Objective To explore the clinical effect of anterior combined with posterior fixation and vertebra reconstruction for unstable lumbar burst fracture via small incision alone posterior median line.Methods This study was based on 40 patients suffering from unstable lumbar burst fracture,who underwent anterior combined with posterior fixation and vertebra reconstruction.All the patients were followed up for 1～2 years.The shape and the function of spinal column were estimated in preoperative stage,postoperative stage and the duration of following.The data in the formal 3 stages were compared.Results Between the preoperative and postoperative data,there were statistically significant differences in the Cobb's angle,angle of kyphosis,anterior height of the fracture vertebral body,sagittal index and JOA scores(t=34.085,31.604,27.988,23.798,31.834,all P＜0.05).But no similar result was detected between the postoperative data and the data during the following(P＞0.05).Conclusion Anterior combined with posterior fixation and vertebra reconstruction via small incision had a significant effect in unstable lumbar burst fracture,and it was worthy of further study and clinical popularization.

The clinical data of 22 cases with gastrointestinal stromal tumors were retrospectively analized.The main clinical manifestations were gastrointestinal bleeding (14/22),abdominal discomfort (5/22) and abdominal lump (3/22),stomach was the most common site of the tumor (14/22).All 22 cases underwent surgical treatment and pathological examination confirmed that 12 cases were benign.Immunohistochemical results showed that 68% cases were negative in solubility acid protein-100 (S-100),and the positive rates of tyrosine-protein kinase acceptor 117 (CD117),hemopoietic stem cell antigen 34 (CD34) and negative rate of smooth muscle actin (SMA) were all 73%.Eighteen cases were followed up for 1-5 years after operation,among them 3 died.The survival was closely related to the size,the pathological characteristics and the recurrance of the tumor as demonstrated by multivariate Cox regression analysis.Since gastrointestinal stromal tumor has no specific clinical manifestations,preoperative diagnosis is difficulty,so surgical resection and subsequent pathological examination is used for confirmation of diagnosis,as well as treatment of the disease.

Most studies show that the blood transfusion can promote patients tumor recurrence, and lower their 5-year survival rate. Even patients in the early phase, a small amount of blood transfusion has significant effect. Blood transfusion causing tumor recurrence may be due to that blood transfusion recipients suppressed immune function, resulting in rapid growth of residual tumor cells. In this paper, blood transfusion for patients with tumors will be discassed. induding the benefit and danger of blood transfusion autotransfusion and blood substitutes for patients with tumors ,and development of transfusion medicine in our country.

OBJECTIVE:To discuss the measures for diversified development of pharmaceutical retail chain stores in Chi-na.METHODS:The current problems existing in pharmaceutical retail chain stores were discussed,and the measures were put forward on the basis of these problems.RESULTS&CONCLUSION:Brand diversification is the only route of development for pharmaceutical retail chain stores in China,to which diversification in drug sales is a most supplement,and creativity is the source of diversification.

ObjectiveTo compare the clinical efficacy of surgical treatment and non-surgical treatment of humerus surgical neck fracture for elderly patients. Methods106 elderly patients who were diagnosed of fracture of surgical neck of humerus were selacted as the research object, of which 56 patients underwent surgical treatment using locking compression plate ( Operation group ), 50 patients underwent non - surgical treatment using skin traction smoothing method( Control group) ,all the patients were followed up for 6 to 10 months,the clinical efficacy and complications were eorpared. ResultsOperation group, good rate of 83.9％, significantly higher than contra group,good rate of 60.0％ ,the difference was statistically significant ( x2 = 7.61, P ＜ 0.01 ). Operation group, no postoperative complications,5 cases of non- surgical complications, two groups had significant differences in complications (x2 =3.86, P ＜ 0.05 ). ConclusionSurgical treatment of humeral surgical neck fractures in elderly rehabilitation had better efficacy, fewer complications.

Objective To verify that traditional Chinese medicines have certain price advantages compared with western medicines,and to estimate the rational increase in the compensation proportion of traditional Chinese medicine in the new rural cooperative medical system.Methods Using stratified sampling survey and literature review,the average outpatient and hospitalization expenses in the treatment of common diseases in rural areas were calculated and compared among traditional Chinese medicine,western medicine,and integrated traditional and western medicine.Results For average outpatient and hospitalization expenses,traditional Chinese medicine was lower than western medicine,integrated traditional and western medicine was lower than western medicine.and traditional Chinese medicine was lower than integrated traditional and western medicine.For hospitalization expense,traditional Chinese medicine had a 25.2%lower expense compared with western medicine.The ratios of expenses were statistically calculated,and the mathematical model for the compensation proportions of traditional Chinese medicine and western medicine in the new rural cooperative medical system was put forward.Conclusions In the implementation scheme of new rural cooperative medical system,the compensation proportion of traditional Chinese medicine in outpatient and hospitalization expenses should be increased by 25%and 33%respectively compared with western medicine.

