OBJECTIVE:To discuss the issue of medical institution's pharmaceuticals purchase by public bidding and so as to put forward some improvement measures.METHODS:The problem in the pharmaceuticals purchase by public bidding sys?tem was analyzed by the governmental management theory.RESULTS&CONCLUSION:The pharmaceutical purchase by public bidding system was far from perfect which were highlighted in the high cost of governmental management,over-burden of bidding factories,financial loses of medical institutions,and chaos of medicine pricing management.The governmental pricing system should be regulated,the medical reform systems should be speed up,and the efficiency of governmental man?agement should be improved.

In recent years, with the rapid development of Chinese materia medica (CMM) industry, its clinical applications have become more and more widespread. While, adverse reactions of CMM have also become increasingly prominent. However, for adverse reactions of some CMM, the applications of conventional toxicology studies cannot draw definitive conclusions. These CMM, which were not defined as toxic drugs in traditional Chinese medicine (TCM) theories, have unknown potential toxicities and affect the safety in their clinical use. This paper reviewed recent advances in studies on potential toxicity of non-toxic CMM. It analyzed and summarized potential toxic compounds among them, and introduced application for metabolomics researches on potential toxicities in non-toxic CMM.

Aim To establish a set of consummate evaluation methods of animal models which are with syndromes of traditional Chinese medicine.Method By means of 2,4-dinitrophenol-induced fever syndrome model for the entry point,making use of meta bonomics as the platform,through analyzing metabolic fingerprint data of rat urine in the control and model group and metabolome of rat urine in model group at different time intervals,to approach the evaluation methods of animal models.Results Through research by metabonomics,the results showed that 2,4-dinitrophenol-induced animal models consisted with clinical fever syndrome of traditional Chinese medicine.Conclusion Metabonomics can be used for evaluation studies of animal models which are with syndromes of traditional Chinese medicine.

Objective To optimize the prescription ofBaichanting Tablets by the central composite design-response surface methodology.Methods The doses of MCC, cCMC-Na, SiO2, and magnesium stearate were set as investigation factors; disintegration time and moisture rate were set as indexes. Linear equation quadratic polynomial described mathematic relationship of disintegration time and moisture rate with other four influence factors. Response surface was described according to the optimal mathematic models; the optimal prescription was chosen; predictive analysis was conducted.ResultsThe relationship of disintegration time and moisture rate with other four influence factors could not be described by linear equation. When quadratic polynomial matching was used, correlation coefficients were 0.837 9 and 0.923 1, with relatively high reliability. Optimal prescription contained 30.6%MCC, 10%cCMC-Na, 0.30%SiO2, and 0.10% magnesium stearate. The theoretical value and predicted value deviations of the disintegration time limit and moisture absorption rate were within 5%.Conclusion The predictability of the established model is good. Application of central composite design-response surface methodology can precisely optimize the prescription ofBaichanting Tablets.

ObjectiveTo study the neuron protection mechanism of Uncariae Ramulus Cum Uncis extract for the MPTP-induced PD mice.MethodsC57BL/6 mice were randomly divided into control group, model group, Uncariae Ramulus Cum Uncis extract group and madopar group, and injected with MPTP in abdominal cavity. Behavior test was used to detect grabbing capacity and body movement coordination capacity: three biochemical indexes (SOD, MDA, GSH-Px) were detected by biochemical process and the activity of two immune enzyme-linked indexes (IL-1β, IL-6) were detected by enzymelinked immunosorbent assay.ResultsCompared with the control group, the autonomic activity numbers of mice increased and climbing pole time decreased in the model group (P<0.05), enzymatic activity of SOD and GSH-Px decreased significantly and the contents of MDA, IL-1β and IL-6 increased obviously (P<0.01). Compared with model group, the autonomic activity numbers of mice increased and climbing pole time decreased in the Uncariae Ramulus Cum Uncis extract group and madopar group (P<0.05). Enzymatic activity of SOD and GSH-Px increased and the contents of MDA and IL-1β and IL-6 decreased (P<0.05,P<0.01).ConclusionUncariae Ramulus Cum Uncis extract can reduce neuronic apoptosis PD mice, whose therapeutic action may be realized through eliminating oxygen free radicals, improving oxidation resistance and reducing inflammatory reactions.

