OBJECTIVE:To provide reference for improving the rationality of the personnel of pharmacy department and pro-moting the development of related pharmacy work in hospitals of Bengbu. METHODS:Questionnaire was designed to investigate and statistically analyze the general situation of secondary and tertiary hospitals in Bengbu in aspects of personnel,dispensing work-load and post setting,suggestions were put forward. RESULTS:Totally 13 questionnaires were sent out,10 were effectively re-ceived with the effective rate of 76.9%. The average proportion of investigated pharmacy staff to the whole health technical workers was 5.0%;primary pharmacist was 39.0%,chief pharmacist was 2.2%;college education was 44.9%,master degree or above was 3.0% ;the average daily prescription volume of outpatient was 375,daily trips of inpatient department was 267;4.4% of the staff were engaged in clinical pharmacy,only 4 hospitals carried out clinical pharmacy work;only 1 hospital had the Pharmacy Intrave-nous Admixture Service (PIVAS). CONCLUSIONS:The hospital pharmacy personnel configuration is not reasonable in Bengbu, dispensing is overloaded,the development of PIVAS is lagging behind,clinical pharmacy work remains to be further improved. It is suggested to promote the work of hospital pharmacy by increasing the numbers of pharmacy personnel,technical titles and practi-cal skills of the pharmacy staff,strengthening the construction of PIVAS and the cultivation of clinical pharmacists according to the condition.

Objective To explore the diagnosis,treatment and prognosis of primary gastric malignant (lymphoma)(PGML).Methods The diagnosis and treatment data of 21 cases of PGML admitted in our(hospital) during 8 years was retrospectively analyzed.The diagnostic methods included barium meal(examination),gastroscopy,B type ultrasonography,and CT scan.All patients underwent operative treatment and most of the patients received adjuvant chemotherapy.Results Upper abdominal pain,digestive tract bleeding,emaciation and abdominal mass were common clinical manifestations of PGML.The resectabilty rate of PGML was 90.5% while the 5-year survival rate was 57.1%.Conclusions The key to a satisfactory prognosis was early diagnosis,radical curative operation and combined treatment.

Objective To summarize clinical features and explore diagnosis and treatment of femoral intercondylar notch non-bony impingement syndrome. Methods 15 patients of femoral intercondylar notch non-bony impingement syndrome were identified during arthroscopic operation of 115 patients (120 knees) with restricted knee joint extention during Oct 2004 to Dec 2007. Among these 15 patients, there were 3 cases of Bucket Handle Tear(BHT), 1 case of ACL's cyst, 3 cases of ACL tibial avulsion injury, 3 cases of synovial incarceration, and 5 cases of synovial chondroma. 9 patients were diagnosed by MRJ and 2 by X-ray before operation. All 15 patients were confirmed under arthroscopy. Results 15 patients( 15 knees) were operated and followed up for a period of 4～24 months, mean 13 months. Mean Lysholm score was 65(range, 41～75) before operation and 89(range, 75～100) after operation. Joint extension restrict was 5～25 degrees (mean 8.1 degree) before operation and 0 degree after operation. Conclusion Arthroscopy could accurately diagnose femoral Intercondylar notch non-bony impingement syndrome. Pre-operation MRI was helpful for diagnosis. If MRI and X-ray showed negative findings, diagnostic arthroscopic examination could be applied. Good subjective and objective effects could be achieved with arthroscopic operation.

Objective To evaluate the short-term efficacy of Perigee system in the treatment of anterior pelvic organ prolapse. Methods From October 2012 to September 2014, 59 patients with pelvic organ prolapse, pelvic organ prolapse quantitation system (POP-Q) were diagnosed as anterior pelvic organ prolapse Ⅲ degree and above were performed Perigee anterior pelvic floor reconstruction, while some patients combined with sacrospinous ligament suspension, posterior wall repair or posterior pelvic reconstruction surgery for pelvic prolapses. Pelvic floor distress inventory-short form 20 (PFDI-20), pelvic organ prolapse-urinary incontinence sexual questionnaire-12 (PISQ-12) were evaluated, and postoperative POP-Q were used to analyze the changes of the indexes and postoperative complications. Results In 59 patients, the average operation time was (99±29) minutes, the average intraoperative blood loss was (119± 92) ml. The median postoperative follow-up time of 59 cases was 17.5 months (range:8-30 months), median follow-up time of subjuctive symptoms was 21.2 months (range:11-34 months), the total score of PFDI-20 was compared with the preoperative, and the difference was statistically significant (5.6 versus 27.8, P<0.01). It was statistically significant of PISQ-12 score before and after surgery (34±3 versus 36±4, P<0.05). Short-term anatomical cure rate was 98%(58/59), 1 cases (2%, 1/59) in recurrence, 2 cases (3%, 2/59) of erosion. Conclusion This results show that the Perigee system is effective and reliable in the treatment of anterior pelvic organ prolapse.

