The hemodynamic features of the involved blood vessels in 11 patients with Budd-Chiari syndrome were studied by duplex Doppler SODography.The results showed that there were abnomalities in the direction,velocity,nature and spectral patterns of the blood flows of the involved blood vessels,It is suggested that duplex Doppler ultrasound examination can nonmvasively obtain the hemodynarnic data of inferior vena cava,hepatic veins and portal vein and is very valuable in the clinical analysis,diagnosis,treatment and evaluation of the theurapeutic effect of Budd-Chiari syndrome.

OBJECTIVE:To discuss how to solve patents problems in the registration and approval of drugs.METHODS:Regulations and problems in the registration and approval of drugs in China were analyzed and which were compared with that of the American and Europe.RESULTS&CONCLUSIONS:The registration and approval of drugs and their patents right protection were legally independent of each other,to which the drug administration law and patent law respectively are appli-cable.There is no necessary association between the registration and approval of drugs and the infringement of patents right.Patent dispute should be solved in accordance with the patent related regulations,the registration and approval of drugs should not involve the solving of patent disputes of drugs.

By analyzing relevant documents of procurement of drugs with target quantity in Shanghai, com-bined with onsite investigations and interviews, this paper summarizes the practice of procurement of drugs with target quantity in Shanghai from six aspects, namely the basic situation of centralized procurement, pilot scope and variety of procurement of drugs with target quantity, business qualification and certification, determination of successful bid-der, drug distribution, and drug payment settlement. This paper argues that Shanghai has successfully implemented the policy of procurement of drugs with target quantity, by scientifically establishing a comprehensive evaluation index of quality, setting up private drug procurement accounts, prepaying drug procurement loans and strengthening plat-form services and regulatory capabilities, in order to effectively guarantee the operation of procurement of drugs with target quantity. From this case study of Shanghai, it can draw the following implications that in order to successfully achieve procurement of drugs with target quantity mechanism, setting up functional departments of unified authority is the most important guarantee, and using technical means and platform building is the basic conditions. Therefore, the setting up of economic and technical bidding should focus on the individual properties of generic drugs, and the pro-moting of tripartite system reform will help to further expand the scope of procurement of drugs with target quantity.

ObjectiveTo explore the effect of cluster needling of scalp acupuncture combined with rehabilitation(Tang's Approach) on depression of stroke patients with motor aphasia.Methods70 stroke patients were randomly divided into the acupuncture with rehabilitation group and the control group. The cluster needle of scalp point with speech rehabilitation training was used in the acupuncture with rehabilitation group, while speech rehabilitation training was used only in the control group. The degree of depression and aphasia were observed in the two groups 4 weeks after treament.Results 4 weeks after the treatment, the classification of aphasia was getting better in the acupuncture with rehabilitation group than in the control group(P＜0.05), and the incidence of depression decreased significantly in the acupuncture with rehabilitation group compared with the control group(P＜0.01). The score of Stroke Aphasic Depression Scale (SADQ) decreased significantly in the acupuncture with rehabilitation group compared with the control group (P＜0.01).ConclusionTang's Approach may improve the depression of stroke patients with motor aphasia.

Objective:To clarify whether nutritional risk screening 2002 could be used as a basis for nutritional support for liver surgery patients.Methods:Among the 243 hospitalized patients,61 patients had ≥ 3 NRS 2002 scores,and 41 of them were given nutrition support.The remaining 182 patients scored ＜ 3,and 73 of them were administrated with nutrition support.Results:The incidence of nutritional risk of hospitalized patients in liver surgery was 25 ％.Among the patients at nutritional risk group,67％ were given nutrition support.And the rates of infection related complication were nutritional supported patients significantly lower than that in the no nutrition support group (P ＜ 0.05).Conclusion:Accurate application of NRS 2002 and necessary nutrition support in liver surgery patients could improve nutritional status and clinical outcome.

OBJECTIVE:To provide reference for the establishment of a system of expired medicine recycling in China. METHODS:The experience of developed countries with respect to the system of expired medicine recycling was summed up,and the existing problems about the recycling of expired medicines in China were considered to make suggestions to the establishment of a system of medicine recycling in China. RESULTS & CONCLUSIONS:Generally,the developed countries such as Britain, France,Germany and America treat expired medicines as hazardous wastes in the Environmental Protection Law,Waste Disposal Law and other laws,and have basically standardized the recycling of expired medicines. The projects of recycling expired medi-cines in those countries are usually funded by their governments or enterprises of manufacturing or selling medicines,where the medicines were recycled at designated places or on a regular basis or by post,executed by pharmacists and pharmacies,and then disposed on the basis of classification or burned and buried at dumps. However,currently there are no laws and regulations and spe-cial funds for medicine recycling in China,leading to people’s lacking of enthusiasm to recycle the expired medicines. It is suggest-ed that China should take such measures as soon as possible,including establishing and improving the laws and regulations of ex-pired medicine recycling,distinguishing the reasonably determination and disposition of different types of expired medicines,accel-erating the reform of the medical insurance payment system,giving full play to the pharmacist’s role of medication guidance,and fully increasing information transparency.

