OBJECTIVE:To reduce the risk of single dispensing,and to improve the quality of pharmaceutical care in emergen-cy pharmacy. METHODS:Single dispensing environmental factors,human factors and social factors of emergency pharmacy in our hospital were analyzed;the suggestions and measures were put forward,risk intervention mechanism was established and manage-ment effects were evaluated. RESULTS:Through improving the pharmacy hardware and software,carrying out the relevant sys-tem,enhancing training,improving the process of dispensing and window order,promoting the drug management and carrying out near error management. Compared with before management(Oct.-Dec. 2014),the times of near error and disputes significantly re-duced after management(Feb.-Apr. 2015)(P<0.05),and medication error reduced to zero. CONCLUSIONS:As single dispens-ing,risk management and the improvement of prescription audit ability can improve pharmaceutical care in emergency pharmacy.

Objective To evaluate the diagostic value of hypersensitive C-reactive protein(hs-CRP),β2-microglobulin(β2-MG) and cystatin C(Cys-C)tests in diabetic nephropathy(DN)of early stage.Methods The turbidimetric immunoassay was adopted to determine serum hs-CRP,β2-MG and Cys-C concentrations in type 2 diabetic patients,including 100 cases with DN of early stage (DN group),50 cases without DN(NDN group)and 100 cases healthy controls(control group).Results Serum hs-CRP,β2-MG and Cys-C concentrations in DN group were significantly higher than that in control group and NDN group(P <0.05).Conclusion Hs-CRP,β2-MG and Cys C are sensitive indicators in the diagosis of DN.The combined determination of the three indicators im-proves the sensitivity of early DN diagnosis and is useful for monitoring the development of DN in early stage.

Objective:To study the mutation frequencies of the exon 5 and the exon 8 of PTEN (phosphatase and tensin homology deleted on chromosome ten) gene in gastric carcinoma and investigate the relationship of the gene mutation and pathological differentiation and clinical stage.Methods:The mutation of exon 5 and exon 8 of PTEN gene was detected in 42 gastric carcinoma samples and the matched adjacent normal gastric mucosa with polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) method.The PCR products of mutant samples were analysed by DNA sequencing technique.Results:The mutation of PTEN was shown in 3 of the 42 gastric carcinoma tissues and in none of the adjacent normal tissues.The mutation rates of PTEN gene in poorly differentiated and well differentiated samples were 12.00% and 0,respectively (P0.05).The mutation rates of PTEN gene in clinical stage Ⅰand Ⅱ (5.88%) had no significant difference with that in clinical stage Ⅲand Ⅳ (8.00%) (P0.05).Conclusion:PTEN gene mutation occurs mainly in poorly differentiated gastric carcinoma tissues,and the mutation rate is not related to pathological differentiation and clinical stage.

Objective To study the correlation of peritumor brain edema and the proliferation of meningiomas.Methods Forty-six patients who underwent resection of meningioma were divided into four groups(no,mild,middle and severe PTBE) according to CT.Proliferating cell nuclear antigen(PCNA) was detected with immunohistochemistry.Results There were 18 cases mild PTBE[PCNA LI (2.83?1.57)],10 cases middle PTBE[PCNA LI (3.14?2.04)] and 5 cases severe PTBE[PCNA LI (4.13?2.43)] in forty-six patients.PTBE was related to meningioma PCNA LI significant.Conclusion PTBE of meningioma relates with tumor cell proliferation.

Objective To investigate the risk factors to acute lung injury based on multiple trauma to provide a theoretical basis for early intervention .Methods The emergency surgical patients with multiple trauma in our hospital from March 2006 to March 2011 were selected .The patients meeting the diagnostic criteria for acute lung injury were taken as the study group and the others as the control group .All patients were enrolled for evaluating the injury severity score (ISS) ,acute physiology and chronic health Ⅱ(APACHE Ⅱ) score and recording smoking ,alcohol abuse ,diabetes mellitus ,number of organ damage ,gastrointestinal bleeding , pulmonary contusion ,diffuse intravascular coagulation (DIC ) ,vomiting ,traumatic shock ,time to correct shock ,blood transfusion . The polymorphism of rs3788853 ,rs13306087 ,rs12709426 of angiotensin-converting enzyme(ACE) gene were analyzed .Results In the study group and the control group ,there were statistical differences in 6 influencing factors of the ISS ,APACHE Ⅱ score ,blood transfusion ,DIC ,traumatic shock ,time to correct shock>6 h(P<0 .05);the gene and genotype frequencies of ACE between the two groups had no statistical difference (P>0 .05);the 6 kinds of influencing factors were risk to acute lung injury based on multi-ple trauma by Logistic regression analysis .Conclusion The ISS ,APACHE Ⅱ score ,blood transfusion ,DIC ,traumatic shock ,long time to correct shock are the risk factors to acute lung injury based on multiple trauma .

