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Pharmacy services in grassroots medical institutions provide professional pharmacy services for patients. This service not only expanded the scope of primary care delivery, but also meets the residents′need for appropriate medication. At present, the majority of grassroots medical institutions in China provide outpatient pharmacy services by means of pharmacy service alliance, and foreign grassroots medical institutions mainly provide pharmaceutical outpatient services with drug treatment management as the core for patients by granting pharmacists partial prescription rights.In recent years, pharmaceutical outpatient services in grassroots medical institutions had achieved good results in improving patient clinical outcomes, enhancing medication rationality, and enhancing patient compliance. However, there were many unresolved issues, including low public awareness, shortage of pharmaceutical talents, and imperfect guarantee systems. The author suggestted that efforts should be made to increase the publicity of pharmaceutical outpatient services, improve the training mechanism for pharmacists, strengthen cooperation between pharmacists and clinical physicians, include pharmacists in the contracted service team of family doctors, and improve various guarantee systems, in order to provide reference for promoting the sustainable development of pharmaceutical outpatient services in grassroots medical institutions in China.
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Objective@#To observe the plaque surface morphology and neo-vascularization within the plaque using superb microvascular imaging(SMI)and contrast-enhanced ultrasound(CEUS), and to compare the correlation and consistency of the two technologies based on making clinical diagnosis of symptomatic carotid artery plaque as the standard.@*Methods@#A total of 92 patients undergoing carotid ultrasonography in Beijing Tiantan Hospital from August 2016 to October 2017 were recruited, including 61 males and 31 females, aged(63.5 ± 7.7)years(range, 42-80 years.A total of 105 plaques were found.According to whether or not to have plaque-induced ipsilateral ischemic symptoms, patients were divided double-blindly into the symptom group and the non-symptom group.The features of plaque(including surface morphology and neo-vascularization)were recorded.The ultrasonographic findings were chi-squarely tested.@*Results@#There were statistically significant differences in the surface morphology and enhancement degree of CEUS between carotid artery plaque-induced ischemic symptom group and the non-symptom group(χ2=6.865, P=0.032; χ2=22.494, P<0.001). The SMI-detected surface morphology and neo-vascularization had statistically significant differences between the two groups(χ2=10.367, P=0.006; χ2=8.186, P=0.041). The correlations of plaque surface morphology(r=0.856, P<0.001)and diagnostic consistency(r=0.802, P<0.001)between SMI and CEUS were higher.In the symptom group, SMI-showed plaque fissures and small surface pitting were in 33.9%(20/59)of patients, and CEUS-showed plaque fissures and small surface pitting were in 25.4%(15/59)of patients.And SMI had a better detection rate of slight and irregular appearances on plaque surface.Taking the first grade of the plaque surface as the standard, CEUS showed a sensitivity of 42.4% and specificity of 80.4% for detecting symptomatic plaques, and SMI showed a sensitivity of 54.2% and specificity of 76.1%.The two methods had similar specificity, and SMI had a slightly higher sensitivity than did CEUS.CEUS and SMI had a good correlation of plaque neo-vascularization(r=0.802, P<0.001)and a moderate diagnostic consistency(r=0.539, P<0.001). Taking the enhancement level of 2 as the standard, CEUS showed a sensitivity of 75.8% and specificity of 67.4% for detecting the symptomatic plaque, and SMI showed a sensitivity of 58.6% and specificity of 69.5%.The two methods had similar specificity, and CEUS had a higher sensitivity than did SMI.@*Conclusions@#SMI and CEUS have a good consistency for detecting plaque surface morphology.SMI and CEUS are more correlated with plaque-induced symptoms than is two-dimensional ultrasound.The SMI has a higher display rate and repeatability than does CEUS for detecting the small fissures and the surface features of plaques.Compared with SMI-detected neo-vascularization, the degree of CEUS enhancement is more correlated with the symptoms.The specificity of CEUS and SMI is similar, and the sensitivity of CEUS is higher than that of SMI.
