OBJECTIVE:To explore the implementation methods of drug price reform in China. METHODS:Current condi-tion and disadvantages of drug price mechanism in China were analyzed,the problems of the implementation of drug price reform were concluded and summarized,and the implementation methods of drug price reform were put forward. RESULTS & CONCLU-SIONS:Current condition and disadvantages of drug price mechanism in China are mainly reflected as failure of policy for maxi-mum retail price causes part of drugs to be overpriced;government-led centralized procurement of drugs results in that part of drugs are underpriced;the defects in the regulation of drug price addition rate leads to hospitals’procurement of drugs at higher price;government’s excessive interference in drug price affects the fair competition and sound development of pharmaceutical in-dustry. However,there are some problems for drug price reform,including unsound drug distribution system,a lack of fair compe-tition in modern drug market,excessive centralization of power of medical insurance authorities,absent public participation and so-cial supervision,and the“practice of using pharmacy profits to subsidize medical services”leading to wrong medical behavior. These measures were suggested to resolve above problems,i.g. reform the drug distribution system,foster modern drug market,es-tablish a medical insurance authorities-led mechanism for drug price negotiation in which multiple interest parties participate,and develop drug retail enterprises gradually replacing the outpatient pharmacies in hospitals to separate medical services from pharma-ceutical services.

Objective:To study the effect of roadside dust inhalable particulate matter on airway inflammation in rats.Methods:Particles at roadside were collected,analyzed and PM10-treat model of rats were established.Lung tissue histopathology was observed.The counts of total leukocytes and neutrophils in bronchoalveolar lavage fluid(BALF)and superoxide dismutase(SOD),glutathion peroxidase(GSH-Px),malondiadehyde(MDA),cytokin-induced neutrophil chemotactics(CINC)in lung homogenate were measured.Results:The counts of total leukocytes,macrophages and neutrophils in PM10-treat group were increased significantly than those in control group(P

Objective:To investigate the role of nuclear factor-?B(NF-?B)in rats with cerebral ischemia-reperfusion injury. Methods:Rat models of cerebral ischemia-reperfusion were established.24hours later,the expression of NF-?B in rat brain of sham-operation group,operation group and intervention group was detected with immunohistochemistry method,Cytokin-induced neutrophil chemotactics(CINC)in rat brain were measured and histopathological examinations were conducted on the hippocampal CAl.Results:The expression of NF-?B p65 and CINC in the operation group increased significantly compared with the sham-operation group(P

Objective: To investigate the effects of the tandem repeat polymorphisms in the enhancer region (ER) of thymidylate synthase (TS) gene and the 6-bp deletion/insertion (del6/ins6) polymorphism in the 3′ untranslated region (3′-UTR) of TS gene on the clinical outcomes of gastric cancer patients treated with 5-FU-based adjuvant chemotherapy. Methods: One hundred and sixteen patients with gastric cancer were treated with 5-FU-based adjuvant chemotherapy. The polymorphisms of TSER and TS 3′ -UTR in those patients were determined by polymerase chain reaction (PCR) method. Results: Of the 116 patients, the frequencies of the TSER 2R/2R, 2R/3R and 3R/3R were 7.8% (9/116), 31.9% (37/116), and 60.3% (70/116), respectively; the frequencies of the TS3′-UTR ins6/ins6, ins6/del6 and del6/del6 were 9.5% (11/116), 41.4% (48/116) and 49.1% (57/116), respectively. The median survival period in ins6/ins6 carriers was significantly shorter than that of del6/del6 (P = 0.017) or ins6/del6 (P = 0.022) carriers. There was no significant difference in median relapse-free survival period between different TSER carriers (P > 0.05). COX multivariate analysis showed that the ins6/ins6 carriers had increased death risk (P <0.05) compared to the other two genotypes. The median no-recurrence survival period had no statistical difference between them. Conclusion: The polymorphism of TS 3 UTR ins6/del6 may be an independent factor for the prognosis of gastric cancer patients treated with 5-FU-based adjuvant chemotherapy.

