OBJECTIVE: To investigate the development of clinical pharmacy according to the publication number of literatures in pharmacy periodicals in China. METHODS: General keywords, such as rational administration, pharmaceutical care, training for clinical pharmacist, and special keywords, such as drug utilization, administration analysis, therapeutic drug monitoring(TDM), adverse drug reaction monitoring, medication history, pharmacoeconomic analysis, medicine consultation, were selected for retrieving related literatures from CBM database from 1994 to 2008. Literatures retrieved were analyzed statistically. RESULTS: Clinical pharmacy developed rapidly relatively in recent years. The number of literatures which were retrieved using general keywords was 12 and 15 for using special keywords in 1994. The number of literatures was increases year by year and up to 1 117 and 329 in 2008. However, development orientation of literatures was unbalanced. Literature about rational administration, drug utilization and administration analysis constituted a high proportion while development of clinical pharmacy should be enhanced in respect of clinical pharmacist training, medication history writing, medicine consultation and adverse drug reaction monitoring. CONCLUSION: Disadvantage in disequilibrium of development should be changed as long as clinical pharmacy develops rapidly in order to promote its overall development.

ObjectiveTo investigate the effects of norepinephrine on oxygen metabolism and postoperative outcomes in the elderly patients undergoing fluid-restored abdominal surgery.MethodsAfter hospital ethics committee approval,and written informed consent was obtained from all patients,40 elderly patients,aged ＞ 64 yr,with a body mass index of 18-24 kg/m2,undergoing elective colorectal surgery,were randomly divided into 2 groups (n =20 each):routine fluid administration group (group A) and restricted fluid administration group (group B).In group A,lactated Ringer's solution was given routinely.Lactated Ringer's solution was given at a rate of 5 ml· kg- 1 · h- 1 and small dose of norepinephrine was infused intravenously at 0.01-0.03 μg· kg- 1 · h - 1 simultaneously during the surgery,and MAP was maintained ≥65 mm Hg in group B.Intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl starch 130/0.4.Before the surgery ( baseline),1 and 2 h after beginning of the surgery,and while leaving postanesthesia care unit,mean arterial pressure (MAP),heart rate (HR),cardiac index (CI) and central venous pressure (CVP) were recorded,and arterial and central venous blood samples were drawn for blood gas analysis.Oxygen delivery index (DO2 I ),oxygen consumption index (YO2I) and oxygen extraction ratio (ERO2) were calculated.The gastric mucosal pH was determined before the surgery and 1 h after beginning of the surgery.Blood samples were taken form the peripheral vein to determine the concentration of Hb,serum albumin,blood urea nitrogen (BUN) and creatinine (Cr) concentrations before the surgery and 1 day after the surgery.The extubation time,duration of stay in hospital,the time when the patients passed the flatus,pulmonary complications,gastrointestinal complications,and wound infections were recorded.ResultsCompared with group A,CI,Hb,ScvO2 and DO2I were significantly increased,CVP and ERO2 were decreased during the surgery,the concentrations of Hb and serum albumin were significantly increased,1 day after the surgery,and the incidence of pulmonary complications and wound infections was significantly decreased after the surgery in group B (P ＜ 0.05 ).There were no significant differences in gastric muscosal pH,the indexes of renal function,extubatiotn time,the time when the patients passed the flatus,duration of stay in hospital and the incidence of gastrointestinal complications between the two groups ( P ＞ 0.05).ConclusionWhen small dose of norepinephrine is used to treat perioperative hypotension induced by fluid restriction,it can increase oxygen delivery,and reduce the incidence of postoperative complications,and has no adverse effects on gastrointestinal microcirculation and oxygen consumption in the elderly patients undergoing colorectal surgery.

Purpose To study the correlation between the expression of podoplanin-positive stromal cells and clinicopathologic features in squamous cell carcinoma ( SCC) of esophagus, and to explore the role of podoplanin-stromal cells in the progression of SCC of e-sophagus. Methods Immunohistochemical EnVision method was used to detect the expression of podoplanin in the stromal cells of e-sophageal SCC. The correlation between the expression of podoplanin-positive stromal cells and clinicopathologic features in SCC of e-sophagus was analyzed. Results Of 69 cases of SCC, podoplanin-positive stromal cells were seen in 43 and the positive rate was 62. 3%. Lymphatic vessel density in SCCs with podoplanin-positive stromal cell was 45. 72 ± 14. 36, which was higher than that with-out podoplanin-positive stromal cell (21. 23 ± 10. 49) (P<0. 01). Expression of podoplanin in stromal cells in SCCs with lymphatic vessel invasion was higher than those without lymphatic vessel invasion (P<0. 05). There was no correlation between podoplanin-posi-tive stromal cells and age, sex, tumor size, the depth of invasion, differentiation, lymph node metastasis, and clinical stage ( P>0. 05). Conclusion Podoplanin-positive stromal cells may promote the lymphangiogenesis and lymph vessel invasion of esophageal SCC.

