OBJECTIVE:To provide reference for improvement in drug pricing and administration in China.METHODS:Drug pricing policy and administration mechanism in European countries were compared,and the successful experience was summarized.RESULTS &CONCLUSION :It is suggested that drug pricing policy in China should be improved to establish the dynamic modulating mechanism and classified administration for drug price.

OBJECTIVE:To evaluate the medical cost of capectabine in treatment of advanced rectocolonic carcino?ma.METHODS:The characteristics of therapeutic effect and medical cost were compared between capectabine and classical MAYO program.RESULTS&CONCLUSION:The capectabine is more expensive than traditional drugs,however,in terms of medical resource,the saving medical cost in use of capectabine would counterbalance the expensive price of drug to maxium limit.The medical cost of capectabine is superior to that of traditional drugs.

Objective To compare the clinical features of patients with myasthenia gravis at various age groups,and to evaluate the therapeutic effects of acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid and acetylcholinesterase inhibitor plus thymectomy in children,young adults,and elderly patients with myasthenia gravis (MG).Methods The clinical data of 300 MG patients admitted to the department during the same period were reviewed retrospectively.The patients with MG were divided into three groups based on the age of disease onset:childhood group (age≤14,n=77),young adult group (age=15～59,n=183) and elderly group (age≥60,n=40).The clinical features of MG patients in various age groups were compared including the incidence,sex ratio,initial symptoms,clinical classification,positive rates of neostigmine test and repetitive nerve stimulation,and thymic abnormalities.Furthermore,the therapeutic effects of acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid,and acetylcholinesterase inhibitor plus thymectomy were investigated.Results The most common ages of MG onset were ranged from 15 to 59 years (young adults group).With increase in age,the incidence of MG lowered in females,while in males it became higher.Extra ocular muscles involvement as the initial symptom was higher in children and elderly patients than in young adults.The limb muscles involvement as the initial symptom was more common in young adults group.About 72.73% patients in childhood group were classified as type Ⅰ,while type ⅡB was the most commonly seen in young adults group (55.74%) and elderly group (50.00%).No significant difference was found among the three groups in the positive rates of neostigmine test and repetitive nerve stimulation.In childhood group,hyperplastic thymus was commonly observed,while thymoma was more common in elderly group.The therapeutic effects of acetylcholinesterase inhibitor alone were better in childhood group than in the other 2 groups (P0.05).The therapeutic effect of acetylcholinesterase inhibitor plus thymectomy was most satisfactory in childhood group,less satisfaetory in elderly group and paorest in young adults group ( P

Objective To investigate the clinical features of multiple myeloma (MM) complicated by extramedullary plasmacytomas(EM). Methods Twenty five patients were enrolled into the study. The proportion male to famale was 15:10 and the median age 55. 2 years. The distribution of different isotypes was IgA ten, IgG nine and light chain λ five. The sites of complicating plasmacytoma included muscle, bone, skin, rectum, and testicles. The most common site was muscle. Results Patients with complicated extramedullary plasmacytomas at the time of diagnosis received traditional treatment, including vincristiuum, adriamycin, dexamethasonum, mephalan, presnisone, thalidomide and bortezomib. Rates of overall response (ORR) were 80%. Plasmacytomas occurring after the diagnosis of MM received cisplatin, etoposide, cyclophosphamide, presnisone, or bortezomib ORR were 66. 7% ,50. 0%. Conclusion These results lend support to the efficacy of bortezomib in the treatment of plasmacytoma. MM cases with unconventional disease recurrence are likely to be seen due to sub-clinical seeding of turnout cells suggestive of the presence of an EM clone of plasma cells with a high degree of chemoresistance. Available data in the literature concerning the optimal therapy for patients with EM relapse were reviewed.

Objective To analyze the clinical characteristics of myasthenia gravis(MG) associated with thyroid abnormalities.Methods A total of 300 MG patients admitted to the department of neurology from July 2008 to September 2009 were reviewed retrospectively.Based on the thyroid function and abnormality of thyroid related antibodies (thyroglobulin antibody and peroxidase antibody), the patients with MG were divided into two groups (260 cases without thyroid disease and 40 cases with thyroid abnormalities).The different clinical features, the relationship between the antithyroid antibodies and antiacetylcholine receptor antibody (AChRAb) and the distribution of T cell subsets between the two groups were compared.Results ( 1 ) Among the 300 MG patients, 13.3% of them was accompanied with thyroid disease and the most common abnormality was positive thyroid antibody.(2) Between the groups of MG with and without thyroid abnormalities, no significant differences on the sex percentage, age of onset, duration of disease, clinical classification and thymic abnormalities were found ( P ＞ 0.05 ).( 3 ) The blood levels of AChRAb in postsynaptic membrane in the thyroid antibody-positive patients were 1.15 ± 0.11, being much higher than those in the antibody-negative patients ( 1.01 ±0.11 ).(4) The percentage of CD8+ T cells was significantly decreased [(21.63 ±5.17)% vs (24.28 ±5.79)%] and the ratio of CD4+/CD8+ T cells was increased (2.10 ± 0.67 vs 1.81 ± 0.61, P ＜ 0.05 ) in the group of MG with thyroid abnormality as compared with the group of MG with normal thyroid.Conclusion In MG patients the incidence positive thyroid related antibodies was much higher than that of other thyroid abnormalities.It is suggested that there are higher levels of AChRAb in MG coexisting with positive thyroid antibodies and more abnormalities of T lymphocyte subset distribution in MG patients with thyroid disease.

