The hemodynamical features of artificial heart valve can influence the life span of the valve in the host, and is highly correlated with its biocompatibility. This paper introduced the methods and indexes to measure hemodynamics of artificial heart valve, and factors that influence the hemodynamics. In addition, the problems in this field were discussed to aid the selection of appropriate artificial heart valves for patients.

OBJECTIVE:To discuss the effect of performance management in medication consultation service in hospital,and to improve the service quality in medication consultation center. METHODS:The performance management mode of medication consultation center was implemented in our hospital through formulating consultation pharmacist performance evaluation content and accounting rules from four dimensions of business skills,cultural literacy,work attitude,workload,conducting daily evaluation and check,developing training,setting development plan,etc. The effects of the mode were evaluated. RESULTS:In performance evaluation,business skills,cultural literacy,work attitude and workload took up 20,15,15 and 50 points,respectively;they were subdivided into 16 specific items and extra point items. After the implementation of above performance management,average weekly clients increased from 104 persons to 247 persons (increasing by 138%);the proportion of patient medication education mainly provided by clinical pharmacists increased from 18.30% to 46.34%(increasing by 153%);the complex and professional problems of medication consultation such as drug interaction rose from 0.96% to 5.28%;the problem of drug usage and dosage in-creased from 6.73% to 23.17%. The performance management mode not only improved the service consciousness and the enthusi-asm of consultation pharmacists,but also improved the level of pharmaceutical care. CONCLUSIONS:Reasonable and effective performance management mode can promote the service quality and ability of medication consultation center,and play more impor-tant role in hospital pharmaceutical care.

OBJECTIVE:To investigate the correlation of gene polymorphism in peripheral artery disease(PAD)patients with antiplatelet efficacy of clopidogrel. METHODS:Reviewing related domestic and foreign literatures in recent years,the correlation of gene polymorphism in PAD patients with antiplatelet efficacy of clopidogrel was summarized and analyzed. RESULTS&CON-CLUSIONS:At present,a variety of genes associated with clopidogrel antiplatelet efficacy and major adverse cardiovascular events (MACE)have been identified,including cytochrome P450(CYP)2C19,adenosine three phosphate binding cassette B subfamily 1 (ABCB1),paraoxonase 1 (PON1) and adenosine diphosphate P2Y12 receptor (P2Y12),etc. CYP2C19*2,*3 allele may reduce the antiplatelet effect of clopidogrel. Their correlation has been confirmed by a number of studies,and study results are broadly con-sistent. Mutations in the ABCB1 C3435T and PON1 Q192R sites may lead to a lower response to clopidogrel and increase the risk of MACE;but there is a lack of large-scale prospective clinical studies,and the present results are inconsistent. P2Y12 gene poly-morphism in PAD patients has not been found to be significantly associated with clopidogrel efficacy.

OBJECTIVE:To provide theoretical foundation for individualized treatment of aspirin in patients with cardiovascu-lar disease. METHODS:Domestic and foreign literatures in recent years were collected and summarized. RESULTS & CONCLU-SIONS:The gene polymorphism can significantly affect the platelet activity. GPIII a PLA2,PEAR1 and PTGS1 alleles are associat-ed with aspirin resistance,and cardiovascular events have significant difference in different genotype patients. Adjusting reasonably dosage regimen and conducting individualized treatment according to the genetic testing result and other factors can reduce aspirin resistance and the incidence of cardiovascular adverse events in the patients.

The ongoing health reform encourages pharmacists of public hospitals to change their traditional role positioning to satisfy patients’urgent needs in medical dosage guidance.This calls for greater capacity of hospital pharmacy services.Pharmaceutical consultation constitutes a major means of quality service of pharmacists for the people.The paper introduced the standard of establishing the pharmaceutical consultation center and the content of assessment system which are jointly worked out by Beijing Municipal Hospital Authority and the hospitals under the administration of the Beijing Municipal Government,and share the practice & effect in assessing and improving their performance.

OBJECTIVETo explore the correlation between expression of surviving gene in acute leukemic cells and its clinical effects.

METHODSBy using semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) technique, surviving gene expression in 50 previously untreated acute leukemia (AL) patients was analysed. The apoptosis of primary leukemia cells cultured in vitro was assayed with terminal deoxyribonucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL).

RESULTSSurviving gene expression levels in cells of AL patients at diagnosis were significantly higher than that in normal bone marrow mononuclear cells (MNCs) (82.0% vs 33.3%, P < 0.05). The expression level was higher in ALL cells than in ANLL cells (89.5% vs 75.0%). Among 22 cases of ANLL, bone marrow remission (BMR) rate was higher in surviving gene negative expression cells from patients accepted a course of chemotherapy than in positive expression cells (83.3% vs 25.0%, P = 0.023). Among 13 ANLL patients received a course of HA regimen chemotherapy, the BMR was higher in patients surviving mRNA negative expression cells than in positive cells (100.0% vs 27.3%). Patients with surviving/beta-actin ratio>0.6 attained lower BMR.

