Objective:This paper aims to analyze the monitoring model of Canadian drug price monitoring mod-el based on the international reference price, and make reference for China. Methods: Through policy analysis and literature research, the system combs the specific Canadian practices of using the international reference prices for the drug price monitoring. Results:For the introduction of new drug prices, Canada uses the international median price comparison test, the highest international price comparison test, the treatment category comparison test and the inter-national treatment category comparison test. For the listed drugs, Canada calculates the international price ratio, and then carries out bilateral comparisons and multilateral comparisons to monitor the prices of drugs already on the mar-ket. At present, Canada has achieved effective monitoring of drug prices, that is to say, the introduction of new drug prices complies with the《Excessive Price Guide》;the patented drugs prices are lower than the designed international price;the price difference between the generic drug and the international level has gradually reduced. Conclusions:The Canadian experience is worth learning, and China should add legislative about drug price monitoring, learn from this experience to identify and monitor the varieties and establish the price monitoring and early warning mechanism with the international reference price as the warning indicator.

ObjectiveTo investigate the clinical value of transvaginal elastography in diagnosing cervical cancers.MethodsTotally,124 patients of cervical lesions with definite pathological results were enrolled.Elastograms were collected and the strain ratios of the benign and malignant lesions were record and compared.ROC curve was used to find the best cut-off point.ResultsElastography was useful in differentiating benign and malignant lesions by different color.Values of strain ratio of different pathological lesions were statistically different ( P ＜0.01).The mean value of strain ratio was 2.71 ± 1.56 for benign lesions and 8.32 ± 4.11 for malignant ones.The best cut-off point was 4.99 basing on the ROC curve.The sensitivity and specificity were 80.7％ and 89.6％,respectively.ConclusionsReal-time transvaginal elastography was a new way in differential diagnosing cervical cancers from benign lesions of the cervix.

Objective To explore the cognitive function of the theory of mind(TOM) in early-onset schizophrenia from faux pas recognition and belief understanding dimensions.Methods 41 early-onset schizophrenias (EOS) and 40 normal adolescents were interviewed by the Chinese version of faux pas recognition task and theory of mind picture-sequencing task(ToM-PST),then early-onset schizophrenias cognitive features were analyzed.Results ①In faux pas recognition task,compared with healthy subjects,EOS showed significantly less total scores (16.11±6.34 vs 20.86±7.79,P＜0.05)and subscores of understanding faux pas questions (9.88±4.11 vs 13.27± 6.07,P＜0.05).In faux pas recognition scores(6.72±2.60vs 7.58±2.20) and control questions(9.83±0.44vs 9.97± 0.16) had no statistically significant difference (P＞0.05).②In ToM-PST task,early-onset schizophrenic patients also had significantly less total score(17.29±3.38 vs 21.48± 1.73,P＜0.01),subscores of understanding first order belief,first order error belief,second order belief,second order error belief,third order error belief,sense of reality,reciprocity,fraud,detecting fraud compared to normal controls had significant difference (all P＜ 0.05 or 0.01).③ The correlation between clinical course time and PANSS score and its subscores of the theory of mind picture-sequencing and faux pas task was non-significant(P＞0.05)except the subscores of understanding the first order belief (P＜0.01).Conclusion The theory of mind is apparent damage in early onset schizophrenia and non-significant correlation is found with psychiatric symptoms.

Purpose To study the expression of inhibitor of differentiation 2 (Id2) in Ewing sarcoma of bone as well as the correlation with cell cycle proteins. Methods The expression of Id2, c-Myc, Cyclin D1, p53, p16 and p27 in 45 cases of Ewing sarcoma were detected by immunohistochemical EnVision methods, the relationship between the expression of Id2 and clinicopathologic characteristics and the correlation with cell cycle proteins were analyzed. Results Total expression of Id2 was found in 88. 9% of Ewing sarcoma. Strong expression of Id2 was detected in 33. 3% cases. Higher frequencies of c-Myc and Cyclin D1 immunostaining were observed (66. 7% and 71. 1%, respectively), but lower frequencies of p53, p16 and p27 expression were present (20. 0%, 35. 6% and 28. 9%, respectively). Id2 overexpression displayed a negative relationship with p27 expression (P<0. 05). Among the follow-up of 24 cases, overexpression of Id2 was found more frequency in dead and metastases cases (41. 2%) when compared to that of progres-sion-free survival cases (14. 3%). Conclusions Id2 was extensively expressed in Ewing sarcoma of bone. Overexpression of Id2 and its correlation with p27 expression suggest that this is an important pathway involved in development of Ewing sarcoma. Moreover, Id2 overexpression may predict poor prognosis.

