OBJECTIVE:To discuss what service marketing strategies the pharmaceutical enterprises in China should choose in the face of more and more fierce competition in pharmaceutical markets.METHODS:The service characteristics of both prescription drugs and over-the-counter(OTC)drugs were analyzed and new conceptions in pharmaceutical marketing such as the development and application of the service marketing were introduced as well.RESULTS&CONCLUSION:Di?versity,standardization,materialization are the right way the pharmaceutical enterprises should follow in the prescription drugs services;however,standardization,mechanics,brands are necessary for the OTC drugs services.

OBJECTIVE: To highlight concepts critical to achieving successful diagnosis and endoscopic therapy for lateral recess of the sphenoid sinus (LRSS) lesions, operative techniques, and avoiding complications in the treatment were discussed. METHOD: Pathology within a lateral recess of a widely pneumatized sphenoid sinus is difficult to access with the use of traditional open and current endoscopic surgical approaches. A new surgical procedure, the endoscopic tranapterygoid approach, directly accesses this region. A clinical experience over several years with this approach is reported as well as a refined and updated description of the technique. Twenty-six patients with LRSS lesions were retrospectively studied, from 2008 to 2013, 11 males and 15 females. Ages ranged from 21 to 68 years (mean 43 years). Radiological investigations consisted of computed tomography (CT) scan and magnetic resonance images (MRI) in all cases. An endoscopic tranapterygoid approach was performed in all patients under general aneasthesia, 4 to resect a middle fossa meningoencephalocele and repair the CSF leak and associated skull base defect. RESULT: All the operations were successful. Patients tolerated the approach well and no significant complications occurred. Post operative pathology made definite diagnosis. Meningoencephalocele 4 cases, sphenoid sinus cyst 10 cases (4 cases only were subtotal resected for it's tight adhesions with optic nerve or internal carotid artery) , fungal sinusitis 5 cases (non-invasive fungal sinusitis, pathogenic funga was aspergillus) chronic sphenoid sinusitis 5 cases. Nine patients had postoperative ipsilateral facial, upper lip and palatal hypesthesia, not given treatment, gradually relieved after 6 months. No recurrence was found during follow-up for 6 to 53 months (mean 23.8 months). CONCLUSION It had very important implications for high resolution CT combined with MRI in diagnosis of LRSS lesions. In selected cases, the endoscopic tranapterygoid approach enables the otolaryngologist to meet modern demands to treat conditions in the lateral sphenoid using minimally invasive techniques that are well-tolerated by patients. The endoscopic transpterygoid approach is an excellent approach for dealing with LRSS lesions.
Adult ; Aged ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies ; Sphenoid Sinus ; Young Adult

OBJECTIVETo compare the difference of Euphorbia Pekinensis Radix before and after being processed with vinegar in the toxicity on rat small intestinal crypt epithelial cells IEC-6, and make a preliminary study on the mechanism of detoxication of Euphorbia Pekinensis Radix processed with vinegar.

METHODWith rat small intestinal crypt epithelial cells IEC-6 as the study object, the MTT method was adopted to detect the effect of Euphorbia Pekinensis Radix before and after being processed with vinegar on IEC-6 cell activity. The morphology of cells were observed by the inverted microscope. The down-regulated mitochondrial apoptosis pathway of enterocytes caused by the vinegar processing was analyzed by using the high content screening.

RESULTCompared with the negative control group, the proliferation inhibition experiment showed that Euphorbia Pekinensis Radix showed a relatively high intestinal cell toxicity (P < 0.01). The results of HCS analysis showed that Euphorbia Pekinensis Radix could significantly reduce the cell nucleus Hoechst fluorescence intensity and mitochondria membrane (P < 0.05, P < 0.01), and increase Annexin V-FITC and PI fluorescence intensity and membrane permeability (P < 0.01, P < 0.01, P < 0.01). After being processed with vinegar, compared with Euphorbia Pekinensis Radix groups with different doses, Euphorbia Pekinensis Radix processed with vinegar could significantly decrease the cell proliferation inhibition effect on enterocytes, increase the cell nuclear Hoechst fluorescence intensity and mitochondria membrane (P < 0.05, P < 0.05), and decrease Annexin V-FITC and PI fluorescence intensity and membrane permeability (P < 0.01, P < 0.01, P < 0.05), and showed a certain dose-effect relationship.

