At present the annual sales of drugs in the world are over 100 billion dollars. America, Japan and West-Europe are the three large pharmaceutical markets. In the past ten years, cephalosporins are the most important antibiotics. Fluoroquinolone products have been developed rapidly in recent years. The sales of cardiovascular drugs occupy the first position in drug markets. ACE inhibitors and calcium antagonists are considered as a big breakthrough. The sale amount of H_2-antagonist, ranitidine is reported in the lead. In the future, OTC products and biotechnological preparations will increase share in the world drug markets.

In the whole world, about 10 millions people suffer from pulmonary tuberculosis each year, of them, three millions died of this disease. At present, there are 5～6 million patients suffering from pulmonary tuberculosis in China. The spread of AIDS results in increase of TB patients. This article emphatically describes the present status of antituberculotie drug markets and the development of the new varieties of antituberculotic in China.

Rapid development of biotechnology necessarily brings about a revolutionary change in drug production. It is estimated that the annual sales of biotechnology drugs will reach 50 billion dollars in 2000. The pharmaceutical factories in USA, Japan and West-European Countries focus their attention on biotechnology drugs. Now, human somatotropin, human insulin and erythropoetin produced by r-DNA technic have occupied an important place in drug market. We believe that the 21st century will be a new era of biotechnology drugs.

Objective To compare the gemcitabine (GEM) plus S-1 and gemcitabine alone in the treatment of advanced pancreatic cancer (PC) by meta-analysis.Methods Articles were searched in PubMed,Cochrane library,Embase,CNKI,and CBM up to August 1st,2013.Only randomized controlled trails (RCTs) for GEM + S-1 and GEM alone in advanced PC were included.Two reviewers retrieved and collected data respectively.Data were selected basing on inclusion and exclusion criteria.The meta-analysis was base on survival advantage (include overall survival and progress free survival),object response rate,disease control rate and adverse reaction.Results A total of 3 trials with 772 cases were included.Meta-analysis demonstrated that GEM plus S-1 significantly improved the progress free survival (HR:0.64,95％CI:0.54-0.75,P ＜ 0.000 01) and overall survival (HR:0.81,95％CI:0.68-0.96,P =0.01),improved object response rate (RD:0.16,95％ CI:0.10-0.21,P ＜ 0.000 01) and disease control rate (RD:0.10,95％ CI:0.03-0.17,P =0.009) also.However,the incidence of WHO 3/4 grade adverse reaction was increased significantly in the GEM + S-1 group.Neutropenia,thrombocytopenia,and gastrointestinal reaction were increased by 18％ (P =0.02),18％ (P =0.008) and 8％ (P ＜ 0.000 01)respectively.Conclusion GEM combined with S-1 can improve the chemotherapy effect compared with GEM alone.The adverse reactions also increase significantly,but the overall survival is benefit.

Objective To investigate clinical first selected method on the differential diagnosis at early stage between amyotrophic lateral sclerosis(ALS) and cervical spondylosis.Methods The clinical features and EMG in 53 patients with ALS,14 patients with cervical spondylotic myelopathy(CSM) and 23 patients with cervical spondylotic radiculopathy(CSR) were analysed.And then the value of ratio of every probability was calculated.According to the value of ratio, the clinical features and EMG were compared in differential dia gnosis.Results A multiprogram that consisted of high multiple clinical features was used in differential diagnosis, true positive rate is 98%, and true negative rate is 86.5%,EMG still couldn't be used in the differential diagnosis.Conclusion The program is the first selected method, which can be used in the differential diagnosis between ALS and CSM/CSR.

A BASIC program was written to analyse the data from radioreceptor assay by microcomputer. Concentrations of ligand, total binding, nonspecific binding, specific binding and the ratio of specific binding (number of receptor sites) to free ligand content were calculated for each point. The receptor binding affinity constant and binding capacity were obtained by Sca-tchard analysis. Results and graphs can be displayed on the screen and/ or printed out by using a graphic printer

OBJECTIVE:To provide reference for clinical individual medication of voriconatole. METHODS:The distribution of MIC of voriconazole to Aspergillus fumigatus and Candida albicans were summarized as well as the pharmacokinetic parameters of voriconazole in different populations. Using probability of target attainment(PTA)and cumulative fraction of response(CFR)as indexes,crystal ball software 11.1.2.4 was used for Monte Carlo simulation of different dosage regimens of same population and same dosage regimen of different populations. RESULTS:For children with impaired immunity,when the drug doses of were 4,6 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%;when the drug doses was increased to 8 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%. For different populations receiving same dosage regimens(4 mg/kg),MIC of teenagers with impaired immunity was lower than 0.25 mg/L and those of healthy adults,patients underwent hematopoietic stem cell transplantation and adults with impaired immunity were all lower than 0.5 mg/L,PTA was higher than 90%. CFR to A. fumigatus were 42.53%,58.41%,77.74%,70.16%,89.40%,93.72%,95.42% and CFR to C. albicans were 96.68%,97.13%,97.94%, 97.54%,98.07%,98.28%,98.35%among children with impaired immunity receiving different drug doses(4,6,8 mg/kg)and dif-ferent populations receiving drug dose of 4 mg/kg(teenagers with impaired immunity,healthy adults,patients underwent hemato-poietic stem cell transplantation,adults with impaired immunity). CONCLUSIONS:Various dosage regimens of different popula-tions included in this study could effectively control C. albicans infection. It is necessary to increase the drug dose of children and teenagers with impaired immunity in order to meet the needs of A. fumigatus infection treatment.

