OBJECTIVE:To provide reference for the further improvement of national essential medicines system. METHODS:Taking theBull's-eyecity Chengdu as an example,based on the trading areas,the existing problems in implementing essential medicine system were analyzed by qualitative and quantitative research methods,and countermeasures were put forward. RESULTS:From the point of view of quantitative data,the first level trading areas of both proportions of medical personnel per thousand ur-ban population and numbers of primary medical and health institutions per 100 thousands population in Chengdu were the lowest. From 2010 to 2012,the outpatient and inpatients increased 1.09 million people and 0.16 million beds per day in Chengdu primary health care institutions,the largest increase in the first level trading areas,and increase and decrease in the second and third level trading areas;outpatient and inpatient drug costs fell respectively 4 yuan and 109 yuan,medicine proportion declined 6.7%,in-crease in the first level trading areas,and decreased to varying degrees in the second and third level trading areas. From the point of view of qualitative interviews,the service ability got enhancement,but still could not meet the services demand,especially the pressure in the first level trading areas near center district remains heavy;drug cost was under controlled,but the subsidies needs to be increased,the per capita drug costs in the first level trading areas remains high;the drug income and medicine proportion were inhibited,especially the significant fell in the second and third level area,but the decrease of income may restrict develop-ment. CONCLUSIONS:It is suggested that more targeted drugs are needed for meeting the services demand,more sophisticated policy are needed for improving the subsidies,and more comprehensive medical conditions are needed for ensuring institutions'de-velopment.

Objective: Finding the essence and regular pattern of the construction of male urine collection devices, and setting up its basic concepts. Methods:Selecting typical construction examples, then analyzing them singly and as a whole. Results:Setting up concepts such as construction module, construction factor, construction factor unit, construction index, construction array etc., and giving out the table of construction factor units. Conclusion:This research has provided mode, methods, means for understanding and further analyzing, studying male urine collection devices.

Objective: To study influencing factors for aspirin resistance in women with ischemic stroke.Methods: A total of 150 women with ischemic stroke, who visited to our hospital from Jun 2013 to Jun 2015, were selected.According to presence of aspirin resistance, they were divided into aspirin resistance group (n=61) and aspirin sensitive group (n=89).All patients received aspirin enteric-coated tablets on morning, then arachidonic acid pathway platelet aggregation inhibition rate and glycosylated hemoglobin A1c (HbA1c) level were measured in two groups on 10 h after administration.According to HbA1c level, patients were divided into normal blood glucose group (n=83) and elevated blood glucose group (n=67), then aspirin resistance rate was compared between two groups.Logistic regression analysis was used to analyze influencing factors for aspirin resistance.Results: Compared with aspirin sensitive group, there was significant rise in body weight[(63.5±7.9) kg vs.(66.9±10.2) kg]in aspirin resistance group, P=0.041.Compared with normal blood glucose group, there was very significant rise in aspirin resistance rate (14.46% vs.73.13%) in elevated blood glucose group, P=0.008.Multi-factor Logistic regression analysis indicated that body mass index (BMI) and blood glucose level were independent risk factors for aspirin resistance (OR=4.012, 3.012, P=0.016, 0.018).Conclusion: Incidence rate of aspirin resistance is high in women with ischemic stroke.Blood glucose control and body weight status may affect incidence of aspirin resistance.

Objective To understand the clinical characteristics and susceptible factors of neonatal nosocomial infection in primary hospital,and discuss the control measures in order to effectively reduce the neonatal nosocomial infection rate.Methods A retrospective analysis about clinical characteristics and susceptible factors of neonatal nosocomial infection was carried out from October 2010 to September 2012.Results Premature rupture of fetal membranes,premature infant,low birth weight,invasive operation were high risk factors for nosocomial infection.Infection most often occurred in respiratory tract,skin and soft tissue.Conclusions Neonatal nosocomial infection is influenced by many factors,in which the awareness of prevention and control among the medical staff,the aseptic operation,hand hygiene compliance,the ward disinfection management level and education during the pregnancy are crucial,which are the key link in the control of neonatal nosocomial infection.

