OBJECTIVE:To discuss the management targets of hospital drug sto rehouse.METHODS:Theory of physical distribution management was applied in combination with the actual situation of hospitals,the professional characteristic of hospital pharmacy,the functional characteristic of pharmaceutical legislation and the commercial characteristic of drug distri?bution were analyzed.RESULTS&CONCLUSION:The management targets of hospital drug storehouse must accord with the mission of hospital and embody its social effects as well as the economic returns.

Achalasia is an esophageal motility disorder with impaired relaxation of lower esophageal sphincter.Its clinical manifestations are progressive dysphagia, retrosternal pain, regurgitation of undigested food, weight loss.Medication, endoscopic treatment and surgery are the main treatments of achalasia.Peroral endoscopic myotomy (POEM) is an endoscopic mini-invasive technique which has smaller surgical injury, remarkable curative effect, lower cost, and lower recurrence rate when compared with the traditional treatment of achalasia.This article reviewed the advances and prospects of POEM in treatment of achalasia.

AIM: To optimize the extraction process for Banxiaxiexin Decoction (Rhizoma pinelliae, Radix Scutellariae, Rhizoma coptidis, Radix Ginsenp, Rhizoma zinpiberis, Fruents Jujubae, and Radix Glycyrrhizae). METHODS: The content of berberine、baicalin and total solid in extract liquor were determined by orthogonal design and single factor experiment in combination with glycyrrhizic acid content and identification of Rhizoma zingiberis, Radix Ginseng and Rhizoma Pinelliae. RESULTS: The extracting was arrived at in the condition of adding eighteen times of 70% alcohol as much as crude drug and refluxing 2 times, 2h and 1h, respectively. CONCLUSION: The extraction is stable and feasible.

Objective To evaluate the role of Restriction fragment length polymorphism (RFLP) analysis in detection of the fragment of GEF1α/a gene which are both located at ct and a mating type loci in identification of species, varieties, genotypes and mating types of Cryptococcus neoformans species complex(Cryptococcus neoformans and Cryptococcus gattii). Methods The GEF1α/a gene was selected from 20 genes which both located at α and a mating type loci for RFLP analysis, according to the requirements of sequence similarities and primer design in PCR-RFLP analysis. Primer pair was designed from the conserved regions of GEF1α/a genes of distinct genotypes and mating types of reference strains to amplify a fragment of GEF1α/a gene from Cryptococcus neoformans and Cryptococcns gattii strains tested. Sequence alignment,restriction maps analysis, endonucleases selection and electrophoresis stimulation were conducted by using DNAMAN and Vector NTI software. EeoT14 Ⅰ and Hap Ⅱ endonucleases were selected for RFLP analysis of the GEF1α/a fragments amplified from 125 isolates of Cryptococcns neoformans and Cryptococcus gattii. Results An approximate 1 300 bp fragment was amplified from total 82 Cryptococcus neoformans and 43 Cryptoceccus gattii isolates. However, negative PCR results were found in the reference strains of Cryptococcus laurentii, Candida albicans, Candida tropicalis, Candida parapsilosis, Candida krnsei,Candida glabrata, Trichosporon asahii, Aspergillus fumigatns and Aspergillus flavus. RFLP analysis successfully identified the species, varieties, genotypes and mating types of total 125 isolates of Cryptococcus neoformans and Cryptococcns gattii tested in this study. Condusion PCR-RFLP analysis of the GEF1α/a fragment has the potential value in identification of species, varieties, genotypes and mating types of Cryptococeus neoformans species complex simultaneously and rapidly, and may be a useful tool in molecular epidemiological analysis.

