Objective:To explore the impact of clinical pharmacists involved in the treatment team on the reasonable drug use rate in medical orders. Methods:Totally 782 medical records including hypertension and 1-3 kinds of hypertension associated diseases in our hospital from January 2011 to December 2011 were used as the pre-intervention group, and 1 061 ones with the same conditions from September 2012 to August 2013 were used as the post-intervention group. The patients of the two groups were divided into 8 dis-ease subgroups, clinical pharmacists performed timely intervention on the medical orders in the post-intervention group, and the rational drug use rate between the two groups was compared. Results:In hypertension, hypertension associated coronary heart disease, hyper-tension with heart failure and hypertension with diabetes subgroups,the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 01), in hypertension with coronary heart disease and heart failure, hypertension associ-ated coronary heart disease and diabetes, hypertension with heart failure and diabetes subgroup, the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 05), while in hypertension with coronary heart disease, heart failure and diabetes subgroups, the difference was not statistically significant(P>0. 05). After the medical records in the 8 sub-groups were aggregated, the difference in the rational drug use proportion before and after the intervention was statistically significant( P<0. 01). Conclusion:Clinical pharmacists should involve in the clinical treatment to intervene irrational drug use,which can signifi-cantly improve the medical record rationality, avoid the health risks as much as possible and ensure the medication safety and treatment effectiveness for patients.

A surgical technique of lateral crus strut graft to correct the deformity of nostril contour and improve asymmetric nostril shape by autologous rib cartilage was reported. Thirty-five patients (20 males and 15 females), with a mean age of 19 years (range of 16-26 years) were included in this study. All of the patients suffered moderate to severe unilateral cleft lip nostril deformity and underwent surgical technique of lateral crus strut graft by autologous rib cartilage to correct the asymmetric nostril contour from 2010 to 2012. The views of the nostril contour on both sides were reviewed and some parameters were measured at different time points (preoperatively, and 3 months and one year postoperatively) including the long axis and short axis of the nostrils. The differences in nostrils including long axis, short axis, elliptical area and eccentricity on the both sides were compared at different time points. The differences in the long axis and eccentricity of the nostrils on the two sides were decreased significantly between the preoperative view and postoperative view (P<0.05). The surgical technique of lateral crus graft with autologous rib cartilage is effective to correct the abnormal nostril contour and improve the asymmetry for unilateral cleft clip patients.

Objective To assess the diagnostic value of multiple-slice spiral CT (MSCT) perfusion imaging technique in pancreatic cancer by measuring and comparing the dynamical characteristics of blood flow between normal pancreas and pancreatic cancer. Methods The CT perfusion imaging were obtained using Siemens Somatoma MSCT scanner in 44 patients with normal pancreas tissue and 18 patients with pancreatic cancer. The mean blood flow (BF),blood volume (BV), time to start (Trs), time to peak (TIP), permeability and patlak blood volume (pBV) were measured and statistically analyzed by using Siemens Body peHusion software package. Results The mean BF, BV, Trs, TIP, permeability and pBV of normal pancreas were: (90.60±29.25) ml·100 ml-1·min-1, (190.35±43.8) ml/L, (205.3±160.2) s, (1403.5±334.0)s, (99.47±49.9) 0.5 ml·100 ml-1·min-1, (157.8±52.5) ml/L, respectively. The mean BF, BV, TTS, TrP, per-meability and pBV of pancreatic cancer were (22.9±10. 63) ml·100 ml-1·min-1, (52.38±18.08) ml/L, (194.3±76.0) s, (1549.5± 308.5)s, (115.25±33.55) 0.5 ml·100 ml-1·min-1, (83.16±41.45) ml/L respectively. The mean BF, BV, pBV and permeability between normal pancreas and pancreatic carcinoma were statistically significant (P<0.01). However the mean TTS and TIP between normal pancreas and pancreatic carcinoma were not statistically significant (P>0.05). Conclusion There are significant differences between perfusion values of pancreatic carcinoma and normal pancreatic tissue, and MSCT perfusion imaging is helpful in diagnosing pancreatic carcinoma.

Objective In order to provide clinical evidence of reducing postoperative complications of procedure for prolapse and hemorrhoids and observe the effects of constipation on postoperative complications of procedure for prolapse and hemorrhoids.Methods One hundred and sixty cases of hemorrhoid were divided into two groups according to whether suffering from constipation:there were eihgty cases who were suffered from constipation in the experimental group and eighty cases who were not suffered from constipation in the control group.All patients' postoperative bleeding,anal edema,stool impaction and satisfaction were observed within 30 days and these data were compared and analysed by using SPSS 13.0 software.Results In the experimental group,the postoperative bleeding incidence was 37.5 ％ (30/80),the anal edema incidence was 31.3 ％ (25/80),the stool impaction inci dence was 8.6％ (7/80),and the patients' satisfaction rate was 88.6％ (71/80).In the control group,the postoperative bleeding incidence was 18.6％ (15/80),the anal edema's incidence was 15.0％ (12/80),the stool impaction incidence was 1.3％ (1/80),and the patients' satisfaction rate was 97.5％ (78/80).All the indexes above were different statistically in the two groups (P ＜ 0.05).Conclusion constipation could increase complications and reduce the degree of satisfaction after procedure for prolapse and hemorrhoids.

