OBJECTIVE:To discuss the impact of the separation of dispensary for outpatients from hospital on patients,hospital and its staff.METHODS:The impact of the separation of dispensary for outpatients from hospital were discussed from aspects of hospital reimbursement mechanism of medical funds,medicine flow links,function of pharmaceutical care,patient's rights on drug choice et al.RESULTS & CONCLUSIONS:In view of current unsound reimbursement mechanism,the high drug price was resulted from multiple medicine flow links and irrational pricing of drugs.Blindly separation of dispensary for outpatients from hospital would lead to supervision vacancy of dispensary for outpatients,loss of function of pharmaceutical care,furthermore,patients would not be benefited form the step,and unhealthy tendency(rebate)would be hard to wipe out,more importantly,it would affect the sustainable development of hospital.

Objective To investigate possible mechanism of Ginsenoside Rg1 on dopaminergic nigral neurons apoptosis of Parkinson's disease (PD) and its protective effect.Methods C57BL/6N mice were administrated with 1-Methy-4-phenyl-1,2,3,6-tetrahydropyri-dine (MPTP) to produce chronic PD model,PD mice were observed in behavioral changes.The expression levels of caspase-3 and TH in ventral midbrain were studied with immunohistochemistry and Western blotting.Apoptotic cell numbers were determined by TdT-mediated dUTP-biotin nick end labeling (TUNEL).Results In group treated with Ginsenoside Rg1,the number of TH-positive neurons in SN was only decreased by 31% as compared with the control group (55%)(P<0.01),the expression of caspase-3 was apparently decreased and major expressed in the cytosol of nigral neurons and TUNEL positive cells in SN decreased (P<0.01).Conclusion The neuroprotective effect of Ginsenoside Rg1 on dopaminergic nigral neurons apoptosis of the mice model of Parkinson's disease induced by MPTP is significant,Decreased expression of Caspase-3 may be the major mechanism of Ginsenoside Rg1 for antiapoptosis.

Objective To investigate the therapeutic effect of stage treatment of severe complicated injuries in palmar forearm and wrist.Methods From March 2008 to Novemler 2011, eleven cases with skin lost combined with fracture and lost of flexor tendon, ulnar radial arteries, median and ulnar nerves,and some of them had fracture of ulnar and radius were treated in the first stage with vacuum sealing drainage after emergency debridement and tissue repair. Secondary microsurgical repair was performed after the VSD was removed. The lost of median and ulnar nerves was repaired with transplantation of sural nerve,and the wound was repaired with free flaps and complex tissue flaps. Results Eleven cases were treated with vacuum sealing drainage for 7 to 10 days.Infections were under control,wound areas reduced and most wound areas were covered by granulation tissues.Flaps and skin grafts were survived.After postoperative follow-up for 3 to 36 months (average 13 months),three cases was received flexor tendolysis.As result,the blood circulation of hand was good, the sensor of injured nerve was higher than S3, and there was a good functional rehabilitation of hand muscles. Conclusion Using vacuum sealing drainage after emergency debridement and tissue repair, there was a good repairing effect of secondary repair with flaps and skin grafts for severe complicated tissue defect in palmar forearm and wrist,and it is an effective choice of operation.

Objective To prepare sustained-release danshensu microcapsules by spray drying.Methods Encapsulation efficiency of different coating materials was compared.The spray process was optimized using a central composite design for two variables to obtain microcapsules with microcapsules yield.Furthermore, in vitro release of danshensu microcapsules was determined.Results PVA was chosen as coating material and the ratio of coating material to core material was 3:1.The inlet air temperature was 190℃,the feed flow rate was 36 r/min,encapsulation efficiency was 85.0%,and microcapsules yield was 56.1%.The particle size of more than 70%microcapsules was between 6—12?m.Conclusion The optimized conditions of spray drying are reasonable,danshensu microcapsules can be used as sustained-release preparation.

