OBJECTIVE:To establish the methods for content determination of lead and cadmium in Achyranthes bidentata from different habitats.METHODS:Graphite furnace atomic absorption spectrometry was applied.RESULTS:There were a good linear relationship between the concentration and absorbance of lead and cadmium.The linear range of lead were 0～80.00 ?g?L-1(r=0.999 6) with recovery of 95%～101%(RSD ranged from 0% to 5.00%,n=10).The linear range of cadmium were 0～7.000 ?g?L-1(r=0.998 2) with recovery of 98%～103%(RSD ranged from 1.00% to 5.00%,n=10).CONCLUSION:The method is simple,accurate,convenient and sensitive and the results are satisfactory.

Objective: To establish the determination of imperatorin and isoimperatorin in Tongketing Capsule (Radix Angelicae Dahuricae, Pheretima, etc.) by HPLC. Methods: The determination was carried out by HPLC. The mobile phase was acetonitrile water (60∶40) and UV detection wavelength was set at 245nm . The flow rate was 1.0mL?min -1 . The column temperature was 40℃ . Results: There were the good linear relationship between the absorption area value and the concentration in the range of 65?g～325?g for imperatorin and in the range of 50?g～250?g for isoimperatorin, respectively. The average recoveries were 98.3% ( RSD = 1.73% ) and 98.7% ( RSD = 1.65% ), respectively. Conclusion: The method is simple, accurate and can be used to determine imperatorin and isoimperatorin in Tongketing Capsule.

OBJECTIVE:To investigate the cognition of clinical pharmacists on the clinical pharmacy practice and their profes-sion,and provide reference for further developing clinical pharmacy practice. METHODS:A questionnaire was designed,and ran-dom sample was conducted for the clinical pharmacists from 30 secondary and tertiary hospitals in Shanghai,and the investigation results were analyzed statistically. RESULTS:Totally 130 questionnaires were sent out,and 102 were effectively received with valid response rate of 78.46%. 94.11% of the investigated subjects were willing to be a clinical pharmacist,but 17.65% of them consid-ered that they were incompetent for their work;29.41% of them thought the current situation of clinical pharmacy practice was not ideal;all the respondents considered that the clinical pharmacist system should be implemented in medical and health institu-tions;the cognition and evaluation of investigated subjects in tertiary hospitals on clinical pharmacy practice and their profession was generally higher than those in secondary hospitals(P<0.05). CONCLUSIONS:The clinical pharmacists in medical and health institutions in Shanghai showed high cognition on their profession,and the clinical pharmacy practice has already made some achievements,but many work still need to be improved. Therefore,clinical pharmacists should continuously study their profession-al knowledge and improve their professional skills and quality;hospitals and universities should strengthen the subject construction and personnel training of clinical pharmacy and deeply carry out the clinical pharmacist system;health administration departments should strengthen the related laws and regulations of clinical pharmacy;colleges and universities should strengthen the discipline construction and personnel training.

Objective To study the optimum inclusion process for volatile oil from Tongketing capsules. Methods The study was carried out with orthogonal test at different levels. The utilization ratio of volatile oil was used as the index to optimize the inclusion process. Results The optimum preparation conditions for inclusion were: oil: ?-cyclodextrin: water was 1: 4: 40 (V: V: V). The inclusion time was 10rain and inclusion complexes was dried at 70℃. Conclusion This optimized process is simple, efficient and can be used for the production of Tongketing Capsule on a large scale.

Objective:To regulate operation requirement for electric instrument using in surgery and eliminate hidden danger so as to ensure their safety in using.Methods: Through discussed the regulation of operative process for electric instrument using in surgery to develop a insulation detector which can adapt the particular case of hospital, and then to carry out relevant management for this kind of electric instrument.Results: The simplest insulation monitoring method got best reliable data, and it provide accuracy basis for clinical electric instrument. Therefore, it ensured the safety of clinical application of electric instrument.Conclusion: The special insulation monitor detects electric instrument in surgery has series of merits including low investment, fast detection and reliable performance, it not only can ensure the safety of surgery but also can provide traceable basis for preventing relevant medical dispute.

