OBJECTIVE:To supply references for the improvement of the essential drug policy of China. METHODS:The pros and cons of present essential drug poliy of China was discussed on the basis of the introduction of the concepts of "essential drug" and "essential drug policy". RESULT & CONCLUSION:The realization of the goal of essential drug policy needs a perfect system of regulations in regard to the selection, production, distribution, pricing and reimbursement of essential drug.

The authors have made an investigation on the conditions of the internet access,the platform for network-aided teaching,the teaching resource and the teaching effect for physical chemistry among 127 pharmacy students of 2008 enrollment.Based on the results of the investigation,an analysis on the current situation and problems of network-aided teaching for this course was performed and recommendations were put forward accordingly.

Objective To establish the pediatric reference intervals for Troponin Ⅰ and Creatine kinase-MB (CK-MB).Methods Healthy children (223 boys and 162 girls) aged from 7 months to 12 years old were studied.Blood specimens were collected and centrifuged,all serum samples were kept refrigerated below-70 ℃.Troponin Ⅰ and CK-MB were measured on the UniCel DxI 800 immunoassay system (Beckman Coulter) on the same day.Nonparametric statistics was used to estimate the 99th percentile reference intervals.Results The children were divided into three groups (group A 128 cases; group B 128 cases;group C 129 cases) according to age.The upper reference limits for CK-MB were dependent of age,and the group A (7 months-1 years) was shown to be 13.41 μg/L,the group B (2-3 years) was shown to be 9.35 μg/L,the group C (4-12 years) was shown to be 5.48 μg/L.The upper reference limit for Troponin Ⅰ was independent of age or gender and shown to be 0.01 μg/L among 385 children.Conclusions Pediatric reference intervals for Troponin Ⅰ and CK-MB have been defined in healthy children at a relevant age group (7 months-12 years).It is effective for clinical diagnosis and treatment of myocardial damage for children by determining reference intervals for Troponin Ⅰ and CK-MB.

Objective To survey and analyze the PBL lessons in the course of Clinical Transfusion Medicine.Evaluate the effect and problems in PBL lessons and explore more effective models.Methods A questionnaire was designed according to the purpose of the survey,4 teachers and 89 students of medical laboratory science in Shanghai Jiaotong University School of Medicine were investigated.Results Students gave high evaluate of both the case and the teachers.Main suggestion was to reduce the class time.When the students were told that the evaluation results will be added to their total score and compared to the teachers' evaluation,they will be more objective.The results were statistically significant.Conclusion PBL cases for Clinical Transfusion Medicine should not be too long.Paying attention to the meaning and feedback of evaluation can greatly improve the enthusiasm and objectivity of the students.

Objective: To investigate the effect of intracellular free Ca 2+ concentration ([Ca 2+ ] i ) on injury following transient Mg 2+ free treatment in vitro in developing cortical neurons. Methods: Embryo cortical neurons of rats cultured for 6 d and 17 d were directly exposed to Mg 2+ free media, or pretreated with NMDA receptor antagonists or calcium channel antagonist before being exposed to Mg 2+ free media. MTT assay was used to study the injury of neurons. [Ca 2+ ] i were measured using fluo 3, a fluorescent calcium sensitive dye and laser scanning confocal microscope, and calculated by the fluorescent intensity. Results:Compared with control, MTT conversion rates decreased after transient (3 h) Mg 2+ free treatment in neurons cultured for 6 d and 17 d in vitro, (59.1?6.87)% and (51.2?5.90)%, respectively. In neurons pre and co treated with 10 ?mol?L -1 MK 801, 50 ?mol?L -1 AP 5 and 10 ?mol?L -1 nifedipine, MTT conversion rates were higher than those of neurons with only Mg 2+ free treatment. Peak values of [Ca 2+ ] i in neurons cultured for 6 d and 17 d were 2.4?0.23 and 3.2?0.32, respectively Peak value of neurons 17 d in vitro was significantly higher than that of neurons 6 d in vitro (P

