OBJECTIVE:To find out an effective way to control the unreasonable increase of drug expenses.METHODS:To analyse and evaluate the role of pharmacoeconomic research in suppression of unreasonable increase of drug expenses.RESULTS:The best therapeutic scheme could be found out by pharmacoeconomic research through the way of determination of the cost and efficacy of pharmacotherapy,and the unreasonable increase of drug expenses could also be cut down in5aspects.CONCLUSION:Pharmacoeconomic research is a practical and feasible way to control unreasonable increase of medical expenses.

Acupuncture Therapy ; Adult ; Aged ; Angina, Unstable ; drug therapy ; physiopathology ; therapy ; Cardiovascular Agents ; administration & dosage ; Combined Modality Therapy ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Male ; Middle Aged

Objective To evaluate the relationship between NK cytotoxicity and anemia in uremia. Methods The effect of rHuEPO on natural killer (NK) cell cytotoxic activity was studied in 12 hemodialysis(HD) patients. Results The levels of hemoglobin (Hb) and NK cell activity were significantly lower in HID patients than that in healthy controls. After two months of the treatment with rHuEPO, the levels of Hb in these patients rose significantly with a parallel rise in NK cell activity. NK cell activity was not increased when they were incubated with rHuEOP but was increased with red blcxxl cells. Conclusion Improved NK cell cytotoxicity in HD patients after treatment with rHuEPO was achieved through the rise in R15C rather than through rHuEPO itself.

Objective To determine the expression of advanced glycation end products(AGE) binding proteins on human joint synovial cells for elucidating the pathobiological effects of ?2m modified with AGE(AGE-?2m) on joint resident cells. Methods Type A and type B synovial cells were isolated and cultured in vitro. The expression of AGE receptor 1 (ACE-R1 ), AGE receptor 2 (AGE-R2), AGE receptor 3 (AGE-R3) and 35 KD receptor for AGE(RAGE) on synoviocytes were detected by immunofluorescent staining using specific antibodies and flow cytometric analyses. mRNA of AGE receptors was examined by RT-PCR techniques.-Results RAGE and AGE-R3, but not AGE-R1 and AGE-R2, were constitutively expressed on the membrane surface of both type A and type B synovial cells. These two types of synovial cell also expressed mRNA of RAGE and AGE-R3. Conclusion Human joint synovial cells express specific AGE binding proteins, RAGE and AGE-R3, suggesting that these cells may be involved in AGE metabolism and might be the target of the biological effects of AGEs in dialysis-related amyloidosis.

Objective To elucidate the mechanism of accelerated apoptosis of monocytes in patients with lupus nephritis (LN). Methods 17 LN patients were enrolled in the study and 15 healthy volunteers were selected as controls. The expression of Faa and Fas ligand (FasL) was examined by immunofluorescent staining and flow cytometer analysis. The apoptosis and survival rate of monocytes cultured in vitro with human FasL (rHu-FasL) was analyzed by flow cytometer analysis and 5-diphenyl tetrazolium bromide (MTT) staining, respectively. Results Faa expression on monocytes was significantly higher in LN patients than that in healthy subjects. There was no difference of monocytes Fas expression between active LN patients and silent LN patients. There was no detectable FasL expression on monocytes from both LN patients and healthy controls. When monocytes cultured in vitro with rHu-FasL, there was a significantly increasing apoptosis and a decreasing survival rate of monocytes in LN patients as compared to healthy controls. Conclusion The up-regulated expression of functional Fas on monocytes may contribute to the accelerated apoptosis of monocytes in LN patients.

To elucidate the effects of pro inflammatory mediators on mRNA expression of AGE receptors in type B synovial cells, type B synovial cells from normal subjects were isolated and cultured in vitro with human serum albumin modified with advanced glycation end products (AGE HSA), tumor necrosis factor ?(TNF ?)and interleukin 1?(IL 1?). The expression of RAGE mRNA and AGE R3 mRNA was examined by RT PCR techniques. TNF ?, AGE HSA and IL 1? up regulated the expression of AGE R3 mRNA in type B synovial cells in a dose and time dependent manner. In contrast, TNF ? and AGE HSA down regulated the expression of RAGE mRNA in a dose and time dependent manner. IL 1? had no effect on RAGE mRNA expression. The regulatory responses induced by AGE HSA were blocked by a neutralizing polyclonal anti human TNF ? antibody, suggesting that the effects of AGE HSA were mediated by TNF ?. The proinflammatory mediators may regulate the gene expression of AGE receptors in type B synovial cells, and the regulatory role of these receptors is different in response to the proinflammatory mediators.