Objective To observe the changes of serum potassium concentration in rectal cancer patients from the admission to before the operation,to provide clinical evidence for preventing serum potassium disorder during and after their operation.Methods Monitoring of the changes of serum potassium concentration of 40 cases of rectal cancer patients according to three time points including the first day of admission,before taking of cathartics and the morning before operation.They were divided into different groups according to their age(young,middle age and elderly group),gender(male and female group),diet(normal,decreased slightly and serious decline group) and course(long,middle and short course group) of disease.The serum potassium concentration was observed between each time point of each group and SPSS13.0 statistical software was used to analyze the changes above.Results The mean of all patients' serum potassium concentration was (4.09 ± 0.62) mmol/L on the first day of admission,was (3.83 ± 0.46) mmoL/L before taking of cathartics that was decreased compared to the former and there was significant difference (P ＜ 0.01),it was (3.36 ±0.40) mmol/L on the morning of operation and had significant difference with the above two groups (P ＜ 0.01).It hadn't significant difference between different gender and age groups at different time points (P ＞ 0.05) except between the young group and the elderly group in the morning of the operation (P ＜ 0.05).There were statistically significant differences between the different diet condition and different course at anytime point (P ＜ 0.01).Conclusions The rectal cancer patients were possiblely in hypokalemia before operation,the causes might be relative to the long course of disease,the decreased diet,the aged and infirm,the diet structure change after admission and taking cathartics cleaning intestinal tract.

Malignant tumor is one of the main causes for death in the world at present as well as a major disease seriously harming human health and life and restricting the social and economic development. There are many kinds of reports about traditional Chinese medicine patent prescriptions, empirical prescriptions and self-made prescriptions treating cancer, and prescription rules were often analyzed based on medication frequency. Such methods were applicable for discovering dominant experience but hard to have an innovative discovery and knowledge. In this paper, based on the traditional Chinese medicine inheritance assistance system, the software integration of mutual information improvement method, complex system entropy clustering and unsupervised entropy-level clustering data mining methods was adopted to analyze the rules of traditional Chinese medicine prescriptions for cancer. Totally 114 prescriptions were selected, the frequency of herbs in prescription was determined, and 85 core combinations and 13 new prescriptions were indentified. The traditional Chinese medicine inheritance assistance system, as a valuable traditional Chinese medicine research-supporting tool, can be used to record, manage, inquire and analyze prescription data.
Drug Prescriptions ; Humans ; Medicine, Chinese Traditional ; Neoplasms ; drug therapy

Objective To observe the clinical effect of thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids(PPH) in the treatment of circumferential mixed hemorrhoid with incarceration.Methods A total of 118 cases of circumferential mixed hemorrhoid with incarceration were divided into two groups:experimental group of 60 cases was treated by thrombus removal combined with PPH;control group of 58 cases was treated by Milligan-Morgan.We observed the differences of postoperative visual analogue scale (VAS)score,edema,bleeding,residual skin tag,wound healing time,anal stenosis,fecal incontinence,anorectal manometry and satisfaction in the two groups.Results There was significant difference between the experimental group and the control group in postoperative edema,bleeding and residual skin tag(χ2=6.63,4.19,6.64,P<0.05),but postoperative anal stenosis and fecal incontinence weren′t statistically significant different(χ2=0.38,1.11,P>0.05).Postoperative VAS score,wound healing time,satisfaction,anal resting and anal maximal squeeze pressure between the two groups were all statistically different(P<0.01).Conclusion The operation of thrombus removal of external hemorrhoid combined with PPH can effectively reduce the postoperative complications and promote recovery.

Objective To observe the Lactulose Oral Solution's influence in PPH postoperative complications and patients′ satisfactory rate for constipation and to find more intervention measures for reducing the complications. Methods A hundred and twenty cases of hemorrhoids with constipation were randomly divided into the two groups: the experimental group, the control group in 60 cases in each group. All patients’ postoperative bleeding, anal edema, stool impaction and satisfaction were observed and compared within 30 days. Results In the control group, the postoperative bleeding’ cases were of 23, anal edema’s were of 20 and stool impaction‘s were of 8. The incidence was 38.3%, 33.3% and 13.3% severally. The satisfactory patients were of 49 and the degree of satisfaction was of 81.7%. In the experimental group, the postoperative bleeding’ cases were of 12, anal edema’s were of 8 and stool impaction's was of 1. The incidence was 20%, 13.3% and 1.7% respectively. The cases who were satisfactory were of 58 and the degree of satisfaction was 96.7%. The postoperative bleeding , anal edema , stool impaction and satisfaction were different statistically in the two groups above (P < 0.05). Conclusion It can reduce PPH postoperative complications and increase patients′satisfaction by using Lactulose Oral Solution in patients with constipation and it will have a certain clinical value if these patients take this oral solution routinely.

