OBJECTIVE:To provide suggestions and countermeasures for improving the accessibility of national essential medi-cines. METHODS:Based on the theoretical analysis,the questionnaire was designed for the pre-survey and formal survey on the experts from universities,enterprises,government agencies and non-governmental organizations,and analytic hierarchy process was used to analyze and discuss the valid questionnaire. RESULTS:Totally 35 question naires were sent out and 27 were effective-ly received with effective rate of 77.14%. The physicians and pharmacists’cognition of essential medicine system and essential medicine,and the reasonable degree of public bid prices of essential medicine,the fairness and impartiality of essential medicine bidding process were the key influential factors;the prescription,provision,reimbursement of essential medicine,and the financial compensation to primary public health care institutions that sell essential medicine by zero-slip were the secondary factors;primary health care institutions’monitoring on the use of essential medicine(such as prescription rate,etc.),the participation of social se-curity sector in bidding and purchasing of essential medicine,the reasonable degree of pricing of essential medicine,the monitoring of the price of essential medicine,and the compensation to manufacturers of essential medicine were the general factors. CONCLU-SIONS:The accessibility of essential medicine involves many stakeholders,whom impact from different levels. Therefore,all rele-vant stakeholders should be coordinated to gradually improve the accessibility of essential medicines.

Traumatic asphyxia is a result of sudden or severe compression of the thorax and/or the upper abdomen.A sudden increase of intravascular pressure transmitted to the intra-and extracerebral vessels may cause petechial hemorrhage in the brain and in the skin over the head,face,neck and shoulder regions.Severe cerebral anoxia accompanying the injury may lead to cerebral edema and the appearance of signs of increased intracranial pressure as well as ARDS following hypoxemia.Spinal puncture and EEG are helpful in early diagnosis.The essential therapeutic measures consist of improvement in ventilation,dehydration and the use of glucocorticoid hormones.By such manoeuvres,11 of 12 patients we treated recovered satisfactorily and only 1 of them succumbed.

OBJECTIVE To understand the susceptibility to antituberculous agents for patients with primary and acquired drug resistance of Mycobacterium tuberculosis. METHODS M. tuberculosis positive sputum samples were collected from Jun to Dec 2006. Ameliorative Lowenstein-Jensen culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis by typing using PNB and TCH. Totally 217 samples were confirmedtobe positive by culturing. Drug susceptibility test against streptomycin (SM),isoniazid (INH),rifampicin (RFP) and ethambutol (EMB) was conducted. RESULTS The total drug resistance rate was 65.90%,the initial drug resistance rate was 39.81% and the initial multi-drug resistance rate was 16.67% ;the acquired drug resistance rate was 91.74%,and the acquired multi-drug resistance rate was 74.31%. The main causes of drug resistance were irregularit of treatment at beginning and preterm stop of the freatment course by patients own selves,which accounted for 71.6%. CONCLUSIONS The drug resistance of M. tuberculosis is caused by irregular treatment,so the key to prevent and control drug resistance is rational and whole-course treatment.

Locally advanced nasopharyngeal carcinoma ( NPC) invaded with paranasal sinus as death is associated with disease and independent prognostic factors for local recurrence .Its symptoms are various and atyp-ical,and often causes misdiagnosis or missed diagnosis .Local recurrence and distant metastasis are the main cause of treatment fails .Currently , there are few literature about NPC intruding paranasal sinus .Its occurrence rate,clinical manifestation,imageological change,intruding pathways,diagnosis,treatment and prognosis are sum-marized in this paper .

Objective To investigate the risk factors of incidence of hypertensive disorder complicating pregnancy(HDCP)and provide reference for prevention and treatment of HDCP.Methods The clinical information of 2 217 cases of maternal delivery were retrospectively analyzed;The relevant social factors and obstetric factors of HDCP were analyzed.Results 186 cases of HDCP occurred in 2 217 cases of maternal,the incidence rate of HDCP was 8.4%.The single-factor analysis showed that the place of residence.prenatal system checks and parity had certain degree of contact with incidence of HDCP(χ2=11.2331,10.6781,5.4456,all P＜0.05),and the age,abortion history and parity had no significant correlation with incidence of HDCP(χ2=4.9201,3.0134,1.7301,all P＞0.05).Multivariate Logistic regression analysis showed that the rural living and no prenatal system check were risk factors of incidence of HDCP.Conclusion The maternal of rural living and no prenatal system check were the high-risk population of HDCP,and emphasis assessment and reasonable control these factors could reduce the incidence of HDCP.

