OBJECTIVE:To promote the development and make full use of the pharmacoeconomics(PE)in China.METHODS:The problems to be able to solved using PE,i.e the necessity of developing PE in China was discussed,and the bottleneck which will restrain or hinder the optimal utilization of PE was pointed out.RESULTS:We should strengthen the cultivation of talents engaged in PE,formulating guidelines of pharmacoeconomic evaluation and gradually apply PE into National Essential Medicine Policy.CONCLUSION:The decision-makers of health policy should have a sufficient understanding of PE so as to facilitate the utilization and sustainable development of PE in health policy-related decision-making.

Objective Direct impact is a common mechanism of injury for blunt thoracic injury, and if resulting thoracic injury is severe the mortality may be as high as 10% ～ 25% . We aim to develop a mechanical device for animal impact injury experiment, so as to establish a rodent model of severe thoracic injury. Method A spring operated mechanical device for animal impact injury experiment was developed. The device allowed for accurate controlled delivery of impact force to specific areas of the chest well, at specific velocities and degrees of chest compression. Eghty-four male Sprague-Dawley rats were anaesthetized and underwent left carotid artery cannulation. They were randomly divided into seven groups and given the following treatment: group A (Control group) were subjected to sham impact; group B to G animals were subjected to impacts on the right lateral superior chest at different velocities and degrees of chest wall compression. ( B 3 m/s, 20%; C 3 m/s 40%; D 6 m/s 20%; E 6 m/s 40%; F 9 m/s 20%; G 9 m/s 40%). Arterial blood gas samples were taken just before injury, and at 2 and 12 post injury. All rats were sacrificed at 12 hours and their degree of thoracic injury rated. Pathological examination of injured lung tissue was also performed. Results The device was able to deliver impact forces accurately, with ＜ 4% deviation from desired velocity and ＜ 3 mm deviation from target area of impact. Other than the control group, all animals experienced significant hemodynamic changes immediately post impact. Arterial blood gas analysis detected significant hypocapnia in groups B and C. Significant hypoxemia and hypocapnia was detected in groups D, E and F. In groups B,C,D and F, die impact produced a mild thoracic injury with low mortality rate at 12 hours. In group E, the impact produced severe thoracic injury with mortality rate of 33.33% at 12 hours. Group C animals sustained the most serious thoracic injury with mortality rate of 83.33% at 12 hours. Pathological examination revealed injuries from direct trauma as well as secondary lung injuries. Conclusions Our device was able to repetitively deliver accurate and precise impact forces to rats and allows us to establish a rodent model of severe thoracic injury firm blunt trauma. We found that with our device, impact force at velocity of 6 m/s and 40% chest compression produced the most severe lung injury in rats.This helps us establish a rodent model of severe thoracic injury which can be use for future research in severe blunt thoracic trauma and the secondary lung injuries.

Objective: To study the precise stress distribution in the apical foramen area of endodontic endosseous implant. Methods:After analysis of the two-dimensional endodontic endosseous implants model with finite element method, left and right areas beside the apical foramen were selected as infinite domains for calculation. Results:Under 45? axial right oblique loading, the stress concentration occurred in both infinite domains of the apical foramen. The tension stress concentrated in the infinite domain near the load side,but the other side was compress concentrated. Two stress concentration points were just at the central points, which were intersections between implant and dentin. In the implant and dentin section, the stress reduced in all directions from two stress concentration points, but in the ligament section, the result was contrary. Conclusion:It is helpful to keep the root stable when the fulcrum of the root changed to lower part after restoration. In the implant area,the diameter of implant at the apical foramen of root shouldn't be reduced for the protection of root in clinical work;It is very important to preserve the tissue of periodental ligament for endodontic endosseous implants.

砄bjective: To establish two dimensional infinite model for endodontic endosseous implants in order to set up infinite element method and study the stress distribution of the apical foramen area of endodontic endosseous implant. Methods: Based on the analysis of two dimensional endodontic endosseous implants model with finite element method, left and right areas beside the apical foramen were selected as infinite domains including implant dentin and ligament sections. D N interactive method was used to connect the finite and infinite domains. Results: After ten times interaction between finite and infinite domains with D N interactive method, the outcome approached to a stable numerical value close to the displacement of both domains. Conclusion: The infinite model of two dimensional endodontic endosseous implants established by D N interactive method is efficient and accurate.