ObjectiveTo evaluate the diagnostic value of ultrasound or CT guided percutaneous Trucut needle biopsy on the diagnosis of pancreatic tumors.Methods One hundred and twenty-four patients clinically diagnosed as pancreatic cancer without pathological diagnosis underwent percutaneous pancreatic biopsy by using Trucut needle under ultrasound or CT guidance.ResultsOne hundred and nine procedures of ultrasound-guided biopsy and 15 procedures of CT-guided biopsy were performed,and one patient received 2.3times of punctures.Tissue samples were obtained in all 124 patients,the diagnostic accuracy was 95.2％,among them 115 were adenocarcinoma,5 were cystadenoma,2 were metastasis cancer,1 was cancer of unknown origin and 1 was normal.The sensitivity,specificity,and accuracy were 99.2％ 100％,and 99.2％,respectively.Transient serum amylase increase was observed in 3 patients; 5 patients' abdominal pain aggravated,but all recovered with conservative management.One patient was found to have tumor seeding on the spot of insertion after 34 days.No other major complications occurred.ConclusionsUltrasound or CTguided percutaneous pancreatic 16 ～ 18G Trucut needle biopsy is a safe and simple procedure with excellent diagnostic value for pancreatic cancer.

OBJECTIVETo study clinical effects of a new internal fixation by using a cable through the bone and Kirschner with a hole in the tail, for the treatment of patellar fractures.

METHODSFrom May 2012 to July 2013, thirty-four patients with patellar fractures were treated with cable through the bone and Kirschner with a hole in the tail. All the patients had close fracture,including 12 transverse fractures and 22 comminuted fractures. There were 18 males and 16 females, ranging in age from 26 to 81 years old, with an average of (46.0 ± 3.0) years old. After open reduction, two appropriate length of Kirschner with a hole in the tail were driven into the patella as perpendicular to the fracture line or the major fragments as possible. A transverse bone tunnel was then drilled with a Kirschner at one side of the patella. Then the cable, which was successively pulled through the bone tunnel and the hole of Kirschner, was crossed in a figure-eight over the anterior of the patella, tightened and fixated by special instruments. The Kirschner was clipped off on the edge of the hole. If it was a comminuted fracture, another cable was used to fasten the patella with cerclage. Postoperative evaluation was based on Bostman.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 26 months, with a mean of (16.0 ± 2.0) months. Fractures healed in all the cases without such complications as infection, loosening of Kirschner and cable loop, and skin irritation. According to the Böstman score system, 33 cases got an excellent result, and 1 good.

CONCLUSIONThe cable through the bone and Kirschner with a hole in the tail is a simple, stable and effective method for the treatment of patellar fractures, especially the transverse fractures, with earlier knee exercise and fewer complications.

Adult ; Aged ; Aged, 80 and over ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Patella ; injuries ; surgery ; Treatment Outcome ; Young Adult

Objective To investigate the methods ofmicrosurgical treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia and their curative effects.Methods The clinical data of 185 patients with Arnold-Chiari Ⅰ malformation combined with syringomyelia,admitted to our hospital from January 1997 to June 2010 and received different surgical treatments,were summarized.The relationship between curative effects and operative methods were analyzed.Results When these 185 patients were discharged from our hospital,the clinical signs and symptoms eliminated in 156 (84.3％)and not changed in 29; no symptomatic deterioration and death were noted.One hundred and forty-seven patients were followed up for 3 months-12 years; symptoms disappeared or alleviated in 110 (74.8％),not changed in 26 and deteriorated in 11.The MR findings in 95 patients demonstrated that the cisternals reconstructed and expanded in 82 and the cavities in spinal cords reduced in 79.Conclusion Both posterior fossa decompression + duraplasty and removal of cerebella tonsils + plastic operation of cistern magna are effective and advisable methods in the treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia.

