OBJECTIVE:To provide reference for continuous improvement of drug counseling and pharmaceutical care. METH-ODS:220 cases of drug counseling answered by inpatient general pharmacist were collected from our hospital during 2012-2013, and the contents of drug counseling were classified and analyzed. RESULTS:Among consultants,73.18% of them were physi-cians;the type of drug involved mainly were antibiotics,accounting for 42.73%;main contents of drug counseling included drug selection,usage and dosage,accounting for 47.27%. CONCLUSIONS:Pharmacists provide drug counseling for physicians and nurses,answer various questions about usage,and guide rational drug use so as to enhance the communication between pharma-cists and physicians,nurses,and promote rational drug use in the clinic.

Objective To investigate the predictive value of dose?volume histograms ( DVHs ) of organs at risk ( OARs ) including the bladder, rectum, and small intestine in volumetric modulated arc therapy ( VMAT) plans for cervical cancer. Methods A total of 100 VMAT plans for cervical cancer were assigned into the learning group. The correlation of the anatomical information with the V30 , V40 , and V50 values of the bladder, rectum, and small intestine was evaluated in the group. The support vector regression ( SVR) algorithm was used to establish the correspondence between the anatomical information and the DVHs of OARs. The DVHs of OARs in the verification group containing 20 VMAT plans were predicted based on the anatomical information. Results The DVHs of the bladder, rectum, and small intestine were likely to be influenced mainly by the spatial relationship between these OARs and target volume. In the verification group, the prediction errors of V30,V40 and V50 by SVR algorithm were-2.4%±3. 5%,-2.5%±3. 8%, and-1.5%±4. 9% for the bladder, 0.5%±2. 6%,-1.5%±5. 1%, and-2.0%±7. 4% for the rectum, and-2.9%± 5. 3%, 2.7%±7. 7%, and 5.3%±11. 1% for the small intestine, respectively. Conclusions After learning the correlation between the anatomical information and the DVHs of OARs from prior VMAT plans for cervical cancer, SVR algorithm can precisely predict the DVHs of the bladder, rectum, and small intestine based on the anatomical information.

BACKGROUND: Research has showed that the abnormal expression of some proteins closely relates to the occurrence and development of cerebral glioma. However, the relationship between the abnormal expression of CyelinD1protein and the occurrence, development and prognosis of glioma is still uncertain which needs further study.OBJECTIVE: To study the expression of CyclinD1 protein in cerebral glioma and relationship between it and the impact of tumor DESIGN: Control study based on pathological specimens.SETTING: Neurosurgery department of a university hospital.PARTICIPANTS: Totally 48 glioma specimens of different malignaut degree were collected from the patients who accepted surgery treatment in Neurosurgery Department of Second Hospital of Xi' an Jiaotong University during January 1990 and December 1995. Twelve normal cerebral specimens were from the non-tumor patients who were conducted intracranial pressure reducing in Neurosurgery Department of Second Hospital of Xi' an Jiaotong University during January 1990 and December 1995.METHODS: S-P immunohistochemical technique was used to detect the abnormal expression of Cyclin D1 protein. Simultaneously, the dyeing results and clinical characters of patients were associated in order to conduct comparison.RESULTS: The positive expression rate of CyclinD1 protein in human cerebral glioma was 54. 12% while in normal cerebral tissue it was about 8.33%. There was significant difference between them(x2 =8. 148 1,P = 0. 004 3 ) . And the positive expression rate in cerebral glioma of low malignancy was 37.04% while in specimens of high malignancy it was 76.19%, there was significant difference (x2 = 7. 294 0, P = 0. 006 9). The positive expression rate of CyclinD1 protein in specimens of patients with long survival period and short survival period after surgery was 70. 37% and 33.33% respectively with significant difference between them (x2 = 6. 5268,P =0.010 6).CONCLUSION: CyclinD1 is closely related to the occurrence and development of human cerebral glioma. It has provided experimental evidence for the prevention to the occurrence of glioma and the estimation of its prognosis by studying the abnormal proliferation of glioma cells targeted on CyclinD1.

Objective To observe the therapeutic effects of nerve blockade combined with millimeter wave on patients with head acute herpes zoster (HZ) following serious pain.MethodsForty-two patients with head acute HZ following serious pain were randomly assigned to two groups: the combined group which treated with nerve blockade combined with millimeter wave, and the control group which received only nerve blockade. The pain degree (Numeric Rating Scales, NRS), blisters and scabbing were evaluated after treatment.ResultsNRS significantly decreased in both groups after treatment. The blister was earlier to disappear and scabbing was better in the combined group than in the control group (P<0.01).ConclusionNerve blockade combined with millimeter wave can effectively relieve the pain and shorten course of head acute HZ following serious pain.