Objective To construct a eukaryotic expression plasmid carrying the PKCI-1/HINT1 gene,to investigate its expression in A375 melanoma cells after transfection,and to evaluate its effects on apoptosis and autophagy of A375 cells.Methods The PKCI-1/HINT1 gene sequence was amplified by reverse transcription PCR (RT-PCR) with total RNA extracted from A375 cells as the template,then inserted into the eukaryotic expression plasmid PCDNA3.1 (+) to construct a recombinant plasmid,PCDNA3.1 (+)-PKCI-1/HINT1.Some A375 cells were classified into two groups to be transiently transfected with the recombinant plasmid (PCDNA3.1 (+)-PKCI-1/HINT1 group) or the empty plasmid PCDNA3.1 (+) (control group).After additional 48-hour culture,RT-PCR and Western blot analysis were performed to quantify the mRNA and protein expressions of PKCI-1/HINT1 respectively,Hoechst 33342 staining was conducted to detect apoptosis of A375 cells,Western blot analysis to detect the expressions of intracellular caspase-3 and autophagy-associated protein beclin1,and cell autophagy was observed by using the green fluorescent protein (GFP)-microtubule-associated protein 1 light chain 3 (LC3) labelling method combined with confocal laser scanning microscopy.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of A375 cells at 24,48,72 and 96 hours after transfection.Results Enzyme digestion and sequencing analysis confirmed that the eukaryotic expression plasmid PCDNA3.1 (+)-PKCI-1/HINT1 was successfully constructed and effectively expressed in the transfected A375 cells.MTT assay showed that PKCI-1/HINT1 could obviously inhibit the proliferation of A375 cells,and the number of live cells was decreased by 17.0％,25.6％ and 29.4％ in the PCDNA3.1 (+)-PKCI-1/HINT1 group at 48,72 and 96 hours,respectively,compared with the control group (all P ＜ 0.05).Hoechest 33258 staining revealed that PKCI-1/HINT1 could promote the formation of apoptotic bodies in A375 cells.Confocal laser scanning microscopy demonstrated that the overexpression of PKCI-1/HINT1 increased GFP-LC3 puncta formation in A375 cells.In addition,Western blot analysis indicated that PKCI-1/HINT1 up-regulated the protein expressions of caspase-3 and beelin1 in A375 cells.Conclusions The eukaryotic expression plasmid PCDNA3.1 (+)-PKCI-1/HINT1 was successfully constructed,and PKCI-1/HINT1 could be effectively expressed in A375 cells.High-level expression of PKCI-1/HINT1 could suppress cellular proliferation,promote apoptosis,and induce autophagy,of A375 cells.

Objective To analyze the imaging and histopathologic features of extra-plural solitary fibrous tumor (SFT) and to improve the diagnose diagnostic ability.Methods The images and pathologic features of 32 SFT cases confirmed by pathology were retrospectively reviewed.Results Of 32 SFT cases, there were 5 cases in the head, 3 cases in the orbit, 1 case in the nasal sinuses, 1 case in the bronchus, 2 cases in the stomach,1 case in the pancreas, 3 cases in the kidney, 3 cases in the retroperitoneum, 4 cases in the pelvic cavity, 6 cases in the soft tissues, 3 cases near the vertebra.6 cases were malignant,8 cases were borderline,18 cases were benign.The tumors located in abdominal and pelvic tumors were larger,the average diameter of the tumors was 13.6 cm.The volumes of the other tumors were smaller, the average diameter was 4.2 cm.The majority of the tumors showed clear boundary, smooth edge or lobulated soft tissue mass, partial necrosis, rare cystic degeneration and calcification.MR images showed hypo to isointensity on T1WI and hyper to isointensity on T2WI.After enhanced enhancement, multiple small circuitous vessels could be found in or around the mass.The tumor showed slightly enhanced in the arterial phase and moderately to obviously heterogeneously enhancement in the venous phase.In addition, part of the tumors can could be seen positive-negative signal changes.The positive expression rate of immunohistochemical indexes were: CD34 100%, CD99 68.8%, Bcl-2 62.5%, Vimentin 46.9%, Ki-67>5% 43.8% respectively.