CONCLUSIONThe vinegar processing can further reduce the toxicity of Euphorbia Pekinensis Radix on enterocytes. Its possible mechanism can decrease the effect of Euphorbia Pekinensis Radix on the permeability of IEC-6 cell membrane, so as to provide a basis for further explanation of the detoxication mechanism of Euphorbia Pekinensis Radix processed with vinegar.

Acetic Acid ; chemistry ; Animals ; Apoptosis ; drug effects ; Cell Line ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; toxicity ; Epithelial Cells ; cytology ; drug effects ; Euphorbia ; chemistry ; Intestine, Small ; cytology ; Rats

Acute Coronary Syndrome ; blood ; Aged ; Cell Membrane ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Thromboplastin ; metabolism

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

To observe the clinical effect of compound Yimucao oral liquid on postpartum lochiorrhea. Methods:A to-tal of 200 patients with postpartum lochiorrhea were randomly divided into the observation group ( 100 cases ) and the control group (100 cases). The patients in the observation group received 20ml compound Yimucao oral liquid three times a day for seven days, while those in the control group were given 15g Yimucao granules three times a day for seven days. After the treatment, the duration, amount, color and quality of lochia, lower abdominal pain, uterine involution and the status of postpartum infection in the two groups were compared. Results: The total effective rate in the observation (94. 0%) was higher than that in the control group(84. 0%). Compared with that in the control group, less average hemostasis time, better situation of abdominal pain, uterine involution and lower postpartum infection rate in the observation group were observed after the treatment(P<0. 05). Conclusion:Compound Yimucao oral liquid can promote the uterine involution. It’ s effective and safe in the treatment of postpartum lochirrhea.

Objective To investigate the value of multi-slice spiral CT image texture analysis in differentiating metastatic (MLN) from non-metastatic lymph nodes (NLN) in patients with rectal cancer.Methods Thirty five patiets with rectal cancer who were pathologically confirmed by total mesorectum excision were included retrospectively,with regional lymph nodes (short-axis diameter of larger than 3 mm)found in preoperative CT images.All the patients underwent preoperative abdominal and pelvic dynamic contrast-enhanced CT scan.Regional lymph nodes were identified according to pathological findings,and were divided into MLN and NLN groups.The short-axis diameter,short-to long-axis diameter ratio of lymph nodes were manually measured and calculated,and the texture features,including skewness,kurtosis,variance,entropy and inverse difference moment,were analyzed.The above parameters between MLN and NLN groups were compared using independent sample t test or Mann-Whitney U test.ROC curve analysis was performed regarding the statistically significant parameters and the areas under curve (AUC) were calculated.Multivariate Logistic regression analysis was accomplished to obtain the independent predictive factor of diagnosing regional lymph nodes.Results A total of 68 regional lymph nodes were obtained and consisted of 31 MLNs and 37 NLNs.The short-axis diameter,kurtosis,and entropy of the MLN group were significantly higher than those of the NLN group (all P＜0.05).Whereas,the short-to long-axis diameter ratio,skewness,variance,and inverse difference moment did not differ significantly between the two groups (all P＞0.05).The AUC for distinguishing MLN from NLN of the short-axis diameter,kurtosis and entropy were 0.79,0.67,and 0.85,respectively.Multivariate logistic regression analysis showed that only entropy (odds ratio=8.48,95％ confidence interval was 3.01 to 23.92,P＜0.01) was screened out as the independent variable,which suggested that the entropy was the unique predictor for characterizing regional lymph nodes of rectal cancer.Conclusion Multi-slice spiral CT images texture analysis can facilitate the accurate differentiation between MLN and NLN in patients with rectal cancer,and especially the entropy has the optimal reference significance.

