OBJECTIVE:To discuss the contents and ways of clinic pharmacy work.METHODS:The different focuses of clinical pharmacy work between China and Japan was compared based on the pertinent data obtained from conference,visiting and learning,and self practice.RESULTS & CONCLUSION:Clinic pharmacy work calls for details and pragmatic attitude,and the elementary clinical pharmacy work is much needed by patients,which thus should be carried out in hospitals at all levels.

BACKGROUND:Intertrochanteric fractures are often treated with extramedulary fixation and intramedulary fixation. Which internal fixation can better repair intertrochanteric fractures remains controversial. OBJECTIVE: To compare the efficacy and safety of dynamic hip plate and proximal femoral intramedulary nail fixation in treatment of intertrochanteric fracture in adults. METHODS: Al randomized clinical trials relevant to comparing proximal femoral intramedulary nail fixation with dynamic hip plate for intertrochanteric fracture in adults from 1966 to 2013 were identified. The quality of the trials was assessed. The outcomes included length of surgery, operative blood loss, postoperative femoral shaft fracture, cut-out of the implant from the femoral head, non-union of the fracture, reoperation rate, wound infection, postoperative hip pain (hip joint pain and thigh pain), which were extracted and reviewed systematicaly. RESULTS AND CONCLUSION:4 757 trial participants with 4 748 fractures were included in the 31 published trials. There was no significant difference in the length of surgery, reoperation rate, cut-out of the implant from the femoral head, non-union of the fracture, wound infection and postoperative hip pain between the two groups (P > 0.05) between dynamic hip plate and proximal femoral intramedulary nail fixation. Compared with dynamic hip plate fixation, proximal femoral intramedulary nail fixation had less blood loss and significantly higher rate of femoral shaft fractures (P=0.003). Experimental findings show that, in treatment of intertrochanteric fracture, intramedulary nail fixation is associated with significantly lower blood loss. However, the risk of femoral shaft fracture is increased compared with dynamic plate fixation. There were no differences in length of surgery, cut-out of the implant from the femoral head, non-union of the fracture, reoperation rate, wound infection and postoperative hip pain. The results of this systematic review should be explained prudently because of some limitations of included trials. To obtain more reliable conclusions, large-scale randomized controled trials of strict design, uniform index and long-term folow-up are needed.

Objective To evaluate the application value of 64-row spiral CT coronary angiography(CAG)in myocardial bridge (MB)and mural coronary artery(MCA) .Methods Imaging data of 436 consecutive subjects underwent coronary CT angiography in Hospital of Beijing Puren were enrolled in this study .The prevalence ,clinical effects of patients ,precise location and incidence of each branch were evaluated .In addition ,the length and depth of MB ,as well as their relationship with MCA in stenosis were evalua-ted .Moreover ,the group of subjects with MB was compared with the control group(subjects without MB)in the probability of ath-erosclerosis .Results Among the total of 436 subjects ,76 subjects(17 .4% ,76/436)were found to have MB .The left anterior de-scending artery(LAD)was the most common coronary artery involved(68 .4% ,52/76) .The pressure level of MCA associated with the length and depth of MB .A significant difference was found between the LAD-MB-MCA group and the control group in the presence of coronary artery plaques(P<0 .05) .Conclusion The anatomic relation between MB and MCA can be precisely displayed on 64-row spiral CT coronary angiography ,which is considered to be an excellent diagnostic method to screen MB-MCA initially . There is a relationship between stenosis of MCA and the length and depth of MB .The present and stenosis of MB-MCA are meant to form coronary artery plaques in LAD segment more easily .

Objective To estimate the performance of Wood's lamp examination in the diagnosis of superficial cutaneous fungal infections. Methods Totally, 129 patients, who were diagnosed with superficial cutaneous fungal infections according to clinical medical history and signs, were enrolled in this study. Wood's lamp examination of lesions was carried out. Cutaneous samples were obtained from the patients and subjected to microscopic examination and fungal culture. Results Wood's lamp examination was positive in 84% and 85.7% of patients with tinea versicolor and malassezia folliculitis, respectively; among these patients positive for Wood's lamp examination, 92.9% were positive for fungal culture, and 87.5% for microscopic examination. In patients clinically diagnosed with tinea manus and pedis, tinea corporis or tinea cruris, 8.3% were positive for Wood's lamp examination, while 85.4% were positive for fungal examination. There was a high consistency between Wood's lamp examination and fungal examination in patients with tinea versicolor and malassezia folliculitis, but not in those with tinea manus and pedis, tinea corporis or tinea cruris. Conclusions Wood's lamp examination shows a high specificity and sensitivity and is useful in the diagnosis of tinea versicolor and malassezia folliculitis, but seems unapplicable for the diagnosis of tinea manus and pedis, tinea corporis or tinea cruris.

58 mm Hg and 24hDBP descend significantly.Diurnal blood pressure rhythm abnormality(blood pressure descending 10% at night)is a high risk factor for renal impairment in essential hypertension.

ObjectiveTo evaluate the clinical effect of integrated traditional and western medicine in the treatment of post stroke depressive disorder (PSDD). MethodsThe data of 52 patients of PSDD evaluated on self rating depression scale(SDS) before and after treatment were analyzed statistically. ResultsThe curing rate of PSDD is about 78.85%.There was an apparent decrease in the level of SDS before and after treatment(P<0.001). ConclusionsThe treatment of integrated traditional Chinese and western medicine can produce a good effect on PSDD.