Objective To analyze the clinicopathologic features and prognosis of early stage cervical adenosquamous carcinoma and adenocarcinoma.Methods Clinical data of 62 patients with cervical adenosquamous carcinoma,149 patients with adenocarcinoma and 2 687 patients with squamous carcinoma of stage Ⅰ B-Ⅱ A,who received surgical treatment and adjuvant radiotherapy from June 2006 to February 2012 were retrospectively analyzed.The Chi-square test,Kaplan-Meier method,log-rank test and logistic regression were used for statistical analysis.Results In patients with adenosquamous carcinoma,adenocarcinoma and squamous carcinoma,the rates of lymph node metastasis were 33.6％ (50/149),29.0％ (18/62) and 22.0％ (591/2 687),deep stromal invasion were 64.4％ (96/149),75.8％ (47/62) and 55.3％ (1 486/ 2 687) and corpus invasion were 26.2％ (39/149),25.8％ (16/62) and 6.7％ (181/2 687),respectively.Those pathological parameters in adenosquamous carcinoma and adenocarcinoma were higher than those in squamous carcinoma (χ2 =12.170,P=0.002;χ2 =14.660,P=0.001;χ2 =97.732,P=0.000).There were no difference between adenocarcinoma and adenosquamous carcinoma in proportion of massive tumor (≥4 cm) [38.9％ (58/149) vs.35.5 (22/62),χ2 =0.220,P =0.639],lymph node metastasis (χ2 =0.410,P =0.522),corpus invasion (χ2 =0.003,P =0.956),deep stromal invasion (χ2 =2.595,P =0.107) and low differentiation[38.9％ (58/149) vs.48.4％ (30/62),χ2 =1.612,P=0.204].The median follow-up period was 45 (3-92) months.Multivariate analysis showed that corpus invasion (P =0.014,RR =3.393,95％CI:1.280-8.991),age (P=0.000,RR =1.077,95％ CI:1.037-1.117) and stage (P =0.007,RR =0.275,95％ CI:0.108-0.699) were prognostic factors of adenosquamous carcinoma.Age (P =0.006,RR =1.025,95 ％ CI:1.007-1.043) and lymph node metastasis (P =0.000,RR =2.525,95％ CI:1.547-4.120) affected the prognosis of adenocarcinoma.The median survival times for adenocarcinoma,adenosquamous carcinoma and squamous carcinoma were 45,46 and 56 months (adenosquamous carcinoma vs.squamous carcinoma:χ2 =1.347,P =0.246;adenosquamous carcinoma vs.adenocarcinoma:χ2 =1.808,P=0.179).There were no difference in recurrence rates between adenosquamous carcinoma and squamous carcinoma[14.0％ (7/50) vs.7.6％ (175/2 298),χ2 =1.968,P=0.161],and between adenosquamous carcinoma and adenocarcinoma [14.0％ (7/50) vs.22.1％ (27/122),χ2 =1.478,P =0.224].Conclusions Clinicopathologic features are similar between stage Ⅰ B-Ⅱ A cervical adenosquamous carcinoma and adenocarcinoma.Corpus invasion,age and stage are the leading indicators affecting the prognosis of adenosquamous carcinoma.Age and lymph node metastasis are the factors affecting the prognosis of adenocarcinoma.There are no difference in survival and prognosis between adenosquamous carcinoma and adenocarcinoma.

