OBJECTIVE:To provide reference for improvement in drug pricing and administration in China.METHODS:Drug pricing policy and administration mechanism in European countries were compared,and the successful experience was summarized.RESULTS &CONCLUSION :It is suggested that drug pricing policy in China should be improved to establish the dynamic modulating mechanism and classified administration for drug price.

Objective To compare the clinical features of patients with myasthenia gravis at various age groups,and to evaluate the therapeutic effects of acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid and acetylcholinesterase inhibitor plus thymectomy in children,young adults,and elderly patients with myasthenia gravis (MG).Methods The clinical data of 300 MG patients admitted to the department during the same period were reviewed retrospectively.The patients with MG were divided into three groups based on the age of disease onset:childhood group (age≤14,n=77),young adult group (age=15～59,n=183) and elderly group (age≥60,n=40).The clinical features of MG patients in various age groups were compared including the incidence,sex ratio,initial symptoms,clinical classification,positive rates of neostigmine test and repetitive nerve stimulation,and thymic abnormalities.Furthermore,the therapeutic effects of acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid,and acetylcholinesterase inhibitor plus thymectomy were investigated.Results The most common ages of MG onset were ranged from 15 to 59 years (young adults group).With increase in age,the incidence of MG lowered in females,while in males it became higher.Extra ocular muscles involvement as the initial symptom was higher in children and elderly patients than in young adults.The limb muscles involvement as the initial symptom was more common in young adults group.About 72.73% patients in childhood group were classified as type Ⅰ,while type ⅡB was the most commonly seen in young adults group (55.74%) and elderly group (50.00%).No significant difference was found among the three groups in the positive rates of neostigmine test and repetitive nerve stimulation.In childhood group,hyperplastic thymus was commonly observed,while thymoma was more common in elderly group.The therapeutic effects of acetylcholinesterase inhibitor alone were better in childhood group than in the other 2 groups (P0.05).The therapeutic effect of acetylcholinesterase inhibitor plus thymectomy was most satisfactory in childhood group,less satisfaetory in elderly group and paorest in young adults group ( P

OBJECTIVE:To evaluate the medical cost of capectabine in treatment of advanced rectocolonic carcino?ma.METHODS:The characteristics of therapeutic effect and medical cost were compared between capectabine and classical MAYO program.RESULTS&CONCLUSION:The capectabine is more expensive than traditional drugs,however,in terms of medical resource,the saving medical cost in use of capectabine would counterbalance the expensive price of drug to maxium limit.The medical cost of capectabine is superior to that of traditional drugs.

Objective To investigate the clinical features of multiple myeloma (MM) complicated by extramedullary plasmacytomas(EM). Methods Twenty five patients were enrolled into the study. The proportion male to famale was 15:10 and the median age 55. 2 years. The distribution of different isotypes was IgA ten, IgG nine and light chain λ five. The sites of complicating plasmacytoma included muscle, bone, skin, rectum, and testicles. The most common site was muscle. Results Patients with complicated extramedullary plasmacytomas at the time of diagnosis received traditional treatment, including vincristiuum, adriamycin, dexamethasonum, mephalan, presnisone, thalidomide and bortezomib. Rates of overall response (ORR) were 80%. Plasmacytomas occurring after the diagnosis of MM received cisplatin, etoposide, cyclophosphamide, presnisone, or bortezomib ORR were 66. 7% ,50. 0%. Conclusion These results lend support to the efficacy of bortezomib in the treatment of plasmacytoma. MM cases with unconventional disease recurrence are likely to be seen due to sub-clinical seeding of turnout cells suggestive of the presence of an EM clone of plasma cells with a high degree of chemoresistance. Available data in the literature concerning the optimal therapy for patients with EM relapse were reviewed.

Objective To analyze the clinical characteristics of myasthenia gravis(MG) associated with thyroid abnormalities.Methods A total of 300 MG patients admitted to the department of neurology from July 2008 to September 2009 were reviewed retrospectively.Based on the thyroid function and abnormality of thyroid related antibodies (thyroglobulin antibody and peroxidase antibody), the patients with MG were divided into two groups (260 cases without thyroid disease and 40 cases with thyroid abnormalities).The different clinical features, the relationship between the antithyroid antibodies and antiacetylcholine receptor antibody (AChRAb) and the distribution of T cell subsets between the two groups were compared.Results ( 1 ) Among the 300 MG patients, 13.3% of them was accompanied with thyroid disease and the most common abnormality was positive thyroid antibody.(2) Between the groups of MG with and without thyroid abnormalities, no significant differences on the sex percentage, age of onset, duration of disease, clinical classification and thymic abnormalities were found ( P ＞ 0.05 ).( 3 ) The blood levels of AChRAb in postsynaptic membrane in the thyroid antibody-positive patients were 1.15 ± 0.11, being much higher than those in the antibody-negative patients ( 1.01 ±0.11 ).(4) The percentage of CD8+ T cells was significantly decreased [(21.63 ±5.17)% vs (24.28 ±5.79)%] and the ratio of CD4+/CD8+ T cells was increased (2.10 ± 0.67 vs 1.81 ± 0.61, P ＜ 0.05 ) in the group of MG with thyroid abnormality as compared with the group of MG with normal thyroid.Conclusion In MG patients the incidence positive thyroid related antibodies was much higher than that of other thyroid abnormalities.It is suggested that there are higher levels of AChRAb in MG coexisting with positive thyroid antibodies and more abnormalities of T lymphocyte subset distribution in MG patients with thyroid disease.

