OBJECTIVE:To discuss the ethical behaviour in pharmaceutical enterprises from the strategic point of view.METHODS:A game model was set up as an example to illustrate the ethical baffle.The game model was strategically rethought.RESULTS&CONCLUSION:The countermeasure of ethical strategy is given.

Objective To analyze patients with acute chest pain as their chief complaint in order to improve our capability of early identifying and diagnosing high-risk patients,give them proper treatment in time and avoid misdiagnosis and improper treatment. Methods The clinical data of 813 patients with chest pain as their chief complaint admitted in the emergency department and critical care medicine department in Guangdong Provincial Traditional Chinese Medicine Hospital from January to December in 2011 were retrospectively analyzed. According to the process of diagnosis and treatment formulated by the chest pain center,all the patients must immediately finish the first electrocardiograph(EEC)examination in 10 minutes and the relevant blood biochemical examinations within 30 minutes after admission. Results In accordance with the relevant examinations,the confirmed diagnoses were as follows:there were 276 cases of unstable angina,accounting for 33.95%;145 cases of stable angina,17.84%;121 cases of acute myocardial infarction,14.88%;103 cases of respiratory system disease,12.67%;78 cases of skeletal muscle disease,9.59%;46 cases of the digestive system disease,5.66% and the high-risk non cardiac chest pain(such as aortic dissection/rupture of tumor or acute pulmonary embolism)12 cases,1.48%.Seven hundred and eighty-five patients finished the first EEC examination in 10 minutes,and 147 patients completed the chest computed tomography(CT)scan within an hour. Conclusions Acute chest pain is a common symptom in emergency department. It is necessary to identify the high-risk patients according to a process as soon as possible in order to get an accurate diagnosis and an effective treatment in time.

Objective The purpose of the study is to understand the epidemiology,distribution and molecular characteristics of oxacillin susceptible mecA positive Staphylococcus aureus (S.aureus).Methods Totally 1588 S.aureus isolates collected from 12 hospitals in 10 cities of China between 2010 and 2012 were retrospectively characterized.The isolates were characterized by antimicrobial susceptibility test of 20antimicrobial drugs.Three different methods (cefoxitin disc diffusion,agar dilution for oxacillin and cefoxitin) to detect oxacillin susceptible and mecA positive S.aureus were also compared.All the strains were confirmed to be S.aureus by detecting S.aureus specific genes by PCR (including nuc,femB,and mecA gene),which was viewed as the golden standard of MRSA.The molecular typing methods included SCCmec and spa typing.The statistical analyses were carried out in statistical product and service solutions (SPSS),Version 18.0.The significance level P was set at 0.05.Results According to the MICs of cefoxitin and oxacillin,a total of 60 isolates were oxacillin susceptible methicilin resistance Staphylococcus aureus (MRSA).Based on the differences of the specimen collection date,it is found that oxacillin susceptible MRSA have increased from 2010 to 2012 (P =0.05,95％ CI 0.045-0.056,X2 =6.099).These isolates were distributed in 9 major cities,and the highest prevalence is 30.0％ (18/60) in Guangzhou,followed by Beijing (18.3％,11/60),Wuhan (15.0％,9/60),Hangzhou (13.3％,8/60).Most of the isolates were from skin soft tissue infection (35％,21/60),blood stream infection (30％,18/60) and respiratory infection specimens (18.3％,11/60).The resistance rate to cefoxitin,erythromycin,clindamycin and tetracycline was 100％ (60/60),86.7％ (52/60),66.7％ (40/60) and 50％ (30/60),respectively.The molecular characterization showed that 21 spa and 5 SCCmec types were detected.The most predominant clone was spa t437-SCCmec Ⅳ (25.0％,15/60),followed by spa t437-SCCmecV (13.3％,8/60).Conclusions The detection rate of oxacillin susceptible MRSA is significantly higher from 2010 to 2012.The major clone is t437-SCCmec Ⅳ.The use of cefoxitin should replace oxacillin in detecting this type of MRSA.Further study is needed to confirm whether beta lactam antimicrobial agents should be used in the treatment of oxacillin susceptible mecA positive S.aureus.

BACKGROUND:Arsenic trioxide is considered to inhibit the proliferation of vascular smooth muscle cel s and promote cel apoptosis. Therefore, we wondered whether the arsenic can inhibit the hyperplasia of vascular smooth muscle cel s, an arsenic-coated stent can be compatible with the vascular tissue, and a better vascular intimal coverage as early as possible can reduce intimal hyperplasia.
OBJECTIVE:To observe the vascular histocompatibility of the arsenic-coated stent.
METHODS:Fourteen white rabbits were randomized into two groups and respectively subject to the implantation of arsenic-coated 316 L stainless steel stents and bare 316 L stainless steel stents into the abdominal aorta. After 28 days, the distal and proximal parts of the vessel at the implantation site were ligated and the ligated vessel was taken for hematoxylin-eosin staining and light microscope observation.
RESULTS AND CONCLUSION:(1) Gross observation:the vessel at the stent site was a little larger than the adjacent vessels in the outer diameter, which was expanded but had no visible thrombus. After cutting the stent, the neointima formed smoothly on the stent surface. (2) Light microscope observation:the stent was located in the middle of the vessel, the medial smooth muscle was pressed, and vascular intimal smooth muscle hyperplasia was found around the stent, thereby thickening the vascular intima. The vascular neointima formed and covered the stent, and there was a thin black layer between the stent and the vascular tissue, which consisted of arsenic and its compounds. These findings suggest that the arsenic-coated stents can be covered with vascular tissues, possessing good vascular histocompatibility.