AIM: To establish the determination of baicalin and wogonin in Chantui Zhike Granules (Periostracum Cicadae, Radix Scutellariae, etc.) by HPLC. METHODS: The determination was carried out by HPLC. The mobile phase was acetonitrile 0.6% phosphoric acid(45∶55) and UV detection wavelength was set at 275nm. The flow rate was 1.0mL?min -1 . The column temperature was at 40 ?C . RESULTS: The contents of baicalin and wogonin in Chantui Zhike Granules could be determined by HPLC. There was a good linearity between the absorption peak area and the concentration in the range of 0.104?g～0.52?g for baicalin and in the range of 0.03?g～0.15?g for wogonin, respectively. The average recoveries were 100.69%( RSD =1.75%) and 98.8%( RSD =1.01%) respectively. CONCLUSION: The method is simple, accurate and can be used to determine the contents of baicalin and wogonin in Chantui Zhike Granules.

Objective To establish a method for determining the content of Shionone in Chantui Zhike Granules.Methods The determination of Shionone was performed at 490nm by TLC Scanning,with Petroleum ether∶ethyl acetate(19∶1)as developer and 10 %ethanol sulfate as color-developing agent.Results The linear range of Shionone was in the range of 0.96～5.76 ?g and r=0.9998.The average recovery was 98.67 %and RSD was 0.77 %.Conclusion This method is accurate with a good reproducibility and can be used for the quality control of Chantui Zhike Granules.

Objective To observe the clinical findings about the endothelial cell injury related to the genesis of inflammatory cytokines and coagulation.Methods A total of 70 critically ill patients with SIRS (systemic inflammatory response syndrome) admitted to intensive care unit (ICU) between September 2009 and February 2010 were enrolled for a prospective and control study.According to diagnostic criteria of Sepsis/SIRS,the patients were divided into two groups:sepsis group (n =38) and SIRS group (n =32),and another 20 healthy volunteers served as control group.Patients in the sepsis group and SIRS group were matched by clinical signs of high blood pressure,diabetes and its complications.The demographics of patients including age,sex,body mass index (BMI),smoking and alcohol addict were comparable among the different groups.The 6 ml peripheral blood samples were collected within 24 h after admission to ICU for enzyme-linked immunosorbent assay (ELISA) to detect the plasma levels of s-CD62P,TNF-α,and hsCRP.And variables of coagulation function such as platelet (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),D-dimer and antithrombin-Ⅲ (AT-Ⅲ) were analyzed during 24 h after admission to ICU.Meanwhile sequential organ failure assessment (SOFA) score of critically ill patients was evaluated.Data were expressed in mean ± standard deviation and were statistically analyzed by using SPSS 17.0 statistical software.The differences in plasma levels of s-CD62P of patients in each group were analyzed by ANOVA and Kruskal Wallis test.The relationship between s-CD62P and inflammatory cytokines as well as with coagulation were determined by Pearson correlation analysis.Changes were considered as statistically significant if P value was less than 0.05.Results ① Compared with control group and SIRS group,the levels of s-CD62P,TNF-α and high sensitive C-reactive protein (hs-CRP) were significantly higher in sepsis group (P ＜ 0.05).② The plasma levels of D-dimer,PT,APTT in sepsis group and SIRS group were significantly higher than those in control group,while the platelet count (PLT) and the activity of AT-Ⅲ were obviously lower (P ＜ 0.05).③ In sepsis group,the plasma levels of hs-CRP and TNF-α positively correlated with PT,APTT,D-dimer,and negatively correlated with AT-Ⅲ,PLT (P ＜ 0.05).④ Plasma levels of s-CD62P were significantly correlated with plasma levels of TNF-α,hs-CRP,D-dimer,PT,APTT,whereas correlated negatively well with PLT,AT-Ⅲ (P ＜ 0.05).Conclusions The plasma s-CD62P concentration is elevated as a early biomarker in patients with sepsis,and it acted as one of pathogenic factors responsible for endothelial cell damage.Coagulation and mediators of inflammation promotes each other,aggravating the severity of the sepsis.The plasma s-CD62P may be the important factor associated with initiation of coagulation development and inflammatory reaction.