Objective To study the clinicopathological characteristics of hepatobiliary cystic neoplasms(cystadenoma and cystadenocarcinoma)in order to improve its diagnostic and therapeutic accuracy.Methods A retrospective analysis was done on the clinical materials of 9 cases of cystic biliary tumors hospitalized in the People's Hospital of Rizhao City from May 1993 to May 2007.All cases were confirmed by operation and pathologic biopsy.Results Six cases were biliary cystadenoma with muhilocular cyst.The other three cases were biliary cystadenocarcinoma,two with single cyst and one with multilocular cyst.Of the three cystadenocarcinorna,two cases had mural nodules and one case had papillary excrescences and cystic wall thickening.Irregular thickening of internal sept.was shown in the multilocular cyst cases.Two had calcification.Enhancement of the wall.internal septa and nlasses were seen in all the malignant tumors on CT scans. Metastatic lymph node was found in one cage. Conclusion There were no special clinical characteristics in difierentiation between hiliary cystadenoma and cystadenocarcinoma. Single cyst, mural nodules and papillary excrescences,irregular thickening of cystic wall and internal septa,coarse calcification and metastatic lymph node increase the likelihood of the diagnosis of the malignant tumors.But the diagnostic differentiation between cystadenoma and cystadenocarcinoma depends on pathology.

Objective To compare the enhancement characteristic of the gallbladder diseases and to evaluate the diagnostic efficacy in differential diagnosis of the gallbladder diseases between contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT).Methods Seventy-two patiens with gallbladder lesions were examined by CEUS and CECT before operation and all final diagnoses were confirmed by surgery and/or pathological diagnosis.Results 1)In early phase,84.6％ (33/39) and 79.5％ (31/39) of benign diseases showed hyper-enhancement on CEUS and CECT,and 97.0％ (32/33) and 87.9％ (29/33) of malignant diseases showed hyper-enhancement on CEUS and CECT respectively (P =0.250).In later phase,91.2％ (31/34) and 88.2％ (30/34) of benign diseases showing hypo-enhancement (P =1.000),and 100％ of the malignant diseases showing hypo-enhancement on CEUS and CECT respectively.2)The time of enhancement from hyper-to hypo in CEUS for benign and malignant diseases were (39.9 ± 15.7)s and (29.9 ± 5.6)s respectively (t =3.61,P =1.000).3)The inhomogeneous enhancement on CEUS and CECT were 41.0％ (16/39) and 53.8％ (21/39) in the benign diseases respectively (P =0.063),84.8 ％ (28/33) and 97.0 ％ (32/33) in the malignant diseases respectively(P =0.125).4)The destruction of the gallbladder wall on CEUS and CECT are 87.9％ (29/33) and 90.9％ (30/33) respectively(P =1.000).5)The accuracy,diagnostic sensitivity,specificity of CEUS and CECT were 91.7％(66/72) and 87.5％(63/72),97.0％(32/33) and 93.9％(31/33),87.2％(34/39) and 82.15％ (32/39) respectively (P =0.250,1.000,0.500).Conclusions The enhancement pattern of the gallbladder diseases on CEUS and CECT were much similar.CEUS has equal diagnostic efficacy in comparison with CECT,but CEUS can supply more diagnostic information than CECT.

Tanshinone ⅡA is one of the main effective components in Salviae Miltiorrhizae Radix et Rhizoma. It plays a role in the resistance to atherosclerosis by participating in anti-inflammatory in vascular wall, such as the regulating endothelial cell apoptosis and correcting lipid metabolism disorder. This article summarized recent researches of the basic role of tanshinone ⅡA in the resistance to atherosclerosis and provided references for clinical application of antiatherosclerotic effect of tanshinone ⅡA.

Objective To investigate the features of low grade dysplastic nodule(LGDN)and high grade dysplastic nodule(HGDN)in cirrhotic liver on the baseline ultrasound(BUS)and contrast-enhanced ultrasound (CEUS).Methods Seventeen LGDNs and 16 HGDNs which were pathologically proved underwent baseline and CEUS examination.CEUS was performed with contrast pulse sequence(CPS)and contrast harmonic imaging (CHI)and used SonoVue as contrast agent.Results Significant differences(all P>0.05)were not shown between LGDN and HGDN for manifestations on both the BUS and CEUS.After contrast agent injected, hyperenhancement in arterial phase and hyper-or iso-enhancement in late phase,hypo-enhancement in early arterial phase and iso-enhancement through late arterial,portal and late phase,hyper-enhancement in arterial phase and hypo-enhancement in late phase,iso-enhancement in arterial,portal and late phase,iso-enhancement in arterial phase and hypo-enhancement in late phase were showed in 10(30.3%),10(30.3%),8(24.3%),4(12.1%),1(3.0%)cases of DN, respectively.Conclusions LGDN and HGDN displayed similar feature on both the BUS and CEUS.There were complicated manifestations of DN on the CEUS and the main contrast-enhanced sonographic feature of DN was,different from regenerative nodule and hepatocellular carcinoma.CEUS was helpful in diagnosing DN in cirrhotic liver.

