OBJECTIVE:To raise the price fixing of drugs to a scientific and reasonable level.METHODS:From the view of the whole society,the economic efficiency of newly-developed drugs and original drugs was compared with cost-effec?tiveness analysis.RESULTS&CONCLUSION:Through comparison,the price ranges with economic efficiency of newly-de?veloped drugs would be obtained,which could guide the price fixing.

OBJECTIVE:Using the result of pharmacoeconomic evaluation to instruct the management of drug prices.ME_ THODS:Establishing a reference price and combining economic benefit to decide the price of a drug.RESULTS&CONCLU_ SION:According to the rational value scope,the prices of new drugs can be fixed.A reasonable and timely adjustment of the price can be made.

Objective To investigate the effect of fasting blood glucose control and its influencing factors in patients with type 2 diabetes mellitus (T2DM) in community.Methods 905 cases of patients with T2DM were collected in Rencheng District of Jining city according to the stratified cluster random sampling method.The general demographic characteristics and lifestyle of the subjects were collected by questionnaire survey,and the height,body weight,blood glucose,blood pressure and blood lipids were measured by physical examination.Multivariate Logistic regression analysis was used to analyze the influencing factors of blood glucose control.Results A total of 905 subjects were recruited in the analysis.74.70％ of the subjects were aged 35 years above.The proportion reaching the control criteria of the blood glucose,blood pressure and cholesterol was 71.27％ (645),29.83％ (270) and 26.74％(242) of the subjects respectively.The influencing factors for blood glucose control in the subjects were age,duration of disease,blood pressure,weight,diet condition and psychological states and treatment compliance,and the differences were statistically significant(x2 =7.58,23.18,7.08,5.22,5.46,5.16,5.65,all P＜0.05).Multivariate Logistic regression analysis showed that age and duration of disease were the risk factors of blood glucose control in patients with T2DM.Standard blood pressure control was the protective factor that affects the effect of blood glucose control (OR=1.430,95％ CI=1.015-2.015,P＜0.05).Conclusion The blood glucose control of T2DM patients need to be improved comprehensively in community.By strengthening the control of blood glucose and blood pressure,establishing good habits of life behavior and improving the ability of self management,patients with T2DM can improve their quality of life.

Objective To study the expression of CD4+, CD25+ regulatory T cells and its significance in carcinoma of stomach. Methods Flow cytometry was used to quantify and analyze the results of CD4+, CD25 + regulatory T cells and CD8+ T cells in 76 patients with gastric cancer. Results CD4+, CD25+ regulatory T cells expression in gastric cancer tissue, adjacent tissues and control group are (1.2±0.9) %, (6.4±1.1) % and (4.1±0.8) %. The results have statistical significance (P<0.05). CD8+ T cells markedly de-creased in gastric cancer tissue, while CD4+ , CD25+ regulatory T cells increased. But this manifest did not happen in adjacent tissues.Conclusion CD4+, CD25+ regulatory T cells suppress gastric cancer though inhibiting CD8+ T cells.

Objective: To study the relationship between Framingham risk score for coronary artery disease (CAD) and cognitive function in healthy community elders.
Methods: A total of 276 healthy community elders were evaluated by Framingham score to predict the risk for suffering from CAD in 10 years. The subjects were divided into 3 groups. High risk group (the risk > 20%), n=46, Mid risk group (the risk at 10%-20%), n=76 and Low risk group (the risk < 10%), n=154. The cognitive function was measured by mini-mental state examination (MMSE) and China adult intelligence scale (CISA). The differences of cognitive function levels to 3 CAD risk groups were studied.
Results: With the increased CAD incidence from Low risk, Mid risk to High risk groups, the MMSE score reduced accordingly (26.9 ± 1.45) vs (24.3 ± 1.53) vs (22.2 ± 1.43), P=0.014. Pearson analysis presented that MMSE score was negatively related to Framingham risk score (r=-0.213, P<0.001). There were several elements of cognitive function related to Framingham risk score including MMSE score, question answering, grid filling, oral arithmetic and word distinguishing (r=-0.247), (r=-0.167), (r=-0.132), (r=-0.152) and (r-0.256), all P<0.05.
Conclusion: CAD risk level was negatively related to cognitive function, the higher Framingham risk score resulted in the lower cognitive function in healthy community elder subjects.

