OBJECTIVE:To provide reference for improving the quality of pharmacy services in drug stores.METHDOS:Using the principle of Marketing Professional Services,pharmacy services were divided into three levels,the main contents of each level were analysed.RESULTS&CONCLUSION:The three levels of pharmacy service is a tightly connecting unity.Only when drug stores try every way possible to do each level of pharmacy services well,can their core market competitive power be raised.

OBJECTIVETo explore the effect of lappaconitine on patient-controlled intravenous analgesia (PCIA) and serum complement 3 and 4 (C3 and C4) levels of cancer patients undergoing rectum surgery.

METHODSTotally 60 patients, who were scheduled for rectum carcinoma surgery, were recruited to the study and assigned in 3 groups, the blank control group, the tramadol group, and the lappaconitine group, 20 in each group. Lappaconitine (8 mg) was intravenously dripped to patients in the lappaconitine group 30 min before ending the operation. PCIA started as soon as the end of the surgery and the total dose of lappaconitine was 36 mg. Patients of the tramadol group were treated with tramadol (100 mg) intravenously within 30 min before ending the operation. The dripping was completed within 30 min. PCIA was started as soon as the end of the surgery and the total dose of lappaconitine was 36 mg. Tramadol (100 mg) was intravenously dripped to patients in the tramadol group 30 min before ending the operation. PICA was started as soon as the end of the surgery and the total dose of tramadol was 900 mg. Pethidine (50 mg) and droperidol (2. 5 mg) was intramuscularly injected to patients in the blank control group for pain relief according to their complaints. Pain degrees were assessed by visual analog scale (VAS) 12 h before surgery, 12, 24, 48, and 72 h after surgery. Blood samples were withdrawn at the same time point. Contents of serum C3 and C4 were determined by immunoturbidimetry.

RESULTSVAS scores of the blank control group were significantly higher after surgery than before surgery (P <0. 01). There was no statistical difference in VAS scores between before surgery and after surgery in the tramadol group and the lappaconitine group (P >0. 05). VAS scores were significantly lower at each post-surgery time point in the tramadol group and the lappaconitine group than in the blank control group with statistical difference (P < 0.01). There was no statistical difference in VAS scores at each post-surgery time point between the tramadol group and the lappaconitine group (P >0. 05). Compared with before surgery, contents of serum C3 and C4 significantly decreased in all of the three groups at 12, 24, and 48 h after surgery (P < 0.05, P < 0.01). They recovered to the pre-surgery level till 72 h after surgery (P > 0.05). Serum C3 and C4 contents at 48 h after surgery were higher in the tramadol group than in the blank control group (P < 0.05). Serum C3 and C4 contents at 24 and 48 h after surgery were higher in the lappaconitine group than in the blank control group (P < 0.05). There was no statistical difference in serum C3 and C4 contents at each time point between the tramadol group and the lappaconitine group (P > 0.05). VAS scores were obviously negatively correlated with serum contents of C3 and C4 (r = -0.622, r = -0.649, P < 0.01).

CONCLUSIONSLappaconitine (used at the dose in this study) showed better pain relief effect after surgery. Besides, it could inhibit the surgic wound and pain, and elevate serum contents of C3 and C4.

Aconitine ; analogs & derivatives ; therapeutic use ; Analgesia, Patient-Controlled ; methods ; Analgesics, Non-Narcotic ; therapeutic use ; Complement C3 ; metabolism ; Digestive System Surgical Procedures ; Humans ; Neoplasms ; Orthopedic Procedures ; Pain Measurement ; Pain, Postoperative ; Postoperative Period ; Rectum ; surgery ; Tramadol

Humans ; Tinnitus ; diagnosis ; therapy

Objective To evaluate the value of metal spring ring for localization of breast lesions. Methods Thirteen cases of nonpalpable breast benign lesion and 41 cases of breast cancer that had been treated by neoadjuvant chemotherapy were enrolled in this study. The lesion was localized with the margin being marked under the guidance of ultrasonography. Metal spring rings with proper length was used according to the maximum diameter of the lesion; and then via a 18G puncture needle, the metal spring ring was place exactly to the two ends of the biggest cross-section of the lesion by using a guide wire. Afterwards, the lesions were resected with the spring ring. The 41 patients with breast cancer received 2-to 3-week chemotherapy after the operation. Results For the 13 cases of benign breast lesion, the mass was resected accurately and completely with the spring rings. In the 41 cases of breast cancer, no residual tumor cells were found in the tissues around the margin of resection. During the postoperative chemotherapy, ultrasonography showed that the mass was reduced in 39 of the cases, among which 9 had no clear margin of the tumor before the operation shown by ultrasonography. Off the 9 cases, postoperative pathological examination found no tumor cells in the successive sections. Conclusions Localization of breast lesions under the guidance of ultrasonography is a new method for diagnosis and treatment of nonpalpable breast lesions. It is valuable for follow-up by ultrasonography, evaluation of chemotherapy, and postoperative biopsy, especially for the breast cancer patients who have received preoperative chemotherapy.

Objective To explore a surgical therapy on close depressed fracture of the skull.Methods Ni-Ti form memory-alloy cramps were fixed on between the depressed bone and the normal surrounding skull in 16 patients with close depressed fracture of the skull.Results The follow up was 5～54 months(average 26 months).It indicated that there was no displacement and depressing of the fixed bone, no subcutaneous collection of fluid, no reject reaction and inflammation, and no erosion. The fixed bone and skull density showed normal by X ray and the fixed cramp did not disturb CT and MR scaning. All patients declared no mental burden and felt safe.Conclusion The Ni-Ti form memory-alloy cramp has a good mechanical restoration force and a good plastic effect,but no complication,it can increase the ability to resist external force in fracture region, and the surgical procedure is very simple, therefore it is ideal to treat the depressed fracture of skull.

