Objective To evaluate the effect of case management model on the stable patients with chronic obstructive pulmonary disease (COPD),containing health knowledge level,the number of acute exacerbation and the quality of life.Methods Fifty patients were divided into the experimental group and the control group with 25 cases each by random digits table method.The experimental group received the case management model for 3 months.The control group received routine care for 3 months.The COPD health Knowledge Questionnaire(CKQ) scores and St George's Respiratory Questionnaire(SGRQ) scores were measured for 4 times (the beginning of the intervention and 1 months,2 months,3 months later),and the numbers of acute exacerbation were measured at 3 months later.Results The CKQ scores at 1,2,3 months after intervention were (28.04±1.43),(28.20±1.00),(28.40±1.04) points in the experimental group,and (18.08±2.30),(18.50±1.87),(18.33±1.66) points in the control group,and there were significant differences (t=18.109,22.556,5.320,all P ＜ 0.01).The scores of SGRQ and symptom at 2 months and 3 months after intervention were (50.56±8.68),(49.40±8.05),(41.52±10.86),(37.16±8.90) points in the experimental group,and (57.42±10.22),(59.46±9.06),(54.50±8.67),(56.71 ±10.03) points in the control group,and there were significant differences (t=-7.222-2.536,P ＜ 0.05 or 0.01).The influence scores at 1,2,3 months after intervention were (46.28±8.74),(44.40±8.11),(42.04±8.22) points in the experimental group,and (51.50±7.77),(51.79±8.06),(54.08±6.96) points in the control group,and there were significant differences(t=-2.206,-3.197,-5.523,P ＜ 0.05 or 0.01).There was no statistically significant difference about activity scores between two groups before and after intervention (P ＞ 0.05).The numbers of acute exacerbation during 3 months with 3,22 cases in 1 and 0 time in the experimental group and 9,15 cases in the control group,and there was statistically difference between two groups(x2=4.306,P＜ 0.05).Conclusions The case management model can promote the stable COPD patients to know more disease-related health knowledge,and improve the health knowledge level.The case management model can reduce the symptoms of the stable COPD patients,reduce the frequency of acute exacerbation,reduce the influence of disease on daily life,prevent further decline in activity endurance,and improve the quality of life.

OBJECTIVE:To promote the development of clinical pharmacy.METHODS:The clinical pharmacists and the status quo of pharmaceutical care in Taiwan region were introduced.RESULTS&CONCLUSION:The clinical pharmaceutical care mode prevalent in Taiwan region can serve as a model for mainland China to follow.What is urgent now is to emphasis the cultivation of clinical pharmacists and to perfect the concept of pharmaceutical care.

BACKGROUND:Generaly, the stent surface modification, especialy seeding cels, may accelerate or cause stent endothelium, and cause restenosis for prevention of in-stent thrombosis.
OBJECTIVE: To develop the optimal conditions for vascular stents coated with bone marrow mesenchymal stem cels.
METHODS: Cerebrovascular stent was co-cultured with passage 3 bone marrow mesenchymal stem cels from rats at 1×106, 1×107, 1×108, and 1×109/L. Cels on the stents were examined with transmission electron
microscopy after 48 hours. A total of 160 male Sprague-Dawley rats were enroled, among which, 20 rats were as normal control group, and the remaining 140 were used for producing models of ischemic stroke that were
randomly sub-divided into seven groups at 8 weeks after modeling: stainless steel stent implanted group, polymer stent group, and different concentrations of cellstent composite groups. After 8 weeks of implantation, the
expression of vascular endothelial growth factor in these cels was examined by western blot assay. Rat platelet activation in different groups was determined by flow cytometry.
RESULTS AND CONCLUSION:Implanted stem cels were able to grow adherently on the stainless steel stent wal. When the planting cellconcentration was 1×107 cels/L, the cels and organeles were morphologicaly
normal and covered the stent surface wel. These coated cels also expressed vascular endothelial growth factor, suggesting that they functioned as endothelial cels, and they also significantly lowered platelet activation. When
co-cultured with 1×107/L bone marrow mesenchymal stem cels, the stent was covered wel with endothelial-like cels and had significant lower platelet activationin vivo.

