OBJECTI VE:To arouse the attention of pri marylevel medical institutions to the pharmaceutical administrationwork.METHODS:Rational proposals and strategies ai med at the problems were put forward by investigation the status quo ofthe pharmaceutical administrationinthe pri marylevel medical institutions.RESULTS &CONCLUSIONS:Policies andlaws ®ulations should be strengthenedin the pri mary level medical institutions so as to i mprove their cognition on pharmaceuticaladministration ; hardware facilities should be i mproved so as to establish a favorable hospital i mage ; Supervision should bestrengthened to facilitate the launching of pharmaceutical administration extensively ;‘People -centered’approach should beemphasized and fully attention should be given to the culture of talents.

Objective:To study the efficacy and safety of mirtazapine and paroxetine in patients with first-episode climacteric depression. Methods:A 8-week double-blind study was conducted with 90 female patients suffered with climacteric first-episode depression. Subjects were randomly assigned to either mirtazapine (n=45) or paroxetine (n=45). All subjects were evaluated with Hamilton Rating Scale for Depression-17 (HAMD-17), Hamilton Rating Scale for Anxiety,and Treatment Emergent Symptom scale (TESS) at baseline, the end of week 1, 4 and 8 after treatment. The study had lasted for 8 weeks.Results:The response rate between two groups (mirtazapine 88.9% vs paroxetine 82.2%) was similar. There were significant differences on the scores of HAMD between the two groups at the end of 1st and 8th week, and HAMA at the 1st week after treatment(21.3?3.5/25.2?2.9,18.2?3.2/21.5?2.4,t=-2.367、-3.514,P=0.042、0.032;7.2?3.5/9.8?2.3,t=-3.258,P=0.035). Mirtazapine had increased food appetite(15.6%), body weight(13.3%), hydropsia(8.9%), dry mouth(6.7%), sleep disorder and nausea(4.4%). Meanwhile paroxetine had dry mouth(22.2%), sleep disorder(20.0%), nausea(17.8%), tremor(15.6%), restlessness/agitation(13.3%) and sexual disturbance(11.1%).Conclusion:Mirtazapine has rapid response, strongly antidepressive effect in female climacteric first-episode patients and less side-effects.

Paeonol is an nerb which has been used us an anodyne. The analgesic action of Paeonol has been shown in this paper by using the following methods: Mice licking hind paw on hot plate (55℃); mice wring evoked by ip 0. 7% acetic acid 10 ml ? kg-1; continuous pain stimuli elicited by sc 2. 5% formaldehyde 0. 03 ml in fore paw of mice.No tolerance of analgesic effect was found after daily sc of Paeonol 100 mg ? kg-1for 7 d in mice assayed with hot plate method. In naloxone-challenge test, no jumping response was observed in mice treated with Paeonol 690mg ? kg-1, the maximal tolerance dose. The results indicate that Paeonol induced no morphine-like tolerance norphysical dependence.The analgesic action of Paeonol was not an-tagonizd by naloxone, but was eliminated by in-traperitoneal injection reserpine 3 mg ? kg-1 3 h prior to Paeonol. These results demonstrate that Paeonol belongs to the non-narcotic analgesic, and suggested that the analgesic action of Paeonol may be related to the monoamine level in brain.

Objective To study the role of cutaneous nerve and protease activated receptor 2 (PAR2)in the development of pruritus in atopic dermatitis(AD).Methods Dermal sheets were prepared from chronically pruritic skin lesions of 7 patients with AD,as well as from the normal skin of 7 healthy human controls.Double labeled immunofluorescence was performed using mouse anti-protein gene product 9.5(PGP9.5)monoclonal antibody and rabbit anti-substance P(SP)polyclonal antibody to observe the morphological changes in cutaneous nerve fibers,and Image-Pro Plus 6 software was used to semiquantitively assess the length,diameter of nerve fibers,integral optimal density of PAR2 and SP in dermal sheets.Results Immunofluoresence double staining showed that PAR2 co-expressed with PGP9.5 or SP in cutaneous nerve fibers.Compared with the normal control skin,both the total length and average diameter of PGP 9.5-expressing nerve fibers were increased(11051.8±1900.9 μm vs 7264.0±2659.9 μm,4.23±0.15 μm vs 3.95±0.15 μm,both P＜0.01)in pruritic lesions,while only the average diameter of SP-expressing nerve fibers was up-regulated(3.99±0.20 μm vs 3.80±0.07 μm,P＜0.05),and the total length of them remained unchanged(4304.7±1455.0 μm vs 3380.0±1735.4 μm,P＞0.05).Also,increased integral optimal density was observed for SP and PAR in pruritic lesions in comparison with the normal control skin (27.71±16.52 vs 12.63±4.31.35.99±8.63 vs 22.69±9.56.both P＜0.05).Conclusion Our results indicate a hyper-plasia of cutaneous nerve fibers in chronic itchv skin lesions of AD and an increase in the expression of PAR2 and SP in the cutaneous nerve fibers,suggesting that the signal enhancement in PAR2 pathway may be related to the mechanism of pruritus in patients with AD.

