OBJECTIVE:To explore hospital pharmaceutical care mode to promote clinical rational drug use.METHODS:The consumption data of drugs for patients with cardiovascular and cerebrovascular diseases during 2006 in dispensary of traditional Chinese medicine of our hospital were investigated and analyzed.RESULTS:The ratio of drug combination increased with the rising of patients' age,so did the incidence of adverse drug reactions(ADR).CONCLUSION:Pharmacists' pharmaceutical care plays an important role in promoting patients' rational drug use and treatment.

Objective To study the application of ultrasonic freestyle extended imaging(FEI) in thyroid,breast,artery,vein diseases.Methods Thirty-five patients with above mentioned diseases were examined by FEI and the images were analyzed.Results FEI could entirely show the scan region needed.It also could enhance image quality,show the physiologic radian of the body,measure the nidi accurately.Conclusion The FEI technology provides more image information and is of great help to improve the clinic diagnosis ratios.

The content of geniposide in Compound Zhizi Granules was determined With TLC-scanner. The optimum experiment design obtained with orthogonal test could eliminate the disturbance of other components. The result was satisfactory.

Objective To investigate abnormal myocardial contractile responses induced by dobutamine in patients with idiopathic dilated cardiomyopathy (DCM).Methods Eighteen DCM patients underwent low dosage dobutamine stress echocardiography (5,10,20 ?g?kg~ -1?min~ -1).Transthoracic echocardiogram was recorded with the use of a HP Sonos 5500 color echocardiographic diagnostic system.Wall motions in 16 myocardial segments were assessed using a four-point scale recommended by the American Society of Echocardiography.During dobutamine infusion,abnormally contracting segments were classified into four different patterns of contractile response: improved,unchanged,worsened and biphasic.Unchanged,worsened and biphasic segments were defined as abnormal contractile responses.Worsened and biphasic segments were judged to be ischemia-like responses.Results All patients showed abnormal myocardial contractile responses of wall motions (100%),and thirteen were ischemia-like responses ( 72.2%).In total 225 segments,126 segments showed abnormal contractile responses ( 56.0%).Among them,97 segments were unchanged segments ( 43.1%),29 segments were ischemia-like responses ( 12.9%),in which 16 segments were worsened ( 7.1%),and 13 segments were biphasic ( 5.8%).The statistical analysis showed that incidence of improved segments was highest in two point segments( 62.1%) compared with three point and four point segments; incidence of ischemia-like responses was highest in three point segments( 24.6%); incidence of unchanged segments was highest in four point segments( 68.4%).Conclusions DCM has the abnormal myocardial contractile responses induced by dobutamine stress echocardiography.It indicates there is the ischemia-like energy mismatch between demand and supply in DCM,which would be related to etiology and progress of DCM.

AIM To express recombinant human cytochrome P450 3A4 mutants CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18, and to employ them for in vitro metabolism studies of CYP3A4. METHODS Use Bac-to-Bac baculovirus expression system to recombinant baculovirus carrying cDNA of CYP3A4 mutants CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18. Spodoptera frugiperda 9 (Sf9), cells were co-infected by recombinant viruses of CYP3A4 mutants, human NADPH-P450 oxidoreductase and cytochrome b5 to obtain recombinant proteins CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18 with metabolic activity. RESULTS The mRNA transcription of CYP3A4 mutants in Sf9 cells were validated by RT-PCR. Testosterone and 7-benzyloxy-4-(trifluoromethyl) coumarin were metabolized by the lysates of Sf9 cells infected by the recombinant viruses. CONCLUSION CYP3A4 mutants CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18 with metabolic activity were successfully expressed by baculovirus-insect cell expression system. The results indicated that recombinant CYP3A4. 5 showed lower activity comparing to the wild type protein towards testosterone, while CYP3A4. 18 with higher activity, and for CYP3A4.3 and CYP3A4.4 showing similar activity to the wild type protein.

Objective To investigate the correlation of serum alpha-fetoprotein (AFP) with clinical pathological factors and prognosis of hepatocellular carcinoma ( HCC ).Methods Two hundred and twenty patients with HCC who hospitalized in our hospital from January 2007 to June 2009 were enrolled in this study.The relationship of AFP levels before operation to clinical pathological factors such as pathological grade,tumor size,tumor encapsulation,tumor numbers,portal vein tumor thrombus,TNM stage and postoperative recurrence were analyzed.Results Serum AFP concentration before operation were related with tumor size ( x2 =11.76,P ＜ 0.05 ),tumor encapsulation ( x2 =17.07,P ＜ 0.05 ),portal vein tumor thrombus ( x2 =8.944,P ＜ 0.05 ),higher TNM stage ( x2 =4.929,P ＜ 0.05 ) and early postoperative recurrence rate ( x2 =5.569,P ＜ 0.05 ).However,it had no correlation with pathological edmondson grade tumor numbers.Conclusion HCC patients with high serum AFP concentration often has greater tumor without encapsulation,high occurrence rate of portal vein tumor thrombus and higher TNM stage,they are more likely to early postoperative recurrence.Serum AFP before operation is useful not only for diagnosis,but also as a prognostic biomarker to predict prognosis and recurrence.