Objective To investigate the morphological and immunophenotypic characteristics of phyllodes tumors (PT) and explore their significance in differential diagnosis and evaluation of prognosis.Methods 48 specimens with PT were observed under light microscope with HE and immunohistochemical staining (EnVision method).The antibodies including CD34,CD10,CD117,p53,and Ki-67 were used.10 cases of fibroadenoma were compared and the clinical data and follow-up results were analyzed retrospectively.Results All of 48 cases with PT presented as well-circumscribed masses with typically leaflike structures composed of double-layered epithelial component arranged in clefts and overgrowing hypercellular mesenchymal component.31 benign,12 borderline,and 5 malignant PT were diagnosed based on stromal overgrowth,cellular pleomorphism,mitosis,margins,and others.Focal necrosis was detected in 3 malignant cases and liposarcoma component existed in 1 case.Immunohistochemical staining showed that the positive rates of CD34 were 93.5 ％,58.3 ％,0 in benign,bordline,and malignant PT respectively,there were significant differences between each groups (P ＜ 0.05).The expression of CD10 were 25.8 ％,83.3 ％,80.0 ％,its expression in benign group was significantly different compared with bordline and malignant PT (P ＜ 0.05).p53 was expressed in three groups with no significant difference (P ＞ 0.05).CD117 and Ki-67 had high expression comparatively in malignant PT.All cases were treated surgically with a local recurrence rate of 22.9 ％.Conclusions Reasonable surgery pattern based on accurate histopathological diagnosis is crucial to reduce the local recurrence rate of PT.Immunohistochemistry examination in PT is helpful to the differential diagnosis and evaluation of prognosis.

AIM: To study the expression and the role of neurokinin-1 receptor(NK-1R) and neurokinin-2 receptor (NK-2R) in distal ileum during acute necrotizing pancreatitis(ANP).METHODS: 130 adult Sprague-Dawley rats were divided into 2 groups: the rats in ANP group( n=80 ) were induced by the retrograde intraductal infusion of 5% sodium taurocholate. The rats in sham operation control group ( n=50 ) received laparotomy only. Reverse transcription polymerase chain reaction (RT-PCR) was used to determine the mRNA expression of NK-1R and NK-2R, Western blot was used to investigate expression level of NK-1R.RESULTS: NK-1R and NK-2R mRNA levels were enhanced in the distal ileum of ANP rats compared with controls. Western blot revealed stronger NK-1R immunoreactivity exited in intestinal mucosa in ANP rats. The overexpression of NK-1R was associated with mucosal pathological score( r=0.77,P

Objective From October 2010 to explore the current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou,Jiaxing and Shaoxing in Zhejiang province.Methods To April 2011,10 644 geriatric patients aged 60 years and over were included,and related questionnaire survey,physical examination and laboratory examination were carried out.The situation of hypertension control and influencing factors were analyzed.Results The control rate of hypertension was 38.6％,and its standardized rate was 27.6％.It showed that female,inhabited city,high level of education degree and regular exercise were positively correlated with hypertension control,while age,smoking,high salt diet and abdominal obesity were negatively correlated with hypertension control,and standardized treatment had a close relationship with hypertension control.Conclusions The situations of hypertensive control among geriatric patients in Hangzhou,Jiaxing,Shaoxing in Zhejiang province are still unsatisfactory.Strengthening standardization management measures for improving the control rate of hypertension is needed and has actual value.

Using the method of stratified random cluster sampling,8 996 elderly hypertensive patients in community were selected in the study.Patients entered the community-based hypertension program receiving stratified management,individualized treatment and health education.After 3 years of intervention,the disease awareness rate,treatment compliance rate and hypertensive control rate were increased from 68.30％,55.40％ and 38.60％ to 98.90％,86.70％ and 77.80％,respectively (P ＜0.05).The systolic and diastolic pressure,body mass index,triglyceride levels and other hypertensionrelated indicators were improved significantly,the number of individuals with obesity/overweight,smoking and drinking were decreased and those with regular exercise increased (all P ＜ 0.05).The results indicate that community-based comprehensive hypertension management is effective for hypertension control for elderly patients in community.

