In order to check unhealthy tendencies in the purchase and sale of drugs, the Drug Allocation Center of Jinshan District in Shanghai started from 1996 the practice of centralized purchase of drugs through bidding, originally handled by fax and then via the Internet by the year 2000. Specific measures adopted include: defining the mode of bidding, standardizing the system of authorizing the purchase of drugs form some pharmaceutical companies and conducting yearly checks of them according to relevant laws and regulations. The system of conducting checks at any time with regard to other pharmaceutical companies may also be adopted. On the basis of the above preparations, the computer network framework, the system model and the flow of data exchange of the bidding center should be determined and bidding via the Internet can thus be conducted thereby. Bidding via the Internet makes it possible for medical organizations to conduct zero stock management of drugs, guarantees the timely supply of drugs, is favorable to fair competition and shortens the business cycle.

Objective To investigate the awareness of amputees to his appearance and their social activities. Methods 45 amputees were investigated with Body Shape Measuring for Amputee self-designed and Social Activities Questionnaire. Results For body shape measuring, the top 3 awareness amputees always feeling were: wearing loose clothing to cover the prosthesis (55.56%); only able-bodied can be attracted (48.89% ); losing of limbs damage the body and affect their daily living (40%). For the social activities, the total score was more in lower limb amputees than in upper limb amputees (P<0.05). For the items, there was no difference in amusement and sport, pastime, community participation, and join in workshop (school) (P>0.05) between the patient with upper and lower limbs losing, but there was in sociality (P<0.05). Conclusion Amputees fall in social withdrawal for limb losing and inferiority, which may associate with what limb lost.

Objective: To study the effect of urotensin(U Ⅱ) on nitric oxide synthase(NOS)/nitric oxide(NO) system in rat aorta. Methods: The aortic slices were incubated in vitro. The medium nitrite content, vascular NOS activities and cGMP content were measured. Results: After incubation of aorta for 1.5－3.0 h, UⅡ(10－9－10－7　mol*L－1) increased nitrite production ( 14.8%－80.9%, P<0.01) in dose-dependent manner. U Ⅱ significantly stimulated the total NOS activities, mainly activated constitutive NOS (P<0.05 or P<0.01), however, the inducible NOS activities were not altered (P>0.05). Incubation of aortic slices with U Ⅱ (10－9－10－7 mol*L－1) increased vascular cGMP content in dose-dependent manner. Co-incubation vascular tissue with U Ⅱ and　GN-L-nitro-arginine, an inhibitor of NOS, obviously inhibited the U Ⅱ-induced NOS activation, NO production and cGMP formation. Conclusion: The results suggest that U Ⅱ can activate the vascular NOS/NO pathway, increasing tissue NO production and cGMP content.

AIM:To investigate the role of B cells in CD45RB antibody-induced transplantation immune toler-ance.METHODS:Single cell suspension was made from the spleen of BALB/c nude mice disposed by CD45RB antibod-y, then mixed cultured with T cells of BALB/c mice and spleen cells of C57BL/6 mice.The Th1, Th2, Treg and Tm cells were monitored by flow cytometry during the culture process .The skin graft model was set up with B 6.μMT-/-mice as re-ceptors and BALB/c mice as donors.CD45RB antibody was intraperitoneally injected into the receptors after transplantation and then CD3+CD45RBhi cells were detected by flow cytometry .In another mixed lymphocyte culture , CD45RB antibody was added, and then B cells were isolated and injected into B6.μMT-/-mice through the tail vein.The heart transplanta-tion model was established with B 6.μMT-/-mice as receptors and BALB/c mice as donors, and then the survival and the migration of B cells to the thymus were observed .RESULTS:When T lymphocytes were co-cultured with B lymphocytes treated with anti-CD45RB monoclonal antibody (mAb) in vivo, the percentages of Th2 and Treg cells were up-regulated and Th1 cells were down-regulated, but Tm cells were not altered as compared with the control .In vivo without B lympho-cytes, anti-CD45RB mAb also down-regulated the expression of CD45RB in T lymphocytes.The reduction was faster and the percentage of CD3 +CD45RBhi T cells was not altered as compared with the control .The B lymphocytes treated with an-ti-CD45RB mAb in vitro prolonged the lifetime of receptor in heart transplantation model but failed to induce complete toler -ance.After recieving B cells treated with anti-CD45RB mAb and allogeneic heart transplantation , B cells migrated to the thymus in B6.μMT-/-mice.CONCLUSION:B lymphocytes play a definite role in the transplantation immune tolerance induced by anti-CD45RB mAb through their affection on T-cell subgroups and also in the central tolerance .However, the induction of immune tolerance can not only rely on B cells .

Objective To investigate the clinical effect of large dosage of Methylprednisolone on epilespy combined with electrical status epilepticus during sleep(ESES) in children.Methods Forty-six epielpsy patients with ESES were treated with additive large dosage of Methylprednisolone.The seizures and video electroencephalogram discharges were observed before and after using Methylprednisolone.The Methylprednisolone effect in eliminating the methylprednisolone of ESES and controlling of clinical seizures and improving cognitive function were analyzed.Results Two cases were lost and 44 cases were included,male 30,female 14,the age at onset was (5.37 ±2.52) (2-9) years old.The duration of follow-up was (4.12 ± 2.00)(1-9) years old.The age at diagnosis of ESES was (8.17 ± 2.09) (4.0-12.5) years old.The efficacy of Methylprednisolone on seizures was 72.7％ (32/44 cases),while the efficacy of Methyl prednisolone on electroencephalograph (EEG) was 59.1％ (26/44 cases).For patients who were resistant to Levetiracetam or Clonazepam,Methylprednisolone was still effective.Intelligence quotient had no significant changes before and after treatment(P ＞ 0.05).The earlier onset age,the worse effect of Methylprednisolone.The efficacy of methylprednisolone for atypical benign epilepsy with cento-temporal spike(BECT) was higher than other syndromes.Conclusions Large dosage of Methyl prednisolone therapy for children with ESES,especially for those resistant to traditional or new antiepileptic drug for ESES,was effective and safe.The onset age and syndrome classification may have a certain value for prognosis and prediction of the effect of Methylprednisolone treatment.