ObjectiveTo explore clinic features of large cerebral infarction and the relationship between infarcted area and prognosis.MethodsClinic materials such as dangerous factors, onset, course, treatment and prognosis, brain CT changes and internal carotid artery ultrasonic examinations of 68 patients with large cerebral infarction were analyzed retrospectively.ResultsThere were 28 cases caused by cerebral embolism, and 40 cases caused by cerebral thrombosis. 6 cases got recovery, and 34 cases, progress, and 11 cases,no progress, and 17 cases, death. ConclusionThe infarcted area was significantly related to prognosis (P<0.05). Internal carotid artery frequently occurring atheromas and senile non-valve atrial fibrillation were major embolic origins for large cerebral infarction.11 out of the 17 deaths could be attributed to brain herniation and secondary infection. The early abnormal brain CT showed that the rate of mortality was 62.5%, and the rate of mid-line dislocation was 42.9%. Either of them indicated that prognosis was bad.

Objective To investigate the therapeutic effect of modified transperitoneal laparoscopic dismembered pyeloplasty in children with with ureteropelvic junction obstruction (UPJO).Methods The clinical data of 27 children with UPJO treated with transperitoneal laparoscopic dismembered pyeloplasty were analyzed retrospectively.The age ranged from 5 to 104 months (mean,37 months).All cases were diagnosed by ultrasonography,IVU,CT and/or renal radionuclide scanning.The antero-posterior pelvic diameter was more than 3 cm by ultrasound in all cases.Indications of surgery were as followings:symptoms of upper abdominal pain or low back pain and/or split renal function ＜40％ and/or progressive dilatation.Modified transperitoneal laparoscopic dismembered pyeloplasty was performed.Double hitch stitches were transfixed at the top of pelvis and ureter to be anastomosed,and a 6 F urethral catheter was inserted as a ureteral stent percutaneously through the puncture hole and was removed 7-9 days postoperatively without double-J stent.Results All operations were completed laparoscopically without conversion to open surgery.The mean operative time was 118 min (range,85 to 176),the mean blood loss was 16 ml (range,10 to 30) and the mean postoperative hospital stay was 10.5 days (range 9 to 13).The perinephric urine drainage occurred in 2 patients with about 200 ml/d,and reduced to 6 ml/d and 4 ml/d 5 to 6 days after operation.During the follow-up period for 12 to 36 months(mean,22 months) in 27 cases,there was no stricture at UPJ and the hydronephrosis reduced significantly or disappeared.Conclusion Laparoscopic dismembered pyeloplasty with double hitch stitches and an ordinary urethral catheter as an ureteral stent is an easy method with high successful rate and less operative time,which avoids reoperation to remove the double-J stent and is worthy of clinical popularization.

Objective To investigate the effects of heat-killed Staphylococcus aureus (HKSA) on the apoptosis and expression of iNOS and IL-1β in THP-1 monocytes in the presence of high concentration of glucose.Methods THP-1 cells were cultured in medium containing 25.0 mmol/L(HG) or 5.5 mmol/L (LG,control) D-glucose for 12 h-8 d.The THP-1 cells cultured for 6 d were extracted on the 0-48 h with or without HKSA,then apoptosis and expression of iNOS and IL-1β were examined.Apoptosis was analyzed by flow cytometry and expressions of IL-1β and iNOS were quantitated by real-time PCR.Results The expression of iNOS and IL-1β in THP-1 monocytes was increased significantly in the presence of high concentration of glucose for 12-48 h(P＜0.05),reaching the highest level at 24 h and returned to baseline after 4 d.The expression was significantly lower than that of control after 4-6 d.Apoptosis rate was also increased significantly after 48 h to 4 days.HKSA infection enhanced apoptosis,but inhibited the expression of iNOS and IL-1 β in the presence of high concentration of glucose.The expression of iNOS and IL-1β increased significantly at 6 h(P＜0.01),reaching the highest level at 12 h,but the levels were significantly lower than those in control groups (P＜0.05).Conclusion These data suggest that high concentration of glucose can interfere with the anti-bacterial function of monocytes by reducing their expression of iNOS and IL-1β and enhancing their apoptosis.

Objective To investigate the effects of gastric bypass on glycometabolism and improvement of islet β cell function and insulin resistance in patients with type 2 diabetes. Methods Eight patients with type 2 diabetes combined with gastric carcinoma who treated with gastric bypass were studied prospectively. Fasting and postprandial plasma glucose levels, fasting and postprandial insulin C-peptide levels, and body mass index (BMI) were measured right before the surgery and at intervals of 1 week, 2 weeks, 1 month and 3 months after the surgery. Glycosylated hemoglobin (HbA1c) levels were measured before and 3 months after the surgery. The outcome of the diabetes after 3 months of the surgery was also monitored. Results Fasting and postprandial plasma glucose levels decreased (P ＜ 0.05) and fasting and postprandial insulin C-peptide levels increased (P ＜ 0.05) after the surgery. HbA1c levels also decreased (P ＜ 0.05) after 3 months of the surgery. There was no significant change of BMI at all intervals after the surgery(P＞ 0.05). All of the 8 patients reached the total effective standard and 6 patients reached the clinical remission standard after 3 months of the surgery. Conclusions It suggests that gastric bypass can significantly lower plasma glucose levels in type 2 diabetes, which does not depend on the loss of weight. The control of plasma glucose by gastric bypass may be due to the improvement of islet β cell function and increasing secretion of endogenous insulin.