Child ; Humans ; Infant ; Spasms, Infantile ; genetics ; Syndrome

objective To compare the clinical characteristics of early-onset and late-onset myasthenia gravis(MG).Methods A total of 819 MG patients admitted in our department during the sanle period were reviewed retrospectively.The patients with MG were divided into two groups by the age of onset, which were the early-onset MG(＜49 years)and late-onset MG(≥50 years).Several clinical features were compared in the two groups including the percentage, initial symptoms, MG types,the positive rates of neostigmine test and repetitive nerve stimulation, thyroid function and thymie abnormalities. Results The more common onset age of MG was 0-49 years(early-onset).In both groups the male and female ratio was presented as the most common type in both groups(41.51%and 51.37% respectively in early-onset and late-onset groups).Type Ⅰ was more common in early-onset group while typeⅡB Was more common in lateonset group(P＜0.05).There Was no significant difference in the positive rates of neostigmine test and repetitive nerve stimulation between the two groups.The thyroid function alnormality ratio was higher in early-onset group. Hyperplastic thymus was common in early-onset group(67.57%)while both hyperplastic thymus and thymoma were common in late-onset group(48.68% and 47.37%).Conclusions The clinical characteristics of early-onset and late-onset myasthenia gravis(MG)Was different in MG type, the positive rate of thyroid function abnormalities and thymic pathologic type.

Systemic inflammatory response has a major role in the development and progression of cancer,and increased systemic inflammatory response usually correlates with poorer survival.Recently the evaluation index of systemic inflammatory response including neutrophil-lymphocyte ratio,C-reactive protein,glasgow prognostic score,platelet-lymphocyte ratio.Several previous studies show that these indexes are the independent prognostic factors for esophageal cancer.Research on the systemic inflammatory markers may also be valuable for the clinical treatment and prognosis of esophageal cancer.

Purpose: The aim of the present study was to investigate the expression of breast cancer resistance protein (BCRP) in primary breast carcinoma and to determine whether such expression can predict survival. Methods: Expression of BCRP in 60 breast cancer patients was determined by immunohistochemistry on formalin-fixed, paraffin-embedded tumor section. The relationship between the expression of BCRP with the clinicphathological characteristics and the prognosis of breast cancer patients were also analyzed. Results: ①BCRP expression was observed in 21 of 60 (35%) cases.② BCRP expression was more frequently observed in patients with lymph node metastasis or hormone receptor (P 0. 05) .③Kaplan-Meier analyses revealed that BCRP expression associated only with disease-free survival (DFS) (P 0. 05) . ④In univariate and multivariate Cox regression analyses, tumor size, lymph node metastasis and estrogen receptor (ER) was associated with DFS and OS (P

Objective To develop a method for simultaneous determination of three kinds of anti-dandruff agents,namely ketoconazole,climbazole,piroctone olamine,in cosmetics by HPLC.Methods The cosmetics were extracted with acetonitrile by ultrasonic,then separated with high-speed centrifuge.The supernatant layer was filtrated through membrane with 0.45 ?m diameter.The filtration liquid was injected into HPLC for detection at ?=210 nm.Quantitative analysis was performed with external standard method.Results In the linear range of 1-250 mg/L,the regression equation of ketoconazole was y=32.23x+ 4.59,the detection limit was 0.069 mg/L.In the linear range of 1-500 mg/L,the regression equation of climbazole was y=13.76x+ 9.41,the detection limit was 0.12 mg/L.In the linear range of 10-500 mg/L,the regression equation of piroctone olamine was y= 24.83x-17.17,the detection limit was 0.71 mg/L.The recoveries and relative standard deviations were 91.8%-98.5% and 0.38%0.84%,respectively.Conclusion The experimental results show that the method is simple,precise and accurate and suitable for simultaneous determination of 3 kinds of anti-dandruff agents in cosmetics.