Objective To investigate the clinical characteristics of juvenile rectal carcinoma in order to improve the diagnostic level and therapeutic efficacy at the early stage. Methods Clinical data, including clinical manifestations, misdiagnosis, clinical pathology, treatment, and prognosis, from 89 cases of juvenile rectal carcinoma were analyzed retrospectively and compared with those from 440 cases of senile rectal carcinoma. Results ① The main manifestations of juvenile rectal carcinoma included anal and rectal pains, abdominalgia, abdominal distention, and sacrococcygeal pain. ② In juvenile group, carcinomas with distance less than 9 cm and less than 7 cm away from the anal verge amounted to 92.13% and 69.66%, respectively (average distance: 5.43 cm). ③ The average period of misdiagnosis in juvenile group was 5.7 months with a misdiagnosis rate of 97.75%, significantly higher than that in senile group ( P

Objective To explore the relationship between the stromal angiogenesis and growth of the large intestinal carcinoma. Methods The vascular quantitative parameters(, , Sv, TA/BA) of the distal and proximal ends of the carcinoma, the center of the carcinoma, and the intestinal mucosa of distal and proximal ends of carcinoma were analyzed with computerized image. Differentiation degree of tumor cell was observed microscopically. Results Of the 48 cases studied, significant differences( P

Objective To provide the theoretic basis for the clearance of the metastatic lymph nodes in radical operation of colorectal carcinoma(CRC) by means of exploring the relationship between mass size of both tumor and lymph nodes and the rate of lymph node metastasis. Methods A total of 702 lymph nodes from 57 cases of CRC radical operations were divided into 5 groups and each of the lymph nodes was examined. The size of lymph nodes, Dukes' phases, the pathological types of CRC and their metastasis rate were analyzed. Results ① High metastasis rate was found at Dukes' C and D phases of CRC, being 29.93% and 48.12%, respectively. ② The metastasis rates of mucous adenocarcinoma and signet ring cell carcinoma were the highest of all pathological types, being 59 52% and 59.26%, respectively. ③ Metastasis rate of lymph nodes was not correlated with the mass size of tumor, but correlated with Dukes' phase. Conclusion ① Metastasis rate of lymph nodes increases with the growth and infiltration of tumor. ② Metastasis rates of mucous adenocarcinoma and signet ring cell carcinoma are higher than those of well and mid differentiated carcinomas. ③ Metastasis may be suggested for lymph node of CRC more than 5 mm in diameter during operation. However, clearance of lymph node of CRC less than 5 mm in diameter needs further study.

OBJECTIVE:To provide reference for promoting the further development of pharmaceutical service in chain phar-macies and the regulation of related departments. METHODS:Field investigation and questionnaire survey were used to investigate the basic situation of pharmaceutical care in 5 chain pharmacies in Chengdu city and analyze the results. RESULTS:In terms of core service,it showed that 2 pharmacies had no suspension of pharmacists license and the pharmacist was not on-the-job;there was significant difference in the medication guidance frequency of pharmacists in those pharmacies(P<0.05);more than 50% sur-veyed consumers received medication guidance when buying drugs in pharmacy B,C and E. In terms of perceived service,3 phar-macies existed illegal drug advertising and 3 existed illegal promotion;drug partitions of all pharmacies were good;service archive material showed best in pharmacy C and worst in pharmacy D;in service advisory zone setting,setting of independent advisory zone was worse. In terms of extended service,5 pharmacies had different preferential ways for memberships except for the prefer-ence in membership day;the unbundling service in those pharmacies was worse,and no pharmacies had no less than 10 unbun-dling varieties. CONCLUSIONS:Pharmaceutical service in chain pharmacies in Chengdu city is barely satisfactory. Pharmacy should strengthen the assessment and management of pharmacists and improve pharmaceutical service,and regulatory authorities strengthen the supervision of advertising and promotion of drugs. What’s more,it is suggested to establish cloud supervision plat-form with the internet information technology,carry out remote service and cloud service and strengthen brand marketing service on the internet to improve the pharmaceutical service levels in chain pharmacies.

OBJECTIVE:To improve the automation of hospital pharmaceutical warehouse management by using Visual Basic for Applications (VBA) language so as to improve work efficiency. METHODS:Through editing VBA language of Microsoft of-fice software,the experience of our hospital was swmmarized,such as letting the computer automatically sort,split and encrypt, pharmaceutical email and track purehase plan. RESULTS & CONCLUSIONS:By adopting VBA programming,our hospital has re-alized automatic splitting of the pharmaceutical purchase plan,sending pharmaceutical shortage warning and automatic warning doc-ument management. Pharmaceutical purchase plans are sent faster and drug distribution to our hospital is becoming more timely. The management of document that have a period of validity is becoming more intelligent. Massive manpower and resoure are saved,and the work efficiency is greatly improved. New ideas and methods for smart warehouse management are provided.