Objective To investigate the effect of ulinastatin on the postoperative immune function of effective T-lymphocytes (Teff cells) and regulatory T-lymphocytes (Treg cells) in the peripheral blood in patients undergoing laparoscopic operation.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 20-40 yr,weighing 45-65 kg,scheduled for elective laparoscopic operation for infertility,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ulinastatin group (group U).At 15 min before induction of anesthesia,ulinastatin 200,000 U (in 100 ml of normal saline) was infused intravenously in group U,while the equal volume of normal saline was infused instead in group C.Anesthesia was induced with iv injection of fentanyl,propofol,and cisatracurium and maintained with iv infusion of propofol and sevoflurane.Before surgery (T0),at the end of surgery (T1) and on 1st and 3rd days after surgery (T2.3),venous blood samples were collected from the peripheral blood for determination of the expression of Teff cells (CD4 + CD25-) and Treg cells (CD4 + CD25+) and serum interferon-γ (IFN-γ) and transforming growth factor-β (TGF-β) concentrations (by ILISA).Teff/Treg and IFN-γ/TGF-β ratios were calculated.Results Compared with the baseline value at T0,the expression of Treg cells was significantly up-regulated,and Teff/Treg ratio was decreased at T2 and T3 in group C,and the expression of Teff cells was up-regulated at T3 (P ＜ 0.05 or 0.01),while no significant difference was found in the expression of Treg cells and Teff/Treg ratio at T3 in group U (P ＞ 0.05).Compared with group C,the expression of Teff cells was significantly up-regulated at T3,the expression of Treg cells was down-regulated and Teff/Treg ratio was increased at T2 and T3,the concentration of serum TGF-β was decreased and IFN-γ/TGF-β ratio was increased at T2 and T3 in group U (P ＜ 0.05 or 0.01).No significant changes were found in the serum IFN-γ and TGF-β concentrations and IFN-γ/TGF-β ratio at each time point in the two groups (P ＞ 0.05).Conclusion Ulinastatin can enhance the immune function of Teff cells in the peripheral blood and decrease the immune function of Treg cells,thus maintaining the balance of the postoperative cellular immune function in patients undergoing laparoscopic operation.

Objective To analize the clinical features of patients with hemophagocytic syndrome (HI'S). Methods The underlying diseases, clinical characteristics, laboratory findings, responses to therapy as well as their outcomes of 45 patients with HPS were analyzed retrospectively. Results The underlying diseases included virus infection (n = 9) , tuberculosis (n =2), rheumatic fever (n =4) , malignancies (n =22) , unknown diseases (n =8). HPS was clinically characterized by high fever(93. 3% ) , hepatomegaly (77. 8% ) , splenomegaly(80% ) , lymphadenopathy (55. 6% ) , skin rash(24.4% ), gastrointestinal hemorrhage(22. 2% ) , renal (35. 6% ) and central nervous systern involvement( 15. 6% ) , five patients presented with disseminated intravascular coagulation( DIC) (11. 1% ). Laboratory data mainly manifested with cytopenia ( 100% ) , liver dysfunction ( 77. 8% ) , hypofibrinogenemia (62. 8% ), hypertriglyceridemia (71. 1% ) , serum ferritin >500 p,g/L(87. 5% ) , low NK-cell activity(92. 9% ) and hemophagocytosis in bone marrow (100% ). Based on treating underlying diseases and use of corticosteroids and immunosuppressive agents in combination with intravenous immunoglobulins(IVIG) therapy, 14 patients recovered , 19 patients died in the hospital, and other 12 cases give up treatment be cause of exacerbation of the disease.Conclusion There are various underlying diseases and clinical manifestations for HPS. HPS is always extremely dangerous with high mortality. Treatment of underlying diseases, corticosteroids, immunodepressant and IVIG may improve the prognosis of HPS.