Purpose To discuss the relationship between age of onset and the HPV types infection in cervical adenocarcinoma. Meth-ods This study included 120 specimens of cervical adenocarcinoma in Jiangxi Maternal and Child Health Hospital. The specimen blocks were sliced by sandwich method. DNA was amplified by SPF10-PCR method. DNA genotyping was used with LiPA method. All biopsy specimens had pathologic diagnosis. The HPV infection of cervical adenocarcinoma specimens was analyzed. Results 120 ade-nocarcinoma cases were included in this study. HPV positive rate was 77. 5% (93/120). HPV 18 was the most prevalent type, which took up 43. 01% (40/93) of the total HPV positive cases, as same as HPV 16, which took up 43. 01%(40/93) of the total HPV pos-itive cases. The average ages of HPV 16 and HPV 18 were 43. 41 and 41. 06 years old respectively, other HPV types were 46. 85 years old, which showed statistically difference (F=3. 58, P=0. 032). Conclusion HPV 18 and HPV 16 are two most prevalent HPV types in cervical adenocarcinoma. The cases of HPV 18 infection are younger than other HPV-types infection.

Although coronary heart disease (CHD) and stroke share important risk factors,some associations differ between these two components of cardiovascular diseases.The objective of this study was to compare vascular risk factor profiles and in-hospital outcomes in acute stroke (AS) and acute myocardial infarction (AMI) patients.Methods We evaluated 383 consecutive patients who were admitted to the 94th Hospital of Chinese PLA and the Third Hospital of Nanchang with diagnoses of AS (ischemic stroke or intracerebral hemorrhage;n = 310) or AMI (n = 73) during a 2-year period.The frequency of risk factors and inhospital mortality rates were assessed in both groups.Results AS patients were significantly older than AMI patients ( 68.9 ± 9.1 years vs.62.8 ±11.7 years;P ＜ 0.01).AMI was significantly more common than AS in patients younger than 65 years;51% of this group had AMI and 26% had AS (P ＜ 0.001).Hypertension was more common in AS patients than in AMI patients (69% vs.58%;P = 0.042).Patients who died did not differ significantly in age between the groups.In-hospital mortality rates were significantly higher in AS than AMI cases (31% vs.12%,P ＜ 0.001 for all patients;37% vs.5%,P ＜ 0.001 for men).Women hospitalized for AMI were more likely to die in hospital than men (28% vs.5%;P = 0.002).Conclusions Patients with stroke and with AMI differ in their risk factor profile.Age at the time of presentation was a significant differentiating factor between patients with AS and AMI.We observed significantly higher in-hospital mortality for patients with AS (when adjusted for age) than for patients with AMI.(J Geriatr Cardiol 2008;5:223-226)

Objective: To establish the animal model of the compressed lumbar nerve and investigate the effect of acupuncture to the ultra-micro structure of the injured rat lumbar nerve and inflammatory medium. Method: Separate the laboratory rats into Group A (model group, n= 45) and Group B (model + electroacupuncture group, n = 45). observe injured lumbar nerve tissue with optic microscope and electron microscope and measure the content of PGE2 and 5-HT. Results: Hyperemia around the nerve tissue, edema and nerve root demyelination of electroacupuncture 15 day (Group B) is less than model group 15 day (Group A). The structure of Schwann cell is normal. Demyelination of electroacupuncture 30-day group (Group B) becomes slight and the nerve edema alleviates. In the Group B,contents of PGE2 and 5-HT after electroacupuncture obviously decrease compared to the Group A. Conclusion: Electroacupuncture can alleviates inflammatory reaction around the injured lumbar nerve and improve the ultra-micro structure of lumbar nerve root.

〔Abstract〕 The paper introduces the connotation of digital learning environment and digital scientific research environment, analyzes the strategies of constructing digital learning environment and digital scientific research environment in hospitals, including hospital librar-ians taking part in scientific research knowledge service, doctors, teachers and researchers participation, creating personalized scientific research information environment, etc.

The clinical data of 39 cases of idiopathic hyperaldosteronism (IHA) confirmed by operation were analyzed. The indications of operation consisted of (1) unable controlled the patients′ conditions by pharmacotherapy, (2) severe side effects due to high doses of medication and (3) difficulty in distinguishing between adenoma and nodule hyperplasia. The unilateral total adrenalectomy was suggested.