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.

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.

Objective To assess the value of intraoperative ultrasonography during the uterus septum resection under a hysteroscope.MethodsThe uterus septum resection was performed under the guidance of transabdominal ultrasonography by using a hysteroscope in 30 patients.The operative procedure and the position of the hysteroscope were monitored,and the depth of the dissection and thickness of the myometrium in the fundus uteri were measured with transabdominal ultrasound during the operation.ResultsThe thickness between the incisal surface and serosal layer in the fundus uteri was within the normal limits in 28 cases.In 2 cases,the tissue was over-ectomized.The position of the urethral catheter balloon was correct in all of the 30 cases.Three months after the procedure,reexamination by transvaginal ultrasonography showed that the uterine cavity was normal in the patients.ConclusionsIntraoperative ultrasonography is quick,safe and precise for monitoring uterus septum resection.It is valuable for establishing surgical strategy and reducing operative complications.

Objective To evaluate the value of ultrasound-guided channel establishment in minimally invasive percutaneous nephrolithotomy(MPCNL).MethodsBetween May 2006 and December 2007,85 patients received MPCNL in our hospital.Puncture points were selected and then channels were established under the guidance of ultrasonography according to the distributions of calculi during MPCNL.ResultsUnder the guidance of ultrasonography the puncture was completed at one session in all of our 85 cases.No massive hemorrhage or other severe complications occurred.In the cases,57 cases were cured after the first operation,and 27 cases received a second surgery.One of the cases was diagnosed as having calcification of the renal papillae without kidney calculi during the operation.Residual calculi(

Objective To investigate the expression of chemokine ligand 2 (CCL2)in chronic uric acid nephropathy(CUAN)and its diagnostic values in kidney damage.Methods 29 patients with CUAN[male 23,female 6,age (44.4 ±8.8)years old ]and 35 health individuals[male 27,female 8,age (40.6 ±7.8 )years old ]were involved in this study.Serum and peripheral blood mononuclear cells were isolated from peripheral blood.CCL2 was assayed by ELISA,and CD +45 /CD +14 monocytes were analyzed by flow cytometry.Liver &kidney functions,lipids and glucose were detected by automatic biochemistry analyzer.Results Serum CCL2 in group of CUAN and health con-trols were 456.2(202.6 -594.9)pg/mL and 245.0(132.2 -544.5)pg/mL,respectively(F =4.915,P =0.030). Percentages of monocytes in each group were 7.4%(5.6% -8.7%)and 6.1%(4.7% -7.9%),(F =8.891,P =0.004).Pearson analysis found that levels of CCL2 positively correlated with percentages of monocytes,serum uric acid and creatinine in CUAN group(r values were 0.535,0.584 and 0.012;P values were 0.003,0.001 and 0.012, respectively),but there was no correlation with urea and retinol binding protein(r value were 0.145 and 0.746,P val-ues were 0.453 and 0.453).Conclusion Hyperuricaemia may directly contribute to elevate levels of CCL2 and facilitate monocytes release into inflammation part to induce kidney damage.

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.

Objective: Enhanced expression of adhesion molecules on synovial tissu e has been demonstrated in patients with dialysis-related amyloidosis (DRA). T he study was conducted to elucidate the mechanisms by which the expression of adh esion molecules on synovial cells was up-regulated.Methods: Human type-B synov ial cells were cultured in vitro with β2-microglobulin modified with adva nced glycation end products (AGE-β2m) , native β2-microglobulin (β2 m) , tumor necrosis factor-α（TNF-α）and interleukin -1β（ IL-1β）. The expression of intercellular adhesion molecule-1(ICAM-1), vasc ular cell adhesion molecule-1(VCAM-1), and E-selectin was examined by immunofluor esc enct staining and flow cytometer analysis. Results:ICAM-1 and VCAM-1, but not E -selectin, were constitutively expressed on human type-B synovial cells. TNF -α a nd IL-1β enhanced the expression of ICAM-1 and VCAM-1 in a dose- and time - depen dent manner. Neither of these cytokines appeared to induce the expression of E - selectin. Both β2m and AGE-β2m had no direct effect on the expression of the a dhesion molecules.Conclusion: Elevated level of IL-1β and TNF-α in the synov ial tissue may up-regulate the expression of adhesion molecules on synovial cel ls and therefore promote local monocytes infiltration.

International communication capabilities of traditional Chinese medicine professionals are closely related to the publicity of Chinese medical culture and know-how.Based on the interview results as well as literature research,this paper discusses the qualification of traditional Chinese medicine professionals and proposes five essential elements constituting their international communication capabilities:knowledge and skills of Chinese medicine,foreign language proficiency,knowledge and skills of international communication,a global perspective as well as personal traits.It is expected that it may contribute to the syllabus design,in-service training and talents cultivation in Chinese medical colleges and universities.

Objective To study the influence of progesterone (PROG) on infarct volume and functional outcome and to evaluate the therapeutic value of PROG on cerebral infarction in rats.Methods Health adult male Sprague-Dawley rats were randomly divided into sham-operated (control) group,ischemic group,vehicle-treated group and PROG-treated group.Permanent cerebral ischemia was induced by occlusion of the left middle cerebral artery (MCA) using an intraluminal filament technique.Sham-operated rats were subjected to the same surgical procedure,except that the filament was not advanced to occlude the MCA.Progesterone or 2-hydroxypropyl-β-cyclodextrin was injected intraperitoneally following permanent middle cerebral artery occlusion (PMCAO) of rats.Zea Longa test was used to evaluate their functional outcome at 1d,2d,3d after stroke.TTC staining was used to detect the infarct volume at 3d after stroke.Results The results of Zea Longa test showed that there were no functional deficits in all animals prior to ischemia.There were no significant changes in motor function in sham-operated animals across the 3 days assessment period.Both PROG and vehicle-treated rats experienced significant decline in scores following occlusion.However,PROG-treated rats (3.00 ± 0.63,2.83 ± 0.75,2.00 ± 0.89 )demonstrated a gradual improvement in scores compared with ischemic (4.00 ± 0.89,3.83 ± 0.75,3.16 ± 0.75 )and vehicle-treated rats ( 3.67 ± 1.21,3.50 ± 1.05,2.83 ± 0.76) at different times (P ＜ 0.05 ).TTC staining revealed that PROG administration significantly reduced the total infarct volume in the PROG-treated rats ( ( 15.03± 3.75) ％ ) compared with ischemic ( (23.74 ± 4.48 ) ％ ) and vehicle-treated rats ( ( 24.42 ± 7.07 ) ％,P ＜0.05).Conclusions PROG significantly reduces infarct volume and promotes the recovery of neurological functions after pMCAO,which has good therapeutic value for the rat model of cerebral infarction.

Objective To evaluate contrast-enhanced ultrasound(CEUS) in the diagnosis of vascular complications of transplanted kidneys.Methods Twelve patients with vascular abnormalities after renal transplantation were observed and analyzed using CEUS, and the diagnosis of all cases was confirmed by means of operation,pathology or angiography.Results Five patients with renal artery stenosis,2 patients with renal artery thrombosis,3 patients with pseudoaneurysm, 1 patient with pseudophlebangioma, and 1 patient with intrarenal extensive microthrombus were found.The coincidence of CEUS was 100%.Conclusions CEUS is a new method with the characteristics of non-nephrotoxic damage to kidney and comparable with angiography in terms of dynamic imaging.