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 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 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 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 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 evaluate the safety and efficacy and explore the clinical application value of the enhancement controlla-ble output channel narrowed ileal bladder suspension surgery and traditional ileal neobladder after total cystectomy.Methods From January 2001 to August 2009,42 patients with bladder cancer received enhancement controllable output channel narrowed ileal blad-der suspension surgery after total cystectomy;and 46 patients received ileal neobladder after total cystectomy.Their clinical data, perioperative situation,postoperative complications and tumor progress were analyzed.Results In regard to the blood loss,postop-erative hospital stay,and postoperative recent or far complications,both surgical methods had no significant statistical difference (P >0.05).The group of Enhanced controllable output channel narrowing ileal bladder suspension surgery was good control of uri-nation after operation(P <0.05).Conclusion Enhancement controllable output channel narrowed ileal bladder suspension surgery has good clinical effect and safety.It is especially suitable for the patients who need control inurine and don′t accepted orthotopic neobladder.

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.

Objective To observe the neuroprotective effect of arcaine,an antagonist of receptor of N-methyl-D-aspartate(NMDA) and(or) channel complex polyamines site,on cerebral ischemia.Methods Forty-five Wistar rats were randomly divided into 5 groups: control group,ischemia model group,24h preoperative group,1h preoperative group and 1h postoperative group.Acute cerebral infarction model was reproduced in rats of the latter four groups with middle cerebral artery occlusion(MCAO) using ligature method.Once the ischemia model was successfully established,rats in the latter three ischemia model groups were given arcaine(3mg/kg) at 24h and 1h before operation and 1h after operation,respectively,while normal saline(0.4ml/kg) was injected to the rats in the control group.Neurological function behavior and cerebral infarct volume were assessed,and pathological features of brain tissue were observed under light-and electron microscope.Results Neural function scores of the rats in 24h preoperative group,1h preoperative group and 1h postoperative group were 1.25?0.46,1.33?0.50 and 1.40?0.58,respectively,which were significantly different from that in ischemia model group(2.63?0.52,P