Objective To explore the hereditary susceptibility of children with asthma through studying the relationship between erythroeyte CR1 genomic density polymorphism and erythrocyte immune function. Methods The rates of RBC-C3_(3b)RR and RBC-ICRR were detected to the asthma group consisted of 65 children with asthma and the control group consisted of 28 normal children. The CR1 activity and genomic density polymorphism of erythrocyte from the two groups were detected by Hind Ⅲ restriction enzyme digestion, polymerase chain reaction restriction fragment length polymorphism. Results Frequencies of high expression gene (HH), mid expression gene (HL) and low expression gene (LL) genotypes were 43.08% (28/65), 36.92% (24/65) and 20.00% (13/65) in asthma group, and 78.57% (22/28), 17.86% (5/28) and 3.57%(1/28) in control group respectively. A significant difference was found in the distribution frequency of CR1 genotype between the two groups(P< 0.01).The rates of RBC-C_(3b)RR were significant lower and the rates of RBC-ICRR were significant higher in asthma group than those in control group (P < 0.01). The rates of RBC-C_(3b) RR in HH, HL and LL were decreased in order (P < 0.01),while the rates of RBC-ICRR in HH,HL and LL were increased in order (P < 0.01). Conclusion It suggests that CR1 gene polymorphism may play an important role in determining susceptibility to asthma.

Objective To study the effect of human prolactin (PRL) on total IgG and anti-dsDNA antibody production in peripheral blood mononuclear cells (PBMC) from patients with systemic lupus erythematosus (SLE). Methods PBMC from SLE patients and control subjects were cultured, with the stimulation of PRL, interleukin 2 (IL-2), interleukin 10 (IL-10) and phytohemagglutinin (PHA). 3H-thymidine (3H-TdR) incorporation assay was used to study the proliferation of PBMC. Total IgG and anti-dsDNA antibodies in the cultured supernatants were measured by enzyme-linked immunosorbent assay (ELISA) in 19 patients of SLE and in 6 control subjects. Results ①The proliferation of PBMC in vitro was enhanced by 10-9 mol/L PRL in 19 patients of SLE. ②The production of IgG and anti-dsDNA antibodies in PBMC from 10 active SLE patients was much higher than that of 9 inactive patients (P

Objective To study the effect of growth hormone (GH) and PRL (prolactin) on the secretion of Th1/Th2 type cytokines in the patients with systemic lupus erythematosus (SLE). Methods The secretion of cytokines in PBMCs stimulated by GH and PRL was detected by ELISA in vitro. Results The results showed that the secretion levels of IL-6 and IL-10 from PBMCs of the SLE patients in active stage were higher than those of the normal controls, and the secretion level of IFN-? was lower than that of SLE patients in resting stage and the normal controls, but it is of no statistical significance. The secretion levels of IL-6 and IL-10 were significantly increased in PBMC stimulated by GH and PRL, but GH and PRL had no effect on the secretion of IFN-?. There was no difference on the secretion level of IL-6, IL-10 and IFN-? when the PBMC was stimulated by GH and PRL. Conclusion GH and PRL might play an important role in the pathogenesis of SLE.

