BACKGROUND: Cholinergic nervous system has a site which is affected by both blineurine and nerve growth factor receptor tyrosine kinase A (NGF-RTK-A). Whether cholinergic injury can affect the changes of tyrosine kinase A (TrKA) is significant to the application of nerve growth factor (NGF) to interfere cognitive disorder disease.OBJECTIVE: To observe the expressive variety of TrKA in different cerebral regions of rats with bilateral fimbria/fornix transection, and comprehend the effect of fimbria/fornix transection on nerve growth factor receptor system.DESIGN: A completely randomized and controlled study on the basis of animals.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was completed in the Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College from March to December 2003. Totally 14 male Wistar rats were randomly divided into control group and model group with 7 in each group.METHODS: The bilateral fimbria/fornix transection was performed on rats in the model group, but rats in the control group were treated with the same methods except fimbria/fornix transection. Twenty eight days after operation, rats in the two groups were killed under anesthesia to take out brain tissues to stain with immunohistochemical staining.MAIN OUTCOME MEASURES: The number of positive TrKA cells in the hippocammpal CA1, cortex, amygdala and Meynert of the basal forebrain of rats in both groups.RESULTS: Totally 14 rats entered the final analysis. The numbers of positive TrKA cells in the hippocammpal CA1, cortex, amygdala and Meynert of the basal forebrain of rats in the model group were obviously smaller than those in the control group [(18.91 ±6.27), (15.17±5.23),(18.71±9.05), (8.03±2.33); (54.77±11.84), (59.69±10.40), (49.23±15.84),(21.49±15.54), t=4.17-10.00; P ＜ 0.01].CONCLUSION: The expression of TrkA positive neurons is decreased in many sections of the brain in the rats with fimbria/fornix transection.Possibly it is the cause leading to the cognitive disorder and senile dementia.

Objective To analyze the cost-effectiveness of integrated pharmaceutical care (IPC) in community-based patients with chronic obstructive pulmonary disease (COPD).Methods The COPD patients were divided randomly into intervention group (group A,n =79) and control group (group B,n =71).Group A received the IPC intervention measures,including serial lectures of pharmaceutical knowledge,home supervision and web-based communications for while group B group had none.Results As compared with group B,group A obviously improved on the knowledge of pharmaceutical treatment effect and side effect (95.1％,67.4％ vs.63.1％,21.9％,x2 =12.445,P=0.000 vs.x2 =55.557,P=0.000).There were notable differences between two groups [ ( 1.77 ± 1.23 ) vs.( 2.42 ± 1.66 ) s,t =2.583,P=0.011],pulmonary rales [ (0.01 vs.0.01)s,Z =2.370,P=0.018],6-min walk distance (6 MWD) [ (457 ± 67 ) vs.(425 ± 72) m,t =2.760,P =0.007 ],vital capacity ( VC ) [ ( 1.60 ± 0.25 ) vs.( 1.49 ± 0.23 ) L,t =2.718,P =0.007 ) ] andquality-of-life items ( 48 ± 10 vs.52 ± 11,t =2.624,P =0.010) after intervention.Analyze of cost-effectiveness show that groupA was superior to group B [ total effect total cost(TE/TC =764.6/4936,15.49％ )vs.(TE/TC =1509.4/4708),32.06％,x2 =6.183,P ＜ 0.01 ].Conclusion IPC can improve the disease condition and achieve excellent cost-effectiveness for community-based COPD patients.

Drug reservation wag investigated in 2077 community residents.We found that most drugs were obtained from the hospitals(83.78%),kept at a relatively lower place(69.23%),packed in box(75.25%),and did not meet the storage requirement(72.60%).Half of the overdue drugs(median time,12 months)were used for internal treatment.This study suggests that there might be unsafe drug storage in communities.

A survey on compliance with topical medication and the relevant factors were conducted in 190 patients with glaucoma in Miaohang Township, Baoshan County of Shanghai. All patients used 1 or more topical ocular hypotensive medications for at least 6 months and a special questionnaire was designed for the survey. The survey revealed that the overall non-compliance rate was 54. 7% (104/190) in this group of patients; which was closely correlated with age, medication application time and the extent of visual defect ( OR = 2. 550, 0. 225 and 0. 342, P ＜ 0. 05 ). Education levels, gender of patients, glaucoma type, number of daily medication, medication types and the stability of diseases were not correlated with the compliance.