Ranolazine hydrochloride sustained-release tablet (RH-ST) was prepared and its release behavior in vitro was studied. The pharmacokinetic characteristics and bioavailability in six Beagle dogs after oral administration of RH-ST and ranolazine hydrochloride common tablets (RH-CT) as reference were compared. Three kinds of matrix, hydroxypropylmethylcellulose (HPMC K4M), ethylcellulose (EC 100cp) and acrylic resins (Eudragit RL100) were selected as functional excipients to keep ranolazine hydrochloride (RH) release for 12 hours. Through orthogonal designs, the polymers were quantified and the optimized cumulative release profile was obtained. The single oral dose of RH-ST 500 mg and RH-CT 333.3 mg was given to six dogs using a two way crossover design. Plasma levels were determined by LC-MS and the absorption fractions were calculated according to Loo-Riegelman formula. The steady-state concentration of RH in plasma of six dogs and its pharmacokinetics behaviors after continuous oral administration of RH-ST and RH-CT at different time intervals were studied by LC-MS. The steady-state pharmacokinetic parameters were computed by software program BAPP2.0. With the increase of the amount of the matrix, the drug release was decreased. The most important factor influencing drug release is the quantity of HPMC K4M. Drug release within the period (from 0 h to 12 h) fitted well into Higuchi model. The correlation coefficient (r) between the dissolution in vitro in release media of the distilled water and the absorptin fraction in vivo was 0.9550. To compare with RH-CT, RH-ST in vivo has a steady and slow release behavior, Tmax was obviously delayed (3.00 +/- 0.50) h and the relative bioavailability was over 80 percentage. The combined use of multiple polymers can decrease the tablet weight effectively, and the drug release rate can be decreased both in vitro and in vivo.

BACKGROUND:Studies have shown that umbilical cord blood stem cel transplantation promote the recovery of spinal cord injury, and electroacupuncture also can inhibit the proliferation of astrocytes to reduce damage to scar formation, suggesting that a combination of umbilical cord blood stem cel transplantation and electroacupuncture may play an important role in the treatment of acute spinal cord injuries. OBJECTIVE:To observe the influence of transplantation of human umbilical cord blood stem cels combined with electroacupuncture at theDu channel on expression of nerve growth factor and neurotrophin 3 in rats with spinal cord injuries. METHODS: Seventy-two female Sprague-Dawlay rats were randomly divided into control group, injury group, transplantation group and combined therapy group. In the control group, only an incision on the back was sutured;in the injury group, a piece of saline-infiltrated gelatin sponge, 1 mm×2 mm×2 mm, was placed into the transected spinal cord at T10 level; in the transplantation group and combined therapy group, a piece of gelatin sponged infiltrated in the suspension of human umbilical cord blood stem cels was placed into the transected spinal cord, respectively, and then, electroacupuncture stimulation at the Duchannel was performed in the combined therapy group at 1 hour after modeling. Specimens were taken at 7, 14, 28 days after modeling in each group, and then immunohistochemistry, western blot and real time-PCR methods were used to detect the expression of nerve growth factor and neurotrophin 3. RESULTS AND CONCLUSION:Compared with the transplantation group, the expression of nerve growth factor and neurotrophin 3 was lower in the injury group but higher in the combined therapy group at 7, 14, 28 days after modeling (P < 0.05). The results of western blot and real time-PCR were consistent with those of immunohistochemical detection. Findings show that human umbilical cord blood stem cel transplantation combined with electroacupuncture has a remarkable synergistic effect in the treatment of spinal cord injury that can significantly up-regulate the expression of nerve growth factor and neurotrophin 3, and contribute to injured spinal cord repair, regeneration and functional recovery after spinal cord injury.

Objective: To explore the application of18F-lfuorodeoxyglucose (FDG) micro- positron emission tomography (PET) myocardial metabolism imaging for evaluating dilated cardiomyopathy model (DCM) in experimental rats. Methods: A total of 12 male SD rats were randomly divided into 2 groups: DCM group, the rats received intraperitoneal injection of adriamycin at 1.0 mg/kg twice per week and Control group, the rats received intraperitoneal injection of normal saline, all animals were treated for 6 weeks followed by 2 weeks observation.n=6 in each group. Echocardiography was performed at pre- and post-modeling,18F-FDG micro-PET myocardial metabolism imaging was conducted after modeling and plasma level of BNP was examined as well. Finally, the rats were scariifed to observe the pathological changes of myocardial tissue. Results: 1 rat died in DCM group and the rest were with successful modeling conifrmed by echocardiography and pathology. Compared with Control group, DCM group showed decreased standard uptake value of18F-FDG (1.23 ± 0.55) vs (6.65 ± 0.41),P<0.01; the standard uptake value of18F-FDG was negatively related to left ventricular end diastolic diameter (LVEDD) (R=-0.709,P=0.015), LVESD (R=-0.924, P=0.000) and plasma level of BNP (R=-0.948,P=0.000), while positively related to LVEF (R=0.968,P=0.000) and fractional shortening (R=0.863,P=0.001). Conclusion:18F-FDG micro-PET myocardial metabolism imaging combining echocardiography, biochemical and pathological examinations may evaluate DCM modeling in rats, which provide a non-invasive and intravital tool for small animal experiment.