Objective:To study the residual stress distribution through the thickness of bilayered dental ceramic subjected to thermal stress, in order to improve the restoration. Methods: The finite element model of bilayered dental ceramic was set up based on International Organization for Standardization(ISO) 96936:1999. The residual stresses were calculated in viscoelastic and elastic phases during cooling of dental ceramic to analyze the residual stress distribution. Results: The deformation of core was greater than the veneer ceramics during the cooling period of dental ceramic. The residual stress increased with the decreasing of the temperature approaching the interface of core and veneer ceramics. But it decreased with the increasing of the thickness of veneer ceramics.Conclusion: Thermal compatibility of core and veneer ceramics is very important to the residual stress distribution in the bilayered dental ceramic, which may benefit to All-ceramic restorations. The viscoelastic behavior of ceramic should be taken into account in the thermal compatibility.

The human brain-derived neurotrophic factor (hBDNF) gene was cloned by polymerase chain reaction and the recombinant adeno-associated viral vector inserted with hBDNF gene (AAV-hBDNF) was constructed. Cultured rat hippocampal neurons were treated with Abeta(25-35) and serued as the experimental Abeta-induced neuronal damage model (AD model), and the AD model was infected with AAV-hBDNF to explore neuroprotective effects of expression of BDNF. Cell viability was assayed by MTT. The expression of bcl-2 anti-apoptosis protein was detected by immunocytochemical staining. The change of intracellular free Ca ion ([Ca2+]i) was measured by laser scanning confocal microscopy. The results showed that BDNF had protective effects against A-induced neuronal damage. The expression of the bcl-2 anti-apoptosis protein was raised significantly and the balance of [Ca2+]i was maintained in the AAv-hBDNF treatment group as compared with AD model group. These data suggested that recombinant AAV mediated a stable expression of hBDNF in cultured hippocampal neurons and resulted in significant neuron protective effects in AD model. The BDNF may reduce neuron apoptosis through increasing the expression of the bcl-2 anti-apoptosis protein and inhibiting intracellular calcium overload. The viral vector-mediated gene expression of BDNF may pave the way of a novel therapeutic strategy for the treatment of neurodegenerative diseases such as Alzheimer's disease.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

BACKGROUND:There is a close relationship between epilepsy and apoptosis. The appearance of epilepsy can lead to the loss of neurons in the hippocampus, triggering a series of programmed cel death. OBJECTIVE:To investigate the effect of bone marrow stromal stem cel transplantation on apoptosis in epilepsy. METHODS:After modeled to be of epilepsy 45, Sprague-Dawley model rats were randomly divided into three groups, fol owed by given no intervention (moldel group), normal saline (normal saline group) or bone marrow stromal stem cel transplantation (transplantation group). At 1, 2 and 4 weeks after modeling, the number of Bax-positive cel s, Bcl-2-positive cel s and Bax/Bcl-2 were detected by immunohistochemistry. RESULTS AND CONCLUSION:The number of Bax-positive cel s, Bcl-2-positive cel s and Bax/Bcl-2 presented no obvious changes in the normal saline group at different time points. However, the number of Bax-positive cel s and Bax/Bcl-2 in the transplantation group was significantly decreased, while the number of Bcl-2-positive cel s significantly increased compared with the other two groups at 1, 2 and 4 weeks after modeling (P<0.05). Moreover, the above indicators varied significantly in the transplantation group at different time points after modeling (P<0.05). These results show that bone marrow stromal stem cel transplantation can affect the apoptosis and effectively reduce the apoptosis in rats with epilepsy by up-regulating the number of Bax-positive cel s and down-regulating the number of Bcl-2-positive cel s.

Objective To investigate the surgery method for early spontaneous posterior interosseous nerve entrapment,to observe the postoperative efficacy in treatment,to evaluate the surgical outcomes,and to provide a foundation for clinical choice of reasonable operation scheme.Methods 21 cases of early spontaneous posterior interosseous nerve entrapment received operation. 1 3 cases (1 8 arms) were treated by neurolysis, and 8 cases (8 arms )were treated by nerve grafts with small vessels wrapping operation;all the patients were followed up for 10 to 20 months;the finger extensor muscle strength and metacarpophalangeal joint activity were evaluated. Results The lesion extensor muscles were part of the denervation changes.Neurolysis muscle strength:14 arms were excellent(82.35%),2 arms were good,1 arm was fair,1 case was lost;extensor function:15 arms were excellent(88.24%),1 arm was good,1 arm was fair,1 case was lost.Nerve graft muscle strength:6 arms were excellent(75.00%),1 arm was good,1 arm was fair;extensor function:7 arms were excellent(87.50%),0 arm was good,1 arm was fair.Conclusion Neurolysis can have a good efficacy in treatment of early spontaneous posterior interosseous nerve entrapment without obvious degeneration.When the severe degeneration of entrapment nerve happens,a nerve graft surgical treatment is needed.

