OBJECTIVE:To investigate the new management model of the hospital pharmacy established by application of vender managed inventory (VMI) model. METHODS:Concerned about the implementation of VMI model,its effects and prob-lems,new management model of hospital pharmacy were described after the hospital cooperated with two suppliers. The hospital is mainly in charge of the management and application of pharmaceutical staff and equipment,drug capital flow,and the selection and optimization of drug use list;focus on the training of pharmaceutical talents;improve drug quality management,pharmaceuti-cal administration,pharmaceutical care and rational drug use. Two suppliers are mainly in charge of drug logistics,and the alloca-tion of servicer,software and hardware(as automatic medicine dispensing machine);share logistic cost of supply chain. Drug in-formation flow was established by both hospital and supplier. RESULTS:After cooperation,pharmaceutical staff,related equip-ment and inventory cost(floating capital decreased by 10 million yuan each month)were decreased,and the efficiency of distribu-tion improved;the error rate of drug dispensing in outpatient pharmacy were decreased (decreasing from 0.39‰ to 0.12‰) after the establishment of automatic pharmacy. The establishment of early warning system for abnormal patients flowrate in pharmacy window shortened the time of getting medicine,and improved service level and satisfactory degree of patients (increasing from 84.91% to 93.62%). CONCLUSIONS:New management model of hospital pharmacy based on VMI model provides reference for public hospital reform and hospital-enterprise cooperation under New Medical Reform.

BACKGROUND: The placental tissue structure is complex, including the amniotic membrane, chorion, and decidua from the mother. Mesenchymal stem cells derived from different tissues of the same placenta have been reported to have similar biological characteristics. To date, there is no study regarding quantitative comparison of differentiation potential and immunomodulatory function of mesenchymal stem cells derived from different tissues of human placenta. OBJECTIVE: To investigate the biological characteristics including differentiation potential and immunomodulatory function of mesenchymal stem cells derived from different tissues of human placenta. METHODS: The amnion-, chorion-, and decidua-derived mesenchymal stem cells were isolated from the placental tissue of a baby boy by enzymatic digestion method. The biological characteristics of these three kinds of mesenchymal stem cells were systematically investigated including cell morphology, immunophenotypes, karyotypeanalysis, adipogenic and osteogenic differentiation potential, and Treg cells proliferation capacity. RESULTS AND CONCLUSION: All three kinds of mesenchymal stem cells showed fibroblast-like morphology and expressed the surface markers of mesenchymal stem cells with high expressions of CD73, CD90 and CD105, as well as low expressions of CD14, CD19, CD34, CD45 and HLA-DR. The karyotypes of the amnion-and chorion-derived mesenchymal stem cells were the same as the fetus, and decidua-derived mesenchymal stem cells had the same karyotype as the mother. There were significant differences in adipogenic differentiation capacity between three kinds of mesenchymal stem cells (amnion-derived mesenchymal stem cells> chorion-derived mesenchymal stem cells> decidua-derived mesenchymal stem cells; P < 0.05). In contrast, the osteogenic differentiation capacity of amnion-derived mesenchymal stem cells was remarkably higher than that of decidua-derived mesenchymal stem cells (P < 0.05). The amnion-and chorion-derived mesenchymal stem cells had the higher potential of Treg cell proliferation induction than decidua-derived mesenchymal stem cells. These findings indicate that three sources of human placenta-derived mesenchymal stem cells have different karyotypes, adipogenic and osteogenic differentiation potential, and immunomodulatory capability, providing a variety of ideal seed cell sources for disease treatment.

Objective:To explore the clinical and imaging features of leucine-rich glioma inactivated 1 antibody associated autoimmune encephalitis (LGI1-AE).Methods:Nine LGI1-AE patients had conformed diagnosis in Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University from January 2016 to December 2021 were enrolled. A retrospective analysis was performed on the clinical manifestations, MRI and PET-CT features, and clinical outcomes of these patients.Results:One patient had acute onset due to sudden disturbance of consciousness; 3 had subacute onset with a duration of 10-15 d, manifested as dizziness, memory loss, unconsciousness and limb convulsions; 5 had chronic onset with a duration of 6 months-2 years, manifested as amnesia, memory loss, dizziness, and headache in the early stage of the disease, including 2 accompanied by emotional stress and personality changes. Eight patients were followed up for an average of 8 months: 1 with acute onset had organic mental disorder (dementia state), 3 had recurrent seizures (1 with subacute onset and 2 with chronic onset), and the remaining 4 had symptom relief or disappearance. In these 9 patients, 8 patients, enjoying good prognosis, showed typical imaging findings: lesions were located at the limbic system, morphological swelling was accompanied by increased T2WI signal, and PET showed reduced or increased metabolism; 1 patient, enjoying poor prognosis, had atypical imaging finding: asymmetric hyperintensity in the basal ganglia, the clinical symptoms were more severe than the 8 patients having lesions at the limbic system, and rapid disease progress was noted.Conclusion:The prognosis of LGI1-AE patients with atypical imaging manifestations might be relatively poor.