Objectives To identify the related knowledge,attitude and behavior of drug of Xi'an adolescents and provide the evidence for establishment of intervention measures. Methods A conve-nience sampling method was used to select 1224 adolescents from grade one of junior middle school to grade three of senior middle school in 4 middle schools in Xi'an. A set of questionnaires were used to col-lect the data on knowledge, attitude and behavior of drug. All data were analyzed by SPSS 11.5. Results Mean score of drug knowledge was (22.45±9.77) and mean score of attitude to drug was (58.82±6.85). A-mong the investigation objects, 16 people (1.4%) admitted having used drug. Conclusions The adoles-cents don't have sufficient knowledge for the relation between infectious disease and drug abuse, and the difficulty of detoxification. The adolescents had a positive attitude towards drug. The adolescents' behavior of using drug should be attached importance to by school and parents.

The teaching method of critical thinking was introduced in the course of medical physics for undergraduate students by means of case teaching,PBL teaching,Bio-Physics teaching and research-oriented teaching patterns.The teaching quality and both the abilities of critical thinking and innovation of the students were enhanced.

Objective To understand the etiology of acute hepatitis B (AHB) in adults and investigate the mechanisms of hepatic injury and viral clearance in AHB. Methods One hundred and twenty adult AHB patients were enrolled. Epidemiological and clinical data were collected from the case history records or face-to-face inquiry, and serum samples were collected during hospitalization and follow-up. To observe dynamic patterns of AHB etiology, the markers of hepatitis B virus (HBV) were detected by enzyme-linked immunosorbent assay (ELISA); the level of HBV DNA and HBV genotype were determined by real-time polymerase chain reaction (PCR). Enumeration data were analyzed by non-parametric rank sum test. Comparison between groups was done by t test and that between rates of samples was done by Pearson χ2 test. Results Serum HBV DNA was positive in 48.33% of patients at the time of diagnosis with mean level of 9.84×04 copy/mL, and became undetectable after 12.5 days on average. The median levels of serum alanine aminotransferase (ALT) were 1600 U/L and 1490 U/L in HBV DNA positive and negative groups, respectively (z=-0. 678, P=0. 498). However, the mean levels of serum ALT were (2058±123) U/L and (1393±139) U/L in groups of HBV DNA<1×104 copy/mL and>1×104 copy/mL, respectively, which was significantly different (t=-2.17, P=0. 049). Genotype B accounted for 52.5%, genotype C 42.5 and genotype B and C mixed type 5.0% in 58 patients with HBV DNA positive. Eight patterns of serum HBV markers were presented at first visiting. HBsAg(+), HBeAg(+), anti-HBc(+), anti-HBc IgM(+) and HBsAg(+), anti-HBe(+), anti-HBc(+), anti-HBc IgM(+) were the most common patterns, which accounted for 38.3% and 30.0%, respectively. The dynamic patterns of serum HBV markers of 28 AFIB patients were prospectively followed up. The rate of serum FIBsAg loss was 100. 0% and the median time of negative-conversion was 3 weeks. The cumulative positive rate of anti-HBs was 85.7% after 52 weeks of follow-up. The rate of serum HBeAg loss was 100.0%. HBeAg was negative in 53.6% of patients at first visiting and the rest of patients achieved negative within 4 weeks after onset. The positive rate of anti-HBe was 82.1% during 52 weeks of follow-up. Total anti-HBc (including IgG and IgM) was keeping positive in all patients within 52 weeks, and the negative rate of anti-HBc IgM was 39. 3% after followed up for 52 weeks. Conclusions Rapid HBV clearance andserum HBV marker conversion are significantly different between AHB and chronic hepatitis B.

