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 evaluate the feasibility and clinical significance of emergency bedside ultrasound-guided central venous catheterization performed by emergency department doctors.Methods The clinical data of 216 patients, who underwent central venous catheterization in the Department of Emergency of Shengjing Hospital of China Medical University from January 2009 to June 2014 were retrospectively analyzed. All the patients received femoral vein puncture or internal jugular vein catheterization. The patients were divided into three groups according to the method of catheterization: 72 patients received emergency ultrasound-guided central venous catheterization by emergency doctors independently were assigned as A group, 72 patients underwent catheterization by emergency doctors after being demarcated by ultrasound doctors served as B group, and 72 patients who underwent catheterization method guided by traditional landmark served as C group. Success rate, time spent for catheterization, number of attempts for intubation, and incidence of complications were compared among three groups.Results As compared with that of groups B and C, a higher success rate [98.61% (71/72) vs. 83.33% (60/72), 73.61% (53/72), bothP< 0.01] was found in group A, also with a shorter successful time for insertion of the catheter (minutes: 5.5±2.5 vs. 9.6±3.7, 16.6±7.2, bothP< 0.05), less frequency of the catheter insertion (times: 1.0±0.0 vs. 1.8±0.7, 2.7±2.6, bothP<0.05), and lower incidence of changing puncture site due to insert failure [1.4% (1/72) vs. 8.3% (6/72), 20.8% (15/72), bothP< 0.05], lower incidence of mechanical and infective complication [15.3% (11/72) vs. 41.7% (30/72), 59.7%(43/72), bothP< 0.05], and also lower catheterization related infection risk [13.9% (10/72) vs. 15.3% (11/72), 12.5%(9/72), bothP> 0.05].Conclusion Emergency bedside ultrasound-guided catheterization resulted in higher success rate and less related complication, therefore it can be recommended for widely application in emergency department treatment.

The mild cognitive impairment and vascular cognitive impairment no dementia are the early stages for Alzheimer's disease and vascular dementia proposed in recent years.They both not only have some differences,but also have many crosses and contacts in concepts,diagnostic criteria,epidemiology,pathology,neuropsychology,and biological markers,etc.This article reviews the recent progresses and problems facing in recent years.

To investigate the application of seminar teaching on postgraduate education of ophthalmology,postgraduate from Grade 2008 to Grade 2010 were divided into experiment groups and control groups.Seminar teaching and conventional teaching were applied to two groups respectively.The performances of seminar teaching groups at each grade were better than the control groups ( P ＜ 0.05 ).Thus,seminar teaching can enhance theory and operation ability of postgraduate.

Objective To assess the therapeutic effects of activated charcoal on the acute dichlorvos poisoning in rats. Method Thirty male clean grade Wistar rats were randomly (random number) divided into three groups: control group (group A, n = 10), single dose activated charcoal group (group B, n = 10) and multi-dose activated charcoal (group C, n=10). The rats of group A were suffered from 35 mg/kg dichlorvos exposure by oral without activated charcoal and senna. The rats of group B received 35 mg/kg dichlorvos exposure by oral with 175 mg/kg activated charcoal given immediately after dichlorvos exposure and 35 mg/kg senna given half an hour later. In the group C, 35 mg/kg dichlorvos was given to rats by oral with 175 mg/kg activated charcoal given immediately after dichlorvos exposure and 35 mg/kg senna given half an hour later and then every four hours. Blood samples were collected from the carotid artery at different intervals after exposure. DDVP concentration and total blood acetyl-cholinesterase activity were detected. Differences in serum DDVP concentration, Cmax, AUC (0→∞ ), MRT and acetylcholinesterase among three groups were calculated by using ANOVA. Results Serum DDVP levels in single dose group and in multi-dose group were significantly different from those in control group (P < 0.05). The DDVP levels in multi-dose group were significantly different from those in single dose group 4 hours after exposure (P < 0.05). The AUC and Cmax in activated charcoal treatment groups were significantly different from those in control group (P < 0.05). There were no significant differences in MRT among three groups. Fours hours after exposure to dichlorvos,the levels of serum acetylcholinesterase in rats of group B and group C were significantly different from that in rats of group A (P < 0.05), and there was no significant difference in acetylcholinesteras between group B and group C (P > 0.05). Another four hours later, no differences in acetylcholinesterase were found a-mong three groups (P > 0.05). Conclusions The peak concentrations of dichlorvos in blood are lower in group B and group C, and the blood acetylcholinesterase inhibition is quelled by activated charcoal. Therefore, the effects of multi - dose of activated charcoal is better than that of single dose of activated charcoal.

