OBJECTIVE:To practice over-the-counter service model in the outpatient pharmacy,to improve the phar-macy service quality of pharmaceutical care and to promote rational drug use.METHODS:The background,preparation,procedure and the whole operation courses in establishing the over-the-counter service model in the outpatient dispensary of our hospital were reviewed,summarized and analyzed.RESULTS:The working objectives and principles of the outpatient pharmacy have been established through the over-the-counter service model;pharmacists'position and responsibility,the operation norm,standardized service language,error-sharing system and the solution schemes for disputes have been further improved and consummated;pharmacists'service consciousness and techniques have been improved and their responsibilities have been reinforced.CONCLUSION:The implementation of the over-the-counter service model can facilitate the estab-lishment of excellent service system in the outpatient dispensary,manifest pharmacist'professional value,promote the at-tractive force of pharmaceutical care in hospital.

OBJECTIVE:To investigate the status quo of teachers'teaching ability of standardized training for hospital pharma-cists in Beijing area,and provide reference for strengthening the faculty construction. METHODS:A dynamic assessment of stan-dardized training base for hospital pharmacists of 17 inpatients in Beijing area was conducted to organize evaluation experts to as-sess the teaching ability of outpatient pharmacy,ward pharmacy and clinical pharmacy in training base. Questionnaire was designed and trainees were organized to evaluate the teaching ability,time,attitude,feedback and others and related results of teaching in bases were vegarded as objects for analysis and summary. RESULTS:The overall ability of teaching was high,and the most promi-nent was clinical pharmacy,which was well received by trainees. But there are differences among departments,the ability of ward pharmacy is slightly lower than the clinical pharmacy and outpatient pharmacy. And the teaching ability still had great improvement. CONCLUSIONS:In order to improve the overall teacher strength in training base,competence-based training for hospital pharma-cists must be strengthened to encourage teachers to attend training courses,strengthen cultivation of humanistic quality and enrich students'evaluation forms.

Objective To study the effect of the PDCA management on safety management of venous transfusion by indwelling needles?.Method The measures included standardizing nurses manipulation,improving the management system related to venous transfusion,and regulating details management process for tube fixing and dressing and tube maintenance.Results The rates of unstandardized maintenance and obstruction of tubes after the enforcement of details management were significantly lower than those before its enforcement(P<0?05).Conclusions PDCA management is effective for standardizing nursing implementation and ensuring the safety of venous transfusion by indwelling needle?

AIM: To determine the contents of Sodum Aescinate for Injection in Beijing market in order to provide the basis for quanlity control. METHODS: According to national criterion, total aescinate is determinted by acid base titration. The contents of sodium aescinate A and sodium aescinate B in products are determined by HPLC. RESULTS: The total aescinate content in samples of the different manufactures are accord with national criterion, but the contents of sodium aescinate A and sodium aescinate B in products are different. CONCLUSION: After national criterion was carried into practice, the contents of sodium aescinate A and sodium aescinate B in products were up to standard.

OBJECTIVE:To provide scientic basis for clinical use of hormone.METHODS:The influence of methylpred?nisolone injection(MP)on levels of serum potassium,sodium,calcium,blood sugar,blood pressure,blood lipid,and protein was observed.RESULTS:MP had the most obvious influence on serum calcium and protein,while it had the least influence on triglyceride.Along with the increases of dosage of drug and patient’s age,the changes of biochemical indices induced by MP w_ ere more obvious.The changes of serum sodium and blood pressure were greater in male patients under age40in comparison with those in females.Supplement of potassium,calcium and protein could postpone the influence of drug on serum calcium and protein but could not reduce the incidence rates.CONCLUSION:The use of hormone should adhere to individualized principle and adopt the minimum dosage with expected therapeutic efficacy to reduce the occurrence of adverse reactions.

Objective To investigate the nutritional risks, prevalence of undernutrition, and nutritional interventions among inpatients in departments of nephrology in some hospitals in Guangzhou, with an attempt to provide evidences for the nutritional support of patients with kidney diseases. Methods Totally 378 adult patients in departments of nephrology in Guangzhou were enrolled in this study by fix-point consecutive sampling. Nutritional Risk Screening 2002 (NRS 2002) was applied for nutritional risk assessment. Nutrition risk was defined by NRS score ≥3 and undernutrition by BMI ＜ 18.5 kg/m2 or serum albumin ＜ 30 g/L. Nutritional interventions were also evaluated in all patients. The relationship between nutritional risk and nutritional support was analyzed. Results The overall prevalence of undernutrition was 21.7% and the nutritional risk was 41.3%. They were especially high among patients with chronic kidney dysfunction (24. 3% and 60. 7% , respectively). The nutritional risk was 42. 3% in patients accompanied with diabetes (P＞0. 05). Of these 378 patients, 102 (27.0%) received nutritional interventions, in which the nutritional support rate was 50. 0% (78/156) for patients with nutritional risks and 10. 8% (24/222) for those without nutritional risks. Conclusions The nutritional risks and prevalence of undernutrition are high among inpatients in the departments of nephrology in hospitals in Guangzhou. Proper application of nutritional interventions remains a concern. Evidence-based guidelines are required to improve this situation.

