OBJECTIVE:To improve the quality of pharmaceutical care.METHODS:The first inquiry accountability sys-tem was carried out besides the original system of personal post responsibility.RESUTLS:The personal responsibility has been effectively enhanced.CONCLUSION:The first inquiry accountability system has enlarged the category of pharmaceutical care,and the quality and levels of pharmaceutical care have been improved as well.

Results: All incisions healed by first intention. Ten cases of thumb reimplantation were successful. All the patients were followed up for 5 months to 2 years and 8 months, with an average of 1 year and 4 months. Two-point discrimination was 3-9 mm (mean, 6.8 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the sensory of the thumb was rated as S 4 in 18 cases and S3+ in 5 cases; the sensory at donor sites recovered to S3. Conclusion Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp.

OBJECTIVE　To determine the concentrations of dopamine (DA) in human urine,studying the change of uric dopamine content before and after laser acupuncture treated Parkinsons disease patients.To estabilsh attemptly the standard of apprasing the treatment method which is combined traditional medical theory with modern technology.METHODS　The urine samples were extracted with organic solvent and determined by HPLC-RF.RESULTS　A good correlation was obtained between dopamine over 20～400 ng*mL-1 and peak height,r=0.9996.The recoveries of DA were (89.69±3.95)%～(92.99±6.5)% for urine samples.There was a close correlation between DA content and the severity of parkinsons disease.The DA content in urine of patients before acupuncture was less than healthy ones.DA content in urine increased most at 4 h and content still maintained high as normal scope at 12 after acupuncture.CONCLUSION　This HPLC-RF assay was sensitive,accurate stable and convenient.It is an important method to evaluate the effects of treated Parkinsons disease by laser acupunctrue.

Objective:To investigate the efficacy of stereotactic body radiation therapy with gamma-knife (γ-SBRT) combined with targeted drug sorafenib and hyperthermia for the treatment of recurrent and metastatic hepatocellular carcinoma. Methods:A total of 71 patients with recurrent and metastatic hepatocellular carcinoma were admitted from August 2007 to December 2009. Among these patients, 39 were treated with γ-SBRT and hyperthermia (group 1); 19 were treated with γ-SBRT combined with sorafenib and hyperthermia (group 2). Results: The total efficacy rate after a three-month treatment was 83.1% (59/71). In group 1, the following results were obtained:one-and three-year local control rates of 41.0%(16/39) and 18%(7/39), respectively;one-and three-year overall survival (OS) rates of 41.2% and 17.9%, respectively; and one- and three-year progression-free survival (PFS) rates of 38.4% and 15.4%, respectively. In group 2, the following results were obtained:one-and three-year local rates of 56.3%(18/32) and 28.1%(9/32), respectively;one-and three-year OS rates of 62.5%and 28.1%, respectively;and one-and three-year PFS rates of 59.4%and 25.0%, respectively. Significant differences in OS and PFS were observed between the two groups. Conclusion:The combination ofγ-SBRT with targeted drug sorafenib and hyperthermia can be used effectively to treat recurrent and metastatic hepatocellular carcinoma. Adverse reactions are mild, and patients can tolerate this treatment.

Objective: To investigate relationship between the clinicopathological features and prognosis of T1 esophageal carcinoma. Methods: Data from 212 T1 primary esophageal cancer patients, who underwent radical surgery in The Fourth Hospital of Hebei Medical University from Jan 2001 to Dec 2009 were enrolled. There were 148 males and 64 females. There were 91 patients with stage pT1a and 121 patients with stage pT1b. Results: The survival of the 212 patients was 27~108 months, and the median survival was 80.8 months. The 1, 3, and 5 year survival rates of patients with stage T1a were 100%, 97.8% and 94.5%, respectively, and the median survival was 86.8 months. The 1, 3, and 5 year survival rates of patients with stage T1b were 100%, 95.9% and 74.4%, respectively, and the median survival was 76.2 months. The rate of lymph node metastasis in 121 patients with stage T1b was 26.4% (32/121). The lymph node metastasis rates in patients with stage sm1, sm2 and sm3 were 11.6% (3/26), 15.0% (6/40) and 41.8% (23/55), respectively. There was no significant difference in lymph node metastasis between stage sm1 patients and stage sm2 patients (P=0.973). Lymph node metastasis rates in patients with stage sm3 were higher than those in stage sm1 and sm2 (P<0.05). Conclusion Radical resection of esophageal carcinoma with peripheral lymph node dissection is recommended for patients with T1b esophageal carcinoma.

Objective To investigate the correlations of the expression of silent information regulator 2 homolog 1 (SIRT1) and colony-stimulating factor 1 receptor (CSF1R) with the clinical characteristics and prognosis of patients with colon cancer. Methods Colon cancer tissue specimens and paracancer tissue specimens were collected from 148 patients with colon cancer. The clinical and pathological features of the patients were analyzed. Immunohistochemistry was used to detect the expression of SIRT1 and CSF1R; the Spearman's correlation analysis was employed to assess the correlation between SIRT1 and CSF1R; the Kaplan-Meier analysis was conducted to evaluate the associations of the expression of SIRT1 and CSF1R with patients' prognosis; the multivariate Cox regression analysis was performed to identify prognostic factors in colon cancer patients. Results Compared with the adjacent tissues, the expression of SIRT1 protein in colon cancer tissues was significantly decreased, and the expression of CSF1R protein was significantly increased (P < 0.05). The expressions of SIRT1 and CSF1R protein were correlated with lymph node metastasis, nerve invasion and invasion depth in patients with colon cancer (P < 0.05). The protein expressions of SIRT1 and CSF1R were negatively correlated (r=-0.536, P < 0.05). The 3-year survival rate of patients with high SIRT1 expression was significantly higher than that of patients with low SIRT1 expression (P < 0.05). The 3-year survival rate of patients with high CSF1R expression was significantly lower than that of patients with low CSF1R expression (P < 0.05). The 3-year survival rate of patients with high SIRT1 expression was significantly higher than that of patients with low SIRT1 expression (P < 0.05). Conclusion In colon cancer, SIRT1 expression is significantly downregulated, whereas CSF1R expression is upregulated, and both are closely related to the clinical and pathological features such as lymph node metastasis, neural invasion, and tumor infiltration depth. Detection of these biomarkers may have important value in predicting patients' prognosis and survival.