OBJECTIVETo Summarize the clinical experience of individual immunosuppressive regime in heart transplantation with high risk.

METHODSFrom September 2001 to December 2006, 51 cases with the complication of Hepatitis B viruses (HBV) infection, diabetes mellitus, renal dysfunction or pulmonary infection in perioperative period were analyzed retrospectively. All cases received daclizumab (Zenapax) induction therapy, and baseline triple immunosuppressive regime was consist of cyclosporine (CsA), azathioprine (Aza) or mycophenolate mofetil (MMF) and prednisone (Pred). Ten cases received HBV infection in preoperative period, the immunosuppressive protocol was emphasized on the use of MMF and the withdraw of Pred one month later in postoperation. Nine cases received diabetes mellitus in pre-operation, 4 cases had post-transplant diabetes mellitus. The immunosuppressive protocol was emphasized on the use of CsA rather than FK506, the use of Pred was less dosage, and the therapy of insulin was necessary. Sixteen cases had renal dysfunction in pre-operation, the use of MMF was routine but the use of CsA was delayed to the time 5 to 19 d postoperative. Twelve cases received pulmonary infection after allograft transplantation. The immunosuppressive agent was to be taped or suspended in therapy time.

RESULTSThe liver function of the 10 cases with HBV infection was stable in 1 year follow-up, and 1 case received acute rejection after 13 months allograft transplantation. In the 6 months follow-up, the blood glucose level of the 13 cases with diabetes mellitus was stable, none of the cases suffered from acute rejection. In the one month follow-up, none of the 16 cases with renal dysfunction suffered from acute rejection, and the renal function was normal. Two of the 12 cases with the pulmonary infection were died of serious infection, others were survival. One case received acute rejection on the 17th day in postoperation.

CONCLUSIONSLow mortality can be realized by selecting appropriately individual immunosuppressive regime and the episode of acute rejection is rare.

Adult ; Female ; Follow-Up Studies ; Graft Rejection ; prevention & control ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Male ; Perioperative Care ; Retrospective Studies ; Risk Factors

OBJECTIVETo analyze the incidence and survival rates of primary liver cancer (PLC) among residents in Yangpu district of Shanghai.

METHODSA total of 9 730 736 permanent residents (male 4 996 390 and female 4 734 346) of Yangpu district in Shanghai were recruited in the study between year 2002 and 2010; among whom 2726 PLC cases were diagnosed and 2427 death cases were certified. The incidence and mortality of PLC were calculated under the analysis of the new PLC cases and death cases between year 2002 and 2010. The rates were standardized by the demographic composition developed in the Fifth Nationwide Census in year 2000, in order to analyze the survival condition of PLC patients and explore the prognosis of surgical excision treatment.

RESULTSAmong the new PLC cases between year 2002 and 2010, 1966 cases were male, whose average age of onset was 59.81; while 760 cases were female, whose average age of onset was 68.93. The crude incidence rate was 39.35/100 000 in male, which was higher than it in female, as 16.05/100 000. The difference showed statistical significance (U = 7.32, P < 0.01). The standardized incidence rates were 21.98/100 000 and 6.96/100 000 in male and female, respectively. The difference showed statistical significance (U = 221.76, P < 0.01). There were 2427 PLC death cases in total, including 1734 male death cases and 693 female death cases. The crude mortality rate was 34.71/100 000 in male and 14.64/100 000 in female, whose difference were statistically significant (U = 6.68, P < 0.01). The standardized mortality rate was 19.16/100 000 in male and 6.06/100 000 in female, whose difference were statistically significant (U = 207.18, P < 0.01). The incidence and mortality rates both increased apparently since males aging over 35 and females over 45. The 1 - 5 year survival rates of PLC patients were 33.95%, 23.11%, 17.04%, 14.42% and 12.29%, respectively. In the surgical excision treatment group (321 cases), the 1 - 5 year survival rates were separately 66.78%, 52.87%, 41.88%, 33.57% and 32.64%; while in the non-surgical treatment group (2405 cases), the 1 - 5 year survival rates were separately 29.04%, 18.58%, 13.30%, 11.16% and 9.01%. The differences in 1 - 5 year survival rates between surgical and non-surgical groups all showed statistical significance (U = 12.78, 10.52, 8.28, 5.56 and 5.12, respectively, P < 0.01).

CONCLUSIONThe incidence of PLC was close to its mortality in Yangpu district of Shanghai. The male incidence and mortality rates were significantly higher than female corresponding rates. The surgical excision treatment could improve the prognosis of PLC.

Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; mortality ; surgery ; Male ; Middle Aged ; Prognosis ; Survival Rate