Objective To analyze the various common causes of acute pancreatitis distribution and related factors.Methods 131 cases of acute pancreatitis patients from April 2007 to August 2013 were chosen.The medical records were retrospectively analyzed .Patients were recorded and analyzed in age ,gender,etiology,clinical pancreatitis type.With biliary tract disease,overeating or high-fat meal,alcoholism,hyperlipidemia,other causes such as to cause the group to 18-29 years of age(youth group),29-44 years old(middle-aged group),44-59 years old(middle-aged group),≥59 years of age(age group) for the sector for the age group,for different reasons,the AP′s gender,age and different clinical types such as distribution were analyzed .Results Biliary disease 61 cases(46.3%);overeating or high-fat meal 38 cases(29.4%);alcoholism 21 cases(16.1%);high ester hyperlipidemia 8 cases(5.9%);other three cases(2.3%).Adult group overeating or high-fat meal,alcoholism and hyperlipidemia constituent ratio were higher than other groups,but with no significant difference(Pearson χ2 =19.1,df=12,P=0.085).Clinical types in a variety of different etiology than AP was no significant difference ( Pearson χ2 =1.9, df =4, P =0.753 ). Conclusion Biliary tract disease remains a major cause of AP ,followed by overeating or a high-fat meal,alcoholism, hyperlipidemia.AP has a clear upward trend,the treatment must remove the cause,to strengthen the integrated man-agement of AP .

Objective To evaluate the antihypertensive effect and safety of domestic produced amlodipine(Lan Di) in the treatment of chronic renal insufficiency with mild-mnderate hypertension and to compare with the effect of imported amledipine.Methods Sixty-onc patients with chronic renal insufficiency(Scr:265～442 μmol/L,seated DBP 90 ～105mmHg and seated SBP≤170mmHg) were enrolled in this study.Patients were randomly assigned to receive Lan Di 5mg or novasc 5mg once daily for 4 weeks.Doses were titrating to 10mg/d for another 4 weeks in patients hating seated DBP≥80mmHg or SBP≥130mmHg at the end of 4 weeks.Blood pressure,heart rate,laboratory examinations were performed at baseline and the end of the trial,and side effects were assessed pre and post Lan Di or novasc treatment.Results Lan Di group(31 cases) and novasc group(30 cases) finished a 8 week clinical trial.At the end of 4,8 weeks,seated SBP and DBP were significantly lowered compared with those at baseline(P＜0.01 ).There was no significant difference in the reduction of seated DBP or SBP between the two groups at the end of 4,8 weeks(P＞0.05).At the end of 8 weeks ,the response rate was 87% in Lan Di group and 90% in novasc group.If the target value of blood pressure is below 130/80mmHg,the response rate was 36% in Lan Di group and 30% in novasc group.At the end of 8 weeks,no difference was found in laboratory findings compared with those at baseline in two groups(P＞0.05).Side effects were comparable during the period of treatment.Condusion Domestic produced amlodipine 5mg or 10mg daily is as effective and safe as imported amolodipine in chronic renal insufficiency patients with mild to moderate hypertension.

0.05).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION:Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.

OBJECTIVE To analyze the homology of carbapenem-resistant Klebsiella pneumoniae(KPN),offering help for clinical therapy and nosocomial infection control.METHODS The antimicrobial-resistant phenotype of forty carbapenem-resistant K.pneumoniae strains was analyzed by the WHONET 5.4 soft and the resistant genotypes were determined by plasmid profile analysis and pulse-field gel electrophoresis(PFGE).RESULTS Analyzing antimicrobial-resistant phenotype to usual eighteen clinical drugs,the main drug resistant profiles were pan-resistant and only sensitive to tobramycin among the eight antimicrobial-resistant profiles(72.5%).Additionally,the main strains were type Ⅰ and type Ⅱ among the five strains analyzed by plasmid profile(82.5%).When analyzed by PFGE,five types were identified and among these strains type Ⅰ was predominant in 34 strains(85.0%).CONCLUSIONS The strains used in this study exhibit higher homology.Therefore,clinical departments and nosocomial infection departments should pay more attention to these strains to avoid outbreak.