Objective To characterize the function of human anti-BP180 single-chain Fv antibody (scFv) in vitro. Methods The IgG autoantibodies against BP180 were purified by affinity chromatography from the sera of patients with BP. The inhibitive effect of previously constructed anti-BP180 scFv on the binding of anti-BP180 IgG autoantibodies to the recombinant NC16A domain of human BP180 antigen was observed by competitive ELISA, competitive immunofluorescence assay and competitive inhibition test for complement activation. Results As ELISA revealed, the scFv significantly inhibited the binding of anti-BP180 IgG autoantibodies to the corresponding antigen (P ＜ 0.01 ), and the inhibitive effect was dose-dependent within the concentration range from 0 to 60 μg/ml. The inhibitive rate peaked at 69.50%. The deposition of anti-BP180-IgG autoantibodies in basement membrane zone and the IgG autoantibody-mediated complement C3 activation were both suppressed by the scFv of 40 μg/ml. Conclusion The genetically engineered anti-BP180 scFv has a certain inhibitive effect on the binding of BP-IgG autoantibodies to BP180 antigen and on the subsequent complement activation in vitro.

Objective To explore the characteristics of illness attribution of outpatients with multiple somatic symptoms in Peking Union Medical College Hospital. Methods It was a cross-sectional study conducted from March to October,2012. A total of 150 outpatients were recruited from the departments of Gastroenterology,Traditional Chinese Medicine and Psychological Medicine by convenience sampling. Somatic symptom scale of the Patient Health Questionnaire (PHQ-15) was used to screening each patient in the waiting list. With the cut-off value of 10,patients were divided into the somatic symptom positive (SOM+) group and somatic symptom negative (SOM-) group. Sociodemographic characteristics were compared between these two groups. All the subjects completed interviews including questions about illness attribution. All the answers of illness attribution were concluded into three major groups as physical factors,situational factors and psychological factors. Results The proportion of female was significantly higher in SOM+ group than in SOM-group (69.3% vs. 53.3%;χ=4.048,P=0.044). In SOM+ group,significantly more patients contributed their illness to psychological factors (64.0% vs. 45.0%;χ=5.273,P=0.022). There was no significantly difference between SOM+ group and SOM-group on the phenomenon of multiple illness attribution (41.0% vs. 32.0%;χ=1.407,P=0.236). However,in the Department of Gastroenterology,there were significantly more outpatients in SOM+ group with multiple illness attribution (60.0% vs. 32.0%;χ=3.945,P=0.047).Conclusions The outpatients in general hospital with multiple somatic symptoms are more likely to contribute their illness to psychological factors. The phenomenon of multiple illness attribution is common among patients. Clinicians should increase their awareness and knowledge of illness attribution,so as to provide better holistic health services.

Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.

Objective To evaluate in vitro effects of specific small interfering RNA (siRNA)-silencing of the casitas B-lineage lymphoma b (Cbl-b)gene on immunocompetence of primary murine lymphocytes. Methods Spleens were resected from C57BL/6 mice, and splenic lymphocytes were sterily isolated and cultured in vitro. These lymphocytes were divided into 3 groups: silence group transfected with a Cbl-b-specific siRNA using the EntransterTM-R 4000 reagent, negative control group transfected with a negative control siRNA using the EntransterTM-R4000 reagent, blank control group receiving no treatment. After additional culture for 72 hours, ELISA was performed to measure levels of interferon γ(IFN-γ)and tumor necrosis factor α (TNF-α)in culture supernatants of lymphocytes. In addition, the Cbl-b gene-silenced lymphocytes were co-cultured with B16F10 melanoma cells to evaluate their immunocytotoxic effects on melanoma cells. Results Splenic lymphocytes were successfully isolated from C57BL/6 mice and cultured in vitro, and the Cbl-b-specific siRNA was also successfully transfected into the primary murine lymphocytes and effectively down-regulated the expression of Cbl-b gene in them. Compared with the negative control group and blank control group, the silence group showed significantly increased supernatant levels of IFN-γ and TNF-α(all P < 0.05). The immunocytotoxic effect of lymphocytes on melanoma cells was significantly stronger in the silence group than in the negative control group. Conclusion Cbl-b gene silencing can promote secretion of IFN-γ and TNF-α by murine lymphocytes, and enhance their immunocytotoxic effects on B16F10 melanoma cells in vitro.