Objective To analyze the therapeutic effect ofShengji-Yuhong ointment in the treatment of patients with pressure ulcer.Methods 86 patients of pressure ulcer were randomly divided into a control group and an observation group, with 43 cases in each. After debridement, the wound was covered with vaseline gauze in the control group, whileShengji-Yuhong ointment in the treatment group. 10 days constituted 1 course of treatment, and both groups were treated for 3 courses. The blood supply of the whole blood viscosity, plasma viscosity, erythrocyte aggregation index detection; white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) were observed in order to observe the control condition of the patients with wound infection.Results The total effective rate was 95.3% (41/43) and 74.4% (32/43) in the observation group and control group respectively, with significant difference between two groups (χ2=5.800,P=0.016). After treatment, the whole blood viscosity (high-shea) (4.06 ± 1.38 mPa?svs. 4.74 ± 1.62 mPa?s,t=2.095), the whole blood viscosity (medium-shea) (3.71 ± 1.22 mPa?svs. 4.34 ± 1.41 mPa?s,t =2.216), blood reduction viscosity (1.13 ± 0.22 mPa?svs.1.44 ± 0.51 mPa?s,t=3.660), the whole blood viscosity (medium-shea) (4.16 ± 0.48 mPa?svs. 4.51 ± 0.89 mPa?s,t=2.270) obviously compared with group before treatment decreased (P<0.05). The patients in the observation group in the whole blood viscosity (medium-shea) (3.71 ± 1.22 mPa?svs. 4.16 ± 0.48 mPa?s,t=2.251), and blood reduction viscosity (1.13 ± 0.22 mPa?svs. 1.32 + 0.31 mPa?s,t=3.278) in the observation group were  obvious better than the control group (P<0.05). After the treatment the WBC, CRP, ESR in the observation group were decreased significantly than the control group (t=5.947, 7.198, 12.064,P<0.01).ConclusionShengji-Yuhong ointment can effectively control the PU infection in the wound, improve wound tissue under the blood circulation, and promote wound healing.

Objective The clinical manifestations of cerebral infarction caused by acute basilar arterial occlusion are complex.The purpose of this study is to explore the relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Methods Fifty three patients diagnosed with cerebral infarction caused by acute artery occlusion were collected from Nanjing Stroke Registry.They were hospitalized in Jinling Hospital from January 2007 to July 2016 and were divided into sudden onset group and progressive onset group.Their clinical and digital subtraction angiography data were analyzed retrospectively.Results Middle and distal segment of the basilar artery occlusions were usually found in sudden onset group.Patients in progressive onset group were more likely to present with proximal segment of the basilar artery occlusions.Significant statistical difference was found between two groups (P<0.05).Logistic regression analysis showed that the symptoms of patients with proximal segment basilar artery occlusion tended to be progressive onset, compared with patients affected by distal segment occlusion (OR=14.77,95%CI:1.57-139.00, P=0.019).Conclusion There was significant relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Early diagnosis and timely treatment may improve clinical prognosis in patients.

