OBJECTIVE:To establish a website platform for clinical pharmacists'online learning and communication and to promote the development of clinical pharmacy.METHODS:A MySQL database in remote server was established,and PHP dynamic web page program was applied to construct a website for clinical pharmacists.RESULTS:The website ran smoothly and fast and its maintenance is very convenient,which met clinical pharmacists' needs for the online learning and communication. CONCLUSIONS:The establishment of website platform is of significance for the online learning,information sharing and communication among clinical pharmacists in clinical pharmacy.

Objective To use the flow cytometry to detect the platelet vasodilator-stimulated phosphoprotein(VASP)phospho-rylation level and to evaluate the clopidogrel curative effect after PCI.Methods 17 cases in the control group without any drug in-tervention and 26 cases of acute coronary syndrome(ACS)after PCI operation with clopidogrel were selected.Platelet VASP phos-phorylation levels at being selecting and on 7 d after anti-platelet therapy were detected by the flow cytometry and the platelet reac-tivity index (PRI)was calculated.Results The PRI after anti-platelet therapy in the ACS group was decreased significantly,the difference between before treatment and after treatment had statistical significance (P <0.05 ).Conclusion The platelet VASP phosphorylation level detected by the flow cytometry can specifically evaluate the effect of clopidogrel.

OBJECTIVE: To investigate the characteristics and regularity of adverse drug reactions(ADR) occurred in our hospital for reference of clinical rational drug use.METHODS: 1 183 ADR cases reported in our hospital between 2006 and 2007 were analyzed statistically using Excel in respect of patients' sex,age,routes of administration,variety of drugs and clinical manifestations etc.RESULTS: Of the 1 183 ADR cases,268(22.65%) were submitted by clinical departments,462(39.05%) by the department of pharmacy,and 441(37.28%) by central injection room.ADR incidence rate was slightly lower in males than in females.Patients over the age of 31 years showed a higher incidence of ADR.901 cases(76.16%) were induced by intravenous route.662 were induced by anti-infectives,followed by the traditional Chinese medicine(163 cases) and cardiovascular system drugs(149 cases).The most common manifestation of ADR was lesion of digestive system(301 cases),followed by lesions of skin and its appendages(236 cases) and damage of central nervous system(224 cases).CONCLUSION: Great importance should be attached to ADR monitoring as well as the analysis and evaluation of ADR so as to ensure safe and effective medication.

The service object of gynaecology clinic operation is female,which involves reproductive organs,personal secrets,marriage,family and parenting.Not only the patients, but also their families,children and social relationship have close relationship with this operation.Tberefore,it is apt to cause contraditions between doctors and patients and difficult to solve.Medical staff should be strict with oneself,strengthen the study of medical ethics while learning to improve professional technique constantly.

Objective To introduce the method of C2,3 pedicle screw fixation for management of unstable Hangman fractures and evaluate the clinical effects.Methods From October 2001 to October 2005,26 cases with unstable Hangman fractures were treated using Axis and Vertex pedicle screw system.According to the classification system designed by Levine depending on the radiological manifestations of Hangman fractures,there were unstable fractures in 26 cases,who were subdivided into type Ⅱ in 11 cases,type ⅡA in 10 cases and type Ⅲ in 5 cases.There were 18 males and 8 females,aging from 21 to 56 years with an average of 38.5 years.According to Frankel scale,graded as spinal injury D in 6 cases and E in 20 cases.Points of entry for C2 screw insertion were located at the entrance at the posterior aspect of lateral mass.The drill bit was parallel to both of the medial and superior border of C2 pars interarticularis(usually 15?-25? cephalad to the transverse plane and 20?-25? medial to the sagittal plane).The screw hole in the posterior cortex was overdrilled.3.5-4.0 mm screws(26-30 mm,determined by depth gauge)were drived in after the cortex being tapped.The points of screw penetration for the C3 pedicles was slightly lateral to the center of the articular mass and close to the inferior margin of the inferior articular process of the cranially adjacent vertebra.The insertion angle of the pedicle screw was 35?-45? medial to the midline in the transverse plane.3.5-4.0 mm screws,determined by depth gauge were drived in after the cortex being tapped.The whole procedure was done under monitoring of "C"-arm fluoroscopy for safety and accuracy.Results All patients were followed up from 6 to 54 months,with the average of 29 months.There were no screw loosing and breakage,and no spinal cord and vertebral artery injury after surgery.3 screws were placed too close to the vertebral artery canal in C2 and 7 screws in C3,but without clinical consequences.There were 16 cases in excellent,7 good,3 fair according to Mayo(McGrory)scores.Conclusion C2,3 pedicle screw fixation is a effected method for management of unstable Hangman fractures,which proved its value as a method achieving solid bony fusion combined with low rate of complications.

