In view of the existing questions in parmacy specialty because it is not closely integrated with teaching contents and post,the author put the reformation for curriculum system of pharmacy specialty,making innovation in curriculum system.,developing the suitable course content,teaching materials and so on,and obtained a lot of achievements in curriculum construction,teaching material construction and talent training quality.

Objective: To investigate the value of enhanced 3D SPACE sequence in displaying brachial plexus. Methods:35 healthy volunteers with no history of brachial plexus injury of brachial plexus MRI examinations by DWIBS scan, and SPACE scanned. Analysis and comparison of DWIBS sequences, sequences of SPACE provides a clear display of the brachial plexus, and two sets of image sequence average signal-to-noise ratio (SNR) and the contrast to noise ratio (CNR). Results:A total of 35 cases 70 lateral brachial plexus after coronary DWIBS is clearly displayed on the sequence;the partial medial cord of brachial plexus, beams and lateral beams can also be displayed in the SPACE sequence. SPACE sequence of image signal-to-noise ratio and contrast noise ratio than the DWIBS sequence, and the difference is statistically significant. Conclusion:SPACE sequence can clearly show the brachial plexus, and DWIBS sequences compared to the normal image has a higher resolution of the brachial plexus.

Objective To investigate the related index of early diagnosis of acute-on-chronic liver failure caused by chronic hepatitis B.Methods 13 cases of the acute-on-chronic liver failure caused by chronic hepatitis B were collected in our department,39 cases of chronic hepatitis B were randomly paired to analyze the difference index.ROC curve analysis was conducted for the different data,then to choose the data whose AUC (area under the curve)is >0.8 to accumulate points,while the cutoff value in the light of Youden index was indentified.Each accu-mulating points data would score 1 point if it is≥cutoff value,otherwise,it would score 0 points.ROC curve analysis was conducted for the total accumulating points,the cutoff value of the total accumulating points according to Youden index was indentified,the sensitivity and specificity were calculated.Results The data of which AUC are >0.8 include glutamic-pyruvic transaminase (ALT)/Upper Limit Of Normal (ULN),neutrophil count (N),alkaline phosphatase (AKP)/ULN,glutamic-oxalacetic transaminease(AST)/ULN,direct bilirubin/total bilirubin(Dbil/Tbil),total bile acid(TBA),whose AUC were respectively 0.869,0.874,0.897,0.917,0.919 and 0.978,while their cutoff value were respectively 18.57,3.1 ×109/L,0.99,22.21,44.41%and 140.20μmol/L.The cutoff value of total accumula-ting points of the six data was 4 points,AUC was 0.987,Youden index was 0.949,and their sensitivity for ealier diag-nosis for the acute -on -chronic liver failure caused by chronic hepatitis B was 100%,specificity was 94.87%. Conclusion The accumulating points of the six data aboved (ALT/ULN,N,AKP/ULN,AST/ULN,Dbil/Tbil,TBA) will help the early diagnosis of acute-on-chronic liver failure caused by chronic hepatitis B.

Objective To quantitatively analyze the palpebral fissure changes in the neostigrnine tests with videonystagmography.Methods Thirty-five patients with myasthenia gravis ( MG),21 non-MG patients and 23 healthy volunteers were intramuscular injected with neostigmine methylsulfate(0.02 mg/kg) and atropine(0.5 mg).The width of palpebral fissure was measured before and after the injection for one hour( once every 10 minutes).The differences of palpebral fissure width of each time point within each group and between groups were analyzed quantitatively with repetitive measure ANOVA.Results There was a significant difference of palpebral fissures (mm) width at different time points within the MG group( before the test:4.67 ± 1.87,after the test:10 min:0.88 ±0.96,20 min:1.49 ± 1.38,30 min:1.71 ± 1.53,40 min:1.77 ± 1.82,50 min:1.79 ± 1.52,60 min:1.62 ± 1.68 ; F =11.202,P =0.002).There were also significant changes of palpebral fissures width in the MG group compared to the non-MG group and the normal control group (F =15.569,P ＜ 0.01; F =15.104,P ＜ 0.01 ).There was alsostatistical significance in the rate of change between these groups.Receiver operating characteristic analytical procedure indicated that 1.17 mm or 17.5％ was of better diagnostic capability in the neostigmine test.Conclusions Measuring palpebral fissure width with videonystagmography could be seen as an objective and accurate method.A patient with palpebral fissure width higher than 1.17 mm or 17.5％ should be highly suspected as MG.