Gene mutation (e.g. substitution, insertion and deletion) and related phenotype information are important biomedical knowledge. Many biomedical databases (e.g. OMIM) incorporate such data. However, few studies have examined the quality of this data. In the current study, we examined the quality of protein single-point mutations in the OMIM and identified whether the corresponding reference sequences align with the mutation positions. Our results show that close to 20% of mutation data cannot be mapped to a single reference sequence. The failed mappings are caused by position conflict, site shifting (peptide, N-terminal methionine) and other types of data error. We propose a preliminary model to resolve such inconsistency in the OMIM database.
Amino Acid Sequence ; Consensus Sequence ; Databases, Genetic ; Molecular Sequence Data ; Point Mutation ; Sequence Alignment

OBJECTIVETo explore the significance of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in patients with vocal cord leukoplakia and early glottic cancer.

METHODSPatients with vocal cord leukoplakia and early glottic cancer encountered in Nanfang Hospital between December 2012 to January 2014 were included in this study. Ambulatory 24 hour multichannel intraluminal impedance-pH monitoring (MII-pH) was applied to obtain LPR and GER events, as well as the reflux properties of substances. Tobacco and alcohol history was also evaluated. Sixteen healthy volunteers were recruited as normal controls.

RESULTSThere were 26.3% (5/19) LPR patients in glottic cancer group, 35.3% (6/17) LPR patients in vocal cord leukoplakia group and 12.5% (2/16) LPR volunteers in normal controls. There was no statistically significant difference in the positive rate of LPR between early glottic cancer patients and normal controls as well as between vocal cord leukoplakia patients and normal controls (P > 0.05). There was statistically significance in numbers of acid reflux events, time of acid exposure, and time of acid clearance between vocal cord leukoplakia patients and normal controls as well as between glottic cancer patients and normal controls (P < 0.05). GER was found in 26.3% (5/19) patients in glottic cancer group and 23.5% (4/17) patients in vocal cord leukoplakia group and 6.3% (1/16) volunteer in normal controls. There was no statistically significant difference in the positive rate of GER between early glottic cancer patients and normal controls as well as between vocal cord leukoplakia patients and normal controls (P > 0.05). However, there was statistically significance in DeMeester scores between glottic cancer patients and normal controls (P < 0.05), while no statistically significance between vocal cord leukoplakia patients and normal controls (P > 0.05). Reflux events were dominated by acid and weakly acidic reflux in upright position. Weakly alkaline reflux events in upright position, acid reflux events in supine position, and weakly alkaline reflux events in supine position in vocal cord leukoplakia patients were significantly more than those in normal controls (P < 0.05). No statistically significant difference existed in positions and contents between early glottic cancer patients and normal controls (P > 0.05). There was also no statistically significant correlation between happening LPR and GER, smoking and drinking in patients with vocal cord leukoplakia and early glottic cancer (P > 0.05).

CONCLUSIONSReflux events are more in vocal cord leukoplakia patients and early glottic cancer patients, however, the relationship between laryngopharyngeal reflux and canceration of the vocal cord is still needed to be investigated. The significance of mucosal injury induced by nonacid refluxes is needed to be further studies.

Adult ; Aged ; Case-Control Studies ; Esophageal pH Monitoring ; Female ; Humans ; Laryngeal Diseases ; complications ; Laryngeal Neoplasms ; complications ; Laryngopharyngeal Reflux ; complications ; Leukoplakia ; complications ; Male ; Middle Aged ; Vocal Cords ; pathology