As an essential part of modern medical service,pharmaceutical care gains more and more attention in the field of medication. The goal of pharmaceutical care is to effectively control rational administration of drugs, improve the therapeutic efficacy and avoid adverse drug reactions.Pharmacology,as the key basis of pharmacy,directly determines the level of pharmaceutical care.Therefore,development of pharmacology,especially for the clinical pharmacology,plays an important role in enforcing capability of clinical pharmacists.In this article,we summarized the functions of medical care in medical practice based on the Chinese medication.Authors described the relationship of pharmacology and medical care in the medication for cancer, infectious diseases, and chronic diseases. Authors proposed that the rational drug administration under the guidance of pharmacology is the core point to evaluate the quality of clinic pharmaceutical care,and the final goal of which is to increase the benefit of medication and guide the training of pharmacists in China.

Objective To explore the effects ofCangfu Congxian Decoction on the mRNA expression of IGF-1R in human mural granulosa cells;To explore the action mechanism for the treatment of polycystic ovary syndrome (PCOS) patients.Methods Totally 48 patients undergoing IVF-ET were randomly divided into treatment group and control group by random number table, 24 cases in each group. Patients in the control group accepted GnRHa/FSH/hCG stimulation, while the treatment group tookCangfu Congxian Decoction orally on the basic treatment of the control group. Serum E2, LH, and P concentration on HCG injection day, number of ovum, high quality embryo rate and clinical pregnancy rate were evaluated. The mRNA expression of IGF-1R on mural granulosa cells in the mature follicle was detected by real-time PCR.Results Compared with the control group, there was no significant difference in serum E2, LH, and P concentration on HCG injection day of treatment group (P>0.05), while the treatment group had higher high quality embryo rate than that of the control group (P<0.01). There was no significant difference in the number of ovum and pregnancy rate between the two groups (P>0.05). The mRNA expression of IGF-1R on granulosa cells in treatment group was significantly higher than the control group (P<0.01).Conclusion The mechanism ofCangfu Congxian Decoction for treating PCOS is up-regulating the mRNA expression of IGF-1R in mural granulosa cells and increasing high quality embryo rate.

Objective To investigate changes of markers of prethrombotic state(PTS)with heart failure and to explore their clinical significances.Methods Plasma levels of t-PA、PAI-1、Fg、PT、APTT、ET-1、MPV were measured in 52 patients with heart failure and in 38 normal controls.Results Compared with the healthy control group,patients with heart failure had significant increase of plasma PAI-1、Fg and ET-1level.Conclusions PTS is present in heart failure,especially in those with more severe Nyha class.

Objective To explore the clinical value of depression and event related potentials P300 in children with narcolepsy(NRL).Methods Event related potentials P300 test and self-rating depressive scale(SDS)test were performed in 39 children with NRL and 38 normal healthy children were selected as controls.Denmark Keypoint 4 path myoelectricity induced potential equipment and short sound stimulus were applied to determine event related potentials P300 test.Participants were required to hit the key for target stimulus,and reaction time and percentage of hits were recorded automatically.Long P300 and(or) low P3 amplitude of wave exceeded control group 2.5 s were abnormal.Zung SDS was adopted to evaluate somatization disorder,psychomotor disturbance,depression obstruction factor value.SPSS 12.0 software and t test were done to analyze the data.Results The abnormal rate of P300 in children with NRL of children group was 82.1%(32/39 cases),the latency of N2(260.7?22.1)ms and P3(353.1?25.9) ms of event related potentials of children with NRL group were longer than those in control group(241.0?23.2)ms,(341.3?26.1)ms,and there was significant difference between two groups(t=2.77,4.82 Pa

Objective Beijing plans to run a DRGs-PPS pilot.The relative height of each DRG group produced by the price of charge categories.Because of serious distortions of medical services prices,DRGs'weight must be adjusted.Methods Dividing medical service into 5 major class-medical,nursing,technique,drugs and consumables,management,a conversion with currency were established to produce the cost.Results The weight of groups involve intervention from MDCF are drop.ConclusionThe weight regulated can optimize resources allocation and reflect the ture value of medical service.

The medical service payment system reform is one of core issues in medical and health system reform.The payment system can directly affect behavior of stakeholders and indirectly affect medical expense,quality of care,efficiency of medical services and efficiency of medical insurance funds.Through behavior analysis of stakeholders in fee for service,DRGs-PPS,global budget,DRGs-PPS is the best payment system that can control the irrational increase of medical expenses and ensure the level of health service and meets interest of stakeholders among three payment systems.In DRGs-PPS,stakeholders continuously make progress in filling in the front sheet of medical records,clinical pathway,construction of information system,cost calculation and restructure costs.

