OBJECTIVE: To provide meaningful reference for the improvement of full-time clinical pharmacists' ability.METHODS: According to clinical practices,the experience of author engaging in clinical pharmacy was introduced.RESULTS & CONCLUSION: Clinical pharmacists should take a correct attitude and practice their profession as best as they could,based on the professional orientation.Scientific research should be linked with problem settlement to promote the growth of clinical pharmacists.

Objective To investigate the value of adenosine stress myocardial contrast echocardiography(MCE) in evaluating the myocardial perfusion in patients with coronary artery stenosis in different degrees. Methods The 384 myocardial segments governed by the corresponding coronary arteries with different degrees of stenosis in 24 patients with coronary artery disease (CAD) were divided into group A (normal),B (50%～75%) ,C (76%～89%) and D (≥90%). Parametric quantification(PQ) was applied at rest and adenosine stress MCE to analyze myocardial perfusion by parameters (A,β and A×β). Then the receiver operating characteristic (ROC) curves were constructed according to the rangeability of the parameters and the cutoff points, sensibility and specificity were obtained. Results At rest, A,β and A ×β in group A,B,C and D decreased by degrees,while there were no significant differences between group A and B. At adenosine stress, the parameter rangeability increased in group A and B, while decreased in group C and D. The ROC curve analyses of parameter rangeability showed that the area under the curve of the rangeability of parameter A ×β was the largest when the rangeability was applied to diagnose stenosis of coronary artery,and the sensibility and specificity were 81.3% and 94. 9% for group B,82.6% and 84.5% for group C,71.9 % and 86. 3 % for group D. Conclusions Adenosine stress MCE can be applied to diagnose the various degrees of stenosis of coronary artery.

Objective:To prepare urokinase targeted thrombus microbubbles combined with low frequency ultrasound to dissolve thrombus in rabbit femoral artery, and to explore the mechanism of thrombolysis through the change of urokinase concentration.Methods:Twenty-four rabbits with thrombosed femoral artery were randomly divided into four treatment groups: urokinase alone (UK) group, ultrasound with non-targeted microbubble and urokinase (US+ M+ UK) group, platelet-targeted microbubble with urokinase (R+ UK) group, ultrasound with platelet-targeted microbubble and urokinase (US+ R+ UK) group. Thrombus-targeted microbubbles were injected through the ear vein and irradiated by ultrasound for 30 minutes, and the pulsed Doppler blood flow meter was used to continuously monitor the blood flow at 0 min, 10 min, 20 min, 30 min, 60 min, 90 min and 120 min after injection. At the same time, the changes in urokinase concentration were monitored, and the characteristics of blood flow and urokinase concentration changes were analyzed.Results:UK and US+ M+ UK groups failed to show recanalization at 120 minutes after treatment.In contrast, the US+ R+ UK and R+ UK groups both achieved persistent recanalization( P<0.001). Compared with the basal state. Both the R+ UK group and R+ UK+ US group showed a decrease at 60 minutes, and the difference was statistically significant( P<0.05). Conclusions:In the thrombolysis process of low-frequency ultrasound combined with a targeted contrast agent carrying urokinase, the targeting can make the local urokinase concentration of thrombus reach the highest level. At the same time, ultrasound and targeted microbubbles promote urokinase to enter the thrombus, and finally achieve the strongest thrombolytic effect.

Objective To study the changes of left ventricular(LV) function before and after rAAV2-GFP targeted to myocardium by the ultrasound mediated microbubbles. Methods Twenty rats were divided into 2 groups. Ten rats underwent ultrasound mediated microbubbles destruction without rAAV2-GFP as control. Another ten rats underwent ultrasound mediated microbubbles destruction containing rAAV2-GFP as experimental group. The mean value of LV rotation of rats was obtained in apical and base plane using speckle tracking imaging(STI) software. LV torsion(LVtor) was defined as apical rotation relative to the base. LV function including circumferential strain,circumferential strain rate of systolic and early diastolic and late diastolic, torsion, time to peak, ejection fraction, fractional shortening, end-diastolic volume, end-systolic volume of LV,heart rate and so on were also measured before and after 14 days. Other rats were killed after 14 days and hearts were harvested. GFP protein expression which showed rAAV2 transfer was observed under fluorescence microscope in frozen section. Results There was no significant difference of LV function of rats before and after rAAV2-GFP myocardium transfection by the ultrasound mediated microhubbles. Conclusions LV myocardial function has no significant difference before and after delivering rAAV2 to the heart in vivo by ultrasound-mediated microbubbles destruction.

This paper introduces the current status of Chinese medical device testing and inspection institutes. There are 53 such institutions, including 10 national institutions. Medical device testing and inspection institutions service in government regulation and supervision of medical devices, playing a technique support role for medical devices from registration before appear on market to monitor and supervision after listing. Meanwhile, they are important practitioners of medical devices standardization work. Finally, put forward the current problems and countermeasures of the inspection institutes in order to facilitate the sustainable development of our national medical equipment.
China ; Equipment and Supplies ; standards ; Health Systems Agencies ; Reference Standards

Objective:To study the influence of all-trans retinoic acid (atRA)on craniomaxillofacial development of C57 mice. Methods:Pregnant C57BL mice were divided into 4 groups(n =5)at gestation day (GD)1 0.Mice in three atRA-induction groups were given atRA of 60,80 and 1 00 mg/kg,respectively.The mice in control group were given the equivalent volume of corn oil.All pregnant mice were sacrificed at GD1 9 and the embryos were collected.Stereo microscope was used to observe the craniomaxillofacial morphology.Standardized radiographs were taken and cephalometric analysis was performed.Results:The embryonic body length and body mass of control group surpassed those of 80 and 1 00 mg/kg atRA groups(P <0.05,P <0.01 ).atRA induced craniomaxillofacial malformations and maldevelopment.The mice induced by atRA exhibited a shorter mandibular body and more retrusive position of max-illary and mandibular(∠NAK and ∠NBD)when compared with their norm(P <0.01 ).Significant decrease in craniofacial length (Op-Rh)was observed in all atRA-induced groups(P <0.01 ).Decreases in cranial vault height(Fp-Os)and cranial vault length(Pa-Na)dimensions were observed in 80 and 1 00 mg/kg atRA groups(P <0.05,P <0.01 ).Conclusion:Exogenous atRA dose-depend-ently induces retardation of craniomaxillofacial morphology in embryo of C57BL mice by inhibition of the sagital and vertical dimension development of the bone.