Objective To study the association between serum prolactin(PRL)level,prolactin receptor(PRLR)expression on peripheral blood mononuclear cells and the disease activity in the patients with systemic lupus erythematosus(SLE).Methods Serum PRL level was measured by time-resolved fluoroimmunoassay(TrFIA)in113patients of SLE and in28gender-and-age matched control subjects,SLEDAI index was estimated.It was also investigated by logistic multiple regression analysis that the association between clinical manifestations,immunologic parameters,anti-dsDNA antibody titers and hyperprolactinemia in113patients of SLE.The specific binding(SB)rate of peripheral blood lymphocyte PRLR was measured by radioactive binding ligand assay(RLBA)and the mRNA expression of PRLR by reverse transcription polymerase chain reaction(RT-PCR)in24active SLE patients,22inactive SLE patients and15gender-and-age matched control subjects.Results The serum PRL levels of63active patients were much higher than those of50inactive patients and28control subjects.The serum PRL levels ranged9~51.2?g/L in79.3%of active patients.It was also found that PRL level was in positive linear correlation with the titer of anti-dsDNA antibody.The concentration of interleukin2receptors in hyperprolactinemia group was higher than that in normal group.It was shown that proteinuria,low levels of complement3and high titers of anti-dsDNA antibody were associated with hyperprolactinemia by logistic multiple regression analysis.The SB rate of PRL receptor was5.03?2.51%(x?s),the total binding rate(TB)was15.4?6.98%in24active patients with SLE.The SB rate of active patients was much higher than that of22inactive patients(SB4.18?2.26%,TB rate14.03?6.54%)and that of15gender-and-age matched control subjects(SB1.62?1.05%,TB8.19?1.47%).The mRNA expression of PRLR in active patients(x?s,0.85?0.45)was much higher than in inactive patients(0.58?0.43)and that in control subjects(0.20?0.13).Conclusion The slightly increased serum level of PRL,high expression of PRLR and the increased specific binding rate are associated with the disease activity of SLE.

Adult ; Aged ; Disease Outbreaks ; Female ; Humans ; Leptospirosis ; epidemiology ; Male ; Middle Aged

Objective To compare the efficacy of combination therapy of intravenous immunoglobulin (IVIG) and corticosteroids versus corticosteroids alone in the treatment of toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). Methods A retrospective study was conducted. Totally, 65 consecutive patients diagnosed as either TEN or SJS from January 1993 to October 2007 were included in this study. For 45 patients collected from 1993 to 2000, including 35 cases of TEN and 10 cases of SJS, methylprednisolone of 1 - i.5 mg per kilogram bodyweight per day or equivalent hydrocortisone or dexamethasone was given; for the remaining 20 patients collected from 2001 to 2007, including 12 cases of based on SCORTEN, a severity-of-illness-score system for TEN/SJS prognosis. Results Among the 45 patients treated with corticosteroids alone, 8.63 patients were expected to die based on SCORTEN system, while 10 deaths were observed. Standardized mortality ratio (SMR) analysis revealed that the patients treated with corticosteroids alone were 16% more likely to die than those treated with routine therapy (SMR = 1.16; 95% confidence interval, 0.56 - 2.13). In the remaining 20 patients who received combination therapy, 3 deaths occurred, while 3.51 deaths were expected based on the SCORTEN system. SMR analysis showed that the combination therapy had a trend to reduce the mortality rate of TEN/SJS (SMR = 0.85; 95% confidence interval, 0.18 - 2.50). No significant difference was noted in the mortality rate of TEN/SJS between the combination therapy and corticosteroid monotherapy (16.7% vs 22.8% in TEN, 12.5% vs 20% in SJS, respectively, both P > 0.05). In patients with TEN, the combination therapy significantly reduced the time to arrest disease progression (4.30 ± 2.36 days vs 7.15 ± 3.35 days, t = 2.46, P < 0.05) and total hospitalized time (23.40 ± 5.10 days vs 34.30 ± 16.00 days, t = 3.14, P < 0.05), but had no significant effect on the time to taper corticosteroid dose (12.30 ± 3.10 days vs 12.20 ± 5.13 days, t = -0.045, P > 0.05) compared with the corticosteroid monotherapy did; so was the case for SJS. Conelusious Compared withsolo administration of corticosteroids, the combination therapy with corticosteroid and IVIG seems to reducethe mortality rate of TEN/SJS. Also, the combination therapy could arrest the progression of TEN/SJS earlier accompanied by a decrease in hospitalization time. However, the time period of corticosteroid tapering is not shortened by the combination therapy.