OBJECTIVETo compare the effect of transumbilical single-site single-port with that of transumbilical single-site double-port laparoscopic varicocelectomy in the treatment of varicocele in adolescents.

METHODSWe randomly assigned 80 varicocele patients aged 10 - 16 years to two groups of equal number to receive transumbilical single-site single-port and single-site double-port laparoscopic varicocelectomy, respectively. We compared the operation time, postoperative hospital stay, incisional pain, complications and satisfaction with the abdominal cosmetic outcomes between the two groups.

RESULTSAll the operations were successfully performed. The double-port group showed a significantly higher score on the Visual Analogue Scale than the single-port group (4.8 +/- 1.4 vs 3.6 +/- 1.1, t = -4.986, P < 0.01), but there were no significant differences between the two groups in the operation time ([29.8 +/- 4.2] vs [31.2 +/- 4.6] min, t = 1.383, P = 0.171), postoperative hospital stay ([1.95 +/- 0.7] vs [1.82 +/- 0.8] d, t = -0.784, P = 0.436), complications (0 vs 0) and scores on the satisfaction with abdominal cosmetic outcomes (4.6 +/- 0.6 vs 4.8 +/- 0.5, t = 1.253, P = 0.214). No recurrence, umbilical hernia, hydrocele and orchiatrophy were found in the two groups of patients at 6 months after operation, and no visible scar was observed on the abdominal surface.

CONCLUSIONWith strict surgical indications, single-site single-port and single-site double-port laparoscopic varicocelectomies have similar clinical effects in the treatment of varicocele, which leave no scar on the abdominal surface. Single-site double-port laparoscopy needs no special instruments and therefore is worthier of wide clinical application.

Adolescent ; Child ; Humans ; Laparoscopy ; methods ; Length of Stay ; Male ; Operative Time ; Umbilicus ; surgery ; Varicocele ; surgery

Objective To assess the clinical application value of axillary lymph node staging of breast cancer by B ultrasound.Methods From February to December 2014, 200 female breast disease patients in Department of Breast Surgery Affiliated Hospital of Academy of Military Medical Sciences, were enrolled, with median age 50 years old, including 153 cases of breast cancer, 44 cases of fibroadenoma, 2 cases of mastitis and a case of huge fibroma.The state of axillary lymph node was assessed by doctor with more than twenty years experience in B ultrasound diagnosis.According to the characteristics of the ultrasound image of lymph node and experience of the B ultrasound doctor, the patients were divided into axillary lymph node metastasis group, suspicious group and no metastasis group.The axillary lymph nodes were staged by sentinel lymph node biopsy or axillary lymph node dissection.Based on pathological diagnosis and results of the ultrasound, the sensitivity, specificity, positive predictive value, negative predictive value, false negative rate, and metastasis burden of axillary lymph nodes in false negative patients were analyzed.The relationship between the B ultrasound characteristics and axillary lymph node metastasis was also studied by univariate analysis.Results The metastasis rate of above-mentioned 3 groups by B ultrasound was 84.51%, 45.16% and 7.14%, respectively.The sensitivity, specificity, positive predictive value and negative predictive value of screening for axillary lymph node metastasis by B ultrasound were 89.6%, 89.1%, 84.5% and 92.7%, respectively in metastasis group and no metastasis group. According to consistency analysis between pathological diagnosis and B ultrasound, the Kappa value was 0.779.The false negative rate was only 7.1%(7/98 cases) in no metastasis group judged by B ultrasound, and the patients′axillary lymph node metastasis burden was very low, with only one lymph node positive.The univariate analysis showed that patients with longitudinal diameter of lymph nodes≥1 cm had a higher risk for metastasis than <1 cm (44.2%/14.3%,P<0.001);lymph node aspect ratio≤1.5, the lymph node metastasis rate was significant higher than>1.5(P<0.001); cortical thickness≥3 mm and lymph node appearing blood flow signal of the central or mixed type were also high metastasis risk factor, the lymph node metastasis rate was 67.5%, 75%and 79%, respectively, P<0.001).Conclusion B Ultrasound is a valuable method for detecting axillary lymph node metastasis in breast cancer.It has lower false negative rate, and the false negative patients just have smaller axillary lymph node metastasis burden.The longitudinal diameter of lymph nodes more than 1 cm, lymph node aspect ratio≤1.5, lymph node of cortical thickness≥3 mm, and blood flow signal of the central or mixed type have higher relationship with axillary lymph node metastasis.B Ultrasound may be a potential alterative method for sentinel axillary lymph node biopsy for axillary lymph node staging in early breast cancer.