Objective To investigate the molecular epidemiology of clinical cryptococcal isolates from China by analyzing the constituents and distributions of the varieties,genotypes and mating types (MAT)of them.Methods (1)PCR fingerprinting and PCR amplification were performed by using the minisatellite-specific core sequence of wild-type phage M13 as single primer.Genotypes of the 110 cryptococcal isolates from China were assigned by comparison with the reference strains of the 8 major molecular types loaded on gel.(2)Identification of the varieties and mating types was carried out by PCR using the specific primers of the varieties and mating types.Results Of the 110 clinical cryptococcal isolates,strains of Cryptococcus neoformans var.grubii with genetype VNⅠ and mating type MATα were the most representative ones(89.1%)followed by strains of C.neoformans var.gattii(8.2%)including isolates of genotype VG I,mating type MATα(7.3%)and genotype VGⅡ,mating type MATα(0.9%);AD hybrids with the genotype VNⅢ,mating type MAT-/α and genotype VN Ⅲ,mating type MATα/-(1.8%);and isolate of C.neoformans var.neoformans with the genotype VNⅣ and mating type MATa(0.9%).Conclusion Of the clinical isolates from China,all three varieties and AD hybrids are found.The vast majority(>99%) of strains possess the α allele in MAT locus and most of them are C.neoformans vat.grubii with the genotype VN I,which accord with the data of most studies of clinical molecular epidemiology in other geographic areas.However.no genotype of VNⅡ.VGⅢ and VGⅣ isolates are found in this study.

Pemphigus is a severe chronic autoimmune mucocutaneous bullous disease. Glucocorticoids are considered as the first line of treatment for this disease. Dysfunctional uterine bleeding is also observed as a result of hypothalamic-pituitary-ovary axis dysfunction. This study reported one female patient with pemphigus vulgaris complicated with dysfunctional uterine bleeding upon systemic glucocorticoid usage. Before this disease was diagnosed, the patient experienced normal menstruation. The mechanism of dysfunctional uterine bleeding triggered by glucocorticoids is elucidated on the basis of case studies and literature review.
Female ; Glucocorticoids ; adverse effects ; Humans ; Metrorrhagia ; chemically induced ; Pemphigus ; drug therapy

Objective To compare and analyze the clinical efficacy of locking plates versus artificial joint replacement for proximal humeral complicated fractures.Methods The retrospective data of 200 cases with locking plate or artificial joint replacement for the treatment of comminuted proximal humeral fractures were collected from February 2013 to July in our hospital.Patients were divided into locking plate group (n =114) and artificial joint replacement group (n =86) according to the treatment.The pain,functional recovery,activity,anatomical position,complications and Neer score after treatment were compared between the two groups.Results In artificial joint replacement group,Neer score was excellent in 34 cases,good in 23 cases,fair in 25 cases,poor in 4 cases,and the excellent and good rate was 66.3％ (57/86).In locking plate group,Neer score was excellent in 53 cases,good in 47 cases,fair in 10 cases,poor in 4 cases,and the excellent and good rate was 87.7％ (100/114).The excellent and good rate was higher in locking plate group than in artificial joint replacement group (x2 =13.35,P＜0.001).The scores of pain,functional recovery,activity and anatomical position were (26.9 ± 8.5),(22.4 ± 7.1),(19.8 ± 5.5) and (8.0 ± 1.8) respectively in locking plate group,and (24.8±10.2),(20.2±6.7),(18.1±6.6) and (7.9±2.1) respectively in artificial joint replacement group.There were significant differences in scores of functional recovery and activity between groups (t＝ 2.22 and 1.99,P =0.014 and 0.024),while no significant differences were found in scores of pain and anatomical position (t=1.59 and 0.36,P＝0.057 and 0.359).There were 2 cases with ankylosis,1 case with malunion and 1 case with humeral head necrosis in locking plate group,and 1 case with ankylosis,1 case with wound infection,1 case with refracture and 1 case with humeral head necrosis in artificial joint replacement group after treatment.There were no significant differences in complications between groups (x2 =0.17,P=0.683).Conclusions The locking plate and artificial joint replacement are effective in the treatment of comminuted proximal humeral fractures.Compared with artificial joint replacement,the locking plate can improve the functional recovery,activity and Neer score evaluation with a low technical requirement,which is an ideal method for comminuted proximal humeral fractures.

