OBJECTIVE To construct a closed-loop management model for externally dispensed intravenous prescriptions， and to provide reference for standardized management of externally dispensed intravenous prescriptions. METHODS Based on the Expert Consensus on Closed-loop Management of Externally Dispensed Intravenous Prescriptions in Guangxi Zhuang Autonomous Region previously formulated by our hospital， risk points during the entire process were systematically identified through multidisciplinary team brainstorming and a fishbone diagram. A series of strategies were subsequently formulated and implemented， including qualifying designated external dispensing pharmacies and the drug catalogs， operating and maintaining the hospital information system and the Pharmacy Intravenous Admixture Service （PIVAS） intelligent management platform， and strengthening differentiated training for staff in the whole workflow. A whole-process closed-loop management system was constructed with PIVAS as the co re hub and the daytime chemotherapy center as the safety terminal. RESULTS A total of 3 cooperating pharmacies and an initial drug list comprising 35 product specifications were selected. A closed‑loop management process encompassing hospital outpatient prescribing， patient drug purchase in designated pharmacies， PIVAS drug dispensing， and medication use in daytime chemotherapy center was successfully established. This system enabled the mandatory grouping and association of externally dispensed intravenous prescriptions with in-hospital diluents， full-process verification based on drug traceability codes， intelligent monitoring of infusion parameters， and whole-process data traceability. CONCLUSIONS The constructed model effectively resolves the coordination and safety oversight during the use of externally dispensed intravenous drugs from out-of-hospital circulation to in-hospital use， and has preliminarily enabled procedural standardization， whole-process information traceability， and proactive control of medication risks.

Pharmacy active consultation refers to the spontaneous activity that clinical pharmacists take the initiative to go to clinical departments to help doctors solve problems related to drug use in clinical practice ，put forward drug treatment suggestions or provide pharmaceutical services ，and form medical documents . The difference between pharmacy active consultation and pharmacy consultation is that the latter is generally proposed by the clinician ，who sends a consultation invitation to the pharmacy department in the hospital information system ，and the clinical pharmacist will go to the consultation after receiving it ，while the former is a pharmaceutical service mode that the clinical pharmacist takes the initiative to carry out in the clinical department . On the basis of routine pharmacy active consultation ，clinical pharmacists in our hospital also further carried out a special active consultation mode （including prompt special active consultation for patients with multidrug resistance bacteria positive ，active monitoring and intervention for patients with drug -induced liver injury ），and patient pharmaceutical supervision in the form of return visit of pharmacy active consultation . Pharmacy active consultation and its special active consultation possess the characteristics of initiative ， early and extensive coverage ，as a supplement to resident clinical pharmacy services . Pharmacy active consultation could help the pharmacy department to improve service efficiency ，provide a new perspective for medical institutions to carry out efficient pharmaceutical services ，and supply new ideas for the reform of pharmaceutical services in China .

Objective To evaluate the accuracy of respirophasic variation in carotid artery blood flow peak velocity(ΔVpeak-CA)in predicting fluid responsiveness in the patients undergoing surgery in the prone position. Methods Forty-three American Society of Anesthesiologists physical status Ⅰ-Ⅲ pa-tients of both sexes, aged 45-75 yr, with body mass index of 20-25 kg∕m2, scheduled for elective posteri-or approach lumbar surgery, were enrolled in the study.After induction of anesthesia, hydroxyethyl starch 130∕0.4 sodium chloride injection 7 ml∕kg was intravenously infused over 20 min when the patients were in the prone position.Subjects were classified as responders if stroke volume index increased≥15% after vol-ume expansion.The receiver operating characteristic curve for ΔVpeak-CA in determining positive fluid re-sponsiveness was drawn. Results The results of receiver operating characteristic curve analysis showed that: the cut-off value of ΔVpeak-CA in predicting positive fluid responsiveness was 7.94%, sensitivity 81.8%, specificity 70.0%, and the area under the curve(95% confidence interval)was 0.818 (0.378-0.757). Conclusion Respirophasic ΔVpeak-CA can accurately predict fluid responsiveness in the patients undergoing surgery in the prone position.

Objective: To study correlation between heart rate variability (HRV) and arteriosclerosis in patients with essential hypertension (EH).Methods: A total of 139 EH patients from our hospital were enrolled as EH group.According to carotid-femoral pulse wave velocity (PWV), they were divided into normal subgroup (n=65, PWV<9 m/s) and abnormal subgroup (n=74, PWV≥9 m/s).Another 60 healthy adults undergoing physical examination in our hospital during the same period were selected as healthy control group.HRV indexes, PWV, carotid intima-media thickness (IMT) and number of carotid plaques were compared among all groups.Correlation among above indexes were analyzed in EH patients.Results: Compared with healthy control group, there was significant reduction in standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording[SDANN, (142.3±21.4)ms vs.(119.3±16.5)ms], significant rise in low frequency[LF, (341.7±37.9)Hz vs.(695.4±43.3) Hz], high frequency[HF, (519.1±33.6) Hz vs.(636.8±39.5)Hz], LF/HF[(0.6±0.3) vs.(1.0±0.2)], PWV[(7.44±0.82) m/s vs.(11.13±0.65) m/s]and IMT[(1.03±0.24)mm vs.(1.74±0.41)mm]in EH group, P<0.01 all;in EH group, compared with normal PWV subgroup, there was significant reduction in SDANN, and significant rise in LF, HF, LF/HF, IMT and mean number of carotid plaques in abnormal PWV subgroup, P<0.05 or <0.01;Pearson correlation analysis indicated that in EH patients, PWV and IMT were significant inversely correlated with SDANN (r=-0.713,-0.699, P<0.01 both), significant positively correlated with LF, HF, LF/HF and carotid plaques (r=0.506~0.935, P<0.01 all), and PWV was significant positively correlated with IMT (r=0.883, P=0.001).Conclusion: In EH patients, SDANN, LF, HF, LF/HF of HRV are significantly correlated with arteriosclerotic extent.Besides lowering blood pressure , HRV etc.related with artery pathological changs should also be treated.