BACKGROUND: Experimental evidence suggests that growth factors can promote myocardial angiogenesis, but the effect and mechanism of basic fibroblast growth factor (bFGF) in controlled release delivered via fibrin glue has not been fully recognized.OBJECTIVE: To evaluate the effect of controlled-release bFGF delivered via fibrin glue in the myocardium on the expressions of vascular growth factors and cell proliferation in the local acute myocardial infarct area in canines, and assess the therapeutic effect of this strategy.DESIGN: Completely randomized controlled experiment.SETTING: Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences; Department of Cardiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology; Shanghai Xinxing Blood Product Research Institute.MATERIALS: This experiment was carried out in the Laboratory of Animal Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, and the Experimental Animal Center of Chinese PLA General Hospital between June 2001 And March 2003.Twelve clean healthy adult mongrel dogs of either sex were selected and randomized into transmyocardial laser revascularization group and bFGF group with 6 in each group.METHODS: With appropriate anesthesia, the chest of the dog was opened and the left anterior descending (LAD) branch of the coronary artery was ligated to establish acute myocardial infarction (AMI) model.The dogs were then randomized into transmyocardial laser revascularization group to receive transmural myocardial penetration 30 minutes after AMI and bFGF group with non-transmural myocardial penetration 30 minutes after AMI and subsequent injection of bFGF-containing fibrin glue into the channel. The expressions of vascular epithelial growth factor (VEGF), transforming growth factor beta 1 (TGFβ1) and proliferating cell nuclear antigen (PCNA) in the loacl ischemic myocardium were examined immunohistochemically (IHC) at postoperative 18 weeks.MAIN OUTCOME MEASURES: Quantitative IHC analysis of VEGF,TGFβ1 and the PCNA expressions in the local ischemic myocardia in transmyocardial laser revascularization group and bFGF group.RESULTS: Five dogs in the transmyocardial laser revascularization group and 6 in the bFGF group survived the operations. Quantitative IHC analysis revealed obviously larger positive area stained for myocardial VEGF,TGFβ1 and PCNA in bFGF group than in transmyocardial laser revascularization group (t=-7.505, -2.690 and -6.895, P ＜ 0.05), and the average absorbance of PCNA staining in bFGF group was greater than that in the transmyocardial laser revascularization group (t= -5.271, P ＜ 0.05).CONCLUSION: Controlled-releasing bFGF delivered in the myocardium can increase local expressions of the vascular growth factors in the ischemic myocardium and enhance cell proliferation, promoting revascularization after AMI.

Objective To explore the key of post-processing techniques for continuous and symmetrical display of cervical verte-bral bony structures using curve planar reformation(CPR).Methods Data from 150 patients who underwent cervical spine CT scans were collected and divided into three groups based on cervical curvature:normal,straightened,and kyphotic.A multi-slice CPR post-processing method was designed,using the display rate of structures such as C2/C3 to C6/C7 intervertebral foramina,uncovertebral joints,facet joints,and pedicles of vertebral arch as the measurement index to find the optimal site and angle for CPR baseline selection.Additionally,the consistency of the intervertebral foramen diameter and area measurements on both sides of the CPR baseline level,as well as the normal appearance of the cervical vertebral bony structures during baseline translation were observed.Results The optimal site for the CPR baseline was C4/C5 with a best angle of 100° for normal or straightened cervical curvature,and C5/C6 with a best angle of 100° for kyphotic curvature.At these baseline levels,the measurements of the longitudinal and transverse diameters,as well as the area,of the intervertebral foramina on both sides were similar,providing a valuable comparison.When translating the baseline forwards and backwards,CPR could continuously and symmetrically display the cervical vertebral bony structures clearly.Conclusion Performing multi-slice CPR image post-processing based on the aforementioned baseline sites and angles aids in the comparison of the left and right sides,facili-tating the convenient and intuitive detection of subtle abnormalities in cervical vertebral bony structures.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combination use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively analyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some previous studies were not reliable.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.

【Objective:】 To preliminary construct a scientific, systematic and applicable evaluation index system of the interest conflict for medical institutions ethics committee. 【Methods:】 Literature retrieval, interpretation of laws and regulations, expert group discussion and Delphi expert letter inquiry were used to screen indicators and determine the evaluation index system of interest conflict and the weight of various indicators. 【Results:】 The response rates of the two rounds of correspondence questionnaire were both 100%, the authority coefficient Cr values of the two rounds were 0.855 and 0.865, and the coordination coefficient W values of the two rounds were 0.817 and 0.826, which were statistically significant (P<0.05). The final formed system included 3 first-level indicators, 10 second-level indicators and 25 third-level indicators. 【Conclusion:】 The evaluation index system of interest conflict for medical institution ethics committee is scientific and reliable.