The purpose of this study was to explore the incidence of tuberculosis (TB) in chronic renal failure (CRF) patients with or without renal replacement therapy and to evaluate the effect of chemoprophylaxis on incidence of active TB. A total of 3360 CRF patients from April 1989 to Sept. 2002 were enrolled in this study. Chemoprophylaxis for TB was given to the patients with increased serum anti PPD IgG levels from Jan. 1995 to Sept. 2002. The prevalence of active TB during this period was compared with that of the historical control group from April 1989 to Dec. 1998 (without prophylaxis). The results showed that the overall incidence of active TB in all patients was 2 4% (82/3360). Extrapulmonary TB was the most common feature (75 6%) with the major infective sites in pleura (20 7%) and lymph node (17 7%). There were 58 5% patients with active TB showing increased serum and/or serous exudate anti PPD IgG levels and 24 2% patients showing positive TB bacillus DNA (PCR). The total incidences of TB (1 76%) and disseminated TB (2 3%) in the chemoprophylaxis group were significantly lower than those in the non chemoprophylaxis group (4 1% and 7 5%, respectively, P

Objective The study was performed to determined the significance and safety of liver biopsies in these patients as a pre-transplantation screening test. Methods From January 1999 to August 2002, seventy-four renal transplant recipients with hepatitis B or C virus infection were received the percutaneous liver biopsy. The severity of liver inflammation(G) and fibrosis(S) were evaluated by semi-quantity technique. The patients whose liver histological diagnosis was G 0-2 S 0-2 received renal transplantation(n=31). Patients with hepatitis B or C virus infection who received renal transplantation in the period of January 1995 to December 1998 were selected as historic controls. Normal level of serum transaminase was considered as a indication for the received renal transplantation during this period. The incidence of liver dysfunction after transplantation was compared between the two groups. Results It showed among thirty-one patients received renal transplantation from 1999-2002, only 1 patient (3.2%) developed liver failure after transplantation. However, among 60 patients of historic control, 17 (23.8%) suffered from liver dysfunction (P

Objective To analyze the congenital anomalies of inferior vena cava (IVC) with their color Doppler and clinical features, and to evaluate the value of color Doppler ultrasound in the diagnosis of congenital anomalies of the IVC. Methods Between July 2009 and March 2012, 22 patients who were diagnosed as IVC anomalies by color and spectral Doppler ultrasound were retrospectively analyzed. After careful and comprehensive scanning on multiple planes, the final diagnosis was made based on the findings obtained on B-mode, color Doppler and spectral Doppler ultrasound. All the results obtained by sonography were compared with computerized tomography angiography, digital subtraction angiography, and other clinical examinations. Results There were 22 cases diagnosed as congenital anomalies of IVC, including 5 cases of the left IVC, 3 cases of the double IVC, 3 cases of membranous obstruction of the IVC (MOVC) and 11 cases of the anomalies of the left renal vein. In left IVC, the infrarenal left-sided IVC entered into the left renal vein, then crossed anterior to the aorta to join the right-sided suprarenal IVC. In double IVC, bilateral IVCs could be seen on both sides of the abdominal aorta, and the left IVC joined the right IVC over aorta then entered into the right atrium. Some patients of the left IVC and double IVC had left renal vein hypertension. All the cases of MOVC in our study presented as Budd-Chiari syndrome, in which B-mode ultrasonography showed the existence of the membranous obstruction in inferior vena cava at the level of entrance to the right atrium. On color Doppler lfow image (CDFI), reverse blood lfow into lumbar and ascending lumbar vein was found. Eleven cases of left renal vein malformations were also seen in present study, including 9 cases of retroaortic
left renal vein, 1 case of circumaortic left renal vein and 1 case of the left renal vein into the left common iliac vein. Among them, 9 cases were associated with left renal vein hypertension. Conclusion Color and spectral Doppler ultrasound can clearly identify the congenital anomalies of IVC with the evaluation of their hemodynamic modiifcation, and can be used as an important approach in the diagnosis of the anomalies of the IVC.

In order to solve some problems which we are confronted with in new period during the course of practical teaching in surgery,we carried out some teaching reforms and explorations,such as stimulating study interests,reforming teaching process,strengthening practical ability,persisting after-school training and so on,which have got good results and laid a firm foundation for cultivating medical talents with practical competence.