Objective To verify the feasibility of Cas9 microinjection in frozen-thawed pronuclear embryos, based on the model of pronuclear embryos of C57BL/6J mice by in vitro fertilization.Methods After fertilized mouse pronuclear embryos cultured in vitro, one-cell and 2-cell embryos were frozen using EFS20/40 cryopreservation tube.The next day recovered and then cultured.The recovery rate and survival rate of the one-cell and 2-cell embryos were compared.The frozen-thawed and fresh pronuclear embryos were injected with Cas9 mixture and injection buffer into the cytoplasm, and then cultivated to 2-cell embryos,and the survival rate and development rate of the 2-cell embryos were compared.Results The recovery rate of frozen-thawed one-cell embryos was 92.5%, the survival rate was 92.8%, the recovery rate of 2-cell embryos was 90.5% and the survival rate was 95.8%, showing no significant difference.Furthermore, the survival rate of fresh one-cell embryos after Cas9 injection was 92.7%, the survival rate of one-cell embryos of the blank group was 97.5%.While the survival rate of Cas9 injected frozen-thawed one-cell embryos was 82.6%, and that of the blank group was 92%,showing a significant difference between the frozen-thawed injected group and other groups(P < 0.05).The development rate of 2-cell embryos after Cas9 injection was not significantly different.Conclusions Frozen-thawed pronuclear embryos can be used for Cas9 microinjection.

Objective To study the expression of S1RT1 in breast cancer with diabetes mellitus,and analyze the correlation between SIRT1 and p53,and analyze blood lipid differences in breast cancer tissue without diabetes mellitus and breast cancer tissue with diabetes mellitus,and to research its relation with type 2 diabetes mellitus and assesse the clinical value.Methods Immunohistochemistry was used to examine the expressions of SIRT1 and p53 in 30 breast cancer patients with diabetes mellitus and 30 breast cancer patients without diabetic mellitus,and their correlation was analyzed.Results The positive rate of SIRT1 in breast cancer tissue with diabetes mellitus was significantly lower than that in breast cancer tissue without diabetic mellitus(P ＜0.05).In SIRT1 positive tissue,the expression level of p53 was significantly higher than that in SIRT1 negative tissue(P ＜ 0.05 ).The expression of SIRT1 was significantly positively related with p53 expression in breast cancer tissue with diabetes( P ＜ 0.05).BMI and TG in breast cancer group with diabetes mellitus were significantly higher than those in breast cancer group without diabetic mellitus( P ＜ 0.05 ),but HDL was lower( P =0.05 ).However,CHO and LDL had no significant differences in both groups( P ＞0.05 ).Conclusions SIRT1 is up-regulated in breast cancer,but the posltive rate of SIRT1 in breast cancer tissue with diabetes mellitus is significantly lower than that in breast cancer tissue without diabetic,and is associated with the progression of diabetes mellitus.SIRT1 protein is significantly positively correlated to p53 expression and it may be involved in the adjustment process of blood lipids,SIRT1 might be a new biological target in diabetes and breast cancer.

Objective:To investigate the incidence of anemia in early and middle pregnancy and to provide better medical service to pregnant women.Methods:We included in this study 556 women in early or middle pregnancy received in our hospital in 2007,detected the levels of hemoglobin and analyzed the incidence of anemia in different periods of pregnancy according to the WHO and Chinese national standard.Results:The anemia incidence was 15.83% according to the WHO standard and 1.81% according to the Chinese national standard,significantly higher in the middle period than in the early trimester of pregnancy(P

Objective To explore a new methodology with bilateral rhomboid dermal flaps for surgical treatment of inverted nipple. Methods 36 cases with 64 inverted nipples were involved in this study. Among these cases, 8 of them were evaluated as mild degree, while 19 moderate and 9 severe. In this procedure, the bilateral rhomboid incisions were designed. The rhomboid skin was deepithelialized and two dermal flaps were created. Then these two dermal flaps were filled crosswise through the tunnel beneath the nipple and fixed as supporting. After the operation, the continuous traction of the nipple lasted for one week, and sutured out 10 days later. Results None of these 36 cases appeared nipple blood circulation disorder after operation. Postoperative follow-up for 6 months-3 years showed that the appearance of the nipple was satisfactory. There were no recurrence and sensory disturbance. Conclusions The method introduced in this study is simple, the appearance of nipple is natural and no complication has been found. The incision is larvaceous while the scar is invisible. Meanwhile this method is also benefit for reserving the function of breast-feeding. It is proved to be an ideal method for correcting the inverted nipple.