Objective To evaluate the value of gemstone spectral imaging (GSI)and multi artifact reduction system(MARs)in re-ducing metallic implants artifacts,and find the best monochromatic images.Methods Twenty-one patients with metal implants in our hospital receievd GSI examination ,MARS reconstruction and polychromatic images(140 kVp).Eleven groups of monochromatic and MARS images were obtained from 40 keV to 140 keV every interval of 10 keV by the special GSI viewer ,respetively.Subjective image quality of two methods were assessed by 3 radiologists in consensus.For every patient one group monochromatic images and blend enery images were selected two heaviest artifacts level and no artifacts level,the CT value and the standard deviations(SD)value of the region of interest(ROI)were meatured of artifacts.Contrast-to-noise ratio(CNR)and artifacts index(AI)were also caculated and were analyzed with paired-t test.Results There was significant statistical differences of CNR between energy spectral images and blend energy images in energy level of 40 to 120 keV(P <0.05),while there was no difference in energy level of 130 to 140 keV (P >0.05),and the optimal CNR was acquired at the energy level of 70 keV(CNR=8.75±3.28).The value of AI for two mehtods has no difference in energy level scope 40 to 60 keV(P >0.05),there was significant statistical differences of AI between energy spectral images and blend energy images in energy level of 70 to 140 keV(P <0.05),and the lowest of AI(AI=26.95±9.64)was ac-quired at 1 10 keV images.Conclusion The energy spectral CT possess superiority in decreasing the artifacts and will provide high image quality in the metal implants.Gemstone spectral CT has great significance for postoperative patients with metal implants in imaging diagnosis.

BACKGROUND: Under the cellular physiological condition, 15.3% N-acetylated chitosan has poor solubility which limits cellular microencapsulation process.OBJECTIVE: This study was designed to prepare 50% N-acetylated chitosan with 15.3% N-acetylated chitosan and investigate its feasibility for preparing chitosan microcapsule used for hepatocyte embedding after in conjunction with methacrylic acid-hydroxyethyl methacrylate-methyl methacrylate (MAA-HEMA-MMA) copolymer under the cellular physiological condition.DESIGN, TIME AND SETTING: This study, a control observation experiment, was performed at the Central Laboratory, First Hospital Affiliated to Jinan University, Guagnzhou, Guangdong Province, China between January and October 2006.MATERIALS: 15.3% N-acetylated chitosan was provided by Sigma-Aldrich Company, Singapore. Hepatocytes were acquired from male Wistar rats, weighing 250-300g, by two-step collagenase digestion method.METHODS: Hepatocytes were microencapsulated using 50% N-acetylated chitosan and MAA-HEMA-MMA copolymer at 25℃ under aseptic condition.MAIN OUTCOME MEASURES: Microcapsule permeability was expressed with the diffusion degree of fluorescein isothiocyanate (FITC)-dextran in the empty microcapsule. The homeostasis of microencapsulated hepatocytes was measured by mechanical shearing-crush tests. The albumin-synthesizing capability of microencapsulated hepatocytes was determined by enzyme-labeled immunosorbent assay (ELISA). Urea-synthesizing capability was tested using kits (Sigma Diagnostics, USA) at the wavelength of 540 nm by colorimetric assay. Cytochrome P450 activity was determined using confocal laser microscopes and quantitated by the fluorescence intensity of products of 0-dealkylated 7-ethoxy resorufin, a substrate of cytochrome P450IA1. The plate-cultured hepatocytes were taken as controls.RESULTS: With increasing mass concentration of 50% N-acetylated chitosan, the diffusion degree of Mr 20000 and Mr 40000 FITC-dextran presented with a decreasing tendency, while the diffusion degree of Mr 70000 FITC-dextran was low and did not alter markedly. When the microencapsulated hepatocyte density was 2×109 L-1, the broken rate of microcapsule was only about 6% after 24 hours of shaking. Under the same condition of shaking, empty microcapsules were all broken after 4 hours of shaking. After 1 day of culture, approximately 30μmol/d urea could be synthesized among 1×106 bepatocytes that was markedly higher than the plate culture experimental result, 15μmol/d. After 7 days of culture, urea-synthesizing capability was close between in the microencapsulated hepatocytes and in the plate cultured hepatocytes. In the first 3 days of culture, 10μg/d albumin was acquired from 1×106 hepatocytes, and after 7 days of culture, only about 5μg/d albumin was obtained. The albumin level in the whole culture process was higher than plate culture results. After 1 day of culture, cytochrome P450 activity in the microencapsulated hepatocytes was higher approximately 8 times compared to plate culture results. After 1 week of culture, cytochrome P450 activity still retained at 50% of 1-day culture level.CONCLUSION: Microcapsule prepared by 50% N-acetylated chitosan under the physiological condition has good permeability and structural stability during the process of culture. Compared with in vivo surface culture test, degenerated chitosan microcapsule is better favorable to in vitro function of hepatocytes.