Objective To investigate the distribution of urate crystal as well as the relationship bet ween the features of the crystals and the attacks of joint pain and/or swollen by foot dual-energy CT.Methods Eight-four patients (68 were diagnosed as gout, 11 were patients with hyperuricemia and 5 were diagnosed as other types of arthritis) who recently experienced foot swelling and/or pain were enrolled and all of them were performed foot dual-energy CT.The relationship between the features of the urate crystals and the attacks of gouty arthritis was determined by Chi test and the potential risk factors were identified by Logistic multiple regression analysis.Results Two hundred and seventyeight urate crystal depositions were found in 68 gout patients,and the most common deposition sites were the distal parts of the first toe(18.2％),the first metatarso-phalangeal joint ( 16.8％ ),calcaneus ( 17.5％ ),the lower end of tibia ( 11.8％ ).Furthermore,patients with the urate crystals deposited in the first metatrasophalangeal joint or the lower end of of tibia were more likely to experience acute episodes of gout attack (P＜0.01,P＜0.05 respectively).In addition,the shape,size and quantity of urate crystals also affected episodes of acute attack of gout.Conclusion Dual-energy CT,which is a non-invasive method,could clearly reveal urate crystal depositions and is helpful for the diagnosis and follow-up of patients with gout.The location,shape,size and quantity of urate crystals and soft tissue swelling,bone erosion may affect the acute attack of gout.

Objective To investigate the relationship between interleukin-18(IL-18)and the pathogenesis of type 2 diabetes melli-tus.Methods 72 healthy Sprague-Dawlay male rats were randomly divided into four groups, NC group,NCS group,HF group and HFS group.At the end of the 8th week,NCS group and HFS group were injected with STZ(25mg/kg)into abdominal cavity.At the end of the 10th week,diabetic rats were screened by oral glucose tolerance test(OGTT).The blood sample was collected when the rats were killed at the end of the 14th and 20th week.The levels of serum IL-18,IL-6 and tumor necrosis factor-α(TNF-α)were assayed with ELISA.Results Most rats in HFS group were achieved the diagnostic standard of diabetic rat, and their insulin sensitivity index(ISI)were decreased.At the end of the 14th week and 20th week,the levels of serum IL-18,IL-6 and TNF-α in HFS group were significantly higher than those in NC group(P＜0.01).In HFS group,the levels of serum IL-18,IL-6 and TNF-α at the end of the 20th week were higher than those at the end of the 14th week,but it had no statistic significance(P＞0.05).Pearson linear correlation analysis showed that the level of serum IL-18 in HFS group was positive correlated with FBG,IL-6,and TNF-α(r=0.90,P＜0.01 or r≥0.73,P＜0.05),and negative correlated with ISI(r=-0.86,P＜0.01).Condusions Our results show that IL-18 is related with the pathogenesis of type 2 diabetes mellitus and chronic inflammation plays an important role in the development of type 2 diabetos mellitus.

Objective To analyze quantitatively intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI)of normal adult kidney and to evaluate the effects of the location of the kidney,gender and age on IVIM-DWI parameters.Methods Thirty healthy adult volunteers were recruited to undergo IVIM-DWI examination.Two radiologists measured the D ,D? and f values of renal parenchyma in both the upper pole,middle part and lower pole of the kidneys separately.Results The D ,D? and f values of the middle part of kidneys in healthy adult were(1.61±0.1 6)×10 -3 mm2/s,(1 7.45 ±3.78)×10 -3 mm2/s and (26.88 ±5.1 9)%, respectively.The D values of right kidney were higher than that of left kidney (P <0.05).The f values of normal kidney in male volunteers were higher than that of female (t = 3.321,P =0.001).The D values of normal kidney in > 50 years group were lower than that of ≤50 years group (t = 3.548,P=0.001).D value of the kidney and age was negatively correlated (r=-0.406).Intraclass correlation coefficient of D,D? and f values between two observers were 0.881,0.56 and 0.741,respectively.The consistency of two observers in measurement of IVIM-DWI parameters in the middle part of kidneys was higher than that of the upper pole and lower pole of the kidneys.Conclusion The IVIM-DWI parameters of adult normal kidneys are influenced by different parts of the kidney,gender and age.

Objective To investigate the MDCT and dual-energy CT (DECT)features of chromophobe renal cell carcinoma (chRCC)and to improve the diagnostic accuracy before operation.Methods The data of MDCT(46 cases of 47 lesions)and DECT (10 cases )of 56 patients with pathologically confirmed 57 chRCC were retrospectively analyzed.All of them underwent plain scan-ning,corticomedullary phase and parenchymal phase scanning after contrast material injection.The lesions were divided into ≤4 cm group and > 4 cm group according to its maximum diameter.Qualitative and quantitative analysis were compared between the groups.Results 64.9% of chRCCs were round and oval,87.7% of chRCCs were solid or mainly solid tumors.The incidence of hemorrhage,necrosis,calcification,cystic degeneration of the tumors was approximately 38.6%,36.8%,10.5% and 12.3%,respec-tively.Central scar(1 7.5%)and vascular sign (24.6% )were seen in part of chRCCs.The tumors showed iso and high attenuation on plain CT scanning in 47.4% and 45.6% of the lesions,respectively.The enhancement pattern of wash-in and wash-out,prolonged enhancement and delayed enhancement were seen in approximately 24.6%,66.7% and 8.8% of the lesions,respectively.The shape, necrosis and cystic degeneration,vascular sign and density uniformity between the two groups were statistically different.The CT value of the lesions were 37.29 HU,82.58 HU and 78.97 HU on unenhanced,corticomedullary phase and parenchymal phase CT scanning.The lesion-kidney ratio on the three phases was 1.29,0.62 and 0.55,respectively.There was no significant difference be-tween CT values and LKR values.The lesions and its subtle signs were much clearer on the 80 kV images of DECT after contrast in-jection.Conclusion The MDCT and DECT findings of chRCC have certain characteristics.However,when the lesions showed atypi-cal CT findings because of its different degree of enhancement and variable enhancement pattern,it would be very difficult to get an accurate diagnosis and the final results depend on pathological diagnosis.