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Objective To observe the plaque surface morphology and neo-vascularization within the plaque using superb microvascular imaging(SMI) and contrast-enhanced ultrasound(CEUS),and to compare the correlation and consistency of the two technologies based on making clinical diagnosis of symptomatic carotid artery plaque as the standard.Methods A total of 92 patients undergoing carotid ultrasonography in Beijing Tiantan Hospital from August 2016 to October 2017 were recruited,including 61 males and 31 females,aged(63.5 ± 7.7) years(range,4 2-80 years.A total of 105 plaques were found.According to whether or not to have plaque-induced ipsilateral ischemic symptoms,patients were divided double-blindly into the symptom group and the non-symptom group.The features of plaque (including surface morphology and neo-vascularization) were recorded.The ultrasonographic findings were chi-squarely tested.Results There were statistically significant differences in the surface morphology and enhancement degree of CEUS between carotid artery plaque-induced ischemic symptom group and the non-symptom group(x2 =6.865,P =0.032;x2 =22.494,P ＜ 0.001).The SMI-detected surface morphology and neo-vascularization had statistically significant differences between the two groups (x2 =10.367,P =0.006;x2 =8.186,P =0.041).The correlations of plaque surface morphology(r =0.856,P ＜ 0.001)and diagnostic consistency(r=0.802,P＜0.001)between SMI and CEUS were higher.In the symptom group,SMI-showed plaque fissures and small surface pitting were in 33.9 ％ (20/59) of patients,and CEUS-showed plaque fissures and small surface pitting were in 25.4％ (15/59)of patients.And SMI had a better detection rate of slight and irregular appearances on plaque surface.Taking the first grade of the plaque surface as the standard,CEUS showed a sensitivity of 42.4％ and specificity of 80.4％ for detecting symptomatic plaques,and SMI showed a sensitivity of 54.2 ％ and specificity of 76.1％.The two methods had similar specificity,and SMIhad a slightly higher sensitivity than did CEUS.CEUS and SMI had a good correlation of plaque neo-vascularization(r =0.802,P ＜ 0.001)and a moderate diagnostic consistency(r=0.539,P ＜0.001).Taking the enhancement level of 2 as the standard,CEUS showed a sensitivity of 75.8 ％ and specificity of 67.4 ％ for detecting the symptomatic plaque,and SMI showed a sensitivity of 58.6％ and specificity of 69.5％.The two methods had similar specificity,and CEUS had a higher sensitivity than did SMI.Conclusions SMI and CEUS have a good consistency for detecting plaque surface morphology.SMI and CEUS are more correlated with plaque-induced symptoms than is two-dimensional ultrasound.The SMI has a higher display rate and repeatability than does CEUS for detecting the small fissures and the surface features of plaques.Compared with SMI-detected neo-vascularization,the degree of CEUS enhancement is more correlated with the symptoms.The specificity of CEUS and SMI is similar,and the sensitivity of CEUS is higher than that of SMI.
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Objective To investigate the correlation between intraoperative ultrasonographic features and expression of immunohistochemical markers in patients with glioma.Methods Totally 116 patients with glioma confirmed pathologically were collected.Ultrasonic features were observed,including the main site of the tumor,maximum diameter,border,cystic degeneration,calcification,the degree of peritumoral edema and CDFI blood flow classification,and the correlation between ultrasonographic features and immunohistochemical results such as Ki-67 and isocitrate dehydrogenase 1 (IDH1) was analyzed.Results Univariate analysis showed that the border,peritumoral edema and CDFI blood flow were significantly different between negative and positive Ki-67 expression patients (P＜ 0.01).The border,cystic degeneration and peritumoral edema were distinct between negative and positive IDH1 patients (P＜0.01).Multivariate analysis showed that gliomas with clear border,high degree of peritumoral edema and rich CDFI blood flow tended to show positive Ki-67 expression,while those with vague border,low degree of peritumoral edema were frequently accompanied by positive IDH1 expression.Conclusion The border of gliomas,peritumoral edema and blood flow showed on ultrasonography may predict the expression of Ki-67 and IDH1.It is of great significance for preliminary evaluation on biological behaviors and prognosis of the tumors before surgical operation.