Objective To study the significance of expression of VEGF in the hepatocellular carcinoma tissue(HCT) and the expression of AFPmRNA in the peripheral vein blood in hepatocellular carcinoma patients(HCC) with metastasis. Methods AFPmRNA was detected in peripheral blood before operation and the expression of VEGF in HCC tissue was analyzed by immunohistochemistry after operation in 20 patients. The relations between the expression of VEGF protein and AFPmRNA with clinicpathological parameters were analyzed statistically. Results (1)Among the 20 patients with HCC, 10 were positive expression of VEGF protein, which had no relation with the clinicopathological parameters. (2)Of the 20 patients, positive expression of AFPmRNA were detected in the peripheral blood in 15 patients, and AFP≥200?g/L were found in 13 patients.(3) AFPmRNA in the peripheral blood vein was detected in 9 of 10 patients with VEGF positive expression. Conclusions (1)Either VEGF protein expressed in HCC tissue or AFPmRNA detected in the peripheral blood could be as a guide line to judge the tendency of the metastasis of HCC,however former is simpler and the later is more sensitive . (2)The detection of AFPmRNA in the peripheral blood is more sensitive than the detection of serum AFP lever for surveillance of the high risk patients and postoperative follow up of the patients with HCC.

Objective To investigate the protein expression of cyclooxygenase(COX)-2 and matrix metalloproteinase(MMP)-2 and their correlation in human gastric carcinoma.Methods The protein expression of COX-2 and MMP-2 was determined by immunohistochemistry in tumor tissues and adjacent cancerous tissues (3 cm and 6 cm away from tumor margin) of 30 patients with gastric cancer,and in gastric mucosa of 10 healthy individuals.Results Expression of COX-2 was found in cancer cells of 26 out of 30 cases (86.67%),which was significantly higher than that in normal control (0 of 10,P

ObjectivesTo study the expression of lipoxygenase-12 (12-LOX) in human pancreatic adenocarcinoma and its relationship with the clinicopathological parameters.MethodsExpression of 12-LOX in pancreatic carcinoma tissue,pancreatic cancer cell lines SW1990 and PANC1,and adjacent normal pancreatic tissue was detected by using immunohistochemistry,RT-PCR,and Western blot,respectively.The relationship between 12-LOX expression and clinicopathological parameters was analyzed.ResultsExpression of 12-LOX was negative in 8 cases,weak positive in 7 cases and strong positive in 15 cases of pancreatic carcinoma.The overall positive rate in pancreatic carcinoma was 73.3％.The expressions of 12-LOX mRNA and protein were positive in pancreatic cancer cell lines SW1990 and PANC1,and negative in adjacent normal pancreatic tissue.The strong positive expression of 12-LOX in pancreatic cancer was associated with TNM stage,pathological grade,lymph node metastasis (P ＜ 0.05 ).ConclusionsThe expression of 12-LOX was up-regulated in pancreatic cancer and is correlated well to malignant behaviors of tumor.

Objective To evaluate the applicability and security of transpancreatic precut sphincterotomy vs double guidewire technique for cannulation in difficult bile duct cannulation in endoscopic retrograde eholangiopancreatography (ERCP). Methods Retrospective analysis of 158 cases difficult bile duct cannulation in ERCP from January 2012 to January 2014, according to the intubation tube method, we divided all the cases into 3 groups, transpancreatic precut sphincterotomy group (group A); double guide wire technique group (group B); single guide wire technique group (group C). Then compare the intubation success rate and the incidence of complications among the 3 groups. Results 54 of 58 patients in group A intubation successful, the success rate is 93.1%, 50 of 56 patients in group B intubation successful, the success rate is 89.3%, 26 of 44 patients in group C intubation successful, the success rate is 59.1%, there was no significant difference between group A and B(P > 0.05), group A and group C, group B and C have significant difference (P < 0.05). In group A, 4 cases were complicated with acute pancreatitis, hemorrhage in 6 cases, infection in 2 cases, the complication rate is 20.7%; In group B, 5 cases were complicated with postoperative pancreatitis, 4 cases of infection, incidence of complications is 16.1%; 7 patients were complicated with pancreatitis in group C, hemorrhage in 2 cases, infection in 4 cases, complication rates is 29.5%, 3 groups were no perforation occurred.The complication rate of group B is lower than in group A, but no significant difference (P > 0.05), group A and group C, B and C complication rates had significant difference (P < 0.05). Conclusions When selective bile duct intubation is difficulty and guide wire thread into the pancreatic duct, continue to single guide wire have low intubation success rate and higher incidence of complications,transpancreatic precut sphincterotomy and double guide wire technique can effectively improve the success rate of intubation, and complication rates are relatively low, no significant difference between the two.