Objective To observe the application of ultrasound-guided femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) for patients undergoing hip fracture surgery.Methods 60 patients scheduled for hip fracture surgery undergoing LMA general anesthesia were randomly divided into 3 groups,20 cases in each group.Before transfer patients from bed to operating table,A group received dezocine 5mg iv,B group received fascia iliaca compartment block(FICB),C group received FNB combined with LFCNB.40mL of 0.375％ ropivacaine was injected guiding by ultrasound in B group and C group.The time of sufficient sensory block and awake,the dosage of propofol and remifentanil,MAP and HR at pre-block (T1),20min after block (T2),transfer bed (T3),LMA insert (T4),skin incision(T5),LMA remove(T6) and sober(T7) were recorded.Pain was assessed using visual analogue scale(VAS) pre-and post block.The incidence of using vasoactive drugs,agitation,pain and adverse reaction were also recorded.Results The time of sufficient sensory block and awake,the dosage of propofol and remifentanil in A,B and C groups were as following:A group (not measured),(20.3 ± 1.3) min,(835 ± 6.7) mg,(1 285 ± 18) μg;B group (i2.2 ±2.7)min,(13.3 ± 1.4)min,(610 ±9.9)mg,(835 ± 15) μg;C group (9.7 ± 2.4)min,(12.8 ± 1.5) min,(555 ± 6.5) mg,(785 ± 16) μg.The time of awake,the dosage of propofol and remifentanil in B group and C group were significantly lower than those in A group(F =2.62,2.41,2.45,all P ＜ 0.05).The time of sufficient sensory block in C group was lower than that in B group (p ＜ 0.05).The MAP and HR at T2,T3,T5 and T7 in A,B and C groups were:A group (115 ± 4) mmHg,(90 ± 8) beats/min,(135 ± 6) mmHg,(98 ± 8) beats/min,(104 ±6) mmHg,(87 ± 4) beats/min,(120 ± 5) mmHg,(88 ± 8) beats/min;B group (102 ± 3) mmHg,(81 ± 6) beats/min,(112 ± 5)mmHg,(82 ± 8)beats/min,(89 ±6) mmHg,(72 ± 3) beats/min,(100 ±6)mmHg,(76 ± 8) beats/min;Cgroup (100 ± 3) mmHg,(80 x 6) beats/min,(109 ± 6) mmHg,(83 ± 5) beats/min,(86 ± 5) mmHg,(70 ± 3) beats/min,(99 ± 5) mmHg,(75 ± 5) beats/min.The levels of MAP and HR in B group and C group were significantly lower thanthose in A group(F =2.25,2.85,2.87,2.91,all P ＜ 0.05).The VAS scores at T2,T3,and T7in A,B and C groupswere:A group (3.9 ± 0.7) points,(8.2 ± 0.3) points,(6.0 ± 0.8) points;B group (2.3 ± 0.4) points,(4.1 ±0.4) points,(2.2 ± 0.7) points;C group (2.1 ± 0.5) points,(2.4 ± 0.4) points,(1.2 ± 0.4) points.The VAS scoresin B group and C group were significantly lower than those in A group (2.36,2.82,2.88,all P ＜ 0.05).The VASscores at transfer bed and sober in C group were significantly lower than those in B group (F =2.32,2.38,all P ＜0.05).The incidence of using ephedrine/atropine,urapidil/esmolol,PONV,agitation,pain and incision pain in A,Band C groups were:A group 30％,30％,25％,25％,40％;B group 10％,10％,0％,0％,10％;C group 10％,5％,0％,0％,0％.The number of patients who required vasoactive drugs and adverse reaction in B group and C group were significantly lower than those in A group(x2 =7.58,8.81,9.11,9.11,8.89,all P ＜0.05).The incidence of incision pain at sober in C group was lower than that in B group(x2 =9.21,P ＜ 0.05).Conclusion The ultrasound -guided FNB and LFCNB can obviously shorten the onset time,reduce the dosage of general anaesthetic and maintain the stability of henodynamics during the perioperative period.It has effective analgesia during transfer of patients from bed to operating table and sober.