The anti-hepatitis B virus (HBV) effects and its mechanisms of the ethanol extracts of Hypericum perforatum L. (EHP) in vitro were explored. HepG2 2.2.15 cells, a stable HBV-producing cell line, were cultured as the model system to observe the anti-HBV effect. The viral antigens of cellular secretion, HBsAg and HBeAg, were determined by enzyme linked immunosorbent assay (ELISA). The quantity of HBV-DNA released in the supernatant was assayed by real-time PCR. In order to understand the mechanisms of the suppression of HBV replication, all HBV promoters (Cp, Xp, S1p, S2p and Fp) with luciferase reporter gene were transfected into HepG2 cells respectively. Then the activities of viral promoters were examined by luciferase reporter assay. It was found EHP effectively suppressed the secretion of HBsAg and HBeAg from HepG2 2.2.15 cells in a dose-dependent manner, as well as the extracellular HBV DNA. And EHP could selectively inhibit the activity of HBV promoter Fp. Our data suggest that EHP exerts anti-HBV effects via inhibition of HBV transcription, which helps to elucidate the mechanism underlying the potential therapeutic value of EHP.

Objective To assess the role of endoscopic ultrasound guided fine needle aspiration (EUS-FNA)for diagnosis of gastrointestinal tract lesions.Methods Sixty-eight patients underwent endoscopic uhrasonagraphy and EUS-FNA between May 2007 and Dec.2008.The result of cytology and/or pathology was compared with that of surgical finding and follow-up study.Results EUS-FNA was successfully performed on 62 patients with lesiorm in oesophagus(4 eases),stomach(19 case),rectum(19 cases),liver(3 case),mediastinum(4 cases)and lymph node(13 cases),and had a successful rate of 91.18%(62/68).Among them,the lesions in 40 patients(64.52%)were cytologically confirmed.The lesions in 10 out of 22 patients(35.48%)were pathologically confirmed.Compared with the results of pathology and long-term followe-up study,the sensitivity,specificity and positive predictive value of EUSFNA in diagnosis of lesions in gastrointestinal tract was 85.48%,100.00%and 90.91%,respectively,The positive predictive value and negative predictive value was100.00%and 57.14%,respectively.Conclusion EUS-FNA is a safe,effective and accurate method for diagnosis of lesions in gastrointestinal tract,and has an important role in cytological diagnosis.

Objective To summarize the common types and clinical characteristics of ureter disease;which can increase manipulation difficulties and adverse events during rigid ureteroscopic procedures. Methods From Jan 2001 to Dec 2010,our team performed 317 rigid ureteroscopic Drocedures for ureteroscopic examination or treatment;including 60 difficult procedures(34 male and 26 female).The mean age of the patients was 37 years (range,18 to 71).The ureteral diseases were classifted into five types according to the pathological characteristics:Type Ⅰ calculous stenosis,Type Ⅱ neoplastic stenosis;Type Ⅲ non-congenital stenosis,Type Ⅳ congenital stenosis,Type Ⅴ expansion of tortuous ureters.The operative time,complications,and conversion to open surgery were evaluated,and the therapeutic methods were analyzed. Results Of the 60 difficuhly-manipulated procedures,the mean manipulated time was 75 min (range,31 to 200).Intra-operative complications occurred in 9 procedures,including 4 cases of mucosal bleeding,2 cases of submucosaI false passage and 3 cases of ureteral perforation.Eleven procedures were converted to open surgery. In five procedures only a double J tube was inserted for drainage due to the difficulty of entering the ureter.Fiftyfive patients were followed up for 17 months (range,3 to 110);48 patients were cured,5 patients improved and 2 patients were unchanged. Conclusions The five types of ureteral disease can increase operative difficulties and risks of rigid ureteroscopic procedures.We should be cautious during surgery and should stop manipulation or convert to other surgeries if necessary.

