OBJECTIVE:To provide legal basis for purchasing drugs by centralized bidding.METHODS:On the basis of the relevant laws,to expound the process of purchasing drugs by centralized bidding and the standards that should be observed. RESULTS ＆ CONCLUSION:Purchasing drugs by centralized bidding should observe the public bidding law of the People's Republic of China,only by observing the law can it benefits the nation and the people.

Using Li Ka Shing Medical School of Hong Kong University as an example, this paper introduced the medical humanities education in Li Ka Shing Medical School of Hong Kong University from four aspects of the medical humanities curriculum implementation in detail. Secondly, it expounded the relationship between students and art through two typical cases. Finally, this paper pointed out the enlightenment for medical humanities educa-tion in Medical Schools. For curriculum, the core curriculum of medical humanities must be determined. For teachers, exchanges and cooperation with foreign mature medical humanities education should be carried out active-ly. For teaching methods, the novelty and diversity must be emphasized.

Objective To compare the characteristics of the SP-AP compound wave elicited by click and tone pip.Methods The electrocoehleogram was recorded with round window electrode,and waves were elicited by click and tone pips,respectively.Results The SP-AP compound waves were elicited 1,2,3,4 and 8 kHz tone pip and click.The amplitude of SP at each frequency was-13.56±8.7,-16.61±10.53,-10.13±14.75,-3.71±14.49,-2.99±5.4 and -4.44±10.81 μv,respectively.Conclusion Tone pip at 1,2,3,4,8 kHz can elicit SP,and produce frequency specific SP wave.This is helpful to identify the lesion site of auditory neuropathy.

Objective To investigate the relationship between serum surfactant protein-A (SP-A) and -D (SP-D) in patients with systemic lupus erythematosus (SLE) complicated with interstitial lung disease.(SLE-ILD) and its clinical significance.Methods Serum SP-A and SP-D levels of SLE patients and controis were assessed using a sensitive enzyme-linked immunosorbent assay (ELISA).The relationship between SP-A and SP-D and SLE-ILD,the correlation between SP-A and SP-D with age,disease activity index,pulmonary function test and high-resolution computed tomography (HRCT) score were analyzed.Results The level of serum SP-A and SP-D in patients with SLE is higher than that in healthy controls(P＜0.05).The level of serum SP-A and SP-D in patients with SLE complicated with ILD was higher than that in patients without ILD and healthy controls (P＜0.05).The level of serum SP-D in patients with SLE-ILD was correlated positively with HRCT score (r=0.508,P=0.004) and interstitial score (r=0.468,P=0.009),and it correlated inversely with vital capacity (%VC) (r=-0.590,P=0.001 ) and diffusing capacity of carbon monoxide (%DLCO)(r=-0.588,P=0.001 ).There was no correlation between the level of serum SP-A with SLE-ILD and HRCT score,%VC and %DLCO.The level of serum SP-D in patients with SLE-ILD correlated positively with serum IgG (r=0.376,P=0.040),and the level of serum SP-A in patients with SLE-ILD correlated positively with serum C reactive protein (CRP)(r=0.403,P=0.027).There was a positive correlation between the level of serum SP-D in patients with SLE and age (r=0.352,P=O.001 ).Conclusion The levels of serum SP-A and SP-D may be useful markers for ILD in patients with SLE.There is correlation between the level of serum SPD and HRCT score,pulmonary function test,and it is positively correlated with age and disease activity index.

Cord lipoma is a trite lipoma, it is a protrusion of extraperitoneal fatty tissue through the internal inguinal ring. The incidence is between 20% to 30%.It is often caused by a protrusion of extraperitoneal fatty tissue through the internal inguinal ring, lobular retroperitoneal fat insinuates itself through the internal ring and over time dilates it. Patients with a higher BMI are more prone to having a cord lipoma. Incidence of lipoma associated with Type II and Ⅲ hernias was bigher. it is suggest that the incidence of lipoma assoeiated with the type of hernias and patients with a larger hernias are more prone to having a coM lipoma. The cord lipoma is difficult to diagnosis before surgery,because it is similar to hernias in symptom. Ultrasound is safe and useful in finding hernias and cord lipoms, the overall accuracy is 92%. It is necessary to resect lipomas and repair as long as the extraperitoneal fatty tissue through into the inguinal canal.