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Yes-associated protein (YAP) is a multifunctional protein that can interact with different transcription factors to acti-vate gene expression. YAP, as the key transcription protein of Hippo pathway, has made important contribution to the control of the or-gan size, stem cell biology, and tissue-specific stem cell self-renewal. In the Hippo pathway, MST1/2 kinases, together with the adaptor protein SAV, phosphorylate LATS1/2 kinases. YAP is phosphorylated and inhibited by the activated LATS1/2, a key component of the Hippo tumor suppressor pathway. In recent years, numerous studies have shown that the high expression of YAP in the embryonic stem cells, neural stem cells, and hematopoietic stem cells can maintain the cancer stem cell;and YAP has become the marker of cancer stem cells. Meanwhile, more and more studies indicate that the disorder of Hippo-YAP signaling pathway may be associated with cancer stem cells. In this review, we mainly discuss the role of the Hippo pathway in the stem cell biology and its potential implications in tis-sue homeostasis and cancer.
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Objective To investigate the diagnostic value of human leukocyte antigen (HLA )-B27 for ankylosing spondylitis (AS) .Methods 2 768 patients with suspected AS were enrolled ,including 600 patients with confirmed AS .Flow cytometry was performed to detect blood HLA-B27 .Results Among 2 768 patients with suspected AS ,598(21 .6% ) patients were found HLA-B27 positive and 2 170(78 .4% ) patients negative .Difference of HLA-B27 positive rates between male and female patients was sta-tistically significant(P< 0 .05) .HLA-B27 positive rate of patients aged 20 - < 40 years was significantly higher than the others (P<0 .05) .Among 600 patients with confirmed AS ,536 cases(89 .3% ) was found HLA-B27 positive .Conclusion HLA-B27 de-tection combined with clinical manifestations contribute to early diagnosis of AS .
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Objective:This study aims to investigate the protein expression of coxsackie-virus and adenovirus receptor (CAR) in partial subtypes of pulmonary adeno-carcinoma, as well as its expression with clinico-pathological factors and prognosis. Methods:CAR expression was immunohistochemically assessed in 137 cases of lung cancer with bronchiole-alveolar carcinoma (PWBF) fea-tures, and analyzed in relation to various clinico-pathological parameters. All data were analyzed using SPSS statistics software, and Ka-plan-Meier survival curves were constructed. A Log-rank test was also conducted. Results: The CAR positive rates in PWBF, other types of lung cancer, and normal lung tissue were 71.5%, 50.0%, and 13.3%, respectively. The difference was statistically significant (P<0.05). In addition, a statistically significant difference was observed between the positive expression of CAR and other clini-co-pathologic parameters, such as pathological type and histological differentiation. No statistical significance was observed in other pa-rameters, such as gender, age, smoking, and tumor diameter. Patients with CAR positivity were characterized by longer survival times than the others;however, this difference did not reach statistical significance. Conclusion:CAR is related to the occurrence and devel-opment of lung cancer, especially PWBF. The higher expression of CAR in PWBF for gene therapy with adenovirus vectors opened a broader space. The conspicuous regulation of CAR may be reliable evidence and may bright future for the gene therapy of other types of lung cancer.