Objective To construct canine bifurcation aneurysms suitable for evaluating the exploration of endovascular devices for interventional therapy by endovascular technique.Methods The right common carotid artery of six dogs was expanded with a pliable balloon by means of endovascular technique, then embolization with detached balloon was taken at their originations DAS examination were performed on 1,2,3 d after the procedurse. Results 6 aneurysm models were created in six dogs successfully with the mean width and height of the aneurysms decreasing in 3 days.Conclusions This canine aneurysm model presents the virture in the size and shape of human cerebral bifurcation saccular aneurysms on DSA image, suitable for developing the exploration of endovascular devices for aneurismal therapy. The procedure is quick, reliable and reproducible.

Objective To investigate the immunological activity and the effect of an anti－ keratin monoclonal antibody 5G5 on the proliferation of serum－ free cultured keratinocytes. Methods The reactivity of 5G5 with cultured keratinocytes was observed by immunohistohemistry technique. The keratins extracted from the cultured keratinocytes was identified by SDS－ PAGE and their reactivities with 5G5 were assessed by immunoblot analysis. MTT was used to study the influences of 5G5 on the proliferation of cultured keratinocytes. Results 5G5 recognized the band of keratin with molecular weight of 50 000 only. Positive staining of 5G5 was found in the cytoplasm of cultured keratinocytes. The strong potential of 5G5 to inhibit the proliferation of cultured keratinocytes was shown by MTT assay with dose－ dependent manner. Conclusions The antibody which specifically recognizes the keratin with molecular weight of 50 000 may be the effective component to inhibit the proliferation of cultured keratinocytes.

Objective To investigate the efficacy and safety of laparoscopic surgery of rectal cancer for different stages of rectal cancer . Methods A retrospective analysis was made on clinical data of 96 cases of rectal cancer from January 2009 to December 2013.Among 42 cases of TNM staged 0-Ⅰ, there were 22 cases of laparoscopic surgery ( laparoscopic group A ) and 20 cases of open surgery ( laparotomy group A ) .Among 54 cases of TNM staged Ⅱ-Ⅲ, there were 20 cases of laparoscopic surgery (laparoscopic group B) and 34 cases of open surgery (laparotomy B group).At the end of follow-up ended in May 2015, the tumor markers, postoperative complications , local recurrence , distant metastasis rate and 1-year and 3-year survival rates were compared in different stages of patients between the laparoscopic surgery and open surgery . Results As compared with the laparotomy group A , the laparoscopic group A had shorter surgery time [(121.7 ±13.5) min vs.(142.4 ±23.5) min, t=-3.530, P=0.000] and less blood loss [(80.9 ±10.6) ml vs.(136.3 ±32.6), t=-7.559, P=0.000].As compared with the laparotomy group B , the laparoscopic group B had less blood loss [(110.3 ±15.3) ml vs.(186.5 ±22.6) ml, t=-12.202, P=0.000].As compared with the laparotomy group A, the laparoscopic group A had significantly reduced distal resection margin distance [(2.3 ±0.6) cm vs. (3.0 ±0.7) cm, t=-3.489, P=0.001].As compared with the laparotomy group B, the number of lymph node metastasis was significantly reduced in the laparoscopic group B (2.7 ±0.4 vs.3.1 ±0.4, t =-3.298, P=0.002).The conversion rate to laparotomy in the laparoscopic group B was 20%.There were no significant difference between the laparoscopic group A and laparotomy group A in local recurrence rate [9.5% (2/21) vs.5.0% (1/20), χ2 =0.000, P=1.000], distant metastasis rate [4.8%(1/21) vs.5.0%(1/20),χ2 =0.000, P=1.000], and survival rate (log-rankχ2 =0.102, P=0.750).There were no significant difference between the laparoscopic group B and laparotomy group B in local recurrence rate [6.2%(1/16) vs.6.2%(2/32),χ2 = 0.000, P=1.000], distant metastasis rate [6.2%(1/16) vs.3.1%(1/32), Fisher test, P=1.000], and survival rate (log-rankχ2 =0.158, P=0.691). Conclusions Laparoscopic radical surgery for TNM stage 0-Ⅰ of rectal cancer has a good effect and safety.The conversion rate to laparotomy in TNM staged Ⅱ-Ⅲrectal cancer patients is still high with relatively high surgical risks , which requires strict preoperative assessment .

