OBJECTIVE:To provide reference for perfecting the "Regulation of Drug Price Difference" issued by National Development and Reform Commission.METHODS:To review the drug price management course in China,analyze the effects and limitations since the initiation of "Regulation of Drug Price Difference" in 12 hospitals in Beijing and put forward suggestions for its improvement.RESULTS & CONCLUSIONS:"Regulation of Drug Price Difference" has contributed to the formation of unified and standard evaluation criterion and computation method or even the holistic evaluation system in drug pricing management,the lowering of the costs of human factors and administrative management in drug price management and the improvement of the governmental pricing efficiency.However,efforts should be taken to improve the unreasonable drug price difference coefficient and computation method and so on.

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Objective To investigate the geriatric syndromes in the very elderly people in Beijing community,in order to provide the basis for management of geriatric syndromes and rational use of medical resources.Methods All community-dwelling residents aged 95 years and over living in Haidian district and some residents aged 85 years and over living in Haidian,Chaoyang and Xicheng districts were investigated in household in Beijing.The survey included the general condition,functional status and geriatric syndromes such as falls,senile urinary incontinence,chronic pain syndrome,chronic constipation and malnutrition occurrence.Results 336 seniors with the mean age of (96.0± 3.0) years were investigated.The percentage of people who had falls within 1 year,chronic pain,and chronic constipation was 27.2％ (88/324),37.3％ (122/327) and 47.6％ (160/336) respectively.The incidence of urinary incontinence was 37.1％ (118/318),with 33.3 ％ (46/138) in males and 40.0％ (72/180) in females,and there was no significant gender difference in the incidence of urinary incontinence (P=0.220).The incidences of malnutrition and malnutrition risks was 10.4％ (31/299) and 50.5％ (151/299).37.2％ of subjects could walk outdoor with a better physical function.The self-rated health satisfaction was lower in elderly people with malnutrition and urinary incontinence than in subjects without those diseases (40.0％ vs.70.4％,34.0％ vs.64.6％,x2 =25.20,25.30,both P＜0.001).26％ of them had never heard of geriatrics.Conclusions Geriatric syndromes are common in community-dwelling older seniors.It is urgent to spread the geriatric knowledge and set a reasonable goal for diagnosis and treatment in the seniors.

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Palliative and hospice care for patients suffering severe or end-stage illness with projected short life expectancy.Such services aim to improve patients' quality of life through prognosticating,prevention and treatment of their ailment.The main components include evaluation and treatment of symptoms,pain control,family care,alleviating and treating patients' psychological burden and depression,and offering comfort and dignity.Hospice and palliative care are different from euthanasia,because they neither hasten nor delay the dying process.Instead,they focus on patients'physical and psychological needs and helping patients to maintain their independence and make their own choice.As a new medical subspecialty,palliative and hospice care are considered one of the important frontier in modern medicine.They employ a multi-disciplinary team approach,and the team members require special skill sets including those in communication and symptom management.

Double-stranded oligomeric nucleotide encoding PEP-1 peptides was synthesized, prokaryotic expression pET15b-pep-1-p27mt recombinant constructed, E. coli BL21 (DE3)pLysS transformed and induced with IPTG to highly express fusion protein PEP-1-P27mt. Fusion protein with an N-terminal His-tag could be purified by Ni2+-resin affinity chromatography and identified by SDS-PAGE and Western blotting. Cultured EC9706 cells treated with PEP-1-P27mt revealed that PEP-1-P27mt was transduced into cells after 15 min and reached maximal intracellular concentrations in 2 h. PEP-1-P27mt of 1 micromol/L final concentration could most strongly suppress the growth. It was suggested that PEP-1 can carry P27mt across membrane, which provides a new biological protocol for using cyclin dependent kinase inhibitors p27mt in suppressing the growth of tumor cells.

In order to be in accordance with the development of college education,the contents and methods of the teaching of basic biochemical experiment as well as test evaluation were reformed.Experimental teaching was classified as three types: the element,the improvement and the research.Besides,contents was chosen and the order was reasonably arranged.Results showed that under the new teaching system,college students realized the importance of biochemical experiment and experimental skills were improved.