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<p><b>OBJECTIVE</b>To explore the expression of Bcl-2 mRNA and its effect on prognosis of patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL).</p><p><b>METHODS</b>Real time quantitative PCR was used to determine the expression of Bcl-2 mRNA in 40 PGI-DLBCL patients and 17 healthy controls. The association of Bcl-2 expression with clinicopathological features and prognosis of the patients was analyzed.</p><p><b>RESULTS</b>The expression level of Bcl-2 mRNA in PGI-DLBCL patients was 1.03 ± 0.93, significantly higher than that of the controls (0.41 ± 0.21) (P < 0.05). The expression of Bcl-2 mRNA in stage IIE-IV patients (1.28 ± 1.01) was significantly higher than that in the stage I-II2 patients (0.62 ± 0.61) (P < 0.05). The expression of Bcl-2 mRNA in patients with international prognostic index (IPI) score >2 (1.95 ± 1.27) was significantly higher than those with IPI score ≤ 2 (0.86 ± 0.75)(P < 0.05). The expression of Bcl-2 mRNA in patients with complete remission (CR) (0.71 ± 0.58) was significantly lower vs. 2.42 ± 0.91 in patients with no CR (P < 0.05). Univariate analysis indicated that β2-MG, IPI score>2, the Lugano staging, and Bcl-2 mRNA expression were associated with overall survival (OS) and progression-free survival (PFS) (P < 0.05). Multivariate analysis indicated that IPI score>2 was independently associated with OS (P < 0.05), and both IPI score >2 and Bcl-2 mRNA expression were independently associated with PFS (P < 0.05).</p><p><b>CONCLUSIONS</b>The expression of Bcl-2 mRNA in the tumor tissue of PGI-DLBCL patients is significantly higher than that in controls. PGI-DLBCL patients with higher expression of Bcl-2 have a poor chemotherapy response and inferior prognosis. IPI score >2 and higher expression of Bcl-2 mRNA are independent poor prognostic factors for PFS in PGI-DLBCL patients.</p>
Subject(s)
Humans , Disease-Free Survival , Genes, bcl-2 , Lymphoma, B-Cell , Diagnosis , Genetics , Metabolism , Lymphoma, Large B-Cell, Diffuse , Diagnosis , Genetics , Metabolism , Prognosis , Proto-Oncogene Proteins c-bcl-2 , Genetics , MetabolismABSTRACT
Through five experiments, such as "Circle", "square", "side that does not shake", "burning edge", "filter", this paper discussed the effect of different experimental methods of polypropylene fiber liquid filtration membrane particles shedding. The results show that: the particles falling off the edge of the polypropylene fiber Double-sided liquid filtration membrane are very important and must be considered off the evaluation of particle pollution.
Subject(s)
Equipment Failure , Filtration , Methods , Particle Size , PolypropylenesABSTRACT
Compare and analyze the standards related to centrifuge apparatus and make corresponding suggestions in allusion to the problems existed in the test method and physical performance during product standard drafting process.
Subject(s)
Blood Component Removal , Centrifugation , Reference Standards , Device Approval , Reference StandardsABSTRACT
Vascular Endothelial Growth Factor Receptor-2(VEGFR-2) plays an important role in stimulating the proliferation of endothelial cells and improving the permeability of blood vessel. We prepared recombinant extracellular domain 3 (KDR3) of human vascular endothelial growth factor receptor-2 in Escherichia coli and studied its specific binding activity with its ligand. The target DNA was synthesized by overlapping PCR, ligated with expression vector p-ET32a and transformed into E. coli Rosetta (DE3). The soluble fusion protein Trx-KDR3 was expressed in cytoplasm, which was up to 20% of total soluble protein in cytoplasm after having been induced by 1 mmol/L IPTG for 5 h at 30 degrees C. It was characterized to be target protein by Western blotting. The product was purified by CM cation exchange resin and immobilized metal affinity chromatography(IMAC). Its VEGF-binding activity was determined by ELISA assay and its influence on the propagation of HUVEC induced by VEGF. The protein product showed high ligand binding activity in the ELISA and HUVEC propagation study compared to the control. Therefore, ligand binding active, soluble recombinant extracellular domain 3 of VEGFR-2 KDR was successfully expressed and purified in E. coli, which would be applied to anti-angiogenesis anti-tumor therapy and anti-KDR antibody development.