Objective To evaluate the activities of 18 pairs of antimicrobials combinations against non - duplicate clinical isolates of multidrug resistant Acinetobacter baumannii (MDRAB) in vitro.Methods Collect isolates of Acinetobacter baumannii from different patients from October 2009 to May 2010,which were isolated in Clinical Laboratory Center of Beijing Friendship Hospital,Capital Medical University.Use broth microdilution method to detect MIC of mono-antimicrobial,and checkerboard broth microdilution method to detect combinatied MIC,and calculate fractional inhibitory concentration (FIC) index to determine drug combinations effects.When the performance of the same drug combinations conflicted,appropriate strains were selected for screening of drug-resistant mechanisms by polymerase chain reaction( PCR),including efflux pump genes.Results In tests in vitro,rifampicin and polymyxin B,imipenem and gentamicin,cefepime and levofloxacin showed synergy at high proportion,68.1％,45.5％,40.9％,respectively.Minocycline and rifampicin,ampicillin/sulbactam and tobramycin.Ceftazidime and ciprofloxacin showed additive effect at high proportion,81.8％,68.2％,68.2％,respectively.There were several combinations which appeared the opposite effects to tested strains.Strains No.19 corresponding reaction was synergy and No.21,No.26 corresponding reactions were antagonism.The three strains above were selected for screening resistant mechanisms.The difference is that genotypes of adeS were negative in No.19 and positive in No.21 and No.26.Conclusion Rifampicin and polymyxin B combination showed synergy against the MDRAB in vitro,which can be considered as the treatment choice for critical infections caused by MDRAB.Imipenem and gentamicin,cefepime and levofloxacin also showed synergy in vitro,but in some isolates showed antagonism.This phenomenon may be due to the gene adeS activated by certain antibiotics,and the activated adeS drived efflux pump express or overexpress,which made the drugs in bacterial cells pumped out,causing antagonistic effect.The individual differences in strains should be considered when clinic strain apply these two combinations above.

Objective To investigate the self-management self-efficacy,health-related quality of life of hemodialysis patients and explore the relationship between them. Methods Self-management self-efficacy questionnaire and SF-36 were used,and 55 hemodialysis patients participated in this study. Pearson correlate and regression analysis were used to test the relationship between them. Results 55 questionnaires were available. Positively associated between self-management self-efficacy and HRQOL(r=0.268,P＜0.05);significantly positively associated between physical activity self-efficacy and HRQOL(r=0.409,P＜0.01). Regression analysis showed that physical activity self-efficacy is the factor of HRQOL (t=3.261,P＜0.01).Conclusion Physical activity self-efficacy is the factor of HRQOL in hemodialysis patients,increasing self-management self-efficacy is benefit to their HRQOL.

Objective To evaluate the role of myosin light chain kinase(MLCK)in the increase in the permeability of human pulmonary microvascular endothelial cells(HPMVECs)induced by mechanical stretch.Methods HPMVECs were cultured in vitro and then randomly divided into 3 groups(n = 4 each): mechanical stretch group(group S),ML9 treatment group(group M)and control group(group C).In group S,the monolayer cells and magnetic beads coated with an RGD peptide were incubated in serum-free MCDB131 medium for 2 h,the unbound beads were washed out,and then the cells were exposed to magnetic twisting stimulation(MTS)for 2 h(frequency 3 Hz,intensity 4.2 mT).In group M,the monolayer cells and magnetic beads coated with an RGD peptide were incubated for 2 h in serum-free MCDB131 medium in which MLCK inhibitor ML9(50μmol/L)was added,and the other procedures were the same as in group S.In group C,the cells after washing as in group S were incubated for 2 h without exposing to MTS.Monolayer permeability was detected with FITC-dextran flux in transwell model.The distribution of integrin αVβ3 and actin was detected using the immunofluorescence assay.Results Compared with group C,the permeability of HPMVECs was significantly increased in group S,while no significant change was found in group M.Compared with group S,the permeability of HPMVECs was significantly decreased in group M.In addition,actin polymerized to form stress fiber,and integrin αVβ3 clustered at the end of stress fiber in group S,while actin mainly distributed in the surrounding area of the cell membrane and integrin αVβ3 evenly distributed on the cell surface in group C and M.Conclusion The mechanism by which mechanical stretch induces the increase in the permeability of HPMVECs is related to MLCK activation-mediated stress fiber formation and integrin αVβ3 clustering.

Gastrodin (GAS) is the major bioactive component of the extracts from the rhizome of Gastrodia elata Blume. The aim of this study is to investigate the transport of GAS in Caco-2 cells and the interaction of P-glycoprotein and GAS. The apparent permeability coefficients (Papp) of GAS were measured as a function of directions and concentrations. It was demonstrated that the efflux ratio was < 2.0 over the range of 50-500 micromol x L(-1) of GAS from bi-directional transport studies. The transport rate of GAS was dependent on the concentrations. Papp of GAS was not affected by transport directions, GAS concentration or the classical inhibitors of P-glycoprotein (verapamil and GF 120918). The cellular accumulation of GAS in Bcap37/MDR1 cells transected with hMDR1 gene, was similar to that in Bcap37 cells. The accumulation in both cell lines was concentration dependent. GAS did not affect the accumulation of Rhodamine 123 in Bcap37/MDR1 cells over the range of 50-500 micromol x L(-1). It indicated that the transport of GAS in Caco-2 cell monolayers mainly is by passive paracellular transport pathway. P-glycoprotein did not participate in the absorption of GAS in the intestine or the transport across the blood-brain barrier.