Objective To explore the reactive inhibition and electrophysiological changes under the GO/NOGO paradigm in patients with alcohol dependence (AD) in order to provide a theoretical basis for neuromechanism study of AD executive dysfunctions.Methods The GO/NOGO paradigm event related potentials (ERP) were tested in 51 AD patients and 29 healthy controls, this paradigm behavior and ERP-N1, N2 and P3 latency and amplitude were analyzed.ERPs and execution functions were followed at different time points of withdrawal(4, 9,13 weeks).Results The number of correct responses (29.18±3.03)lowered and error responses (5.16±3.77) heightened in AD patients, and differences had statistical significance compared with those in control group(32.35±2.58,3.19± 1.84, P＜0.05), and there was no group difference in response time.There was no statistical significance in group difference in N1 component under the GO/NOGO tasks and in P3 latency under GO.N2 ((3.48±2.21) μV, (4.49±3.00) pV) and P3 amplitude ((3.47±2.31) μV, (3.92±4.09) μV) decreased and N2 latency ((256.30±31.62) ms, (256.09±33.77)ms) prolonged in AD group under both GO/NOGO tasks and so did P3 latency ((355.33±25.96) ms) under the NOGO, and the differences had statistical significance.Group main effects in N2 and P3 component (P=0.000) and task main effects in N2 amplitude and P3 latency (P＜0.05) were significant,group and task interaction was significant only in P3 latency (P＜0.01).ERPs of AD patients had no notable changes at different time points of withdrawal, executive dysfunctions were the worst within the 1st week of withdrawal and gradually recovered to pre-withdrawal levels.Conclusion AD patients have lower reactive inhibition manifested mainly by weakened capacity to inhibit and adjust conflict monitor and pre-executive motor program, ERP and executive functions cannot be well improved during short-term withdrawal, and the GO/NOGO-ERP can completely reflect electrophysiological changes of reactive inhibition process of AD patients.

Objective To explore the changes of cognition and sleep status in the youngsters with internet addiction disorder (IAD), and to clarify the relation between cognition and sleep-related indicators of IAD youngsters.Methods Event related potential (ERP) and Pittsburgh Sleep Quality Index (PSQI)test were used for forty-two IAD (case group)and forty non-IAD (control group) in youngsters, and the indexes of period latency (PL)of N1 ,P2 ,N2 ,P3 and amplitude of P3 (P3 amp)of ERP were analyzed,the factor scores of sleep quality (SQ), sleep latency (SL), sleep time (ST), sleep efficiency (SE), sleep dysfunction (SD), sleeping pills (SP), daytime dysfunction (DD)and total score of PSQI were analyzed. The correlation between the P3 PL, P3 amp of ERP and all the indexes of PSQI in case group was analyzed.Results The PL of N2 ,P3 of ERP in case group was significanly longer and the P3 amp was significantly lower than those in control group (P<0.01);the factor scores of the SQ,SL,ST,SE,SD,DD,and the total score of PSQI test had significant differences between two groups (P<0.01).The correlation analysis results showed that there were remarkable positive correlations between the P3 PL and the factor seores of the SQ,SL,ST,SE,SD,DD and the total score of PSQI test in case group (r=0.46,0.34,0.51,0.40,0.48,and 0.54;P<0.01),and there were remarkable negative correlations betweeb P3 amp and the indexes of PSQI test in case group (r=-0.42,-0.45,-0.49,-0.38,-0.38,and -0.50;P<0.01).Conclusion The IAD youngsters have cognition and sleep dysfunction,and the both factors can affect each other.

Objective To explore the effect of relaxation treatment (RT) on the sleep quality of patients with generalized anxiety disorder (GAD).Methods Ninety-two GAD patients were recruited and evenly divided into a study group (n =46) and a control group.The control group was treated with conventional medications,while the study group received RT in addition.The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to test for changes in sleep before and after treatment.Results There were no significant differences between the two groups before treatment in terms of average PSQI scores or PSG results.After treatment,both groups scored significantly better on the PSQI than before the treatment.PSG showed that after treatment there was less awakening,greater sleep efficiency and longer total sleep time.There was shorter sleep latency and rapid eye movement sleep latency,shorter duration of shallow sleep,and longer duration of deep sleep and rapid eye movement sleep in the study group,as well as fewer awakenings,greater sleep efficiency and longer total sleep time.The PSQI and PSG results of the two groups after treatment were significantly different.Conclusions RT can significantly improve sleep disorders in GAD patients.

Objective To study the effect of coenzymes complex combined with vitamin E on liver and kidney inju-ry induced by neonatal hyperbilirubinemia. Methods One hundred and fifty full-term neonatals with hyperbilirubinemia were chosen as observation groups, who were divided into mild, moderate and severe groups according bilirubin. Forty five healthy full-term newborns in the same period, who are either healthy or with physiological jaundice, were selected as con-trol group. Serum total bilirubin, gamma-glutamyl transferase (γ-GGT) , Malondialdehyde (MDA) and Cys-C were measured within 24 hours of hospital admission.The observation groups were randomly divided into regular and combined treatment groups. Coenzymes complex combined with vitamin E were given in addition to regular method to combined group while reg-ular group only received regular methods.All above biochemical indexes were tested in the 7th day after medication admin-istration. Results Serum MDA were higher in all observation groups (mild, moderate and severe groups) than in control group (P＜0.05);but the levels ofγ-GGT and Cys-C increased in moderate and severe groups compared with control group (P＜0.05). There were positive correlations (P＜0.05) between levels of serum total bilirubin with MDA,γ-GGT and Cys-C. Positive linear correlation were found between MDA with γ-GGT and Cys-C(P＜0.01). After early intervention,γ-GGT, Cys-C and MDA declined with drop of bilirubin level. This is more prominent and faster in a in combined treatment group than regular group (P＜0.05).Conclusion In hyperbilirubinemia newborns, lipid peroxidation activated by bilirubin may lead to damages of liver and kidney. Coenzymes combined with vitamin E have protective effect to these damages.