 investigate the clinical effect of antidepressants combined with α-blockers in the treatment of chronic prostatitis.Methods A retrospective analysis of 90 cases of chronic prostatitis treated in our hospital from January 2016 to December 2016 was divided into two groups according to the random number table.The control group was treated with α-blocker Combined with vitamin C treatment, the study group using antidepressants combined with α-blockers treatment.The NIH-CPSI score and SDS score were recorded before and after treatment, and the therapeutic effects were compared between the two groups.Results There were no significant differences in NIH-CPSI scores and SDS scores between the two groups.After treatment, the scores of NIH-CPSI and SDS were significantly better than those before treatment, and the study group was superior to the control(91.1%) was higher than that of the control group(71.1%), the total effective rate of depression(93.3%) was higher than that of the control group(73.3%), and the total effective rate was 91.1%, The difference was statistically significant(P<0.05),comparable.Conclusion Antidepressants combined with α-blockers are effective in the treatment of chronic prostatitis, which is beneficial to the alleviation of clinical symptoms and the improvement of their symptoms.Therefore, it has a good clinical value and worthy of further popularization.