OBJECTIVE:To explore the suitable clinical service mode for pharmacists in China.METHODS:A questionnaire was designed and a random sample of 170 people were selected from 2 hospitalized patients,doctors,nurses and pharmacists,the results were analyzed using statistical method.RESULTS:There was a general lack of knowledge about clinical pharmaceutical service,higher demands on participation of pharmacists in clinical work were made,and present situation was less than satisfied.CONCLUSION:Clinical service mode of patients first and rational drug use foremost should be established,Chinese pharmacists should improve their knowledge construction and clinical service capability.

OBJECTIVE:To study the potential of three kinds of Chinese medicines in combination with Ceftriaxone in inducing endotoxin release from Klebsiella for references of combined use of Chinese medicines and western medicines in the treatment of severe infections.METHODS:The amount of endotoxin released from Klebsiella after being treated in vitro by Ceftriaxone(high,medium and low concentrations)alone or in combination with 3 antibacterial Chinese medicines for 4 hours was compared.RESULTS:The amount of endotoxin released by Klebsiella in low concentration of Ceftriaxone either alone or in combination with Chinese medicines were the maximum but minimum in high concentration Ceftriaxone group.The amount of endotoxin released in low concentration group was larger than in blank group(without antibacterial treatment),and that released amount in Shuanghuanglian plus Ceftriaxone group was less than in Ceftriaxone alone group.CONCLUSION:Low concentration of Ceftriaxone can induce Klebsiella to release endotoxin,while Shuanghuanglian can reduce Ceftriaxone-induced release of endotoxin.

100MIC.The endotoxin could be released more and more with the time.CONCLUSION:It is reasonable to choose antibiotics to refer to the characteristics of the endotoxin release by germs.

Objective To investigate the effects of perfusion pressure with a cardioplegic solution on endothelium-dependent relaxation and smooth muscle function of porcine coronary artery. Methods The hearts were infused with a modified St.Thomas’ hospital solution at the pressures of 40, 60 and 80 mmHg. The distal part of porcine left anterior descending coronary artery (LAD) having a diameter of 1.0-1.5 mm, was dissected free from the surrounding tissue, cut into 1 mm long segments, immediately transferred to organ baths for the evaluation of endothelial and smooth muscle function. Results Smooth muscle function was not affected after cardioplegic flushing at the pressures used in this study. The maximal endothelium-dependent relaxations of the vessels in 40 and 60 mmHg groups were not reduced compared to fresh segments . The maximal EDR was significantly reduced to (90.8?2.2)% (P

OBJECTIVE:To provide reference for further promoting the rational use of antimicrobial drugs in the rural commu-nity health service stations. METHODS:4 800 prescriptions were collected from 8 community health service stations affiliated to our hospital from Jan. 1,2012 to Dec. 31,2014,the use of antimicrobial drugs in the prescriptions was statistically analyzed and the indicators were compared before and after intervention. RESULTS:The proportion of use of antimicrobial drugs in these com-munity health service stations was decreased from 52.88%in 2012 to 30.38%in 2014;the clinical diagnosis of prescription of anti-microbial drug was mainly respiratory infections;what the most used types of antibacterial drugs was cephalosporins;and the pro-portion of antimicrobial drug of irrational use was decreased from 43.50%(368/846)in 2012 to 22.84%(111/486)in 2014. CON-CLUSIONS:The combination of technique and administrative intervention is remarkable. However,the unreasonable use of antibac-terial drugs still exists. Therefore,related training should be organized,and the proportion of use of antimicrobial drugs should in-cluded in the performance appraisal to further improve the use level of antimicrobial drugs in the rural community health service sta-tions.

Objective To provide a reliable differential diagnosis among the progressive supranuclear palsy ( PSP), striatonigral degeneration ( SND ) and Parkinson disease ( PD ) . Methods Conventional MRI data in clinically proved PSP(8 cases), SND(9 cases), PI)( 12 cases)and 12 normal controls were retrospectively analyzed. Midbrain area, pons area, ports diameter and middle eerebellar peduncles width were measured. The ratio of pons area over midbrain area (pons area/midbrain area) was calculated in all patients and normal controls. Then one way ANOVA and a Kruskal-Wallis H test were used for statistical analysis. Results Midbrain area of the PSP group [ (85. 8±12. 0) mm2 ] was the smallest, and there was statistically significant difference ( P < 0. 05 ) comparing with the SND group [ ( 133.2± 8. 4) nun2 ], PD group[ ( 133. 5±10. 8) mm2 ] and the control group [ ( 135.9±7.5 ) mm2 ]. There was no overlapping in the distribution of midbrain area between the PSP group(66.0-98. 2 mm2 ) and SND, PD and normal groups( 116. 2-142. 1, 110. 8-146. 2 and 121.7-145.8 mm2 ). The pons area-midbrain area ratio (P/M) of the PSP group (5.9±0. 8) was the largest in four groups, and there was statistically significant difference ( P < 0. 05 ) comparing with the SN D group ( 2. 9±0. 5 ), PD group ( 3.8±0. 3 ) and the control group (3. 8±0. 3 ). There was no overlapping in the distribution of P/M between the PSP group(5.0-7.2) and SND,PD and normal groups(2. 2-3.5, 3. 3-4. 6 and 3. 2-4. 2). SND group had the smallest P/M, pens area, pons diameter and middle cerebellar peduncles width [ 2.9±0. 5, ( 384. 8±62. 6) mm2 , ( 18. 6±2. 0) nun and( 12. 9±2. 4) mm ] in all groups, and significant difference ( P < 0. 05 ) was found comparing with the PSP group[5.9±0. 8, (500.1±21.8)mm2, (22. 7±1.7)mm and( 16. 3±1. 1) nun],PD group[3.8±0.3, (500.2±25.8)mm2, (23.7±1.0)mm and(16.8±1. 1)mm]and the control group [3. 8±0. 3, ( 508. 8±20. 6 ) mm2, ( 23.2±1.2) nun and ( 16. 4±0. 9 ) mm]. But the PD group and control group had no statistically significant difference in the midbrain area, pans area, pons diameter, P/M and middle cerebellar peduncles width ( P > 0. 05 ). Conclusion MRI measurements helps in the differential diagnosis among PSP, SND and PD.

