The article presented the drugs supply management mode reform in place since 2009 in the one district of Shanghai.Authors analyzed and commented the implementation and outcomes,and studied the potentials of successful promotion nationwide.They hold that such a mode works to some extent in terms of reducing management costs of medical institutions,lowering drug purchase price,encouraging rational drug use of such institutions,and reforming the compensation manner for medical institutions.This mode,however,calls for an operating environment in need of not only funding support,but also new concepts and economic development strength of the society as a whole.This means that such a mode is only recommended in developed areas in China.

Objective To investigate the effect of isoflurane administered before ischemia on polymorphonuclear neutrophil (PMN) infiltration and expression of adhesion molecules in the lung injured by ischemia-reperfusion.Methods One-hundred and twenty male SD rats weighing 250-350 g were randomly divided into 4 groups ( n = 30 each) :Ⅰ sham operation group (S) ;Ⅱ I/R group in which hilum of left lung was clamped for 45 min and then undamped for reperfusion; Ⅲ Iso + I/R in which 1 MAC isoflurane was inhaled for 30 min before ischemia and Ⅳ Iso + S in which 1 MAC isoflurane was inhaled for 30 min without I/R. The animals were anesthetized with intraperitoneal pentobarbital 50 mg?kg-1 then tracheostomized and mechanically ventilated with 100% O2(VT= 10-15 ml?kg-1) . PaCO2 was maintained at 35-45 mm Hg. Right jugular vein and left carotid artery were cannulated for BP monitoring, blood sampling and fluid and drug administration. Anesthesia was maintained with ketamine 10 mg?kg-1?h-1 and vecuronium 0.1 mg?kg-1?h-1. 1 MAC isoflurane (1.38% in rats) was inhaled for 30 min before hilum of left lung was clamped with an atraumatic clamp. Left lung ischemia was maintained for 45 min then the left lung was released for reperfusion. MAP was monitored and blood gases were analyzed during experiment. The animals were killed at the end of 45 minute ischemia and at 30, 60 and 120 min reperfusion and left lung was removed for: (1) determination of W/D lung weight ratio, myeloperoxidase (MPO) activity and expression of ICAM-1 mRNA; (2) light and electron microscopic examination; (3) broncho-alveolar lavage (BAL). BAL fluid (BALF) was collected and the number of cells, percentage of PMN and total protein concentration in BALF and the expression of CD18 on PMN surface were determined. Results The W/D lung weight ratio, MPO activity and expression of ICAM-1 mRNA in the lung tissue, the percentage of PMN and TP concentration in BALF and the expression of CD18 on PMN surface were all significantly increased during reperfusion in I/R group but isoflurane pretreatment significantly attenuated the I/R induced increases. Histological examination showed that the I/R induced lung injury was also ameliorated by isoflurane pretreatment. Conclusion Inhalation of isoflurane before ischemia could protect the lungs against I/R injury by inhibiting the PMN infiltration and expression of ICAM-1 mRNA and CD-18.

0.05) but CO, SV and CVP increased and SVR decreased significantly after AHH in both groups as compared with those before AHH. pH, Lac and COP did not change significantly after AHH. There was no significant difference in the volume of solution infused, blood loss, CO, SV, CVP and SVR between the two groups. Conclusion Age is not a primary factor negating the use of AHH. Under combined general-epidural anesthesia AHH with 6% hydroxyethyl starch (15 ml?kg-1 ) can be well tolerated by the elderly patients without cardiac and pulmonary disease.

Chronic prostatitis is a common male disease, and its pathogenesis is not yet clear. Most scholars believe that oxidative stress and immune imbalance are the keys to the occurrence and progression of chronic prostatitis. Currently immunotherapy of chronic prostatitis remains in the exploratory stage. This article relates the active ingredients of 5 Chinese medicinal herbs (total glucosides of paeony, tripterigium wilfordii polglycosidium, curcumin, geniposide, and quercetin) for the treatment of chronic prostatitis and their possible action mechanisms as follows: 1) inhibiting the immune response and activation and proliferation of T-cells, and adjusting the proportion of Th1/Th2 cells; 2) upregulating the expression of Treg and enhancing the patient's tolerability; 3) suppressing the activation of the NF-kB factor, reducing the release of iNOS, and further decreasing the release of NO, IL-2 and other inflammatory cytokines, which contribute to the suppression of the immune response; 4) inhibiting the production of such chemokines as MCP-1 and MIP-1α in order to reduce their induction of inflammatory response. Studies on the immune mechanisms of Chinese medicinal herbs in the treatment of chronic prostatitis are clinically valuable for the development of new drugs for this disease.
Chemokines ; immunology ; Cytokines ; immunology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Immune System ; drug effects ; Male ; NF-kappa B p50 Subunit ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Plants, Medicinal ; Prostatitis ; drug therapy ; immunology ; T-Lymphocytes, Regulatory ; drug effects ; Th1-Th2 Balance

