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.

Objective:To observe the effects of transurethral split of the prostate (TUSP) on the urodynamics, the sexual function and the quality of life of benign prostatic hyperplasia.Methods:Eighty patients with benign prostatic hyperplasia admitted to the Deqing People′s Hospital of Zhejiang Province from January 2017 to June 2019 were enrolled into the research objects prospectively. According to the random digits table method, they were divided into group A and group B, with 40 cases in each group. The group A was treated with TUSP, while the group B was treated with bipolar transurethral plasma kinetic prostatectomy (TUPKP). The operation time, intraoperative blood loss, bladder irrigation time, urinary catheter indwelling time, hospitalization time of the two groups were compared and surgical effects were evaluated. The changes of hemoglobin (Hb), serum sodium (Na), post-void residual volume (PVR), maximum urinary flow rate (Q max), international prostate symptom score (IPSS) and international index of erectile function score (IIEF-5), the quality of life index (QOL) of 2 groups before and after the operation were measured. Surgical complications were recorded. Results:The operation time, bladder irrigation time, urinary catheter indwelling time and hospital stay in group A were all shorter than that in group B: (15.63 ± 4.17) min vs. (58.79 ± 10.45) min, (6.26 ± 1.17) h vs. (45.51 ± 10.03) h, (3.07 ± 0.68) d vs. (5.67 ± 1.51) d, (3.63 ± 0.43) d vs. (6.08 ± 1.72) d, (18.32 ± 2.79) ml vs. (65.26 ± 20.64) ml, and there were statistical differences ( P<0.05); there were no statistical difference between 2 groups in surgical curative effect grade and Na 1 d after operation ( P>0.05); 1 day after operation, Hb in group A was higher than that in group B: (115.63 ± 9.78) g/L vs. (109.65 ± 8.36) g/L, and there was statistical difference ( P<0.05); PVR, Q max, IPSS, IIEF-5 and QOL 3 and 6 months after surgery were improved in 2 groups ( P<0.05), but the difference between 2 groups was not statistically significant ( P>0.05); the total complication rate in group A was lower than that in group B: 10.00% (4/40) vs. 27.50% (11/40), and there was statistical difference ( P<0.05). Conclusions:TUSP and TUPKP are equally effective in the treatment of benign prostatic hyperplasia, both of which can improve the symptoms of prostatic hyperplasia, improve the quality of life and improve sexual function. But TUSP has less intraoperative bleeding, shorter operation time, faster postoperative recovery, fewer complications, and higher safety.

Aim To investigate the effects of newly synthesized 2, 3-dimethyl-2-butylamine derivatives on potassium channels in cortical neurons from rats.Method On cultured cortical neurons, the influences of those novel compounds on I A and I K currents were evaluated using whole-cell patch clamp technique. Result On cortical neurons, these compounds (5),(6),(7),(9) showed no effects on outward potassium currents, while the compounds (4),(8) exhibited inhibition of I K currents. But on a rterial smooth muscle cells(SMCs), all the six compounds had potassium channels opening activities. While the other three compounds had no effects on potassium channels of SMCs, the compound (3) decreased the I K currents evoked on neu rons.Conclusion The novel 2,3-dimethyl-2-butylamine derivati ves had the different modulation of potassium channels on cortical neurons as SM Cs.

Aim To establish a cell model heterologously expressing Kir6.x and SUR subunits of K_(ATP)channels and to study the selectivity of iptakalim on different subtypes of K_(ATP) channels.Methods Cell were transfected with the pcDNA vector containing the coding sequenced of Kir6.x and SUR using liposome and the pEGFP-N1 vector encoding for green fluorescent protein was added for easy identification of transfected cells.Using immunocytochemical technique,we detected the expression of Kir6.x and SUR protein in[FL(2K2]transfected cells.The electrophysiological experiment was performed after transfection 48-72 h.In whole cell configuration,the effects of K_(ATP) channel openers iptakalim,pinacidil and diazoxide on the clone currents in transfected HEK-293 cells and the antagonism of K_(ATP) channel inhibitor glibenclamide were evaluated.Results Immunocytochemical study identified the expression of Kir6.x and SUR protein in transfected cells.The electrophysiological experiment showed that in cells with recombinant expression of the Kir6.1/SUR2B channel complex,iptakalim(100 ?m),pinacidil(100 ?m)and diazoxide(200 ?m)significantly increased the clone current from(-88.0?30.8) pA to(-2042.6?127.3) pA,(-1431.9?142.4) pA and(-1104.7?228.9) pA,respectively,at-100 mV,and the actions were inhibited by glibenclamide(10 ?m).In cells expressed with Kir6.2/SUR2A channel,both iptakalim and pinacidil activated the currents,which was sensitive to glibenclamide.While diazoxide had no effects on the clone currents.In contrast,in cells with Kir6.2/SUR1channel,diazoxide increased the activity of recombinant K_(ATP) channels,while iptakalim and pinacidil had little effects.Conclusion From these observations,the effects of K_(ATP) channels openers with different chemical structures on the subtypes of K_(ATP) channels were diverse.Iptakalim showed selective action on Kir6.1/SUR2B and Kir6.2/SUR2A,but not Kir6.2/SUR1 K_(ATP) channels