Background and objective Pulmonary sarcomatoid carcinoma is a rare histologic subtype of non-small cell lung cancer. hTe effective treatment for this disease has not well deifned due to its extremely low morbidity. hTis study explores the clinicopathological characteristics and prognosis of 38 patients with PSC, so as to provide some clues for its diagnosis and treatment. Methods hTe study enrolled 38 patients with PSC that were diagnosed with histology or cytology in our hospital between January 2000 and December 2013. We retrospectively analyzed general clinical characteristics, smoking history, tumor size, TNM staging, pathology, immunohistochemistry, diagnostic method, treatment and prognosis. We used SPSS 19.0 statistical sotfware and Kaplan-Meier method to analyze our data. Results Patients in this study were aged from 26 to 76 years old (the median age was 57.5 years old). Among all of them, the male to female ratio was 4:1, and 81.6%of patients had smoking history. Cough and hemoptysis were the most common primary symptoms. hTe median survival was 21 months, while one-year survival rate, three-year survival rate and five-year survival rate were 68.4%, 31.6%and 18.4%respectively. Tumor size, TNM staging, distant metastasis and surgery therapy were associated with the prognosis of patients. Conclusion Patients with PSC present with no special symptoms generally. According to our study, factors that affect patients’ prognosis include tumor size, TNM staging, distant metastasis and surgery. Complete resection is the key treatment for PSC patients, but comprehensive chemoradiotherapy needs further exploration in evidence-based medicine. Biological target therapy may give new insight into treatment for PSC.

Objective:To explore the clinical features and risk factors of systemic lupus erythematosus(SLE) concomitant with interstitial lung disease(ILD) in children.Methods:A retrospective analysis was performed.A total of 111 hospitalized children diagnosed with SLE in the Department of Rheumatology and Immunology, Children′s Hospital of Soochow University from February 2016 to November 2018 were selected as the research subjects and divided into the SLE-ILD group(18 cases) and the SLE-non-ILD group(93 cases)according to the lung high-resolution CT manifestations. T-test and Wilcoxon rank sum test were used to compare and analyze the general situation, clinical manifestations and laboratory results.Multivariate Logistic regression was used to analyze the risk factors of SLE-ILD. Results:The prevalence of SLE-ILD was 16.2%(18/111 cases). There were significant differences between the SLE-ILD group and the SLE-non-ILD group in the course of disease [14.00 (12.00-24.25) months vs.1.00(1.00-2.00) months], the incidence of serositis [55.6%(10/18 cases) vs.8.6%(8/93 cases)], post-activity shortness of breath [83.3%(15/18 cases) vs.25.8%(24/93 cases)], nervous system damage [27.8%(5/18 cases) vs.6.5%(6/93 cases)], cardiovascular system damage [38.9%(7/18 cases) vs.9.7%(9/93 cases)], the occu-rrence of increased erythrocyte sedimentation rate [66.7%(12/18 cases) vs.31.2%(29/93 cases)], the decreased C 3[88.9%(16/18 cases) vs.62.4%(58/93 cases)], positive anti neutrophil cytoplasmic antibody (ANCA) [88.9%(16/18 cases) vs.18.3%(17/93 cases)], positive anti-Sm antibody [61.1%(11/18 cases) vs.15.1%(14/93 cases)] and anti ribonucleoprotein antibody (anti RNP antibody)[66.7%(12/18 cases) vs.16.1%(15/93 cases)](all P<0.05). Logistic regression analysis demonstrated that serositis( OR=30.535, 95% CI: 2.167-430.336, P=0.011), shortness of breath after exercise( OR=55.115, 95% CI: 1.117-2 579.852, P=0.041), positive ANCA( OR=65.090, 95% CI: 4.488-944.071, P=0.002) and positive anti-RNP antibody( OR=10.007, 95% CI: 1.362-73.500, P=0.024) were risk factors for SLE-ILD. Conclusions:The longer the course of SLE, the higher the incidence of ILD; serositis, shortness of breath after exercise, positive ANCA and positive anti RNP antibody may be risk factors for SLE-ILD.