Objective:To investigate the short-term effect of thoracoscopic and laparoscopic surgery in the treatment of esophageal cancer and its impact on stress response and inflammatory response.Methods:The clinical data of 124 patients with esophageal cancer admitted to Huai′an Cancer Hospital from March 2018 to March 2020 were analyzed. The patients in observation group (62 cases) were treated with thoracoscopic esophagectomy and the patients in control group (62 cases) were treated with traditional open esophagectomy. The changes of perioperative indexes, postoperative complications, stress response, inflammatory response indexes before and 3 d after operation, and pulmonary function before and 1 month after operation were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group: (189.52 ± 37.28) ml vs. (258.94 ± 32.14) ml; the operation time in the observation group was longer than that in the control group: (271.92 ± 25.43) min vs. (231.09 ± 23.16) min, and the differences were statistically significant ( t = 11.105, 9.347, P<0.05). But there was no significant difference in the total number of lymph node dissection between the two groups ( t = 1.295, P>0.05). The postoperative complications in the observation group was less than that in the control group: 9.68%(6/62) vs. 24.19%(15/62), χ2 = 4.644, P<0.05. The serum levels of cortisol and norepinephrine at 3 d after operation in the observation group were lower than those in the control group: (145.32 ± 12.39) μg/L vs. (197.56 ± 18.78) μg/L, (84.54 ± 5.98) μg/L vs. (98.93 ± 7.26) μg/L, and the differences were statistically significant ( t = 18.283, 12.047, P<0.05). The serum levels of interleukin 6, C-reactive protein and tumor necrosis factoralpha at 3 d after operation in the observation group were lower than those in the control group: (101.31 ± 6.56) μg/L vs. (149.09 ± 12.31) μg/L, (18.94 ± 4.53) mg/L vs. (29.95 ± 4.16) mg/L, (84.52 ± 5.89) ng/L vs. (109.32 ± 8.64) ng/L, and the differences were statistically significant ( t = 26.972, 14.096, 18.675, P<0.05). The levels of the first second forced expiratory volume (FEV 1) as a percentage of the estimated value and the ratio of FEV 1 and forced vital capacity at 1 month after operation in the observation group were higher than those in the control group: (8.79 ± 4.50)% vs. (72.16 ± 3.64)%, (67.84 ± 3.24)% vs. (60.39 ± 4.15)%, and the differences were statistically significant ( t = 9.020, 11.142, P<0.05). Conclusions:The short-term effect of thoracoscopic and laparoscopic surgery in the treatment of esophageal cancer is obvious, and the stress response, inflammatory response and lung function are less affected.

Objective To extract envelope of heart sounds exactly,for the purpose of the further analysis of its characteristics.Methods The way that envelope extraction of heart sounds based on key-points was given.The points of local peak and valley were calculated firstly,and then heart sound envelope was gotten by the interpolation of these points.Results Compared with the envelope extracted by Hilbert-transform and mathematical morphology,respectively,the outline of heart sounds was extracted more accurately,and its time-domain characters were acquired by this method.Conclusion The envelope of heart sound is extracted correctly by this method,which is useful for the further analysis.

OBJECTIVE:To explore the effects of enteral nutrition powder in children with phenylketonuria(PKU)under one year. METHODS:120 PKU children under one year were selected and given enteral nutrition powder(20 g/kg,qd)for consecutive 32 weeks. The level of benzene,height,weight,head circumference,IQ level,nutrition indicators and ADR were compared be-fore treatment,8 weeks after treatment,32 weeks after treatment. RESULTS:8 and 32 weeks after treatment,the level of benzene decreased gradually,and height,weight and head circumference increased gradually,with statistical significance(P<0.05). IQ lev-el of children after 8 weeks treatment were better than before,and those of children after 32 weeks treatment were better than after 8 weeks treatment,with statistical significance(P<0.05). 8 and 32 weeks after treatment,nutrition indicators were improved sig-nificantly,compared with before treatment;ALT,Alb and TP levels 32 weeks after treatment were significantly better than 8 weeks after treatment,with statistical significance(P<0.05).There was no statistically significant difference in BUN,TBil and Pa levels between 32 weeks after treatment and 8 weeks after treatment(P>0.05). 66 cases suffered from 181 times of ADR,mainly including 10 times diarrhea and 126 times upper respiratory tract infection,among which one children developed moderate gastroen-teritis. They were all recovered after symptomatic treatment. CONCLUSIONS:For PKU children under one year,enteral nutrition powder can effectively control the phenylalanine levels,prevent the decrease of IQ and improve the nutritional status so as to meet the normal growth and development of children nutritional requirements,with better safety and tolerance.