Objective To analyze MRI findings of the mitochondrial encephalopathy, in order to improve the understanding of this disease. Methods MR findings of 5 patients of clinically proved mitochondrial encephalopathy were retrospectively analyzed. Results Brain parenchymal lesions in all patients were low intensity on T1WI and high signal intensity on T2WI. One patient had bilateral globus pallidus involvement, while involvement of gray matter and white matter were observed in 4 patients. Three patients had enlargement of supratentorial ventricles, 2 patients had cerebellar atrophy and 1 patient had bilateral basal galia calcification. Conclusion MRI can show the intracranial lesions in patients with mitochondrial encephalomyopathy clearly, but accurate diagnosis should depend on clinical data.

Objective To study the effects of hypothermia therapy on coagulopathy in neonates with hypoxic-ischemic encephalopathy(HIE) of different degrees.Methods Twenty-five newborns with HIE were divided into 2 groups (moderate HIE group and severe HIE group) by amplitude integrated electroencephalogram(aEEG).The platelet (PLT) count,activated partial thromboplastin time (APTT),prothrombin time(PT),thrombin time(TT),fibrinogen (Fbg) and international normalized ratio (INR) were measured before hypothermia therapy and those after 24 hours,48 hours,72 hours after hypothermia therapy were collected.The hematological parameters of 2 groups were analyzed by repeated measurement analysis of variance.Results The APTT(t=2.239,P<0.05)and PT(t=2.453,P<0.05) of severe HIE group were significantly longer than those of moderate HIE group and significantly different.PLT,PT,APTT and Fbg(all P>0.05)showed no statistically significant difference between 2 groups after hypothermia therapy.The differences in INR(F=12.470,P<0.05),TT(F=8.275,P<0.01)between 2 groups were significant.Fbg at diffe-rent time points showed no significant difference (P>0.05) between 2 groups.The differences in PLT(F=32.420,P<0.01),PT(F=9.377,P<0.01),APTT(F=15.420,P<0.01),TT(F=7.326,P<0.01)and INR(F=12.699,P<0.01)at different time points were significant between 2 groups.The degree of brain injury and time had no interactive effects in PLT,INR and Fbg(all P>0.05).But the degree of brain injury and time had interactive effects in PT(F=3.374,P<0.05),APTT(F=4.227,P<0.05)and TT(F=3.585,P<0.05).It indicated that the change trend in PT,APTT and TT were different between 2 groups.The increase range of PT,APTT and TT of severe HIE group was higher than moderate HIE group after hypothermia therapy for 24 hours.The percentages of severe HIE group who received transfusion with blood product were higher than those of moderate HIE group(P>0.05).Conclusion The coagulopathy function is worse in neonates with severe HIE in hypothermia therapy which may aggravate the hemorrhage risk.And the effect of hypothermia on neonates with moderate HIE is less evident.So hierarchical intervention on coagulopathy in neonates with HIE during hypothermia should be adopted to relieve the hemorrhage risk.

Objective To investigate the correlation between mRNA expression of VEGF,bFGF and dynamic contrast-enhancedT_1-weighted MRI together with conventional MRI features in pituitary adenomas.Methods Conventional MRI and gadolinium-enhanced dynamic Turbo-FLASH imaging was performed preoperatively in 30 patients with histologically verified pituitary adenoms.VEGF and bFGF mRNA expression were determined in pituitary adenomas by using comparative reverse transcription-polymerase chain reaction(RT-PCR) in all patients.The correlation between mRNA expression of VEGF/bFGF and dynamic contrast-enhanced and conventional MRI featureswere studied.Results Significant difference in VEGF and bFGF mRNA expression was found among pituitary adenomas according to different signal intensity-time curve(SI-TC) type(P

Objective To enhance the understanding of MR imaging in neurosyphilis Methods One case of syphilitic gumma with positive treponemal antibody test in the serum was confirmed pathologically after operation, and the other case with positive treponemal antibody test in the cerebrospinal fluid (CBF) was cured by medical therapy Both patients were examined by MRI Results Syphilitic gumma has some characteristic MRI findings The roundish areas of low signal or mixed low and iso signal intensity were revealed on T 1WI with the diameter ranged from 2 0 cm to 2 5 cm The lesions were located at the cortex or infra cortex surrounded by obvious edema The lesions showed high signal or mixed signal made up of iso , high, and low signals on T 2WI Gd DTPA enhanced T 1WI demonstrated irregular circular enhancement on the edge of the lesions and abnormal neighboring meningeal enhancement, and the border of the lesions was angulated with neighboring meninges by obtuse angle Conclusion The final diagnosis of neurosyphilis should depend on laboratory examination or histopathologic examination, but neuroimaging suspicion is paramount to early detection and diagnosis of neurosyphilis