Objective To explore radiation-induced esophagitis and its related factors in the patients with local advanced non-small cell lung cancer ( NSCLC ) which were treated with three-dimensional conformal radiation therapy (3D-CRT). Methods From January 2001 to December 2008, 203 patients who suffered from stageⅢNSCLC were achieved, including 163 males and 40 females, with a median age of 63 years old, while 79 cases were in stageⅢa and 124 in stageⅢb . The equivalent median dose of tumor was 62 Gy( range of 50-78 Gy) . Among them, 74 cases were administered with radiotherapy alone, 45 with sequential radiotherapy and chemotherapy, 87 cases with concurrent radiochemotherapy. Radiation esophagitis was evaluated with RTOG standard. The dosimetric parameters was estimated from dose volume histogrma ( DVH ) . The clinical and dosimetric parameters of radiation esophagitis were evaluated by spearman correlatived univariate and Logistic multivariable analysis. Results After radiotherapy, out of 203 patients, 87 had acute radiation esophagitis(RE), 47 in grade 1, 37 in grade 2, and 3 in grade 3 RE. According to spearman correlatived analysis, the correlatived factors included ages, chemotherapy, GTV, PTV, the mean doses of PTV and lung, the max and mean dose of esophagus, V40 , V45 ,V50 ,V55 ,V60 , length of esophagus( total circumference) treated with 45 Gy ( LETT45 ) , and LETT50 ( r=-0. 162-0. 235,P<0. 05). All the 14 factors had good correlation with RE in univariate analysis. But for other factors,such as gender, site of tumor, smoking, T, N, clinical stage, equivalent dose of tumor, style of radiation, the mean dose of GTV, LETT55 and LETT60 , there were not correlation with ≥grade 2 RE with univariate analysis(r= -0. 106-0. 122, P>0. 05). There were 21 factors, such as gender, age, smoking, clinical stage, site of tumor, chemotherapy, GTV, PTV, mean dose of PTV and lung, max and mean dose of esophagus, V40 -V60 of esophagus, LETT45-60 , incorporated into multivariable analysis, only chemotherapy and V45 of esophagus were independent predicted factors(Wald=4. 626, 9?882, P<0. 05). Conclusions In local advanced NSCLC after 3D-CRT, chemotherapy ( especially concurrent radiochemotherapy) could increase radiation-induced esophagitis. The parameter of DVH could also be used to predict radiation-induced esophagitis, V45 of esophagus may be the most valuable predictor.

Objective To investigate the effect of folic acid combined with Helicobacter pylori (Hp) eradication therapy on chronic atrophic gastritis.Methods From December 2009 to March 2011 at the First Affiliated Hospital of Nanjing Medical University,184 patients with endoscopic and pathological diagnosis of chronic atrophic gastritis (90 Hp positive and 94 Hp negative) were selected.Hp positive patients were divided into group A and group B.Forty-three patients in group A were treated with standard triple Hp eradication therapy and follow by folic acid therapy for three months.Forty-seven patients in group B and Hp negative patients received three months of folic acid therapy.The clinical symptoms of each group were scored before treatment,one month after folie acid therapy and three months after folic acid therapy and analyzed by t test. Patients of each group received gastroscopy before treatment and three months after medicine withdrawal. Endoscopic scores,pathological scores and t test were recorded.The serum levels of pepsinogen ( Ⅰ,Ⅱ ) and gastrin 17 in venous blood of 55 Hp negative patients were detected by enzyme-linked immunosorbent assay (ELISA) method before treatment and three months after medicine withdrawal.Results Compared with three months therapy (1.15 ± 0.03),after one month folic acid therapy (1.55 ± 0.04) was statistically significant in clinical symptoms score of all patients (t =8.18,P＜0.01).By the end of therapy,clinical symptom score of group A (1.06 ± 0.04) was lower than that of group B (1.56 ±0.08),and the difference was significant (t=6.00,P＜0.01).There was significant difference in endoscopic scores of all patients between before treatment (1.57±0.95) and after treatment (1.00±0.76,t=11.12,P＜0.01).The differences in each pathological score of all patients (inflammatory scoring,active scoring,atrophy scoring,intestinal metaplasia scoring,atypical hyperplasia degree scoring) were significant between before treatment and after treatment (t=5.51,6.90,7.53,6.34,2.90,respectively,all P＜0.01).The serum level of pepsinogen Ⅰ before treatment of 55 Hp negative patients [(1.03±0.19) nmol/L] was lower than that after treatment [(2.24±0.33) nmol/L],and the difference was statistically significant (t=3.19,P＜0.01).After treatment the level of gastrin 17 [(0.86±0.05) nmol/L] was higher than that before treatment [(0.47±0.05) nmol/L],and the difference was statistically significant ( t =5.33,P＜ 0.01 ).Conclusion Folic acid in combination with Hp eradication therapy can be favorable to atrophic gastritis,which may promote the secretion of pepsinogen and gastrin.