The clinical data and ultrasound findings of 185 patients with thyroid nodules undergoing thyroidectomy from June to December 2015 were retrospectively reviewed.Postoperative pathology confirmed malignant thyroid nodules in 86 cases and benign nodules in 99 cases.The ultrasonographic findings showed that there were significant differences in obscure boundary [51％ (44/86) vs.16％ (16/99)],hypoecho [(95％ (82/86) vs.27％ (27/99)],internal micro-calcification [63％ (54/86) vs.21％ (21/99)] and lymph node enlargement [33％ (28/86) vs.5％ (5/99)] between malignant and benign nodules (all P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of thyroid imaging reporting and data system (TI-RADS) in differentiation of malignant and benign thyroid nodules were 77％ (66/86),86％ (85/99),83％ (66/80),81％ (85/105) and 82％ (151/185),respectively.The positive rates of thyroid globulin antibody(TGAb) and thyroid peroxydase antibody (TPO-Ab) in malignant nodules [6％ (5/79) and 25％ (20/79)] were significantly higher than those in benign nodules [0 (0/94) and 12％ (11/94)] (both P ＜0.05).There was no significant difference in free T3 (FT3),free T4 (FT4) and TSH between the two groups [(4.91-± 0.78) vs.(4.93-± 1.98) pmol/L,(13.57 ±2.22) vs.(13.58 ±2.17)pmol/Land(1.78±1.40) vs.(1.88±2.36)mU/L] (allP＞0.05).The results indicate that TI-RADS grading and thyroid immunity index are valuable for differential diagnosis of thyroid nodules.

At present,nutrition therapy plays a very important role in critically ill children,which can impact on the development and outcome of the disease by the process of metabolism and immunity.Immune-modulating nutrients,such as glutamine,which is a current hot topic,but now there is a little research in it in critically ill children,and this paper summarizes the approach,the dose and the efficacy of glutamine in critically ill children,aiming to offer reference in clinics.

OBJECTIVE To investigate the prevalence of metallo-?-lactamase in carbapenem-resistant clinical Pseudomonas aeruginosa isolates.METHODS Sixteen strains of P.aeruginosa isolated from Tianjin General Hospital during 2005-2006 which were resistant to all tested antibiotics besides carbapenem were studied.The general PCR was adopted to amplify the resistance genes of matallo-?-lactamae.Restriction endonucleases performed restriction analysis were used to certify the type of genes of matallo-?-lactamase by different endonuclease recognition site.RESULTS Two of the 16 clinical strains of P.aeruginosa(named P02 and P16) were confirmed bearing IMP-1 metallo-?-lactamase gene detected by PCR amplification and restriction analysis.CONCLUSIONS P.aeruginosa producing IMP-1 metallo-?-lactamase is the major type in our hospital.The hydrolyzing effect of the metallo-?-lactamase is not the main machanism in these carbapenem-resistant P.aeruginosa isolates.

Objective To investigate the role of sex hormones and interleukin (IL)-6 in the pathogenesis of primary Sjgren′s syndrome (pSS). Methods Serum specimen of 21 postmenopausal patients with pSS and 21 postmenopausal healthy women were collected. Serum estradiol (E2) and testosterone (Te) were estimated by the commercial radioimmunoassay kits, whereas serum dehydroepiandrosterone sulfate (DHEAS) were measured by enzyme-amplified chemiluminescence assay. Enzyme linked immunosorbent assay kits were used to determine levels of IL-6 in serum. Results The DHEAS and the Te level in serum were lower in postmenopausal patients with pSS than in healthy controls (P0.05). The level of IL-6 in pSS patients was higher than that in controls (P0.05). Conclusion Primary Sj(?)gren′s syndrome, in which an altered metabolism of sex hormones has occured, appears to be influenced by the change of the levels of sex hormones and IL-6 in serum.

Objectives:To evaluate the potent role of matrix metalloproteinases(MMPs) and its tissue inhibitors(TIMPs) in the processes of metastasis and local invasiveness of Chinese human ductal adenocarcinoma of the pancreas,and to evaluate the possible biologic association between its gene expression and the clinical manifestations.Methods:Northern-blot and in-situ hybridization has shown MMPs and TIMPs gene expression in the pancreas and alterations associated with neoplastic transformation.Fifteen cases of surgical pancreatic specimens were examined with cDNA probes to MMP2,MMP9 and TIMP1,findings were correlated with the size of tumor section,CA19-9,pathological classification,thrombosis and infiltration of capsule and lymph nodes.Results:Increased levels of genes mRNA from MMP2,MMP9 and TIMP1 were found in the examined pancreatic cancer tissues,MMP2≈MMP9＜TIMP1,whereas low levels of transcripts for MMP2,MMP9 and TIMP1 were detectable in pancreata of organ donors.Transcripts coding for MMP2,MMP9,TIMP1 were found in both stroma and tumor cells.Gene expression of MMP2,MMP9 and TIMP1 has shown an obvious correlation with the infiltration of capsule cells,surrounding lymph nodes and the specific histopathological features.Conclusions:Imbalance between MMPs and TIMPs may help physicians to assess the metastatic potential and the prognosis of individual patients.