Objective To optimize the extraction method for assaying Jinyou Tankeqing Tablets(JTT).Methods With the total flavonoids content as the index,Orthogonal Experimental Design was used to optimize the extraction condition for assaying JTT.Results The optimized ultrasonic extraction method was as follows: adding 0.2 mL?mg-1 powder to 95 % ethanol,extracting for 30 min;the optimized Sohlex extraction method was: adding 1.2 mL?mg-1 powder to 95 % ethanol,extracting for 2 h,the former method being better than the later.Conclusion The optimized extraction method for assaying JTT is adding 0.2 mL?mg-1 powder to 95 % ethanol and extracting for 30 min with ultrasonic wave.

Objective To study the quality standard of Jinyou Tankeqing Tablets (JTT). Methods Total flavonoids in JTT were identified by TLC. Naringin content in JTT was determined by HPLC. Results The relevant spots of total flavonoids in JTT can be identified by TLC. The content of naringin in JTT can be determined by HPLC. The linearity of naringin was good in the range of 2～20 ?g (r= 0.999 9). The average recovery of naringin was 101.29 %with RSD = 2.58 %. Conclusion The established quality standard is simple,feasible and repeatable,and can be used for the quality supervisory of JTT.

OBJECTIVE:To put forward suggestions for the guaranteeing of the supply of the essential medicines in China. METHODS:The problems occurred in the production,circulation and application of essential medicines as well as the policies issued in the medical reform including the assigned production,centralized purchasing,direct distribution and standard application were discussed.RESULTS & CONCLUSION:The essential medicines can be produced by selectively assigned production,and the continuity of the production of the essential medicines calls for efforts of multiple means.It is better for medicare agency to be responsible for centralized purchasing and the construction of the delivering and distributing system of medicines should be strengthened.The system of enforcement use and incentive measures should be established to ensure that the essentials medicines be used by clinicians.

Objective To observe different priming techniques with intubation dose when using cisatracurium in onset time and safety. Methods Eighty ASA physical status Ⅰ and Ⅱ patients undergoing elective surgery requiring general anesthesia were enrolled. Group Ⅰ with 20 cases received cisatracurium 0.010 mg/kg, group Ⅱ with 20 cases received cisatracurium 0.015 mg/kg,group Ⅲ with 20 cases received cisatracurium 0.010 mg/kg,and group Ⅳ with 20 cases received normal saline. Four minutes after priming,group Ⅰ received cisatracurium 0.140 mg/kg ,group Ⅱ received cisatracurium 0.135 mg/kg, group Ⅲ received cisatracurium 0.190 mg/kg,and group Ⅳ received cisatracurium 0.200 mg/kg. Mechanomyography assessed the neuromuscular function of the adductor pollicis with train-of-four (TOF) supramaximal impulses T1. The trachea was intubated when the amplitude of T1 decreased to 0. Recorded T1 and TOF in 4 minutes and onset time of muscle relaxation, then evaluated intubation condition. Results The onset time in group Ⅰ , Ⅱ, Ⅲ and Ⅳ were (151.30 ± 10.90), (138.90 ±8.37), (145.45 ± 17.12), (148.75 ± 18.70) s,respectively. The onset time in group Ⅱ was obviously shorter than that in group Ⅰ , Ⅲ and Ⅳ (P ＜ 0.01 ),thus there was no significant differences among the group Ⅰ , Ⅲ and Ⅳ. During the priming interval, the value of T1 and TOF were both showing downtrend, in group Ⅱ ,there was TOF ＜ 90%. Conclusions Priming dose 0.010 mg/kg and intubation dose 0.140 mg/kg is just the same like that in intubation dose of quadruple ED95 whether priming. There is no benefit in priming cisatracurium of intubation dose quadruple ED95. There is TOF ＜ 90% in 4 minutes priming interval when using priming dose 30% ED95 and it is proved unsafely.