AIM: To quantify cyclooxygenase-2 (COX-2) mRNA in carcinoma of larynx and evaluate the correlation between the quantity of COX-2 mRNA and clinical staging or histological grade. METHODS: The expression of COX-2 mRNA in 30 cases of carcinoma of larynx tissue and adjacent non-cancerous tissues were evaluated by PCR, which includes a fluorescence dye , SYBR green Ⅰ, and the sequence specific primer. The GAPDH was used as control. RESULTS: The specificity of products was proved to be COX-2 and GAPDH by the analysis of the melting curve of the amplified products and agarose gel electrophoresis. The expression of COX-2 mRNA was detected in all cancerous tissues of 30 patients (100%), but only in 12 adjacent non-cancerous tissues of 30 patients (40%). The N_ COX value of carcinoma of larynx tissue and adjacent non-cancerous tissues was 16.54?13.27 and 9.24?6.91, respectively, and the expression levels of COX-2 mRNA elevated significantly in laryngeal squamous cell carcinoma tissue and there were significant correlation between the expression levels of COX-2 mRNA and clinical stage or histological grade. CONCLUSION: The expression of COX-2 mRNA in carcinoma of larynx can be determined by real-time PCR technique. An increase in COX-2 mRNA may be associated with carcinogenesis of carcinoma of larynx, and it may be useful as a biomarker in laryngeal cancer.

Objective To investigate the changes in tumor necrosis factor-alpha ( TNF-a) and interleukin-8 (IL-8) mRNA in skeletal muscle during open heart surgery with cardiopulmonary bypass (CPB) . Methods Ten patients (4 male, 6 female) aged 35-62 yr undergoing valve replacement under CPB were enrolled in this study. Anesthesia was induced with midazolam, fentanyl and pancuronium and maintained with isoflurane-fentanyl and pancuronium. A specimen of rectus muscle of abdomen (2g) was taken while chest was being opened (baseline) and closed. Blood samples were obtained before anesthesia (T0), while chest was being opened (T1), 15 min after initiation of CPB (T2), 5 min after aortic unclampmg (T3) and while chest was being closed (T4) for determination of plasma TNF-a and IL-8 level using enzyme-linked immunosorbent assay technique. Results TNF-a and IL-8 mRNA expression in skeletal muscle were significantly increased while chest was being closed as compared with the baseline ( P

The inhibitory effects of two kinds of selective cyclooxygenase-2 inhibitors on the proliferation of human carcinoma of larynx Hep-2 in vitro and their corresponding mechanisms were investigated. Hep-2 cells were cultured with two kinds of selective cyclooxygenase-2 inhibitors (Sc-58125 and Celecoxib) at various concentrations for 24 h. Morphological changes were observed under the phase microscopy and the growth suppression was detected by using MTT colorimetric assay. Apoptotic DNA fragments were observed by agarose gel electrophoresis, and the cell cycle and apoptotic rate were detected by flow cytometry (FCM) respectively. Hep-2 cells became rounded and detached from the culture dish after being treated with Celecoxib for 24 h, however, they remained morphologically unchanged with Sc-58125. Sc-58125 could increase G2 phase cells, whereas, Celecoxib rose G1 phase cells. Both of the two effects were dose-dependent. Moreover, the Hep-2 cells cultured with 50 micromol/L and 100 micromol/L Celecoxib showed obvious apoptosis, with the nuclear DNA of cells exhibiting characteristic DNA ladder. So Sc-58125 could inhibit the proliferation of Hep-2 cells by altering the G2 phase cells. However, Celecoxib had the same effect by changing the G1 phase cells and inducing apoptosis at higher concentration.
Antineoplastic Agents/pharmacology ; Apoptosis/drug effects ; Cell Proliferation/drug effects ; Cyclooxygenase 2 Inhibitors/*pharmacology ; Dose-Response Relationship, Drug ; Laryngeal Neoplasms/*pathology ; Pyrazoles/*pharmacology ; Sulfonamides/*pharmacology ; Tumor Cells, Cultured

Objective To investigate the effect of p21-activated kinase 1 on chemotherapy sensitivity of 5-fluorouracil. Methods Cell proliferation was measured by CCK8 and apoptosis rate by flow cytometry or Hoechst staining; the expression of Bcl-xl, Bcl-2, XIAP were determined by Western Blot. Results 5-FU combined shRNA-Pak1 group (combination group) could be significantly inhibited in terms of proliferation (P <0.05). The percentage of apoptosis rate in combined group was the highest and the difference among groups indicated statistical significance (P < 0.05). The expression of Bcl-xl, Bcl-2, XIAP in combination group was significantly inhibited compared with 5-FU group or shRNA-Pak1 group. Conclusion PAK1 inhibited by RNA interference can enhance chemotherapy sensitivity of 5-Fu on growth inhibition and apoptosis induction in colon cancer significantly.

Objective To study the experience of laparoscopic repair in gastric and duodenum perforation. Methods 35 patients with gastric and duodenum perforation were performed laparoscopic repair.Results 34 pati- ets with gastric and duodenum perforation were safely operated.1 case with perforation of gastric carcinoma was con- verted to open for radial gastrectomy.The mean time of hospitalization was 7.5 days.There was no intraoperative and postoperative complications.Pathological examination showed 4 patients with perforation of gastric ulcer and one with perforation of gastric carcinoma.Conclusion Laparoseopic repair was one of the safe,quick recovery and little suffering treatment for duodenum perforation.