CONCLUSIONHigher expression level of surviving mRNA in AL cells may be one of the reasons that leukemic cells are insensitive to chemotherapy.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Chromosomal Proteins, Non-Histone ; genetics ; metabolism ; Drug Resistance, Neoplasm ; genetics ; physiology ; Female ; Gene Expression Regulation, Leukemic ; Humans ; Inhibitor of Apoptosis Proteins ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; metabolism ; Male ; Microtubule-Associated Proteins ; Middle Aged ; Neoplasm Proteins ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; metabolism ; RNA, Messenger ; biosynthesis ; Remission Induction ; Treatment Outcome

Objective: To explore the relationship between parents’ unstable marital status and offspring’s suicide attempts and the possible mediating factors, and to provide reference for suicide prevention among off spring grom unst able families. Methods: From 2017 to 2018, 2 766 valid questionnaires were collected from freshmen in a university in Hunan province. Students completed questionnaires of childhood trauma and depression traits,and reported their parents’ marital status and suicide attempts etc. Results: Compared to college students with parents of stable marital status,students with parents of unstable marital status showed higher reported rate of suicide attempts and higher scores of depression trait and childhood trauma (t/χ2=2.78, 5.83, 20.30, P<0.05). Controlling possible confounding factors,unconditional Logistic regression showed that childhood trauma,unstable marital status of parents and depressive traits were positively correlated with suicide attempt(OR=1.05, 1.45, 1.08, P<0.05). The 95% confidence interval of the Bootstrapping method with four mediation pathways (parental marital status→childhood trauma→depressive trait,childhood trauma→depressive trait→suicide attempt,parental marital status→childhood trauma→suicide attempt and parental marital status→childhood trauma→depressive trait→suicide attempt) does not include zero. Conclusion Childhood trauma and depressive traits mediate the relationship between parental instable marriage and suicide attempts in off spring.

Objective Acute aortic dissection occurs when a tear in the inside of the aorta causes blood to flow between the layers of the wall of the aorta,forcing the layers apart.In most cases this is associated with a sudden onset of severe chest or back pain,often described as "tearing" in character.The main management includes medication,endovascular repair and surgery.Medical management plays an very important role in the management of acute aortic dissection.Aortic dissection generally presents as a hypertensive emergency.Individuals can benefit from blood pressure control and anti-impulse therapy in perioperative period.

Objective To explore the mediating effects of neuropeptide S receptor 1 and negative coping in chronic stress induced emotional responses. Methods A survey of 366 local residents who were chosen from County of Nandan in Guangxi Province by stratified random sampling method. Questionnaires of the life events scale (LES),the simplified symptom checklist and the Simplified Coping Style Questionnaire (SCSQ) were used. The level of NPSR1 was measured by Elisa. Data was analyzed by SPSS 21 and AMOS 21 statistical software for statistical analysis. Results The level of chronic psychological stress was (25. 24± 29. 26) and score of negative coping was(14. 84±4. 35). Somatic factor,anxiety factor,depressive factor and hostile factor were (1. 58±0. 58),(1. 43±0. 56),(1. 44±0. 55),(1. 23±0. 37). The total score of life e-vents was positively correlated with negative coping,somatic factor score,anxiety factor score,depression fac-tor score(r=0. 23-0. 46,P<0. 05),while negatively correlated with the expression level of detection of NPSR1 in plasma(r=-0. 26,P<0. 05). NPSR1 level was negatively correlated with body factor score,anxiety factor score,depression factor score and hostility factor score(r=-0. 18--0. 61,P<0. 05). Negative coping was positively correlated with body factor score,anxiety factor score,depression factor score and hostility fac-tor score(r=0. 12- 0. 27,P<0. 05). Both neuropeptide S receptor 1 and negative response had significant me- diating effects on emotional responses induced by chronic psychological stress (P<0. 05),and the effect val-ues were -0. 08 and 0. 05,respectively. According to the Bootstrapping method,the results of the mediation model showed that Bias-Corrected of 95% CI of the total standardization effect,the indirect standardization effect,the direct standardization effect were not including 0. Conclusion NPSR1 and negative coping plays a dual mediating effect on stress induced emotional responses.

Under the background of deepening the medical and health system reform, it is necessary to explore the measures of fine and rational drug use management and strengthen the rational drug use. Through giving full play to the management functions of pharmacy administration and pharmacotherapeutics committee, formulating the performance evaluation index system of pharmacy affairs in the hospital, adhering to the prescription doctor′s advice review and prescription pre audit, continuing to carry out drug dynamic monitoring, implementing standardized-path antimicrobial drug management, the hospital implemented refined and rational drug use management. Before and after the management, the average drug cost, prescription unqualified rate, auxiliary drug amount and antibacterial drugs related indicators were significantly improved, suggesting that fine pharmacy management could promote the rational use of drugs in the whole hospital, promote the transformation of pharmacists′ work, and control the unreasonable growth of drug costs.