Objective This study was carried out to reveal the photocatalytic degradation characteristics of Bisphenol A,a representative endocrine disruptor,with immobilized nanometer TiO2 catalyst supported on fiberglass net.Methods The effects of photolysis under black light lamp and cold cathode low-pressure mercury lamp,and initial concentration(0.98-6.23 mg/L) on the degradation of bisphenol A(BPA) was explored by photoreactor in laboratory.Photocatalytic mineralization and intermediates under different irradiations was also investigated.Results It was found that the reaction kinetics was first order with respect to BPA concentration,and the apparent kinetic constants decreased with the increase of initial concentration.Photodecomposition of BPA under black light lamp irradiation was caused by not photolysis but photocatalysis,while that under cold cathode low-pressure mercury lamp was caused by the synergistic effect of photolysis as well as photocatalysis.Further studies showed that photocatalytic mineralization of BPA differed greatly under those different irradiations.1,4-benzoquinone,p-dihydroxybenzene,methyl p-hydroxybenzoate,D-hydroxyacetophehone,1-(4-hydroxyphenyl)-1-propanone,1-(4-hydroxyphenyl)-vinyl alcohol were identified as intermediates under black light lamp,and 3-hydroxyl-3-crotonic acid,4-hydroxybenzaldehyde,D-hydroxyacetophehone,2-acetyl-3-methoxyl-5,8-dihydroxy-1,4-naphthoquinone,3,4-di-(4-hydroxyphenyl)hexane were found under cold cathode low-pressure mercury lamp.Conclusion The differences of photocatalytic mineralization under different illumination are attributed to the molecule structure with two benzene-rings.

Objective To evaluate the feasibility of suprasternal mini-thyroidectomy.Methods A total of 15 patients with nodular goiter underwent suprasternal mini-thyroidectomy(2.5-3.5 cm in incision at length) with ultrasonic scalpel.Results All operations including unilateral partial thyroidectomy(n=4),unilateral subtotal thyroidectomy(n=2) and bilateral subtotal thyroidectomy(n=9)were completed successfully.The mean operation time was 46 minutes(range,30-65 minutes).The intraoperative blood loss was less than 10 ml,except 25 ml in one patient.No complications occurred except superficial Ⅱ degree skin burn in 2 patients.The mean postoperative hospital stay was 1.8 days(range,1-3 days).All the patients were followed up for 8-10 months and no recurrence was found.Conclusions Suprasternal mini-thyroidectomy is feasible and safe with certain cosmetic effects.

Objective To study the effects of panax notoginseng saponins (PNS)on rat superficial renal medulla cells after femoral fracture and to discuss the protective role of PNS in renal injury after fracture. Methods We divided 102 Wistar rats randomly into simple fracture group (n =36),fracture and medication group (n =36)and normal control group (n =30).In the former two groups 6 rats were respectively executed at 1,6,12, 24,36,48 h after fracture modeling,while 5 rats in normal control group were executed at the corresponding time points.Regular HE staining was used to observe pathological changes and TUNEL was used for apoptotic cells.And immunohistochemistry and in situ hybridization were used to detect the expressions of Bcl-2 and Bax in superficial renal medulla tissues.Results In simple fracture group,mild granular degeneration could be seen in renal tubular epithelial cells of superficial renal medulla and the interstitial small vessels were slightly expanded and congested. Compared with simple fracture group,the lesions were slighter in fracture and medication group.In simple fracture group,Bcl-2 and Bcl-2 mRNA expressions were significantly higher than those in normal control group at 1 -36 h (P <0.01).Bax expression was higher than that in normal control group at 12-36 h (P <0.01),and Bax mRNA expression was higher than that in normal control group after 6 h after fracture (P < 0.01 ).In fracture and medication group,Bcl-2 expression was obviously higher than that in simple fracture group at 1 h (P <0.01),and Bcl-2 mRNA expression was higher than that in simple fracture group at 1 -48 h (P <0.01).Bax and Bax mRNA expressions were both lower than those in simple fracture group at 1 - 48 h (P < 0.01 ).Conclusion Fracture trauma has significant influences on protein expression and mRNA transcription of Bcl-2 and Bax in superficial renal medulla.PNS can upregulate anti-apoptosis gene Bcl-2 and downregulate pro-apoptosis gene Bax,thus playing the role of inhibiting tissue cell apoptosis.

