OBJECTIVE:To promote physicians and pharmacists obtain thorough knowledge about drug fever and its main features,clinical manifestation and identification evidence so as to improve the level of diagnosis and treatment. METHODS:The step and process of clinical pharmacists involving in medical consultation and intervention for drug fever were introduced and related knowledge of drug fever was interpreted term-by-term. RESULTS:Drug fever was common in the process of medical diagnosis and treatment. Once occurrence time of drug fever,feature of thermal variation and accompanying body reaction were observed, the relevant diagnosis can be conducted. CONCLUSION:Clinical pharmacists involving in ward around and medical consultation contribute to medical diagnosis,treatment and patient using drug safely,effectively,economically and rationally.

Objective To evaluate the effectiveness of clinical rotation training in pain department for general practitioner.Methods Totally 31 general practitioners of 3 years program in the First Affiliated Hospital of Chongqing Medical University were involved in clinical rotation training in pain department form August 2008 to December 2011.Training lasted for one month.Clinical rotation training in pain department was conducted for general practitioners by studying rules and regulations,treatment methods,imaging data and clinical practice.Evaluation was made according to the treatment,theoretical knowledge,interpersonal skill and professional competency of general practitioners.Measurement data were expressed as mean ± standard deviation ((-x) ± s) while enumeration data were expressed as rate.Descriptive analysis of the data was used.Results Average total number of patients managed by 31 general practitioners was (15 ± 2),average total number of disease species was (5 ±2),average number of case discussion and small lecture participated was 1 ～2,average number of nerve block participated as assistant was (40 ± 5) and average number of minimally invasive surgery visited and studied was (2 ± 2).Residency duties were skillfully completed and assessment score was (85 ± 4.50).Conclusions Through clinical rotation training,general practitioners can understand common disease diagnosis and treatment category; familiarize clinical evaluation methods and master standards of diagnosis and treatment in pain department.Meanwhile,they would learn doctor-patient communication to establish a good therapeutic relationship with patients.

Objective To analysis the major problems and the causes in the process of centralized purchasing of national essen -tial drugs, and to give some effective solutions according to the price problems for ensuring the quality and regular supply of national es -sential drugs , decrease patients burden effectively and safeguard the medication safety of patients .Methods The implementation of cen-tralized purchasing of national essential drugs was investigated , the problems which were major and outstanding were analyzed to find out the internal causes and the effective solutions were given .Results The progression of centralized purchasing of national essential drugs was successfully in general .The implementation of the principle of winning of the bidding with the lowest bid price lead to excessive low price, which caused some problems such as lower quality or bad supplied of some national essential drugs .Conclusion The price policy of centralized purchasing of national essential drugs should not be instituted based on the lower price , more winning of biddings .It needed more scientific and overall perspective thoughts .It maybe solve the problems mentioned above by winning of the bidding with the lowest bid price in the interval average price , appropriately loosing the control of difference rate with the results of decreasing the drug price , avoiding cut-throat competition, ensuring the quality and supply of drugs , lightening the patients′burden, releasing the problem of high cost of getting medical treatment .

Objective To prospectively determine the feasibility of high-resolution in vivo MR imaging in the evaluation of esophageal carcinoma invasion at 3.0 T.Methods One hundred and eighteen patients with esophageal carcinoma,proven by the gastroscopic biopsy,were prospectively studied using 3.0 T MR.The esophageal specimens were sectioned transversely to keep consistent in the orientation with the MR images,the histopathological stage was made and the thickness of the tumor on the largest diameter of the slice were measured.The MR images were reviewed in the transverse plane.According to the seventh American joint committee on cancer,the MR stage was made and the tumor's thickness was measured.The MR images and the histopathological slices were matched.The staging diagnostic efficacy of the MR imaging was evaluated with the histopathological results as the standard reference,Kappa test was used to compare the stage of MR imaging with that at the histopathological analysis.Bland-Altman scatterplots were used to compare the thickness of tumor measured on the MR images with that at the histopathological measurement.Results Ninety seven cases(82.2％,97/118) of MR stage were accurately made,including 7 T1a,15 T1b,18 T2,25 T3 and 32 T4a cases,furthermore,14 cases were over staged and 7 cased were underestimated.The MR stage was highly consistent with the histopathological stage (Kappa=0.772).The sensitivity for the staging of high-resolution MR imaging at 3.0 T was 58.3％(7/12) to 100.0％(32/32),the specificity was 95.3％ (82/86) to 98.1％ (104/106),and the accuracy was 91.5％ (108/118) to 96.6％ (114/118),respectively.Bland-Altman scatterplots demonstrated that the discrepancy of the mean thickness between the value obtained by three radiologists respectively and the histopathological analysis were 2.0,2.6 and 2.1 mm,which demonstrated a good consistency.Conclusion High-resolution MR images obtained at 3.0 T can be used to evaluate the depth of carcinoma invasion and provide excellent diagnostic accuracy for preoperative staging.

Reactive perforating collagenosis is a rare skin disease characterized by the expulsion of denatured collagen fibers through the epidermis. The specific pathogenesis of the disease is not clear, and according to the etiology it can be divided into hereditary and acquired. Hereditary is relatively rare, usually seen in infants, and acquired is usually seen in adults, often associated with other systemic diseases, such as diabetes, chronic renal failure, cirrhosis, pulmonary fibrosis, tuberculosis, pulmonary aspergillosis, thyroid disease, scabies, hepatitis, acquired immunodeficiency syndrome (AIDS), malignant tumors and so on. There is no standard treatment for the disease.

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.
Humans ; Brain Neoplasms/pathology* ; Neoplasm Recurrence, Local/metabolism* ; Glioma/pathology* ; Neural Stem Cells/pathology* ; Oligodendrocyte Precursor Cells/pathology* ; Tumor Microenvironment