ObjectiveTo explore the role of the lymphocyte subsets in the peripheral blood in diagnosis, treatment and prognosis of hemophagocytic lymphohistiocytosis (HLH) in children.MethodA total of 30 children with HLH were enrolled in this study and treated according to the HLH-2004 diagnostic guidelines. 20 children with HLH entered complete remission (CR) and 10 children with HLH died. Thirty age-matched healthy children were selected as normal controls. T cell subsets in the pe-ripheral blood were measured by lfow cytometry.ResultsCompared with control group, CD3+T and CD8+T cells were signiif-cantly increased, CD4+T and CD3-CDl6+CD56+ NK cells were signiifcantly decreased, and CD4+/CD8+ cell ratio was signiifcantly decreased in 20 CR children and 10 died children with HLH in acute phase (P<0.05). CD19+B cells was not statistically different in 20 CR children and 10 died children with HLH in acute phase from control group (P>0.05). In acute phase, the lymphocyte subsets were not statistically different between 20 CR children and 10 died children (P>0.05). In 20 CR children, the proportion of CD3-CD16+CD56+NK in CR phase was statistically different than that in acute phase (P<0.05).ConclusionsChildren with HLH have obvious changes in peripheral blood lymphocyte subsets and have cellular immunity disorders. Dynamic detection of the changes may help determine the therapeutic effect and prognosis of HLH.

Objective:To evaluate the clinical efficacy and safety of oral mifepristone (10 mg/day) versus placebo in the preoperative treatment of uterine fibroids.Methods:This study was a multi-center, randomized, double-blind, placebo, parallel controlled trial. A total of 132 patients with uterine fibroids were randomly divided into study group and control group, with 66 cases in each group. The patients in the study group orally took 1 tablet/day of mifepristone (dose of 10 mg/tablet), the patients in the control group orally took 1 tablet/day of placebo, and both groups were treated for 3 months. The primary efficacy evaluation indicators were the change rate of maximum fibroid volume; the secondary efficacy evaluation indicators included amenorrhea rate, improvement of subjective symptoms and anemia; the safety evaluation indicators included the analysis of adverse events and changes in laboratory biochemical indicators.Results:At the end of treatment, the maximum leiomyoma volume was reduced by 25.97% (95% CI: -34.79%--15.95%) in the study group and reduced by 1.51% (95% CI: -13.03%-11.54%) in the control group. The change rate of the maximum leiomyoma volume before and after treatment in the study group was significantly greater than that in the control group, and the difference in the change rate of the maximum leiomyoma volume between the two groups was -24.84% (95% CI: -36.56%--10.94%), which was much higher than the 10% superiority threshold goal set by this study within the 95% CI interval. At the end of treatment, the complete amenorrhea rate [84% (52/62)], dysmenorrhea elimination rate [98% (61/62)], and menstrual blood loss disappearance rate [87% (54/62)] in the study group were significantly higher than those in the control group (all P<0.05). At the end of treatment, the mean hemoglobin [(131±13) g/L], red blood cell count [(4.5±0.4)×10 12/L] and hematocrit (0.39±0.03) in the study group were significantly increased compared with the baseline, and the differences had statistical significance (all P<0.05); after treatment, the differences in the above three indicators between the two groups had statistical significance (all P<0.01). The serum estradiol level in the study group was significantly lower than that in the control group at the end of treatment, and the difference was statistically significant ( P<0.01). There were no significant differences in follicle-stimulating hormone and cortisol levels before and after treatment between the two groups ( P>0.05). The overall incidences of any adverse event were not significantly different between the two groups (all P>0.05). Abdominal pain was the most common adverse event in the study group [9% (6/65)], but the incidence was not significantly increased compared with the control group [3% (2/64); P>0.05]. Conclusion:Compared with placebo, oral mifepristone 10 mg/day is significantly superior to placebo in reducing the size of uterine fibroids and improving anemia, without significant adverse reactions, and could be used as a drug treatment for patients with of uterine fibroids before surgery.