Objective To measure the effect of panax notoginseng saponins (PNS) on renal cortical tubule cell apoptosis and apoptosis-related genes in early stage after renal trauma and to investigate the protective mechanism of PNS for renal trauma.Methods Seventy-eight Wistar rats were divided into trauma group (n =36),trauma + treatment group (treatment group,n =36),normal control group (control group,n =6) according to the random number table.In treatment group,rats received intraperitoneal administration of PNS (70 mg/kg).Instead,substitute of an equal dose of isotonic saline was used for the rats in trauma and normal control groups.Trauma and treatment groups were subdivided at 1,6,12,24,36 and 48 hours posttrauma,with 6 rats per group.The kidney specimens were extracted at each time point to detect Bax expression in the cortex with immunohistochemistry and in situ hybridization histochemistry.Moreover,the positive expression of Bax was compared among groups and its variation regularity with time were detected.Results In trauma group,mRNA transcription of pro-apoptosis gene Bax increased at 12 hours in the superficial cortex,but increased at 1 hour in deep cortex; protein expression of pro-apoptosis factor Bax showed no apparent reduction within 36 hours in the superficial cortex,but evident decrease within 12 hours in the deep cortex.In treatment group,mRNA transcription of pro-apoptosis gene Bax decreased immediately after treatment in the renal cortex and lasted until 48 h; protein expression of pro-apoptosis factor Bax showed unidirectional reduction until 48 h in the renal cortex.Conclusion PNS inhibits cell apoptosis by down-regulating the mRNA and protein expression of Bax.

Objective To explore the feasibility and application value of combined C2 laminar screw fixation technique in treatment of cervical vertebral injury. Methods Dense axial CT scanning was done on C2 laminar of 32 specimens of cervical vertebra to measure the length and height of the axis, the thickness of upper, middle and lower parts of the axis as well as the angle between the axial ray and the sagittal plane. There were eight patients with cervical vertebral injury including two with type Ⅱ odon-told process fractures combined with backward dislocation of atlanto-axial joint, one with forward disloca-tion of atlanto-axial joint, one with nonunion of odontoid process fractures, two with type Ⅲ odontoid process fractures combined with atlanto-axial joint instability and transverse ligament rupture, one with type Ⅱ Hangman fracture combined with instability of C2～3 and one with forward dislocation of atlanto-axial joint combined with transverse ligament rupture. With accomplishment of traction reduction, combined fixation with axis laminar screws and posterior autogenous lilac graft fusion were done based on injury se-verity of the patients. Results The length and height of axis laminar was (26.2±1.2) mm and (12.8±1.6) mm, respectively. The thickness of upper, middle and lower parts of the C2 laminar was (3.0±1.4) mm, (6.0±1.6) mm and (5.6±1.2) mm, respectively. The mean angle between the axial ray and sagittal plane was 43.5°. All patients were followed up for 6-14 months ( mean 6 months), which showed that all patients obtained favourable bone union and all screws remained at sound position, without deflexion of the screws or any perioperative or postoperative complications. No screw loosening or breakage occurred. Conclusions C2 laminar screw fixation technique can prevent the risk of vertebral artery injury during screw insertion. In the meantime, such technique is simple to operate and free from limitation of the vertebral artery in the cervical foramen. Whole course of visualization during C2 laminar screw insertion may facilitate it as a supplementary method for conventional posterior C2 screw fixation.