Objective To evaluate the efficiency of PCR-restriction fragment length polymorphism (PCR-RFLP)aiming at the structure gene g6341,versus PCR fingerprinting analysis in the genotyping of Cryptococcus neoformans MethodsEight reference strains and 68 clinical and environmental isolates of C.neoformans were genotyped by PCR-RFLP and PCR fingerprinfing.In PCR fingerprinting,the minisatel lite-specific core sequence of wild-type phage M13 was used as a single primer.The structure gene g6341 was selected for PCR-RFLP analysis by sequence alignments of multiple genes,a pair of pnmers were developed based on the conserved region of g6341 gene.PCR products were digested with the appropriate restriction endonucleases,and RFLP profiles were analyzed.Partial sequence analysis of g6341 gene was performed for different genotypes of C.Neoformans.Phylogenetic analysis was done to study the relatedness between these genotypes.Results As sequence homology analysis showed,g6341 gene was suitable for RFLP analysis.In the case of enotyping of 76 C. Neoformans strains,the results obtained from PCR-RFLP were consistent with those from PCR fingerprinting.Sequence analysis of g6341 gene revealed a homology of 84%-97%among the eight genotypes as well as a consistency of 99%-100%within a same genotype.In the phylogenetic tree,genotypes VNⅠ,VNⅡ,VNⅢand VNⅣ belonged to one cluster,and genotypes VGⅠ,VGⅡ,VGⅢ and VGⅣ to another cluster.Conclusions PCR-RFLP analysis aiming at the structure gene g6341 is a useful tool to genotype C.neoformans.Sequence analysis of g6341 gene can disclose the relatedness among different molecular types of C.neoformans.

Objective To identify the AD hybrid strains and its hybrid types within Cryptococcus neoformans.Methods Difierent hybrid types of AD strains were analyzed by PCR 0f STE20 and MF genes within MAT locus and CIA4 and GPal genes out of MAT locus.The PCR-RFLP analysis of g6341 gene was also performed.Results The mating types of 18 AD strains were precisely identified by PCR of STE20 gene,whereas those of H strain were not identified.CL44 gene was better than the GPal gene in PCR identification of the AD hybrids.In the RFLP analysis of g6341 gene,AD strains were grouped into 2 distinct RFLP patterns based on the mating type on serotype A allele.The mating types of AD strains were not identified by the molecular analyses based on the CL44,GPal and g6341 genes.Conclusion It is necessary to use multi-locus analyses of genes within and out of the MAT locus in precise identification of the AD strains and their hybrid types of Cryptococcus neoformans.

Objective To assess the subgenotypes of pathogenic Cryptococcus gattii isolates from China and to elucidate the epidemiological links between these domestic isolates and those from other parts of the world. Methods DNA was extracted from 9 clinical isolates of Ctyptococcus gattii from China. The partially variable regions of the three unlinked loci, namely IGS1, PLB1 and GEF1, were amplified and sequenced, and the bioinformation at these loci was obtained from GenBank for multi-locus sequences alignment and phylogenetic analysis. Results Of these 9 clinical isolates, 8 were genotype VG Ⅰ and mating type α with the same sequences at the tested regions as the reference strain WM276, which was a representative isolate of an independent subgenotype; 1 was of genotype VG Ⅱ and mating type α, which was the first report in China, with the tested sequences consistent with those of the referrence strain R272. Sequencing and phylogenetic analysis of GEF1 gene, which was located at mating type locus, successfully identified the genotypes and mating types of all the Cryptococcus gattii isolates involved here. Conclusions Multi-locus sequence analysis shows that causative Cryptococcus gattii isolates of genotype VG Ⅰ in China carry similar sequences at the tested loci in IGS1, PLB1 and GEF1 genes, to a widely distributed subgenotype in the world, and the sequences of the first VG Ⅱ genotype isolate from China resemble the less virulent subgenotype VG Ⅱ b found in Vancouver islands.