AIM:To observe the clinical effects of Huangkui Capsule (Abelmoschus manihot (Linn)Medic.)on the treatment of IgA nephropathy of damp-heat syndrome.METHODS: Sixty-four patients were assigned randomly into two groups: treatment group in which 32 cases were treated with Huangkui Capsule,and control group,in which 32 cases were treated with fosinopril.The therapeutic course for both groups was 12 weeks.The indexes of efficacy ,including damp-heat syndrome scores,24 h urinary protein,serum creatinine,urea nitrogen and the indexes of safety,including liver function,electrolyte and occurrence of adverse events were observed.RESULTS :There was no significant statistical difference between the two groups in aspects of baseline clinical figures,after 12 weeks of treatment,the content of 24h urinary protein significantly decreased by (0.49±0.78 )g/24 h and (0.4±0.76 ) g/24 h respectively in the two groups,showing significant difference in comparing with baseline,but insignificant difference between the two groups ( P ＞ 0.05 ),the scores of damp-heat syndrome in the two groups decreased by (0.88±1.43 ) scores and (1.94±1.63 ) scores respectively with significant difference as compared with baseline (P ＜0.05 ),and in comparison between groups(P ＜0.05 ).The total effective rate of 24 h urinary protein was 53.1% in the treatment group and 65.6% in the control group (P ＞ 0.05 ),The total effective rate of dampheat syndrome scores was 84.4% in the treatment group and 50% in the control group ( P ＞ 0.05 ).No significant change in levels of serum creatinine,urea nitrogen in the two groups was found (P ＞0.05 ).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION: Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.

Objective To investigate the effect of berberine on endoplasmic reticulum stress PERK apoptosis pathway in HK-2 cells by high fructose.Methods HK-2 cells were grown in DMEM/F12, containing 10% fetal bovine serum (FBS) and divided randomly into four groups: normal control group (Group C); Fructose group (Group F): it contains 25mmol/L fructose culture; Berberine group (Group B): 25mmol/L fructose + 10μmol/L berberine treatment group; TUDCA group (Group T):25mmol/L fructose +2μmol/L TUDCA culture group; Cells were collected after culturing 24h. The expression of glucose-regulated protein 78 (GRP78), CHOP protein and the phosphorylation levels of PERK, eIF2α were tested by Western blotting. The cell cycles were detected by flow cytometry and the apoptosis of cells were detected by TUNEL staining.ResultsWestern blotting showed that the expression of GRP78 and CHOP protein in group F was significantly higher than that in group C, and the levels of p-PERK and p-eIF2α in group F were significantly higher than those in group F. Compared with group F, GRP78, CHOP, p-PERK and p-eIF2α in group B and T were significantly lower (P<0.05). The expression of GRP78, CHOP, p-PERK and p-eIF2α in group B had no significant difference. Flow cytometry and TUNEL staining showed that the cell viability of fructose group was significantly lower than that of C group, and the apoptotic index was significantly higher than that of group C (P<0.05). Compared with group F, the activity of HK-2 cells in group B and T significantly increased, otherwise the apoptosis index significantly decreased, and the difference was statistically significant (P<0.05). Compared with group T, the viability index and apoptosis rate of group B had no significant difference (P>0.05).Conclusion Persistent high fructose can activate the intracellular PERK pathway in HK-2 cells, causing endoplasmic reticulum stress. Berberine can inhibit the fructose-induced PERK and eIF2α phosphorylation, down-regulated the expression of GRP78, CHOP protein, thus by regulating PERK Pathways to alleviate cell cycle arrest and reduce cell apoptosis.

OBJECTIVE:To improve the quality of talent training of clinical pharmacy.METHODS:The present situation of teaching team in clinical pharmacy practice base were summarized to analyze the existing problems.The future development countermeasures were put forward in respects of thought,ability,system.RESULTS & CONCLUSIONS:The post cognition of clinical pharmacy teaching team can be strengthened by strengthening the awareness of clinical pharmacy teaching team,clarifying the responsibilities of clinical pharmacy teaching team and improving the curriculum system of teaching,The comprehensive ability and level of clinical pharmacy teaching team can be improved by improving the professional knowledge structure of clinical pharmacy teaching team,promoting the theoretical level and ability of teaching and strengthening the construction of teachers' ethics.The level of teaching team in clinical pharmacy practice base can be enhanced by constructing collaborative incentive and competition mechanism between universities and hospitals.It not only can guarantee the quality and effect of teaching,but also can adapt to the reform and development of higher education and public hospitals,improve the level of medical services.