Objective To evaluate the surgical outcome of cystic vestibular schwannoma patients with fluid-level imaging by MRI.Methods Forty-five patients of cystic vestibular schwannoma were enrolled and divided into fluid-level (n =24) group and non-fluid-level (n =21) group by MRI.The incidence of peritumoral adhesion,incidence of complete tumor removal and postoperative facial nerve function of the two groups were recorded.Results The incidence of peritumoral adhesion in fluid-level and non-fluid-level group were 70.8％ (17/24) and 28.6％ (6/21),and the difference was significant (x2 =8.010,P ＜ 0.05).The incidence of complete tumor removal were 45.8％ (11/24) and 76.2％ (16/21) in fluid-level and non-fluid-level group,which showed significant differences between groups (x2 =4.30 ; P ＜ 0.05).Patients of House-Brackmann grade Ⅰ-Ⅲ in fluid-level group at discharge and one year after operation,were 62.5％ (15/24) and 50.0％ (8/16),and 81.0％ (17/21) and 83.3％ (15/18) in non-fluid-level group.The was significant difference at one year after operation (P ＜ 0.05) in terms of patients of House-Brackmann grade Ⅰ-Ⅲ.Conclusion The cystic vestibular schwannoma patients with fluid level have more frequency to adhere to surrounding neurovascular structures and less favorable surgical outcome.These findings may be useful in predicting surgical outcome and making surgical strategy preoperatively.

AIM: To investigate the effect of insulin on vascular smooth muscle cells (VSMCs) proliferation and to evaluate the intracellular signaling pathways involved. METHODS; VSMCs separated from Sprague - Dawley rats were used in this study. The proliferation of VSMCs induced by insulin was assayed by [~3H ] - thymidin incorporation. The protein expression and activity of p -ERK1/2 were determined by immunblot and [~(γ-32)P]ATP incorporation. RESULTS: Insulin induced cell proliferation in a concentration - dependent manner. The proliferative effect of insulin on VSMCs was inhibited partly by LY294002 (48.8% ) , an inhibitor of PI -3 kinase, and the ERK1/2 inhibitor PD98059 (43.6% ) , respectively. Moreover, phosphorylation of ERK1/2 and activity of ERK1/2 induced by insulin were also inhibited partly by LY294002.CONCLUSION: PI -3 kinase and ERK1/2 are involved in insulin induced VSMCs proliferation.

BACKGROUND:Stem cell transplantation and tissue engineering in repairing bone defects is a hotspots of recent study.OBJECTIVE:To observe the therapeutic effect of engineering repair on bone defect by auto-transplantation of bone marrow stromal cells(BMSCs)DESIGN: Left-right comparative studySETTING:Experimental center of the First Affiliated Hospital of Harbin Medical UniversityMATERIALS:Twelve New Zealand rabbits with birth age of 10 days to 2months were selected ,male or female with body mass of 2 to 2.5 kg.METHODS :The experiment was conducted in the Experimental Center of First Clinical Medical College, Harbin Medical University from June 2002to June 2003. Self-BMSCs were separated for subculture. 1.5 cm bone was intercepted at middle of radius in 12 rabbits so as to simulate complete bone defect. Then, the left radius defect was filled with collagen sponge carrying BMSCs ( experimental side),which was replaced by simple collagen sponge in the right side(control side). Twelve weeks later, rabbits were put to death and the outcomes of both sides were compared.X-ray assessment was accorded to the standardized stage of bone defect repair (bone repair was graded into 0 to 5 grades,grade 5 implies that bone defect has been completely replaced by new bone,grade 0 implies that no new bone repair).MAIN OUTCOME MEASURES:The general observations of rabbit radius defects,X-ray scanning, histological and electro-microscopic observations.At week 12, callus became strong and protruded to bone defects in experimental side,well connecting with broken ends. While broken ends in control group were only connected by fibrous tissue and no continuous callus was found continuously crossing through the bone defect of experimental side, marrow cavity was smooth, but molding was incomplete. While in control side, no continuous callus could be observed passing through the broteoblasts and new stroms could be observed in bone defect of experimental side, but only a few of osteocytes appeared in the broken ends of control vations: The osteoblast observed in the experimental side seems normal and was rich in enlarged endoplasmic reticula energetic in ,protein synthesis and abundant in organelle.CONCLUSION :As osteogenetic cells, BMSCs possess better osteogenesis property. They can be used as seed cellsin bone defect repair by using bone-engineering techniques.