Objective To assess the feasibility of low-dose MDCT pulmonary angiography (MDCTPA) by using low kVp combined with individual-adapted low tube current protocol and noise reduction filter algorithms.Methods Fifty-six consecutively patients with MDCTPA were enrolled in the study.The patients were randomly divided into group A (120 kVp,100 mAs) and group B (100 kVp,individual-adapted tube current about 1.0 mAs/kg).Two series of images were reconstructed in group B:B1 with standard filter algorithms (FC13,B1) and B2 with noise reduction filter algorithms (FC11,B2).The image noise,quality and radiation dose in two groups were compared.Results The CTDIvol,DLP and E of group B were 5.1 mGy,83.3 mGy· cm and 1.4 mSv respectively,which were reduced by 64.3％,66.4％ and 66.7％,respectively (F =32.57,12.32,11.98,P ＜ 0.05) when compared with those in group A.Compared with group A,the image noise in B1 was increased by 118.2％ (t =10.05 P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 51.5％,46.6％,50.8％,45.3％and 20.4％,respectively(t =7.20,6.30,6.58,5.54,8.35,P ＜ 0.05).Compared with B1,the image noise in B2 was reduced by 32.5％ (t =6.12,P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 46.2％,46.2％,45.9％,46.9％ and 18.4％ (t =3.19,3.55,2.95,3.37,5.42,P ＜0.05).Compared with group A,the image noise in B2 group was increased by 47.3％ (t =4.03,P ＜0.05),the central and peripheral SNR and CNR and scores were reduced by 29.1％,21.8％,28.2％,19.6％ and 8.2％(t =4.06,2.82,3.68,2.22,3.02,P＜0.05).Conclusions Keeping effective diagnostic image quality,the protocol with low kVp and individual-adapted low tube current for low-dose MDCT pulmonary angiography would be effective and feasible,and the radiation dose would be significantly reduced.

Objective To study the feasibility of reducing radiation dose in aorto-iliac and lower extremity arteries CT angiography (CTA) with low tube voltage (100 kV) and automatic tube current modulation(ATCM).Methods Totally 61 patients requiting aorto-iliac and lower extremity arteries CTA for clinical reasons were prospectively enrolled in study.The patients were randomly assigned to 3 groups:Group A(120 kV),Group B (100 kV) and Group C (100 kV with automatic tube current modulation).Both quantitative and qualitative analysis were included in this research.Group C was divided into obese group(BMI≥ 24.9 kg/m2) and normal group(BMI ＜ 24.9 kg/m2).The radiation doses were analyzed respectively among two groups.Results The subjective evaluations of image quality for axial,MIP and VR were good.There were no significant differences among group A,B and C in SNR and CNR (P ＞0.05).The effective dose of group A,B and C was 8.20 mSv,5.36 mSv,and was 7.48 mSv,respectively Group B was 34.6％ less than group A.Group C was 39.5％ more than group B,and there was no significant differences between group A and C (P ＞ 0.05).The effective dose of group C1 was 7.11mSv,group C2 was 9.69 mSv,the E with group C1 were significantly less than group C2 (t =-3.163,P ＜0.05),the effective dose of group C1 was 13.3％ less than group A (Z =-2.822,P ＜ 0.05),but the group C2 was more than group A (P ＞ 0.05) and group B (Z =-3.426,P ＜ 0.05).Conclusions Lowkilovoltage (100 kV) CT scanning protocol is feasible in multi-detector CT angiography for aortoiliac and lower extremity arteries.Automatic low tube voltage (100 kV) with automatic tube current modulation (ATCM) scanning protocol can be used for someone with BMI less than 24.9 kg/m2.