Objective To identify the differential serum proteins in patients with hepatic injury resulting from coal-burning type of arsenism. Methods Six serum samples were collected from patients with liver injury resulting from coal-burning type of arsenism and healthy subjects(control gruop) in endemic arsenism area. Twodimensional gel electrophoresis(2-DE) was performed to separate serum proteins, after silver staining, the differential expression of proteins were analyzed and then identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS). Results The 2-DE map of serum protein patterns of patients and normal control were established successfully. The results showed that there were an average of (824 ± 31 ) spots and (782 ± 42) spots on 2-DE matching of the patients and control groups and the matching rate was 94.9%(782/824). From these two groups 49 differential protein spots were identified, of which over 3 times the difference in the expression of 30 protein spots were singled out and MALDI-TOF-MS analysis was carried out. Ten proteins were identified. Upregulated expression was observed in alpha-2-macroglobulin, B-cell receptor-associated protein, keratin 1,apolipoprotein A-I, and down-regulated expression was observed in haptoglobin, α2-heremans-schimid-glycoprotein,mitogen-activated protein kinase 4, zinc finger protein 323, ZAP-70 and SP40 in the patient group. Conclusions The well-resolved and reproducible 2-DE serum patterns of patients are established and some differentially expressed proteins are characterized. Whether these proteins of differential expression are serum markers for liver injury resulting from coal-burning type of arsenism need to be further verified.

Objective To investigate the psychological well-being and the correlation between psychological status and social support among the settled immigrations from Three Gorges Reservoir areas. Methods A cluster randomized sampling was selected and 646 objects were interviewed with Basic Situation Scale,Symptom Check-list 90(SCL-90) and Social Support Rating Scale (SSRS). Results Our findings from the results of SCL-90 revealed that the positive rate of psychological problem was higher in settled immigration than that of local permanent residents (χ2= 4.10, P=0.04). The differences of scores on 6 factors including compulsion ( t=2.644, P=0.009 ), interpersonal-sensitivity ( t= 3.220, P =0.001), depression ( t=2.684, P=0.008 ), anxiety ( t=3.003, P= 0.003 ), paranoid-ideation ( t =3.246, P=0.001 ), psychoticism ( t=2.088, P=0.038) and the total score ( t=2.506, P=0.013) were significantly different in female between the two groups. There were also significant differences of 10factors score and total score (t=4.114, P=0.000) noticed between the two groups in age≤50 (P<0.05) and the differences of 4 factors score including somatization ( t=2.777, P=0.006), interpersonal-sensitivity (t=2.384, P=0.018), hostility ( t = 3.174, P = 0.002), paranoid ideation ( t = 2.611, P =0.010). The total scores (t = 2.125, P = 0.034) were significantly different between the two groups in illiteracy and having received primary school education. Other than compulsion factor (t = 1.884, P =0.061) and phobic anxiety factor (t = 0.979, P = 0.328), there were significant differences on other factors and the total score between the two groups in non-farmers (P< 0.05). Except compulsion (r =- 0.103,P >0.05), hostility ( r = -0.084, P>0.05) and paranoid ideation factor ( r =-0.071, P>0.05), the negative correlations were obvious between the total score, other factors score and social support(P<0.05 ). The negative correlation was obvious between somatization (r=-0.128, P<0.05 ),depression ( r=-0.140, P<0.05 ), anxiety. ( r=-0.137, P<0.05 ), phobic anxiety ( r =-0.120, P <0.05),additional factor ( r=-0.143, P<0.05) total score ( r =-0.137, P< 0.05) and subjective support. The correlation coefficient was not significant between SCL-90 total score, 10 factors score and that of objective support (P>0.05). Conclusion The psychological status of settled immigration was not satisfactory and closely correlated to psychological mental level and social support.