Objective To investigate the effect of 1,25-dihydroxyvitamin D3 on proliferation and apoptosis of glomerular mesangial cells via the PI3K/Akt/mTOR signal pathway. Methods The normal control group, 1,25-dihydroxyvitamin D3 (10-8 mol/L) group, rapamycin (0.1 μg/mL) group and the rapamycin in combination with 1,25-dihydroxyvitamin D3 group. The cell proliferation was measured by cell counting kit-8 assay. The cell cycle and cell apoptosis were detected by flow cytometry assay , respectively. Results Compared with the normal control group, the proliferation of glomerular mesangial cells was significantly inhibited in the 1 ,25-dihydroxyvitamin D3 group, in the rapamycin group and in the rapamycin in combination with 1,25-dihydroxyvitamin D3 group. The cells at G1 phase were significantly increased, but the cells at S phase were significantly decreased, with significant increase of cell apoptosis rate. Compared with the 1,25-dihydroxyvitamin D3 group, the proliferation of human glomerular mesangial cells was significantly inhibited in the rapamycin group and in the rapamycin in combination with 1,25-dihydroxyvitamin D3 group. Compared with the rapamycin group, the cells at G1 phase were significantly increased and the cells at S phase were significantly decreased in the rapamycin in combination with 1,25-dihydroxyvitamin D3 Group. Conclusions 1,25-dihydroxyvitamin D3 inhibits cell proliferation and promotes human glomerular mesangial cell apoptosis of human glomerular mesangial through the PI3K/Akt/mTOR signal pathway. 1,25-dihydroxyvitamin D3 and rapamycin can synergistically inhibit the proliferation of human glomerular mesangial cells.

Objective To investigate the effects of 1,25-dihydroxyvitamin D3 [1,25 (OH)2D3] on PCNA expression and cell proliferation in human glomerular mesangial cells. Methods The cultured human mesangial cells, which was subcul?tured 3-8 generations, were randomly divided into four groups: normal control group (plus the DMEM medium containing 5%fetal bovine serum), proliferation in the control group (EGF group, plus 10μg/L of EGF), general intervention group [VD group, plus 10-8 mol/L of 1,25(OH)2D3], proliferation in the intervention group [EGF+VD group, plus 10μg/L EGF and 10-8 mol/L 1,25(OH)2D3] for treatment of 48 h. The cell cycle was detected by flow cytometry,and the expression of PCNA was detected by Western blot assay in four groups. Results (1) Compared with normal control group, G1 phase cells were signifi?cantly reduced, S, G2/M phase cells were increased and PI index was higher in EGF group. And G1 phase cells were signifi?cantly increased, S and G2/M phase cells were significantly decreased, and PI index was lower in VD group. Compared with the EGF group, G1 phase cells were significantly increased in VD group and EGF+VD group, and S, G2/M phase cells de?creased, PI index was lower. (2) Compared with normal control group, the expression of PCNA was higher in EGF group, and lower in VD group. Compared with EGF group, the expression of PCNA was lower in VD group and EGF+VD group. Conclu?sion 1,25 (OH) 2D3 inhibits the proliferation of human glomerular mesangial cells by arresting cell cycle and inhibiting the expression of PCNA protein.

Objective To analyze the molecular epidemiology and resistant mechanisms ofmacrolide-nonsusceptible Moraxella catarrhalis.Methods A total of 383 strains of Moraxella camrrhaliswere collected from nasopharynx of children under 2 years old.The minimum inhibition concentration (MIC)values were determined by Etest method,and the production of β-lactamase was examined by using anitrocefin-based test.The pulsed-field gel electrophoresis (PFGE) method was used to analyze the type ofdifferent isolates.Polymerase chain reaction (PCR) and sequencing were performed for the resistancemechanism of macrolide resistance in Moraxella catarrhalis.The non-susceptibility rates of six cities( Beijing,Shanghai,Jinan,Nanjing,Wuhan and Dongguan) were compared byx2 test.ResultsAccording to Clinicaland Laboratory Standards Institute (CLSI) breakpoints,the non-susceptibility rates for erythromycin andazithromycin in 383 strdns of Moraxella catarrhalis were 40％ and 23％,respectively.Whereas,the non-susceptibility rates were 59％and 60％based on pharmacokinetics/pharmacodynamics(PK/PD)breakpoints.Significant differences in non-susceptibility rates to macrolide were observed in different cities,and the higher non-susceptibility rates were determined in relatively northern cities,such as Beijing andJinan.Among the 383 strains of Moraxella catarrhalis,92％ (353/383) of isolates produced β-lactamase.Atotal of 14 patterns of groups were generated by PFGE in 37 high-level macrolide resistant Moraxella catarrhalis,and 43％ ( 16/37 ) of isolates could be considered to be related or indistinguishable to group A.In this study,the ermA,ermB,mefA,and merE genes were not detected,while the A2982T,A2796T,A2983T mutations in 23S rRNA gene may be related to macrolide resistance in Moraxella catarrhalis.The A2982T and A2796T mutations conferred high-level macrolide resistance,while the A2983T mutation conferred low-level resistance.ConclusionsA large number of macrolide-nonsusceptible Moraxella catarrhalis isolates are detected in the study.The macrolide resistance is probably related to the mutations in 23S rRNA gene,and the relationship between MIC values of macrolide and mutations has been determined.