Objective:To investigate the status quo of psychological contracts and influencing factors among members of the "1+N" family doctor teams in Shenzhen and to explore the impact of psychological contracts on job burnout.Methods:This cross-sectional study was conducted from September 30 to October 31, 2022 among 361 members of 92 family doctor teams from 92 community health service centers which provided family doctor team service in Shenzhen city. A self-designed general information questionnaire, an employee psychological contract questionnaire (including organizational responsibility and personal responsibility dimensions), and a job burnout scale (including emotional exhaustion, depersonalization, and personal accomplishment dimensions) were used in the study. T-tests, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis were used to analyze the influencing factors of psychological contracts and job burnout.Results:Among 361 respondents, there were 299 females (82.8%) and 62 males (17.2%), and a higher proportion of general practitioners (37.5%, 129/361) and nurses (41.8%, 151/361). The total score of psychological contracts among the 361 respondents was (141.6±19.5), with organizational responsibility scoring (70.6±11.2) and personal responsibility scoring (71.0±9.3). On the job burnout scale, emotional exhaustion scored (17.89±6.82), depersonalization scored (6.51±2.54), and personal accomplishment scored (30.95±5.70). General practitioners scored lower in organizational responsibility and personal responsibility compared to other members ( F=7.341,3.119, all P<0.05), and higher in emotional exhaustion and depersonalization ( F=7.637, 2.415, all P<0.05). Members with≤5 years of work experience scored lower in personal responsibility and personal accomplishment ( F=3.656, 4.205, all P<0.05). Correlation analysis showed that scores of organizational responsibility and personal responsibility were negatively correlated with levels of emotional exhaustion and depersonalization ( r=-0.618, -0.526, all P<0.01), ( r=-0.404, -0.393, all P<0.01), and positively correlated with personal accomplishment ( r=0.500, 0.558, all P<0.01). Multiple linear regression analysis indicated that organizational responsibility negatively affected emotional exhaustion and depersonalization ( β=-0.554, -0.274, all P<0.01), and positively affected personal accomplishment ( β=0.172, P<0.05). Personal responsibility positively affected personal accomplishment ( β=0.404, P<0.01). Conclusions:The study demonstrates that general practitioners in family doctor teams in Shenzhen city have lower psychological contract levels and are more prone to emotional exhaustion and depersonalization; members with≤5 years of work experience have lower personal responsibility and accomplishment. The results indicate that enhancing organizational responsibility can reduce job burnout of members in family doctor teams.

BACKGROUND: Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase (RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula (BF) during the treatment of lung cancer patients and summarize the possible causes. METHODS: We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and PubMed for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula." RESULTS: Our literature search produced two case reports (three patients) which, in addition to our three patients. We collated the patients' clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus (DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophago-tracheobronchial fistula. Six patients all died within 6 months. CONCLUSIONS Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.

Generation of mutants with clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) is commonly carried out in fish species by co-injecting a mixture of Cas9 messenger RNA (mRNA) or protein and transcribed guide RNA (gRNA). However, the appropriate expression system to produce functional gRNAs in fish embryos and cells is rarely present. In this study, we employed a poly-transfer RNA (tRNA)-gRNA (PTG) system driven by cytomegalovirus (CMV) promoter to target the medaka (Oryzias latipes) endogenous gene tyrosinase(tyr) or paired box 6.1 (pax6.1) and illustrated its function in a medaka cell line and embryos. The PTG system was combined with the CRISPR/Cas9 system under high levels of promoter to successfully induce gene editing in medaka. This is a valuable step forward in potential application of the CRISPR/Cas9 system in medaka and other teleosts.
Animals ; CRISPR-Cas Systems ; Cell Line ; Gene Editing ; Oryzias/genetics* ; RNA, Guide/genetics* ; RNA, Transfer/genetics*