Objective To explore the efficacy of low dosage of olanzapine combined with fluoxetine in the treatment of depression.Methods A 8-week study was conducted in 130 patients met the diagnostic criteria for de- pression.Subjects were randomly assigned to two groups:fluoxetine(20mg/d)alone and olanzapine(2.5～5 mg/d) plus fluoxetine(20mg/d).They were evaluated with Hamilton depression scale(HAMD).Hamilton anxiety scale (HAMA)at baseline,the 1 week,2 weeks,4 weeks and 8 weeks subsequently.Results(1)There were significant differences in the total scores and reduction rates of HAMD between two groups in every interview.(2)The combi- nation group had greater reduction in depressive and anxiety symptoms than that in fluoxetine group.(3)The re- sponse rate in combination group was higher than that of fluoxetine group in 1 week,2 weeks and 4 weeks.There were no significant differences in response and remission rate between combination group and fluoxetine group.Con- clusion The combination of olanzapine with fluoxetine demonstrated a rapid,effective antidepressant action.

Objective:To promote the rational drug use in the patients treated with ambulatory chemotherapy. Methods:A model of integrated pharmaceutical care was established using such service as the real-time prescription examination, configuration standardi-zation, active care and prescription review. Results:The integrated pharmaceutical care could effectively reduce the unreasonable drug use, optimize drug use structure, lower the medical expenses and provide supporting data for clinical decision-making. Conclusion:The development of integrated pharmaceutical care in the patients treated with ambulatory chemotherapy is an important field for phar-macists displaying professional skills, which can promote the rational drug use. The treatment efficacy and life quality of cancer patients can be improved with the cooperation of doctors, nurses and pharmacists.

Objective To explore the effects of lycium barbarum polysaccharide (LBP) on restraining the mouse pancre?atic cancer cells LTPA by the polarization of macrophages to type 1 macrophages (M1). Methods LTPA tumor model of the subcutaneous CB-17SCID mice was constructed. Model mice were randomly divided into tumor-bearing model group (n=10) and LBP treatment group (n=10). The LBP treatment group was fed 10mg/kg LBP every day, and the tumor-bearing model group was fed the same dose of normal saline. The same amount of macrophages Raw264.7 was randomly divided into the control group and experimental groups (different concentrations of LBP). MTT assay was used to detect the optical density (OD) of Raw264.7 in experimental groups and control group. ELISA was used to detect the levels of the interleukin (IL)-12 and IL-10 in experimental group (LBP was 100 mg/L) and the control group. Flow cytometry was used to test the levels of the membrane protein CD16/32 and CD206 in experimental group (LBP was 100 mg/L) and the control group. The tumor mass was weighted and the volume was calculated after three weeks. The effects of LBP on the growth of subcutaneous tumor were detected. HE staining and KI-67 staining were used to detect the microscopic changes of tumor and the proliferation of the LTPA. Results The dose of 100 mg/L LBP can promote the growth of the macrophages Raw264.7 (P<0.01), and induced the high expression of CD16/32 and low expression of CD206, high secretion of IL-12 and low secretion of IL-10. The weight, volume of the tumor and the expression of KI-67 were significantly lower in experimental group than those in the con?trol group (P<0.01). The microscopic necrosis area range of tumor was larger than that of control group. Conclusion The LBP has the effect of restraining LTPA by the polarization of macrophages to M1.

OBJECTIVE An understanding of the complex anatomy of the anterior skull base is crucial for the surgeon doing endoscopic surgery. The anatomic data of the olfactory sulcus and adjacent structures in Chinese patients were defined using 3-dimensional reconstruction images. The surgeon is encouraged to develop a detailed pre-operative surgical plan by utilizing these dynamic anatomical observations to avoid intracranial injury. METHODS The paranasal sinus CT scanning images of 100 adults were reconstructed for observation using EBW2.0 software and multiplanar reformation. All data obtained were in the coronal plane from the anterior point of the olfactory sulcus. The cribriform plate depth as compared to the ethmoid roof and adjacent structures, was measured bilaterally. Data obtained on adjacent structures include the vertical height of the lateral lamella of olfactory sulcus, the horizontal distance between the cribriform plate and the orbital lamella, the length of the middle turbinate, the height of the orbit, and the vertical distance between the cribriform plate and the nasal floor. RESULTS The olfactory sulcus was classified into three types: platform type (60 %), sloping type (17 %) and mixed type(23 %), as distinguished from Keros classification. In this study the vertical height of the lateral lamella of olfactory sulcus was (5.03 ± 0.17) mm (R) and (5.39 ± 0.19) mm (L) in platform type, and (2.79 ± 0.49) mm (R) and (4.72 ± 0.49) mm (L) in the mixed type. There were statistically significant differences between the right side and the left side in these two types (P＜0.01). The horizontal distance between the cribriform plate and the orbital lamella on the same side was significantly different between the platform type and the mixed type of olfactory sulcus. A similar result was observed for the vertical distance between the cribriform plate and the nasal floor. Gender differences exist in the horizontal distance between the cribriform plate and orbital lamella on the same side and the vertical distance between the cribriform plate and the nasal floor. CONCLUSION Different types of olfactory sulcus have distinct characteristics, hence care which must be taken into account when doing endoscopic surgery.