Objective To prospectively analyze the impact of frailty on the short-term outcomes of coronary heart disease (CHD) and its related factors.Methods A total of 505 patients aged ≥65 years,with diagnosis of CHD in Cardiology Department and Geriatrics Department in our hospital were selected.Clinical data including geriatrics syndromes were collected by using Comprehensive Geriatrics Assessment (CGA).Frailty was defined according to the Clinical Frailty Scale (CFS).The impact of the comorbid conditions on the risk was quantified by the coronary artery disease-specific index.Patients were followed up by clinic visit or telephone consultation.Following-up items included recurrence of all-cause mortality,recurrence of cardiovascular events,and unscheduled returned visit.The impact of frailty on the prognosis of coronary heart disease was analyzed by Cox regression.Results Of the 505 patients,221 patients (43.76％) were considered to be frail elderly,in whom 126 patients (24.95％) were assessed as moderately to severely frail elderly.The incidences of comorbidities and geriatrics syndrome including incontinence,fall history,visual impairment,hearing impairment,constipation,chronic pain,sleeping disorder,dental problems,anxiety or depression,and delirium were higher in frail patients than in non-frail patients[51.1％ (113/221) vs.30.6％ (87/ 284),31.2％ (69/221) vs.19.0％ (54/284),43.9％ (97/221) vs.29.9％ (85/284),49.3％ (109/221) vs.29.6％ (84/284),60.2％ (133/221) vs.33.8％ (96/284),62.0％ (137/221) vs.46.8％ (133/284),49.3％ (109/221) vs.37.7％ (107/284),79.2％ (175/221) vs.55.6％ (158/284),11.3％ (25/221) vs.6.0％ (17/284),2.7％ (6/221) vs.0 (0/284),x2=21.831,10.053,10.510,20.519,34.894,11.481,6.886,30.695,4.624,7.803,respectively,all P＜0.05].After adjusting for sex,age,severity of illness and other coexist factors,the Cox survival analysis showed that frailty was the independent risk predictor for the all-cause mortality and unscheduled return visit in CHD patients (HR=2.881 and 1.835,95％CI:1.591-5.215 and 1.458-2.311,both P＜0.001).Conclusions Comprehensive Geriatrics Assessment and Clinical Frail Scale are useful to evaluate the clinical features in elderly CHD patients.Frailty is the independent risk predictor for the short-term prognosis including all-cause mortality and unscheduled return visit in elderly CHD patients.

Objective To explore the effect of calories supplement or protein supplement on the skeletal muscle in the elderly.Methods The ambulatory elderly (≥65 yrs) with reduced handgrip strength and/or gait speed were enrolled,who did not suffer from any neurological or arthritic disease impairing mobility,or any severe pulmonary or heart disease,or chronic kidney failure.The subjects were recruited with their written informed consent from clinical practices in five hospitals in China.The subjects were randomized to control group(n=26),nutrition supplementation (Nutren 400 kcal/ d) group (n=27) or protein supplementation(Biopro Protein 20 g/d) group (n=21).All the subjects were given healthy lifestyle education.The physical performances i.e.gait speed and handgrip strength were measured at baseline and at 2 and 3 months of followed up.Lean soft tissue mass (muscle mass) was measured by BIA at baseline and at 3 months of follow-up.Results A total of 74 subjects completed the trial,including 26 in controls,27 in Nutren,and 21 in protein group.At the end of the trial,the changes from baseline in appendicular muscle mass were-490.0 g (95％CI:-801.9--245.5,P=0.001)in control group,90.0 g (95％CI:-346.8--442.0,P=0.241) in Nutren group,and 290.0 g (95％CI:-746.6-20.1,P=0.007) in protein group.There were no significant difference in above indices among the three groups (P=0.051),except between Nutren group and control group (P=0.020).The handgrip strength and gait speed in the three groups were improved obviously as compared with those at baseline,but not statistically significant between different groups.Conclusions Caloric supplementation group may have greater effect in maintaining muscle mass than the protein supplement group in the elderly.Both the caloric supplement and the protein supplement produce no additional effect on muscular function as compared with healthy lifestyle education.

Objective To investigate the clinical value of blood oxygen level-dependent functional magnetic resonance imaging (BOLD-FMRI) in guiding the dose reduction and functional protection of the motor cortex during postoperative radiotherapy for brain astrocytoma.Methods This study included 27 brain astrocytoma patients with tumors near the motor cortex,who underwent routine MRI and BOLD-FMRI before postoperative radiotherapy.The location and scope of the motor cortex,which were acquired based on BOLD-FMRI results,were marked on positioning CT images,so that the motor cortex would be dealt with as organs at risk.The dose to the motor cortex was reduced as much as possible while ensuring the therapeutic dose to the target area.Finally,the radiotherapy plan that would reduce the mean received dose of the motor cortex was formulated and compared with the routine plan that could not reduce the received dose.Results With the protective radiotherapy plan,the mean received dose of the motor cortex decreased 0.76％-59.20％ (mean 30.78％) on the affected side and 23.33％-68.30％ (mean 48.07％) on the unaffected side;the coefficients of variation were 71.41％ on the affected side and 36.71％ on the unaffected side.Conclusions BOLD-FMRI can help to reduce the received dose of the motor cortex while ensuring the therapeutic dose to the target area when formulating the postoperative radiotherapy plan for brain astrocytoma,thus protecting the motor function and improving patients' quality of life.