BACKGROUND:The application of robot-assisted technology for total knee arthroplasty is one of the current research hotspots.Since the 1980s,robot-assisted technology has been introduced into total knee arthroplasty outside China to achieve accurate osteotomy and good recovery of lower limb alignment.After decades of use,the robot has continuously improved its performance with new iterations,but has been criticized for increasing perioperative time and surgical trauma. OBJECTIVE:To summarize the advantages and disadvantages of current orthopedic surgical robots in total knee arthroplasty. METHODS:PubMed database and CNKI were searched to analyze the advantages and disadvantages of robot-assisted total knee arthroplasty in surgical trauma.English search terms were"arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted".The Chinese search terms were"robot-assisted,robotic arm,knee osteoarthritis,arthritis".After the initial screening of all articles according to the inclusion and exclusion criteria,62 articles with high quality and relevance were reviewed. RESULTS AND CONCLUSION:(1)Robot-assisted total knee arthroplasty did not increase the degree of surgical trauma in patients,and showed a lower trauma effect than conventional manual total knee arthroplasty.(2)Robot-assisted total knee arthroplasty has the advantages of accurate auxiliary osteotomy,individualized prosthesis implantation,better protection of soft tissue around the knee joint,reduction of analgesic drug use,reduction of postoperative inflammatory index changes,and shortening of hospital stay.However,there are also shortcomings such as prolonged operation time,increased complications,and increased medical costs.(3)It is concluded that preliminary clinical application studies have shown that robot-assisted total knee arthroplasty can reduce surgical trauma,but it is necessary to be alert to potential risks.Simultaneously,its exact advantages compared with conventional manual total knee arthroplasty need to be verified by large-sample randomized controlled studies and long-term follow-up.

Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.

OBJECTIVE： To set up a standard for evaluating core competency of clinical pharmacists， and to provide reference for competency training and evaluation of clinical pharmacists. METHODS： By Delphi method， the first-level and second-level indicators were summarized and sorted out in three dimensions as research ability， professional ability and comprehensive ability that clinical pharmacists should possess. The second-level indicators were designed as questionnaire items， so as to consult their importance according to Likert 5 grade scoring method. During Jun.-Oct. 2017， 35 experts were selected for the first round of questionnaire consultation， and then the corresponding items were deleted， merged and added. Then the second round of questionnaire consultation was conducted. SPSS 20.0 software was used to input the data of the questionnaire and establish the database， and the experts’ enthusiasm degree， the  authority degree and opinion coordination degree were analyzed statistically. RESULTS： The positive coefficients of expert consultation in the first and second rounds of questionnaire consultation were 100％ and 92.9％； the authority degrees of experts were 0.878 6 and 0.901 9； the coordination coefficients of experts were 0.298 and 0.681， respectively. The evaluation standard for core competency of clinical pharmacists was established finally， involving 16 first-level indicators and 41 second-level indicators. The dimension of research ability contained 5 first-level indexes and 8 second-level indexes （3 “extremely important” indexes in latter ones）； the dimension of professional ability contained 5 first-level indexes and 21 second-level indexes （9 “extremely important” indexes in latter ones）； the dimension of comprehensive ability included 6 first-level indexes and 12 second-level indexes （4 “extremely important” indexes in latter ones）. CONCLUSIONS： The most important core competence of clinical pharmacists is professional competence， and the most important responsibility orientation and work assessment focus is to participate in clinical treatment of patients. Clinical pharmacists should pay attention to communication with medical staff and patients， and establish the concept of lifelong learning. The experts in this consultation and research are highly motivated and authoritative， and have good coordination of opinions. The core competence evaluation criteria can provide a basis for the training and evaluation of clinical pharmacists.