Objective To evaluate the efficacy of three-dimensional conformal radiotherapy (3DCRT) and prognostic factors for stage Ⅲ non-small cell lung cancer (NSCLC).Methods From 2000 to 2010,474 patients with stage Ⅲ NSCLC undergoing 3DCRT were enrolled as subjects.Those patients,consisting of 382 males and 92 females,had a median age of 63 years.In those patients,211 had stage ⅢA NSCLC and 263 had stage ⅢB NSCLC;165 were treated with radiotherapy alone and 309 with chemoradiotherapy;55 were treated with conventional radiotherapy plus 3DCRT,340 with 3DCRT,and 79 with intensity-modulated radiotherapy;the median equivalent dose was 60 Gy (44-77 Gy).The Kaplan-Meier method,log-rank test,and Cox model were used for survival rate calculation,univariate analysis,and multivariate analysis,respectively.Results The follow-up rate was 96.6％.In all patients,the 1-,3-,and 5-year overall survival rates were 63.0％,24.9％,and 17.8％,respectively;the median survival time was 18 months.The univariate analysis showed that sex,age,immediate response,radiotherapy method,fractionation scheme,chemotherapy,and radiation pneumonitis (RP) were prognostic factors (P=0.004,0.001,0.000,0.007,0.004,0.009,0.049).The multivariate analysis showed that sex,age,immediate response,radiotherapy method,and RP were independent prognostic factors (P=0.006,0.000,0.000,0.003,0.048).Patients with radiation doses of 60-66 Gy had the best prognosis of all.Conclusions In patients with stage Ⅲ NSCLC undergoing 3DCRT,female patients,patients at a young age,patients with satisfactory immediate response,patients treated with full-course 3DCRT,and patients with grade 0-1 RP have better prognosis than others.3DCRT combined with chemotherapy improves survival in patients.A radiation dose of 60-66 Gy is recommended.

ObjectiveTo investigate the clinical significance of peripheral blood lymphocyte subsets in patients with idiopathic inflammatory myopathy (ⅡM).MethodsPeripheral blood lymphocyte subsets was determined by flow cytometry in 89 patients with polymyositis(PM ) or dermatomyositis ( DM ).The association between clinical features and peripheral blood lymphocyte subsets was analyzed by F test,t test and x2 test.ResultsPatients with active DM showed significant decreases in counts of CD3+ cell,CD3+CD4+ cell and CD3+CD8+ cell[(8±4),(5.4±2.8) and (2.6±1.6) ×108/L respectively],compared with those in inactive DM [(16±6), (10.4±5.6) and (5.6±3.8) ×108/L respectively] and healthy controls [(14±4), (8.3±2.8) and (4.6±1.7) ×108/Lrespectively](F=12.901,8.257,7.084; P＜0.05).Logistic regression analysis indicated that myositis disease activity could influence the counts of peripheral blood CD3+ cell,CD3+CD4+ cell and CD3+ CD8+ cell (b=0.211,0.344,0.289; P＜0.05 ).ILD in ⅡM could influence the counts of CD3+ cell and the ratio of CD3+CD4+cell (b=0.928,1.974; P＜0.05 ).Logistic regression analysis indicated that the count of CD3+CD8+ cell was risk factor for death,and the relative risk was 0.989(b=-0.011 ; P＜0.05).ConclusionPeripheral blood lymphocyte subsets may be regarded as useful laboratory parameters for monitoring RA disease activity.Decreased CD8+ T cell may predict a poor outcome of patients with IIM.

Objective: To study the influence of inflammatory cytokine TNF-? on the expression of adhesion molecules and specific markers of rat MSCs, and to study the optimal stimulation of MSCs with inflammatory factors in inducing adhesion molecule expression which promotes migration of MSCs to the ischemic area in liver. Methods: The MSCs stimulated with different concentration of TNF-? were detected for adhesion molecules and stem cells markers on cell surface with the method of flow-cytometry, MSCs which were stimulated with the optimal concentration of TNF-? and labeled with 1, 1-Dioctadecyl-3, 3, 3, 3-tetramethylindocarbocyanine Iodade(DiI)were delivered intravenously to the rats whose liver was injured by ischemia, the liver function of the experimented animals were tested, and liver samples in the ischemic area were obtained, the number of MSCs was counted under a fluorescent microscope. Results: Stimulated with TNF-?, MSC ex-pression of VCAM-1 increased, while that of stem cell markers did not change markedly. Exposed to lower concentration of TNF-?, the adhesion ability of MSCs obviously increased and more MSCs rested in the ischemic areas in the rat liver, compared to the control groups. Conclusions: TNF-? can increase the expression of VCAM-1 on rat MSCs while exert little effect on the stem cell character of MSCs. Suitable concentration of TNF-? can promote MSCs migration to the damaged tissue, which provides rationale for the treatment of liver disease.