Objective To investigate the relationship of cardiac function and ventricular structure with the training intensity and the periods lived in Tibet.Methods Sixty recruits to Tibet were selected and examined of their cardiac function,cardiac ventricular structure and the changes of elctrophysiology by color Doppler echocardiography and electro cardiogram.They were examined continuously in two years.After their training for three months together,they were divided into the different training intensity groups,Group A and Group B.The 30 recruits in Group A had high-intensity training,and the others in Group B had normal training.Results After three months,their cardiac function and ventricular structure had obvious difference in comparison with the level on plain( P 0.05 ).But there were obvious differences between in Tibet and on plain in the parameters of cardiac function and ventricular structure two years later( P 0.05 ).Conclusions Hypoxia can effect the cardiac function and ventricular structure directly.After three months in Tibet,cardiac function can fit the condition of hypoxia.The parameters of cardiac function are still less than those on plain.The right ventricules are bigger and the pulmonary arteries wider as the main character of the ventricular structure changes.The indexes of cardiac function showed no significant difference with the training intensity and the periods in Tibet.

Objective To study the neuroprotective effect of apigenin on microglia which was exposed to oxygen glucose deprivation and reperfusion (OGD/R), which was characterized by its influence on IL-1? and TNF-? expression. Methods Primary microglial cultures were prepared from newborn rat brain. The purity of isolated cells were identified by GSA-IB4. The cells were randomized into 5 groups:normal group, DMSO group and apigenin-treated groups (10, 25, 50 ?mol/L). The cells of DMSO group and apigenin-treated group were exposed to 8 h of OGD and 24 h of reperfusion in the presence or absence of apigenin at a range of concentrations. Culture supernatants were collected and IL-1? and TNF-? were detected by ELISA assay. Results The expression of IL-1? and TNF-? were significantly higher in DMSO group (P

Objective: To plan the future for the establishment and development of health econometrics in China. Methods: To analyze the main current situation of the research on domestic and oversea health econometrics, and to look into the prospective future of its application field of public health in China. Results: Overseas studies on health economics have been relatively mature and extended to generate health econometrics as the independent discipline. However, the research on health economics in China is lagging, and on health econometrics even vacant. Conclusion: The results from foreign studies have revealed that this new discipline plays a unique and significant role in medical health research. Health econometrics occupies broad application prospect in the field of public health in China, which should be paid more attention and support.

Objective To observe the influence of systemic and intraperitoneal hyperthermic perfusion chemotherapy on serum vascular endothelial growth factor(VEGF) and human epididymis protein 4 (HE4) in patients with ovarian cancer.Methods 116 cases with ovarian cancer were,randomly divided into the observation group and the control group according to the number table,58 cases in each group.The observation group was given systemic and intraperitoneal hyperthermic perfusion chemotherapy,and the control group received systemic chemotherapy,they all completed a total of two cycles of chemotherapy.Serum VEGF and HE4 were measured before and after chemotherapy.Results The total effective rate of the observation group was 74.1％,and that was 56.9％ of the control group,the difference was significant (x2 =4.290,P ＜ 0.05).After chemotherapy,the serum VEGF and HE4 were signifi cantly decreased in two groups,and compared with the control group,the observation group decreased more significantly(t =3.180,2.725,all P ＜ 0.05).Conclusion Systemic and intraperitoneal hyperthermic perfusion chemotherapy in treatment of patients with ovarian cancer can significantly reduce serum VEGF and HE4.

Objective To observe the effect of neoadjuvant chemotherapy for patients with advanced cervical cancer.Methods According to the digital table ,106 patients with advanced cervical cancer were randomly divided into the two groups ,53 cases in each group .The observation group was given TP Scheme neoadjuvant chemotherapy before surgery ,the control group underwent surgery directly .The total effective rate of chemotherapy and the changes of diameter of tumor before and after chemotherapy were observed .The serum levels of vascular endothelial growth fac-tor(VEGF) and matrix metalloproteinase-9(MMP-9) of the observation group were detected ,and the operation condi-tions were compared between the two groups .Results After chemotherapy ,the total effective rate of the observation group was 60.4%.Before and after chemotherapy ,the average tumor diameter of the observation group was (5.24 ± 1.35)cm,(2.64 ±0.67)cm,respectively,the difference was significant (t=3.947,P<0.05).The operative time, blood loss and lymph node metastasis in the observation group were significantly less than those in the control group (t=3.725,5.392,χ2 =4.28,P<0.05 or P<0.01).After chemotherapy,the serum levels of VEGF and MMP-9 were significantly lower than that before chemotherapy (t=3.130,4.724,all P<0.05).Conclusion Neoadjuvant chemotherapy in the treatment of advanced cervical cancer can significantly reduce serum VEGF and MMP-9 expression.