Objective To make a clinical summary of the variation of cystic duct so as to collect 20 years of operative experience and to provide evidence for preventing injury of bile duct in laparoscopic cholecystectomy. Methods A retrospective analysis were made for 20 000 patients experienced laparoscopic cholecystectomy in the second affiliated hospital of Chongqing medical university and Chonggang General Hospital from April,1993 to December,2011. Results There were 3 265 cases of cystic duct variation which occupied 16. 33% of the 20 000 patients. And there were 3 200 cases of variation in the junction of cystic duct, 51 cases of short cystic duct;and 14 cases of gall-bladder surrounded by the liver. Most of the variation were found in the junction of cystic duct, including 371 cases (11. 36%) of cystic duct accompanied the common hepatic duct and then made a lower confluence;995 cases (30. 47%) of cystic duct traversed above the com-mon hepatic duct and then made a confluence, 643 cases (19. 69%) of cystic duct traversed below the common hepatic duct and then made a confluence;963 cases (29. 49%) of gallbladder neck attached to the common bile duct;and 228 cases (6. 98%) of higher confluence of cystic duct and common bile duct. Conclusion The rate of cystic duct variation accounted for a high rate, and most of the patients were found with a variation in the junction of cystic duct. Being familiar with the categories of cystic duct, discriminating the anatomic structure carefully, using choledochoscopic examination when necessary, and masterting reasonable time to make a transfer to laparocholecystotomy were reliable methods for coping with the injury of bile duct caused by variation of cystic duct.

Objective To generate the spaO-ompA fusion gene of Salmonella paratyphi A and its prokaryotic expression system,and to determine the immunoprotection of the recombinant expression product rSpaO-OmpA.Methods A flexible peptide sequence was used to link spaO and ompA genes and a prokaryotic expression system of spaO-ompA fusion gene was subsequently generated.SDS-PAGE and Bio-Rad Agarose Image Analyzer were applied to examine the expression as well as the yield of the target recombinant protein rSpaO-OmpA.The antigenicity and immunoreactivity of rSpaO-OmpA were determined using immunodiffusion test,Western Blot assay and micro-Widal's test.By a mouse infection model,the immunoprotection of rSpaO-OmpA against the lethal challenge of S.paratyphi A was determined.In the animal protective test,the recombinant expressed SpaO (rSpaO) and OmpA ( rOmpA ) were used as the controls.Results The generated spaO-ompA fusion gene had 100％ nucleotide and amino acid sequence identities compared to the single spaO or ompA gene.The constructed prokaryotic expression system IPTG E.coli BL21DE3pET42a-spaO-ompA expressed the recombinant protein rSpaO-OmpA.rSpaO-OmpA combined with the antiserum against wholecell of S.paratyphi A to present positive hybridization signal and induced specific antibody in the immunized rabbits.Immunization with 100 or 200 μg rSpaO-OmpA contributed 66.7％ (8/12) or 83.3％ (10/12) immunoprotective rates in mice when the animals were attacked with S.paratyphi A.The immunoprotective rates produced by rSpaO-OmpA were significantly higher than that of equal rSpaO or rOmpA( P＜0.05 ).The sera from rSpaO-OmpA immunized mice presented 1∶5-1∶40 agglutination titers to the H antigens of different S.paratyphi species,and 1∶1-1∶16 immunodiffusion titers to rSpaO,rOmpA and rSpaO-OmpA proteins,respectively.Conclusion The artificially fusion antigen,rSpaO-OmpA,has more powerful immunogenicity and immunoprotection that the equal rSpaO or rOmpA.

OBJECTIVE: To study the effect of total flavonoids from Alpinia officinarum on gastrointestinal motility.METHODS: Gastric emptying method was applied to observe the effect of total flavonoids from A.officinarum on gastric emptying of normal mice and sthenic gastric emptying induced by pyridostigmine bromide.Effect of total flavonoids from A.officinarum on gastric smooth muscle of rats was observed through in vitro test and small intestine advancement was used to observe the influence of total flavonoids from A.officinarum on intestinal motility.RESULTS: Total flavonoids from A.officinarum had no significant influence on gastric emptying of normal mice,but distinctly inhibited sthenic gastric emptying induced by pyridostigmine bromide(P