Estradiol ; blood ; Female ; Hot Flashes ; prevention & control ; Humans ; Isoflavones ; therapeutic use ; Luteinizing Hormone ; blood ; Middle Aged ; Phytotherapy ; Postmenopause ; blood ; drug effects ; Prospective Studies ; Soybean Proteins ; therapeutic use ; Soybeans ; chemistry ; Sweating ; drug effects ; Syndrome

The modern physicians have different views on acupoint combination and acupuncture-moxibustion prescription and confuse them in clinical practice. It is significant to clarify the conception, connotation and relationship between them so as to normalize the therapeutic program of acupuncture and moxibustion and promote the standardization of acupuncture and moxibustion. Through the collection of relevant literature and analysis on the differences in the understandings among physicians, the conception, connotation and relationship between acupoint combination and acupuncture-moxibustion prescription are summarized. It is viewed that the acupoint combination is based on TCM theory. Under the guide of acupoint selection, in combination of the characters of clinical practice and acupoint indications, two or more than two acupoints of the same function are combined to enhance the collaborative effects of acupoints so as to achieve specific efficacy and improve clinical efficacy. Regarding acupuncture-moxibustion prescription, on the basis of disorder and syndrome differentiation of patients, the concrete therapeutic program is put forward, including acupoint composition and therapeutic method. Acupoint combination is the basic element of acupuncture-moxibustion prescription. Acupuncture-moxibustion prescription is the specific application of acupoint combination.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Moxibustion

China ; Hepatectomy ; methods ; Humans ; Liver Transplantation ; methods ; Living Donors

Purpose:To investigate the relationship between cell apoptosis and dephosphorylated RB protein in human breast cancer. Methods:In our work,human breast cell lines (MCF-7/S,the chemosensitive cell line and MCF-7/ADR,the chemoresistent cell line)were evaluated. Chemosensitivity of two cell lines was evaluated by the MTT colorimetric assay;the expressive levels of dephosphorylated RB protein were detected with immunocytochemistry. Apoptosis rates were determined by flow cytometry(FCM). Results:ADR inhibited proliferation of chemosensitive cell line MCF-7/S ,the 50% inhibition concentration (IC 50 ) was 0.128 ?g/ml;And IC 50 of MCF-7/ADR was 10.89 ?g/ml. The chemotherapeutic sensitivity of MCF-7/S was more than that of MCF-7/ADR by 86 times . Before treatment with ADR,phosphorylated RB protein was positive in two cell lines,but dephosphorylated RB protein was negative;After treatment of different concentration ADR,when the concentration of ADR was increased,expression of dephosphorylated RB protein elevated accordingly in MCF-7/S,but no significant change in MCF-7/ADR. Apoptosis and cell cycle was detected by FCM assays shows ADR induced apoptosis of MCF-7/S more than MCF-7/ADR(P0.05).

Objective To evaluate the application of endoscopic needle- knife precut sphincterotomy (PST) in treating acute suppurative cholangitis. Methods After failure of routine papillary intubation during encoscopic retrograde cholangio-pancreatography (ERCP) in papillary incarcerated stone or inflammatory stenosis cases, needle-knife PST was applied to find the lower opening of the common bile duct. After that, routine papillary sphincterotomy or balloon dilation followed. Then net basket for stone extraction and nasobiliary catheter for drainage were made. Results Eleven of the 12 cases′ stones were extracted successfully, the success rate was 91.7%. In the 11 cases, 5 cases′ incarcerated stones dropped into duodenum automatically after sphincterotomy; 9 cases′ stones were extracted successfully in one treatment while 2 cases′ stones were extracted secondarily after stents were implanted; 1 case′s stone could not be extracted and need surgical treatment after nasobiliary catheter drainage because of stenosis of the lower part of the common bile duct. There was no dead case in all the cases. Conclusions Acute suppurative cholangitis patients, who have papillary incarcerated stones or inflammatory stenosis, can receive more efficacious diagnosis and treatment by applying PST when routine endoscopic papillary intubation fails. PST is an important endoscopic treatment for acute calculous suppurative cholangitis

Objective To study the changes and clinical significance of serum kalium,natrium,chlorine,calcium and glucose in children with febrile convulsion(FC).Methods Serum kalium,natrium,chlorine,calcium and glucose concentrations were measured in 41 children with FC(FC group),30 children with fever and without convulsion(fever group) and 30 normal children(normal group) by automatic biochemical detector.Results Serum kalium and calcium concentrations had no significant difference between FC group and fever group,but they were significantly lower than those of normal group(F=5.965,3.048 P0.05).Conclusions There are hyponatremia,hyperglycemia and lowered blood kalium and calcium in patients with FC.Hence,while treating the patient with FC,the disturbance of blood electrolytes and glucose need be corrected to avoid the recurrence of FC and the progressive injury of important organs such as brain.