Objective To investigate the molecular mechanisms of synergistic effects of BFA and CDDP on human lung cancer GLC-82 cells, and to test the levels of PERK-ATF4 pathway. Methods GLC-82 cells were incubated with 50 ng/mL of BFA or/and 2 μg/mL of CDDP for 24 or 48 hours. The levels of PERK, p-PERK and ATF4 in GLC-82 were analyzed by real-time PCRand/or Western Blot. Results The levels of PERK were lowest in CDDP group, but higher in BFA group (P < 0.05), the highest in group of BFA+CDDP (P < 0.05 or P < 0.01). The p-PERK level decreased in group of BFA+CDDP (P < 0.05 or P < 0.01). There was no significant change of ATF4 expression in CDDP group, but ATF4 expression increased slightly in BFA group, and increased further in group of BFA+CDDP (P < 0.05 or P < 0.01)which was also higher than that in BFA group or CDDP group (P < 0.05 or P < 0.01). Conclusions The upregulated levels of PERK and ATF4 by the combination of BFA and CDDP may be one of the mechanisms of synergistic anti-cancer effect of BFA and CDDP on GLC-82 cells.

OBJECTIVE:To establish a high performenc capillary zone electrophoresis method for the determination of the water-soluble active ingredients in different parts of the Salvia miltiorrhiza.METHODS:Capillary electrophoresis was conducted using uncoated capillary column(75 ?m?50.2 cm,effective length=40 cm)with 5 mmol?L-1 phosphate-borax(ph7.4)as running buffer by pressure injection(0.5 psi/4 s)and constant voltage separation(20 kV)with a detection length of 210 nm and a column temperature of 25 ℃.RESULTS:A complete baseline separation of PAH,DSS and PA was achieved within 8 min under the optimized conditions.The good linear range was from 2.5 ?g?mL-1 to 200.0 ?g?mL-1 for all the three ingredients.The average recoveries of the 3 ingredients were 100.04%,99.99%,and 100.01%,respectively,with RSD at 1.75%,1.73%,and 1.74%,respectively.CONCLUSION:The method is satisfactory in precision,recovery and linearity,and it can be used to determine three water-soluble active ingredients in different parts of the Salvia miltiorrhiza.

Objective:To investigate the body composition and sarcopenia in patients with stable chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors.Methods:A total of 220 patients with stable COPD were enrolled in the study from China-Japan Friendship Hospital during July 2018 to December 2019; 220 age and sex-matched healthy subjects (control group 1) and 220 healthy young adults aged 20-40 years (control group 2) were enrolled from the community. The body composition was measured by bioelectrical impedance method. The demographic characteristics, disease conditions, living background and other related factors were collected by questionnaire. T test or one-way ANOVA were used for comparison between groups, and non parametric test was used for non normal distribution data.Results:Compared with the control group 1 and control group 2, the body fat rate ( Z=-10.037, t=-8.411), the fat free mass index ( Z=-8.165, t=-7.856), and appendicular skeletal muscle index (ASMI) ( t=-7.158, t=-11.989) were significantly lower in stable COPD patients ( P<0.05). Among 220 patients with stable COPD, 51 (23.2%) were diagnosed as sarcopenia; the prevalence of sarcopenia was 18.3% (24/131) in men and 30.3% (27/89) in women (χ2=4.297, P=0.038). The decreased ASMI and grip strength in COPD patients with sarcopenia were significantly associated with age≥75 (χ2= 15.746, F= 14.048), female sex ( Z=5.805, t=2.672), low income ( Z=-4.291, t=-4.789), Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade Ⅳ (χ2=22.644, F=3.905), Modified British Medical Research Council (mMRC) Dyspnea Scale grade 4 (χ2=12.475, F=4.369), not receiving systematic health education ( Z=-4.239, Z=-2.474), no exercise (χ2=14.786, F=3.402), insufficient nutrition intake (χ2=40.531, F=10.529). The range of 6-min walking distance was (110-268) m, that was even shorter for patients with mMRC dyspnea scale grade 4 ( F=3.468, P<0.05). Conclusion:The impairment of body composition is common in COPD patients, which will further affect the body function. It is suggested that the routine evaluation of COPD should include the measurement of body composition.