The Risk-sharing agreements have achieved remarkable success in improving patients'access to drugs, lowering the uncertainty of the drugs cost-effectiveness, financial risk control and other aspects of medical in-surance fund , so they have attracted widespread attention by the concerned governments and insurers .This paper sys-tematically reviewed the patient access schemes in UK from several aspects , including the origin of the program , clas-sification , application processes and the implementation effects as well .The results of the research indicated that Chi-na has basically met the conditions for implementation of the risk-sharing agreements .In order to gradually promote the risk-sharing agreements implementation , this paper suggests that China should clarify the main root of risk-sharing agreements implementation , establish risk-sharing agreements standardization process and strengthen the application of health technology assessment in health resources allocation to improve the Chinese medicines bargaining system more scientifically and efficiently .

Objective To investigate the treatment of noninvasive ventilator in chronic obstructive pulmonary disease merge chronic type Ⅱ respiratory failure and to analysis its clinical efficacy and safety.Methods According to the random number table,115 cases were randomly divided into two groups,the observation group (n =59)and the control group(n =56).The control group received conventional symptomatic treatment,while the observation group therapy was combined with non -invasive ventilation in the basis of the control group.The changes of HR,RR, PaCO2 ,PaO2 ,Forced expiratory volume in one second 1 (FEV1 ),Forced expiratory volume in one second 1 (Forced expiratory volume in one second 1,FEV1 /FVC)were compared between the two groups before and after treatment 48h.Results Before treatment,there were no significant differences in HR,PaCO2 ,RR,FEV1 ,PaO2 ,FEV1 /FVC (P >0.05).After the treatment,in the control group,HR,RR,PaCO2 ,PaO2 ,FEV1 and FEV1 /FVC were respectively (90.16 ±4.15)beats/min,(23.17 ±1.63)beats/min,(59.68 ±5.85)mmHg,(69.16 ±5.26)mmHg,(2.65 ± 0.25)L and(65.47 ±1.97)%.In the observation group,HR,RR,PaCO2 ,PaO2 ,FEV1 and FEV1 /FVC were respectively (82.93 ±3.76)beats/min,(19.02 ±1.57)beats/min,(50.82 ±6.53)mmHg,(78.06 ±5.48)mmHg,(2.96 ± 0.31)L and (72.38 ±2.15)%.The difference was statistically significant(t =9.800,13.907,7.649,8.877,5.917, 17.942,all P <0.05).No adverse reactions occurred during the treatment.Conclusion The clinical efficacy of non-invasive ventilator in the treatment of COPD associated with chronic type Ⅱ respiratory failure is significant,safe and reliable,which has important research value,and is worthy of further application.

Objective To investigate the efficacy of electrochemotherapy with pingyangmycin (bleomycin A5) for the treatment of human prostate cell line PC 3M in vitro. Methods The prostate cancer cells were treated by pingyangmycin alone, electric pulse alone and by electrochemotherapy, i.e. electric pulses were delivered after pingyangmycin was given. Cytotoxicity was examined by MTT assay and histological examination. Results The maximum nontoxic dose for pingyangmycin was 0.1 ?g/ml; The maximum voltage not showing cytotoxicity was 125 V/mm.The 50% inhibitory concentration was 100 times reduced in electrochemotherapy than pingyangmycin alone. Conclusions The cytotoxicity of pingyangmycin can be enhanced by electric impulses. Pingyangmycin may be a novel drug for electrochemotherapy.

Objective To investigate the therapeutic mechanism of dexamethasone in hyperoxia-induced lung injury. Methods Use bronchoalveolar lavage (BAL) method to gain alveolar macrophages (AM) from newborn SD rats. AM were adherence purified for 24 hours, then randomly assigned to four groups: Ⅰ. hyperoxia group, Ⅱ. hyperoxia plus LPS group, Ⅲ. hyperoxia plus dexamethasone group, Ⅳ. hyperoxia plus LPS plus dexamethasone group. Every group contains 7 samples. After cultured for 48 hours, supernatants were harvested. L-lactate dehydrogenase (LDH) activity? hydrogen peroxide (H 2O 2) and IL-8 contents of supernatants were examined in all groups. Results (1)48 h after culture, the content of IL-8 in groupⅠandⅡwas (46?15)pg/ml?(145?27)pg/ml respectively, in groupⅢandⅣwas(29?4)pg/ml?(39?8)pg/ml respectively, IL-8 content was decreased in group Ⅲ and Ⅳcompared with group Ⅰand Ⅱ(P