Objective To observe the level of serum transforming growth factor ?(TGF ?) in patients with colorectal cancer and study its clinical significance. Methods Serum TGF ? was measured with radioimmunoassay in 54 patients with colorectal cancer and 25 healthy subjects,compared with 42 patients with colorectal cancer before and after the operation. Results The levels of serum TGF ? were significantly higher in patients with colorectal cancer than those in healthy controls(P

Objective To discuss color Doppler uhrasonographic (CDU) grading of varicocele (VC) in predicting the changes of the fertility index (FI) after varicocelectomy.Methods One hundred and fifty-one patients with VC were diagnosed and graded by CDU.All patients were grouped by the regurgitant volume and the maximum diameter of pampiniform plexus veins(PPV).The relation between the regurgitant volume and the maximum diameter of PPV and the changes of the FI after varicocelectomy was analyzed.Results The pathological regurgitation could be detected when the PPV diameter > 1.5 mm.The positive correlation was observed between the regurgitant volume and the diameter of PPV (r = 0.89, P <0.01).The pre- and postoperative FIs were extremely significant difference in regurgitation grade Ⅱ and regurgitation grade Ⅲ (P < 0.01) but not significant difference in regurgitation grade Ⅰ (P>0.05).The pre- and postoperative FIs were no significant difference in the group with the PPV diameter ≤ 2.0 mm (P > 0.05), but statistically significant difference in the groups with the diameters 2.1-2.5 mm and 2.6-3.0 mm (0.01 < P <0.05).FIs in the group with the diameter > 3.0 mm exhibited extremely significant difference after varicocelectomy (P < 0.01).Conclusions CDU grading of VC could be used to predict the changes of seminal quality after varicocelectomy.Varicocelectomy isn't necessary to the patients with VC that the PPV diameter ≤ 2.0 mm or pathological regurgitation being detected only on Valsalva maneuver.

Objective To investigate the expression of p-MNK1 in non-small cell lung cancer and its relationship with clinic pathological features and prognosis.Methods The level of p-MNK1 in 115 cases of nonsmall cell lung cancer was detected by tissue microarray technique and immunohistochemistry technique.Results The level of p-MNK 1 in non-small cell lung cancer was correlated with cancer tissue type (P ＜ 0.05),clinical stage (P ＜ 0.05),lymph node metastasis (P ＜ 0.01) and prognosis (P ＜ 0.05).Cox multiple regression analysis showed that p-MNK1 expression was an independent prognostic factor for non-small cell lung cancer (P ＜ 0.01).Conclusion The level of p-MNK1 in non-small cell lung cancer is associated with poor prognosis.It can be used as an independent prognostic marker and a new therapeutic target.

OBJECTIVE:To investigate the cognition,evaluation and demands of medical staff to the clinical pharmacy work in the secondary and tertiary medical and health institutions in Xi’an city,and provide reference for further promoting the develop-ment of the local clinical pharmacy work. METHODS:20 secondary and tertiary medical and health institutions in Xi’an city were randomly selected to conduct a random sampling questionnaire for physicians,nurses (senior nurses),pharmacists (non-clinical pharmacist)and other medical technicians. And the results were statistically analyzed. RESULTS:Totally 1 020 questionnaires were sent out,851 were effectively received with effective recovery of 83.4%. 45.9% respondents knew clinical pharmacy,and“Col-league”was the main channel;34.3% thought clinical pharmacy“only maintained normal operation. 74.7% surveyed medical staff,92.6% surveyed pharmacists and 70.6% surveyed physicians thought clinical pharmacists“should”take round with the doc-tors and nurses;44.3% respondents showed“dissatisfaction”and“general satisfaction”with the clinical pharmacy work in their hospitals. 48.5% respondents would take the initiative to consult the clinical pharmacist for medication;45.5% respondents partial-ly accepted the drug information provided by clinical pharmacists. There were significant differences in the investigation results in aspects of respondents’understanding level and channel for clinical pharmacy,cognition for development situation of clinical phar-macy,evaluation for clinical pharmacists participating round,demand for consulting the medication,acceptance for drug informa-tion provided by clinical pharmacists,and other items(P<0.05). CONCLUSIONS:The cognition and effect of clinical pharmacy work on medical staff need to be further strengthened,clinical pharmacists should also have solid clinical knowledge and the knowl-edge of medicine to meet the demand of medical staff in different positions,the acceptance of medical staff to the pharmaceutical care needs to be further improved. Clinical pharmacists should earnestly fulfill their job functions through various efforts to promote rational drug use.