OBJECTIVE:To provide reference for the management of re-use of single-use devices (SUDs) in China. METH-ODS:The management situation of SUDs use in China and the management policy of SUDs re-use in America and Germany were introduced,the published literature of SUDs re-use was researched and the safety and ethicality were analyzed and discussed. RE-SULTS:China had no regulation for the clear definition of the range,standards and requirements of SUDs re-use;America and Germany had well-management for the SUDs re-use with different modes. Literature analysis showed that there were 3 results for the SUDs re-use,including supporting,opposition and classified management. In terms of safety,SUDs re-use needs the base of specific species and disinfection operations;in terms of ethicality,SUDs re-use should focus on the right to know of patients and the effects on cost savings and environment. CONCLUSIONS:China should establish and improve the management policy of SUDs re-use,develop the classification assessment of re-use,encourage third-party organizations participating in the recycling of SUDs and strengthen the monitoring of adverse reactions,etc.

Under National Health Insurance system ( NHI) , Taiwan implemented “Family Physician Integrat-ed Health care Plan” by focusing on the key functions of primary medical institutions and family physicians. This plan had continuously strengthened the family physician system and the quality of integrated health care provision. Taiwan’s achievements and experiences were valuable for Mainland China. This paper first introduced the health sys-tem and health care provision system of primary medical institutions in Taiwan from the aspects of financing, pay-ment, health care delivery system structure, and market-capture institutions. Then, we made a comprehensive intro-duction on the policy objectives, organization structures, operation system, service schemes and health insurance pay-ment system of this plan. Finally we proposed the suggestion for integrated health care provision system in Mainland China. It is of vital importance that government should design the integrated service provision system by focusing on the key functions of family physicians. It is also of equal significance that the health administrative departments should cooperate with health insurance administrative departments to gain sufficient policy and funding resources for the plan’s successful implementation.

Objective To compare the curative effect of laparoscopic and laparotomic operation for elderly Chinese women with cervical cancer. Methods The randomized controlled trials (RCT) and case controlled trials (CCT) were collected by searches of WanFang database, CNKI, VIP, China Biology Medicine (CBM) , PubMed. Data were extracted from these trials and data analysis was performed by RevMan 5.2.9. Results There were no RCTs, however, a total of 10 CCTs met the inclusion criteria and had data extracted for this review. The baseline characteristics of the laparoscopic group were similar to those of the laparotomic group. Comparing to laparotomic group, the laparoscopic group have longer operation time (MD =32.60, 95%CI: 5.65~59.55, P = 0.020), less amount of bleeding (MD = -94.01, 95%CI: -130.65 ~ -57.37, P = 0.000), smaller number of lymph node dissection(MD = 1.69, 95%CI: 0.67 ~ 2.72, P = 0.001), earlier anus exhaustion (MD=-17.09, 95%CI: -21.19 ~ -12.98, P = 0.000) and shorter hospital stays (MD = -4.30, 95%CI: -5.57 ~ -3.02, P = 0.000). There was significant difference between the two groups. But there was no statistical significance in postoperative indwelling catheter time (MD = -0.67, 95%CI: -1.92 ~ 0.58, P = 0.290) and surgical complications incidence (OR=0.62, 95%CI: 0.27 ~ 1.42, P = 0.260) between the two groups. Conclusion Laparoscopic management has the advantages of less traumatic and recovered quickly, and did not increase the incidence of complications. Laparoscopic operation is an ideal procedure for elderly Chinese women with cervical carcinoma.

Objective To explore the effects of task-oriented training on forelimb motor function and expression of synaptophysin andgrowth associated protein (GAP)-43 in rats after focal cerebral ischemia. Methods Endothelin-1 (ET-1) was used to induce focal cerebralischemia model in rats with forelimb dysfunction. The rats were randomly divided into 4 groups: sham operation group, model group,task-oriented training group and treadmill running group, each group was divided into 4 subgroups by 3 d, 7 d, 14 d, and 21 d. 24 hours aftermodeling, the rats in task-oriented training group were trained with forelimb reaching and the rats in the treadmill running group weretrained by treadmill, and the model group had no intervention. Motor function of rats was evaluated by net screen test, and immunohistochemistrystaining was used to observed the expression of GAP-43 and synaptophysin in cortical ischemia lesions of the rats in each groupat different time points. Results The scores of behavioral tests were better in the task-oriented training group than in the model group (P<0.01) and the treadmill group (P<0.05) on the 14th and 21st days after modeling. The expression of GAP-43 was higher in the task-orientedtraining group than in the model group (P<0.05) and the sham group (P<0.01) on the 7th and 21st days after modeling. The expression ofsynaptophysin was higher in the task-oriented training group than in the model group (P<0.05) and the sham group (P<0.05) on the 14th andthe 21st days after modeling. Conclusion Task-oriented training can facilitate the recovery of forelimb motor function of rats after focal cerebralischemia, and it may be partially related to the up-regulation of expression of GAP-43 and synaptophysin in peri-infarction cortex.