Objective To investigate the therapeutic effect of different doses of caffeine on premature apnea.Methods 80 patients with apnea were divided into observation group and control group,each group in 40cases.The two groups applicated caffeine citrate.The control group received the basal dose, first application of 20 mg/kg, intravenous injection, intravenous injection of 5 mg/kg after 24 h.The observation group was treated with intravenous injection of 10 mg/kg after 24 h.The treatment period was 7 d.The therapeutic effect, blood gas and oxygenation index and adverse reactions were observed in the two groups.Results The effective rate of the observation group was 92.5%,which was significantly higher than 75.0% of the control group(x2=4.501,P<0.05).After treatment, the duration[(9.05±1.82)s vs (13.53±2.63)s]and lost time[(2.52±0.94)h vs (3.42±1.13)h]of apnea in the observation group were longer than those of the control group.The number of seizures[(22.15±4.16) vs (33.53±8.48)]was less than that of the control group,the differences were statistically significant(t=8.767,5.434,9.231,all P<0.05).After treatment, PaO2[(84.74±9.74)mmHg vs (71.46±8.53)mmHg],PaCO2[(42.62±4.15)mmHg vs (48.54±5.18)mmHg]and PaO2/FiO2[(221.52±26.51)mmHg vs (197.76±21.71)mmHg]in the observation group were significantly better than those of the control group(t=7.574,4.765,8.643,all P<0.05).The incidence rate of adverse reactions include tachycardia, hyperglycemia, hypoglycemia and restlessness had no significant difference between the two groups (15.0% vs 10.0%, P>0.05).Conclusion In the treatment of premature apnea, advanced caffeine citrate treatment can better improve the clinical symptoms and blood gas index, the curative effect is reliable.

Objective To investigate the therapeutic effects of two parenteral nutrition (PN)methods in preterm infants. Methods Forty-two preterm infants who could not tolerate full enteral feeding were randomly divided into two groups. Twenty-two cases of the experimental group started to receive amino acids (AA) by 1.0 g/(kg·d) within 24 h after birth. Then AA was increased by 1.0 g/(kg·d)each day to maximum of 3.0 g/(kg·d)The dose and add method of intralipid was given alike AA within 48 h. Complete PN was achieved 5 d after birth. Twenty cases of the control group started to receive AA by 0. 5 g/(kg·d) ,and then increased by 0. 5 g/(kg·d) each day to maximum of 3.0 g/(kg ·d). The dose and add method of intralipid was given alike AA after 72 h. Complete PN was achieved at 8 or 9 d after birth. The feeding results was observed,the blood biochemistry was monitored at 72 h and 10 d after birth,and the incidence of complication was recorded. Results In comparison with the control group, time returning to birth weight, the weight loss rate, PN time and time returning to full enteral feeding were shorter in the experimental group (P ＜0. 01). There were no significant differences in the blood glucose,total bilirubin, urea nitrogen,carbon dioxide combining power,total cholesterol and the incidence of complication between the two groups (P ＞ 0. 05). Conclusion Quantity sufficient and early parenteral nutrition can be tolerated by preterm infants within 24 h after birth.

The DNA copy-number variant (CNV) is a kind of segments of DNA ranging from 1 kb to 3 Mb that is present in a variable number of copies.CNVs widely distribute across the human genome,and dramatically increases genetic diversity.In recent years,researches have found that most CNVs are closely related to complex diseases.If a cancer gene is directly encompassed or overlapped by a CNV,it may lead to activation of oncogenes or inactivation of tumor suppressor genes,and finally results in tumorigenesis.CNVs can affect gene expression,phenotype differences and phenotypic adaptations by changing gene dosages and gene activities,and then sequentially lead to tumor or any other genetic dieases.Investigating CNVs is apparently helpful for studing chromosome recombination,genomic evolution,gene expression and the pathogenesis of multiple complex diseases especially tumor.

AIM: To investigate the effects of pioglitazone on corneal neovascularization(CNV)induced by alkali burnin rats and on expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF).METHODS: CNV was induced by alkaline burn in rats which were then administered pioglitazone subconjunctivally.Corneal angiogenesis was evaluated and observed with a slit lamp microscope and the VEGF and b-FGF level were determined by immunohistochemistry and Western blot at different intervals.RESULTS: The CNV of the rats was shown two days after alkaline burn, and reached its highest level in 7-10 days. The mean values of the area and length of neovascularization and the VEGF and b-FGF levels in the pioglitazone-treated group were significantly lower than those in the control group at various time.CONCLUSTON: Local application of pioglitazone could remarkably inhibit CNV, probably by means of downregulation of VEGF and b-FGF expression.

Objective To compared the condition of DSA and MRA for detection the lesion vessels in elder patients with recurrent ischemic cerebrovascular disease(ICVD).Methods 52 patients with ICVD,including 41 cases of cerebral infarction(CI) and 11 cases of transient ischemic attack(TIA) were detected by DSA,and the 44 cases of them were detected by MRA too.Results The vascular anomalies were detected in 43 cases(82.69%) of the 52 patients by DSA.Among them,39 cases(75%) had vascular stenosis,in which 31 cases(75.61%) were CI,and the other 8 cases(72.73%) were TIA.The aneurysm were founfd out in 2 cases,and vascular dysplasia and variation were also found in each 1 case by DSA.The vascular stenosis were found in 10 cases(22.73%) of 44 patients by MRA,in which 8 cases(18.18%) were CI,while 2 cases(4.55%) were TIA.The detection rate of lesion vessels in DSA was significantly higher than that in MRA(P