OBJECTIVETo explore a method for the treatment of the skin defects at the distal phalanges of 2-5th fingers.

METHODSThe island flap at the dorsum of the middle phalange was designed with the pedicle of dorsal branches from the digital proper artery. When the flap was used to repair defect at finger pulp, the dorsal branch of the digital proper nerve in the flap was kept to be anastomosed to the digital proper nerve at the recipient finger. From Feb. 2005 to May. 2010, 54 cases with skin defects at the distal phalanges of 61 fingers were treated with the flap, including 35 defects at finger pulp and 26 defects at finger tip.

RESULTSThe maximum size of defects and flaps was 2.2 cm x 2.5 cm and 2.4 cm x 2.7 cm, respectively. 61 flaps survived completely. Blister was happened in 3 flaps 2 days after operation, which healed spontaneously without necrosis. 54 cases were followed up for 5 to 22 months (average, 11 months). The flaps had good texture and color match with normal sensation (grade S4). The 2-point discrimination distance was 6-9 mm. The interphalangeal joint had normal movement.

CONCLUSIONSThe island flap at the dorsum of the middle phalange is an ideal method for the skin defect at the distal phalange of finger.

Adolescent ; Adult ; Aged ; Arteries ; Female ; Fingers ; blood supply ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

OBJECTIVETo study the therapeutic effect of collapsed and comminuted distal radius fracture.

METHODSTwenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius.

RESULTSAll 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient's radius. The average volar tilt was 6 to 15 degrees and the average ulnar tilt was 18 to 25 degrees. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good.

CONCLUSIONSThe method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.

Adult ; Aged ; Bone Transplantation ; methods ; Cohort Studies ; Combined Modality Therapy ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; physiology ; Fractures, Comminuted ; diagnostic imaging ; surgery ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Radiography ; Radius Fractures ; diagnostic imaging ; surgery ; Recovery of Function ; Retrospective Studies ; Risk Assessment

Objective: To investigate the expression of nucleolar and spindle-associated protein 1 (NUSAP1) in non-small cell lung cancer (NSCLC) and analyze its relationship with the prognosis of NSCLC patients. Methods: Real-time fluorescent quantitative PCR and immunohistochemical staining were performed to determine the expression of NUSAP1 in NSCLC tissues and adjacent tissues collected from hospital. The relationship between NUSAP1 expression and prognosis of NSCLC patients was analyzed by online database. Results: The expression level of NUSAP1 mRNA in tumor tissues was significantly higher than that of adjacent tissues (P<0.05). The high expression rate of NUSAP1 protein in NSCLC tissues was 58.0% (29/50), significantly higher than 22.0% (11/50) of adjacent tissues (P<0.05). The high expression of NUSAP1 protein in NSCLC tissues was closely correlated with tumor size, lymph node metastasis and TNM stage (P<0.05), but was not related to age and gender. The data showed that the expression level of NUSAP1 mRNA was inversely associated with the overall survival (OS) of NSCLC patients (P<0.001). The expression of NUSAP1 mRNA was significantly correlated with the pathological grade, clinical stage, gender, chemotherapy, smoking history, and histological type of NSCLC patients (P<0.05). Conclusions The expression of NUSAP1 is up-regulated in NSCLC, which is correlated with the growth and development of NSCLC and prognosis of the patients. These results indicate that NUSAP1 can be used as a potential prognostic marker for NSCLC.

OBJECTIVETo describe trends of changes in blood lead levels in children aged 1 - 6 years during the time period before and after introducing lead free gasoline in Shanghai 1997 and 1999.

METHODSBlood lead levels of 1 969 children aged 1 - 6 years were determined by a sampling survey in five districts of Shanghai in August and September, 1997. Blood lead levels of the same population were re-determined by the same method from April to June in 1998 and from August to September in 1999. Filter paper blood lead test was carried out monthly using the filter paper blood lead proficiency testing program of Centers for Disease Control in the United States. The results from blood lead samples were under acceptable ranges during the study.

RESULTSThe geometric means of blood lead levels were 83 microgram/L in 1997, 80 microgram/L in 1998 and 76 microgram/L in 1999, respectively. The prevalence rates of childhood lead poisoning (blood lead level was equal or more than 100 microgram/L) were 37.8% in 1997, 25.7% in 1998 and 24.8% in 1999. The amounts of decrease on average blood lead levels in the five districts between 1997 and 1999 were 10 microgram/L, 11 microgram/L, 6 microgram/L, 4 microgram/L and 2 microgram/L, respectively.

CONCLUSIONLead poisoning is a preventable disease. The average levels of lead in young children in Shanghai decreased significantly after the introduction of lead free gasoline to Shanghai. Lead emissions from vehicles running on leaded gasoline was one of the important contributors to increase the children's blood lead levels in Shanghai. Lead poisoning is not evenly distributed among children in Shanghai, resulting in the different levels of decline.

Child, Preschool ; China ; Environmental Monitoring ; methods ; standards ; Environmental Pollutants ; blood ; Gasoline ; standards ; Humans ; Lead ; blood ; Time Factors