Child ; Humans ; Infant ; Spasms, Infantile ; genetics ; Syndrome

Systemic inflammatory response has a major role in the development and progression of cancer,and increased systemic inflammatory response usually correlates with poorer survival.Recently the evaluation index of systemic inflammatory response including neutrophil-lymphocyte ratio,C-reactive protein,glasgow prognostic score,platelet-lymphocyte ratio.Several previous studies show that these indexes are the independent prognostic factors for esophageal cancer.Research on the systemic inflammatory markers may also be valuable for the clinical treatment and prognosis of esophageal cancer.

Aim To establish a cell model heterologously expressing Kir6.x and SUR subunits of K_(ATP)channels and to study the selectivity of iptakalim on different subtypes of K_(ATP) channels.Methods Cell were transfected with the pcDNA vector containing the coding sequenced of Kir6.x and SUR using liposome and the pEGFP-N1 vector encoding for green fluorescent protein was added for easy identification of transfected cells.Using immunocytochemical technique,we detected the expression of Kir6.x and SUR protein in[FL(2K2]transfected cells.The electrophysiological experiment was performed after transfection 48-72 h.In whole cell configuration,the effects of K_(ATP) channel openers iptakalim,pinacidil and diazoxide on the clone currents in transfected HEK-293 cells and the antagonism of K_(ATP) channel inhibitor glibenclamide were evaluated.Results Immunocytochemical study identified the expression of Kir6.x and SUR protein in transfected cells.The electrophysiological experiment showed that in cells with recombinant expression of the Kir6.1/SUR2B channel complex,iptakalim(100 ?m),pinacidil(100 ?m)and diazoxide(200 ?m)significantly increased the clone current from(-88.0?30.8) pA to(-2042.6?127.3) pA,(-1431.9?142.4) pA and(-1104.7?228.9) pA,respectively,at-100 mV,and the actions were inhibited by glibenclamide(10 ?m).In cells expressed with Kir6.2/SUR2A channel,both iptakalim and pinacidil activated the currents,which was sensitive to glibenclamide.While diazoxide had no effects on the clone currents.In contrast,in cells with Kir6.2/SUR1channel,diazoxide increased the activity of recombinant K_(ATP) channels,while iptakalim and pinacidil had little effects.Conclusion From these observations,the effects of K_(ATP) channels openers with different chemical structures on the subtypes of K_(ATP) channels were diverse.Iptakalim showed selective action on Kir6.1/SUR2B and Kir6.2/SUR2A,but not Kir6.2/SUR1 K_(ATP) channels

Objective To observe the neuroprotective effect of arcaine,an antagonist of receptor of N-methyl-D-aspartate(NMDA) and(or) channel complex polyamines site,on cerebral ischemia.Methods Forty-five Wistar rats were randomly divided into 5 groups: control group,ischemia model group,24h preoperative group,1h preoperative group and 1h postoperative group.Acute cerebral infarction model was reproduced in rats of the latter four groups with middle cerebral artery occlusion(MCAO) using ligature method.Once the ischemia model was successfully established,rats in the latter three ischemia model groups were given arcaine(3mg/kg) at 24h and 1h before operation and 1h after operation,respectively,while normal saline(0.4ml/kg) was injected to the rats in the control group.Neurological function behavior and cerebral infarct volume were assessed,and pathological features of brain tissue were observed under light-and electron microscope.Results Neural function scores of the rats in 24h preoperative group,1h preoperative group and 1h postoperative group were 1.25?0.46,1.33?0.50 and 1.40?0.58,respectively,which were significantly different from that in ischemia model group(2.63?0.52,P

This article introduces the experience of CHEN Ying-yi, chief physician and one of the teacher of the fourth group of inheriting academic experience of veteran TCM experts of China, in treating perimenopausal women’s dysfunctional uterine bleeding. Chen holds that the basic pathogenesis of perimenopausal dysfunctional uterine bleeding is kidney deficiency with fever or stagnation. Treatment should focus on replenishing kidney and using the traditional Chinese drug by stages. The methods of stopping bleeding, clearing origin and reinstating the status quo are used flexibly. In clinic, it should grasp the key points of syndrome differentiation, and modify the therapy in accordance with the symptoms. Validated by clinical application, Chen’s experience has satisfactory curative effect and reference values for the treatment of perimenopausal women’s dysfunctional uterine bleeding.