Objective To study the mechanism of chemotherapy resistance caused by interleukin-6 (IL-6) in ovarian cancer cells and its related signal pathways. Methods Ovarian cancer cell lines A2780(IL-6 receptor positive, while non-IL-6-expressing and cisplatin/paclitaxel-responsive) and SKOV3 cell lines( overexpressing of IL-6 receptor and IL-6 and cisplatin/paclitaxel-resistant) were suitable models for this study. The effect of exogenous (a short period of treatment with recombination IL-6) and endogenous IL-6(by transfecting with plasmid encoding for sense IL-6 ) in A2780 cells or deleting of endogenous IL-6expression in SKOV3 cells (by transfecting with plasmid encoding for antisense IL-6) on the sensitivity to cisplatin and paclitaxel was investigated. Meanwhile, the mechanism of chemotherapy resistance caused by IL-6 in ovarian cancer cells and its related signal pathways were also analyzed. Results We found that both exogenous and endogenous IL-6 induce cisplatin and paclitaxel resistance in non-IL-6-expressing A2780 cells (the resistance multiple to cisplatin and paclitaxel was: exogenous, 6. 25 and 7.31; endogenous, 7. 13 -8. 34 and 7. 61 - 10. 70), while deleting of endogenous IL-6 expression in IL-6-overexpressing SKOV3 cells promotes its sensitivity to anticancer drugs ( the resistance multiple to cisplatin and paclitaxel was 0. 15 and 0. 10, 0. 10 and 0. 08). IL-6 significantly up-regulated the expression levels of mRNA and protein of drug resistance-associated genes, MDR1 and GST-π, and apoptosis-inhibiting genes, bcl-2, bcl-xL and XIAP in a dose-dependent manner in A2780 cells. In accordance with this finding, the mRNA and protein levels of MDR1 and GST-π enhanced in sense IL-6-transfected A2780 cells, and reduced in antisense IL-6-transfected SKOV3 cells compared with the corresponding parental and control vector-transfected cells, which had no difference. It was found that PD98059 [ mitogen-activated protein kinase-extracellular signalregulated kinase (MEK) inhibitor ] and wortmannin [ phosphatidylinositol 3-kinase (PI3K) inhibitor ]significantly antagonized IL-6-induced phosphorylation of extracellular signal-regulated kinase ( ERK ) and protein kinase B (Akt), respectively, and both of them blocked IL-6-induced cisplatin and paclitaxel resistance and the inhibitory effects of PD98059 and wortmannin were dependent on its concentration.Conclusions These data suggest that IL-6-induced chemoresistance may be associated with increase of both drug resistance-associated genes ( MDR1 and GST-π) and apoptosis-inhibiting genes ( bcl-2, bcl-xL and XIAP), and activation of MEK/ERK and PL3K/Akt. Therefore, modulation of IL-6 expression or its related signaling pathway may be a promising strategy of treatment for drug-resistant ovarian cancer.

OBJECTIVE:To provide reference for promoting the management of antibiotics in the hospitals. METHODS:Each 3 hospitals from county second grade class A general hospitals,municipal third grade class A general hospitals and provincial third grade hospitals(including 2 third grade class A general hospitals and one third grade special hospital)in Anhui province were select-ed and respectively included into group A,B,and C. By on-site survey mode,questionnaires were used to investigate and score the situation of antibiotics management in hospitals of 3 groups,and then analyzed statistically. RESULTS:Scoring rate (SR) of overall situation on antibiotics management were 65.33%,89.34% and 86.67% in group A,B and C respectively;group A was statistically significantly lower than group B and C (P<0.001). SR of basic situation indicator on antibiotics management were 90.46%,95.25% and 95.25% in group A,B and C,respectively and there was no statistically significant difference among 3 groups (P>0.05). SR of development indicator of antibiotics management were 58.33%,88.90% and 86.10%,respectively in group A,B and C;group A was significantly lower than group B and C (P<0.001). SR of information construction indicator of antibiotics management were 50.00%,83.33% and 77.79% respectively in group A,B and C;group A was significantly lower than group B and C (P≤0.001). SR of information construction indicator of antibiotics management in 3 groups were all signifi-cantly lower than SR of basic situation indicator(P<0.05). SR of development indicator of antibiotics management in group A and C were all significantly lower than SR of basic situation indicator(P<0.05). CONCLUSIONS:The antibiotics management of mu-nicipal third grade class A general hospital is equal to that of provincial third grade hospital,and that of county second grade class A general hospital is in relatively low level. Different levels of hospitals should further strengthen the related antibiotics manage-ment work and information construction,especially for county second grade class A general hospitals.

Objective To evaluate the muscle mass in elderly patients with inguinal hernia using CT scan.Methods 30 male (age 70-90 years) hospitalized patients scheduled to receive surgery for inguinal hernia were selected into study group, 10 male health volunteers (40-50 years) were involved in adult control group, and 10 men of the same age as the study receiving annual physical examination were enrolled as elderly control group.General information were recorded;CT scanning of the stomach muscles and thigh muscles were conducted, and the muscle area was calculated using a special software.Results The index of grip strength in the study group was significantly lower than the adult control group [(36.44 ± 14.15) kg vs.(77.30 ± 22.69) kg, P =0.001], the calf circumference in the study group was significantly less than the adult control group [(25.18 ±2.31) cm vs.(27.62 ±2.33) cm, P =0.006].There was no significant difference in L3 abdominal area, subcutaneous fat area, abdominal fat area, and vertical spinal muscular volume between the study group and the adult control group;while the L3 abdominal muscle area and vertical spinal muscular mass was significantly less in the study group than in the adult control group [(12 094.23 ± 1 970.30) mm2 vs.(17462.00±1 600.58) mm2, P=0.001;(1 642.60±266.90) mm2 vs.(2 003.50±350.91) mm2,P =0.007].L3 skeletal muscle index of the study group was 50.64 ±7.52 and 66.7％ (20/30) of the study group had sarcopenia (≤52.4％).The CT findings of abdominal muscle of the study group were not significantly different from those of the elderly control group.The thigh muscle mass in the study group was significantly less than that in the control group (P =0.001), but there was no significant inter-group difference in thigh fat and femur areas (P ＞ 0.05).Conclusion The muscle mass and strength in elderly patients with inguinal hernia are significantly lower than those of adult controls, for which CT scan can be applied for assessment.