[Objective] To investigate the role SPAG5 play in ovarian adenocarcinoma cell mitosis,Taxol sensitivity and ovarian high grade serous carcinoma patients' prognosis.[Methods] Transient knockdown of SPAG5 in SKOV3 cell were performed,and MTT assay and cell cycle flow cytometry assay were carried out.IHC staining of SPAG5 protein in 110 high grade serous carcinoma patients' tumor tissues were performed,and the expression were analyzed with clinical data and prognosis.Finally,SPAG5 were knocked down in OVCAR3 A2780 and SKOV3 cells followed by 0.5μM Taxol treatment,MTT assay were performed to detect cell viability.[Results] SPAG5 knockdown inhibited cell mitosis of ovarian adenocarcinoma cell SKOV3 by G2/M arrest.High grade serous carcinoma patients after neoadjuvant chemotherapy gained the expression of SPAG5.Patients without neoadjuvant chemotherapy with low SPAG5 expression have poor progress free survival,especially in early stage patients.Patients with low SPAG5 expression also have poorer overall survival,but the difference was not statistically significant.Furthermore,SPAG5 knockdown in OVCAR3 A2780 and SKOV3 cells reduced Taxol sensitivity.[Conclusion] SPAG5 regulated cell mitosis and promoted cell proliferation in ovarian adenocarcinoma cell lines.Expression of SPAG5 in patients' tumor tissues predicted patients' prognosis and Taxol sensitivity.As the results,individualized treatment of high grade serous carcinoma patients is necessary.

OBJECTIVETo investigate the expression of CD33⁺ HLA-DR⁻ myeloid-derived suppressor cells (MDSCs) in the peripheral blood of patients with renal carcinoma and its correlation with the clinicopathological features of renal cancer.

METHODSForty-four patients with renal carcinoma treated in our hospital between June, 2011 and October, 2012 and 18 healthy volunteers were enrolled in this study. Flow cytometry was performed to detect CD33⁺ HLA-DR⁻ MDSCs in the peripheral blood, and its correlation with the clinicopathological features of the patients were analyzed.

RESULTSThe positivity rate of CD33⁺ HLA-DR⁻ MDSCs in the peripheral blood was significantly higher in the cancer patients than in the healthy controls [(1.91 ± 0.66)% vs (0.62 ± 0.22)%, P<0.001]. The expression levels of CD33⁺ HLA-DR⁻ MDSCs in patients with renal carcinoma showed significant differences between stage I+II [(1.46 ± 0.44)%] and stage III [(2.04 ± 0.35)%] patients (P<0.01) and between stage III and stage IV patients [(2.50 ± 0.64)%] (P<0.05), but did not differ significantly in respect of age or gender.

CONCLUSIONCD33⁺ HLA-DR⁻ MDSCs expression in the peripheral blood is associated with tumor stage and differentiation in renal carcinoma and may play an important role in predicting the prognosis and tumor immunology of renal carcinoma.

Adult ; Aged ; Case-Control Studies ; Female ; Flow Cytometry ; HLA-DR Antigens ; metabolism ; Humans ; Immunophenotyping ; Kidney Neoplasms ; blood ; immunology ; Male ; Middle Aged ; Myeloid Cells ; cytology ; metabolism ; Neoplasm Staging ; Prognosis ; Sialic Acid Binding Ig-like Lectin 3 ; metabolism ; Young Adult

Adult ; Angiomyolipoma ; diagnosis ; pathology ; Biopsy, Needle ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; Diagnosis, Differential ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; Male

Angiomyolipoma/diagnosis ; Angiomyolipoma/*pathology ; Biopsy, Needle ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/*pathology ; Diagnosis, Differential ; Liver Neoplasms/diagnosis ; Liver Neoplasms/*pathology

Objective To prepare the flurbiprofen orally disintegrating tablets and establish the procedures of controlling the quality.Methods Flurbiprofen orally disintegrating tablets was prepared by wet granulation and it content was determined by HPLC.Results The obtained tablets were fine in the shape and smooth in the surface.Their hardness was 2 kg,the disintegrating time was about 30 s.The linear correlation was in a range of 1.0-10.0 ?g/ml,r=0.999 9.The average recovery was 99.32%,RSD=1.09%(n=7).Conclusion Our methods of flurbiprofen orally disintegrating tablets are simple and feasible in preparation and quality control.

OBJECTIVE:To prepare collagen bilayer minipellet of recombinant human erythropoietin(rhEPO)and for which to establish a content determination method.METHODS:The bilayer minipellet was prepared and shaped by pressuriz-ing gel with the collagen protein as coating material and the sodium chondroitin sulfate as releasing moderator;the content of rhEPO in minipellet was determined by RP-HPLC.RESULTS:The linear range of rhEPO was0.25～20?g/ml(r=0.9998),the average recovery rate was96.2%,the intraday RSD was0.9%and the interday RSD was2.6%(n=3).CONCLUSION:The preparation for the rhEPO bilayer minipellet is easy and the content determination method of which is accurate and reli-able.