OBJECTIVE:To provide reference for improving the pharmaceutical care of chain drug stores.METHODS:By convenience sampling,questionnaire survey about pharmaceutical care of drug stores was conducted among the customers in 5 chain drug stores (selecting each one branch drug store with certain scale) from Chengdu.The data were analyzed statistically.RESULTS:A total of 413 questionnaires were issued,of which 400 were valid,with effective recovery rate of 96.9％.Only 25.5 ％ respondents could identify the licensed pharmacist;higher educated respondents and respondents with academic background of medicine were more likely to make distinction (P＜0.05).The respondents who had often received the service of medication guidance,the service of recommending same effect medicine with low price and the service of medication instruction was only 45.5％,19.0％ and 48.3％ respectively,5.3％,13.0％ and 10.8％ of those who had never received such services.Respondents' satisfaction with the general service staff (64.0％) was much higher than with licensed pharmacist (34.3％).Respondents believed that the three most important pharmaceutical care were medication guidance,helping boiling TCM and free health test.CONCLUSIONS:Consumers can not clearly distinguish the licensed pharmacist in drug stores.The situation that consumers can get major items of pharmaceutical care is still unsatisfactory.Consumers are less satisfied with licensed pharmacists,but their attention to medication guidance services reflects their strong awareness of medication safety.

Objective To observe the effect of transcatheter thrombectomy combined with catheter-directed thrombolysis(CDT)for treating acute medium-high and high risk pulmonary thromboembolism(PTE).Methods After placement of inferior vena cava filter,transcatheter thrombectomy combined with CDT were performed in 28 patients with acute medium-high or high risk PTE.After treatment,clinical symptoms improved or not was assessed,and interventional related complications were recorded.The outcomes of arterial blood gas analysis,coagulation function,blood routine test,pulmonary artery pressure(PAP)and right ventricular diameter/left ventricular diameter(RV/LV)were compared before and 72 h after treatment.Regular follow-up was performed,then PAP and the clearance of pulmonary arterial thrombosis were observed 1,3,6 months and 1 year after treatment during follow-up.Results Among 28 cases,significant improvement of clinical symptoms achieved in 26 cases after treatment,while 2 patients died of respiratory failure.Puncture site bleeding occurred in 4 cases and improved after conservative treatment.Compared with those before treatment,among 26 survived patients,blood pH,arterial oxygen pressure,fibrin degradation products and D-dimer increased while the heart rate,N-terminal pro-B-type natriuretic peptide,PAP and RV/LV decreased 72 h after treatment(all P＜0.05).During follow-up,compared with those before treatment,PAP decreased,while the clearance rate of pulmonary thrombosis increased 1,3,6 months and 1 year after treatment(all P＜0.05).No active bleeding nor recurrence of PTE happened.Conclusion Transcatheter thrombectomy combined with CDT was safe and effective for treating acute medium-high and high risk PTE.

OBJECTIVETo compare the efficacy and toxicity of the chemotherapeutic regimen containing pirarubicin and mitoxantrone on the treatment of relapsed or refractory acute myeloid leukemia (AML) in adults.

METHODSIn this open prospective multicentre study, we randomly assigned patients with relapsed or refractory AML to receive TAE regimen (pirarubicin+cytarabine+etoposide) versus MAE regimen (mitoxantrone + cytarabine + etoposide). The efficacy and toxicity were compared between the two groups.

RESULTS56 patients entered this clinical trial. The complete remission (CR) rate on TAE arm was 79.0% versus 55.6% on MAE arm with the overall response (OR) rates of 86.8% versus 88.9%, respectively. The CR was higher on TAE arm (P=0.035) but with no significant difference between the two groups regarding the overall response (OR) rate. The regimens were well tolerated in both groups. Hematologic and non-hematologic toxicity were similar except relatively lower the mean dosage of G-CSF, red blood cells and platelets transfusion on TAE arm. No significant differences were seen between the two groups regarding the overall survival and relapse free survival rates.

CONCLUSIONTAE regimen might be an effective salvage therapy in patients with relapsed or refractory AML.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Dactinomycin ; administration & dosage ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Etoposide ; administration & dosage ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Methotrexate ; administration & dosage ; Prospective Studies ; Recurrence ; Remission Induction

Tacrolimus (FK506) is a 23-membered macrolide with immunosuppressant activity that is widely used clinically for treating the rejection after organ transplantation. The research on tacrolimus production was mainly focused on biosynthesis methods, within which there are still some bottlenecks. This review summarizes the progress made in tacrolimus biosynthesis via modification of metabolic pathways and control of fermentation process, with the hope to address the technical bottlenecks for tacrolimus biosynthesis and improve tacrolimus production by fermentation engineering and metabolic engineering.
Tacrolimus ; Immunosuppressive Agents ; Fermentation ; Macrolides ; Anti-Bacterial Agents