Objective To evaluate the efficacy and safety of combination therapy of oxaliplatin and S-1 vs oxaliplatin and docetaxel for advanced gastric cancer (AGC)patients.Methods From April 201 1 to Janu-ary 201 3,62 cases of AGC were collected in the Fifth People′s Hospital of Qinghai Province.All cases were randomly divided into group A (31 cases)and B (31 cases)by random number table.In group A,oxaliplatin plus S-1 was administered,and in group B,oxaliplatin plus docetaxel was applied.The response rate (RR), time of diseases controlled rate (DCR),progression-free survival (PFS),overall survival (OS)and adverse reactions of the two groups were observed and compared.Results There were no statistically differences between group A and group B in RR (48.4% vs 54.8%),DCR (67.7% vs 77.4%),mPFS (5.4 months vs 6.2 months),mOS (9.0 months vs 9.8 months),and the statistical values were as follows:χ2 =0.26,P =0.71 1 ;χ2 =0.73,P =0.393;χ2 =0.51 ,P =0.473;χ2 =0.03,P =0.829.The incidence of degrees Ⅰ-Ⅱperipheral neuropathy (9.7% vs 22.6%),nausea and vomiting (1 2.9% vs 32.3%)in group A were signifi-cantly lower than those in group B (χ2 =5.78,P =0.002;χ2 =4.63,P =0.01 6).Conclusion Both the two chemotherapies are similar in therapeutic effect for patients with AGC.Oxaliplatin plus S-1 treatment may be better than oxaliplatin plus docetaxel in the tolerance of patients.

Objective To explore the correlation between 18F-FLT SUVmax and intratumoral microvessel density (MVD) in NSCLC patients.Methods From January 2008 to December 2010,68 patients (48males and 20 females; age ranging from 36 to 84 years) with NSCLC underwent 18F-FLT PET/CT followed by surgery within two weeks.Tumor proliferation was evaluated in terms of Ki67 labeling index (LI) with SP.MVD was determined using anti-CD31 mAb (CD31-MVD),anti-CD34 mAb (CD34-MVD) and anti-CD105 mAb (CD105-MVD) for each resected tumor.Linear correlation analysis was used to analyze data.Results The mean values of CD31-MVD,CD34-MVD and CD105-MVD were 159.6,166.1,and 38.0 per view field,respectively.Tumor SUVmax was 4.1±2.9,and Ki67 LI was (37.0± 14.5) ％,both of which had significantly correlations with CD105-MVD (r=0.550,0.633 ; both P＜0.05),but there was no significant relationship between SUVmax and CD31-MVD,CD34-MVD (r=0.228,0.235; both P＞0.05).Conclusion 18F-FLT PET/CT imaging has a positive relationship with CD105-MVD of NSCLC,and it could reflect the ability of tumor angiogenesis.

AIM: To investigate the protective effect of microRNA-218 (miR-218) silencing on kidney tissue of streptozotocin (STZ)-induced diabetic nephropathy rats and the potential mechanism.METHODS: The diabetic rat model was established by a single intraperitoneal injection of STZ (50 mg/kg).Meanwhile, the miR-218 short hairpin RNA (shRNA) lentiviral vector was constructed.The Sprague-Dawley rats were randomly divided into 4 groups: healthy control group, diabetes group, empty vector group and miR-218-shRNA group.The blood glucose, 24 h urinary protein, serum creatinine (SCr) and blood urea nitrogen (BUN) in the rats at different time points (4, 8 and 12 weeks) were measured by an automated analyzer.The expression of miR-218 was detected by RT-qPCR, while the expression of heme oxygenase-1 (HO-1), nephrin and p38 mitogen-activated protein kinase (p38 MAPK) at mRNA and protein levels in the kidney tissues was determined by RT-qPCR and Western blot.The caspase-3 activity was detected by caspase-3 activity assay kit, and the cell apoptosis of the kidney tissues was analyzed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).RESULTS: Compared with healthy control group, the expression of miR-218 was significantly increased in STZ-treated rats.Meanwhile, the concentrations of blood glucose, 24 h urinary protein, SCr and BUN were significantly increased in STZ-treated rats (P<0.05).The mRNA and protein expression of HO-1 and nephrin was significantly decreased, while the level of phosphorylated p38 MAPK was significantly increased in STZ-treated rats.In addition, the activity of caspase-3 was also significantly increased in STZ-treated rats.When the model rats were infected with miR-218-shRNA, the expression of miR-218 was significantly decreased and the above effects were markedly reversed.Furthermore, TUNEL results showed that compared with diabetic group and empty vector group, miR-218 silencing significantly attenuated the cell apoptosis in the kidney tissues in miR-218-shRNA group.CONCLUSION: miR-218 is involved in the kidney injury in diabetic rats, and silencing of miR-218 by lentiviral vector-mediated miR-218-shRNA transfection effectively inhibits kidney cell apoptosis, suggesting that miR-218 is a potential target for the treatment of diabetic nephropathy.