OBJECTIVE:To review and analyse the progress and problems in establishing and implementing national es?sential drugs list in our country.METHODS:Searching literature about essential drugs policy reported on domestic periodicals and published by WHO.RESULTS&CONCLUSION:National essential drugs list has been carried forward steadily and pre?liminary achievements have been gained.Intensified efforts should be made to the selection,production and use of essential drugs and to promote rational use of drugs,thus to slow down the irrational increase of medical cost.

Objective To investigate the clinical manifestation, biochemically detected data, and radiographic features of a pedigree with suspected mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome, and to explore the correlations between the clinical features and the mutant heteroplasmy levels of mitochondrial genome. Methods The personal details, histories of stroke-like episodes and seizures within the proband and 11 members in the maternal lineage of the family were collected. Routine blood examinations and plasma lactate levels before and after movements of these family members were detected, followed by cephalic MRI examinations. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing were used to detect and validate the A3243G point mutation in mitochondrial genome, and real-time PCR were used to quantify the mutation proportion of A3243G. Results Typical symptoms of MELAS such as seizures, stroke-like episodes and hyperlactacidemia and atypical symptoms such as growth failure, exercise intolerance, fevers and migraines were observed on several members in the pedigree. Cephalic MRI findings performed during episode periods were in accord with the typical radiographic features of MELAS and cerebellar atrophy was commonly observed. Family members on the maternal side all harbored the point mutation on 3243 site in mitochondrial genome. Meanwhile, patients with higher heteroplasmy levels relatively manifested more typically and severely according to the clinical observation. Conclusions The pedigree is diagnosed with maternal inheritance of MELAS syndrome. The main cause can be attributed to a mitochonorial A3243G mutation.The mutant heteroplasmy levels of hemocytes in peripheral blood are positively associated with genetic relationship, seizure anticipation, plasma lactate data and other clinical features.

The paper gives a brief account of the basic concept of job burnout and the current state of job burnout among physicians and nurses,analyzes the damage job burnout brings about to medical safety and the causes,further explains theories related to job burnout,and puts forward some countermeasures: ① enhancing understanding of job burnout and relevant measures of intervention;② making rational work arrangements so as to guarantee the sound interaction between people and work;③ implementing active psychological interventions so as to keep the employees in a sound psychological state;④ encouraging the employees to get involved in safety control so as to promote safe behavior over a long period of time.

Objective To evaluate the therapeutic effect of Xiaoying Ruanjian Decoction on experimental autoimmune thyroiditis (EAT) from the levels of autoantibodies, interleukin-1, tumor necrosis factor-? and apoptosis-regulated proteins Fas/Fasl of EAT rats, and investigate the mechanism from the relation between cytokines and apoptosis-regulated proteins. Methods Sixty SD female rats of SPF level were divided into normal group and model group. An animal model of EAT in rats was developed by injecting thyroglobulin mixed with Freund’s adjuvant immunization and drinking periodate water. The rats modeled were divided into Chinese medicine group, western medicine group and model group. The levels of autoantibodies, interleukin-1, tumor necrosis factor-? were detected with enzyme-linked immunosorbent assay. The level change of Fas/Fasl in the thyroid of rat was observed with immunohistochemical staining. Results Ruanjian Xiaoying Decoction significantly reduced the levels of autoantibody, interleukin-1, tumor necrosis factor-? and lowered the expression of Fas and Fasl in thyroid cells. Conclusion Ruanjian Xiaoying Decoction alleviates the levels of apoptosis-regulated proteins Fas/Fasl by decreasing the relative expression of antibodies and cytokines in serum levels, which plays a role in reducing apoptosis of thyroid cells.

The aim of this procedure is to reconstruct the defecation and urinary functions in paraplegic patients. In 30 patients, two normal vascularized intercoastal nerves above the paraplegic level were isolated and their distal ends divided. They were transferred to the vertebral canal through a submuscular tunnel. The sural nerve was harvested with enough length and separated into two segments, which were sutured as a bridge with S 2-4 nerve roots by interfascicular neurorrhaphy in patients with spinal cord injury above T 11 or with S 2-4 nerve roots outside of the vertebral canal in patients with spinal cord injury below T 12. After 2 to 11-year (mean 5 years) follow-up, 26 (86.6%) patients regained partial micturition reflex and defecation reflex, and partial sensation (S1-2) in buttock, perineal and vulva regions. In 23 (76.7%) patients had also recovery of the function of voluntary urination, and 8 (27%) of them showed partial recovery of function of the detrusor muscle, urethral sphincter, and anal sphincter. The results showed that the procedure described above could be used as an alternative method to reconstruct the function of defecation and urination, and also partial sensation of perineal and vulval region in a part of paraplegic patients.

Objective:To study the in vitro bacteriostasis of water extract of humulus. Methods:By using double dilution method and 96-well plates trace broth dilution method, the inhibitory test of water extract of humulus was conducted on Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. The minimum inhibitory concentration ( MIC ) , minimum bactericidal concentration ( MBC) and the diameter of inhibition zone were determined. Results: The drug showed different sensitive degree on the test strains. MIC and MBC for Escherichia coli were 31. 25 mg·ml-1 , that for Staphylococcus aureus were 3. 91 mg·ml-1 , and that for Pseudo-monas aeruginosa was 125 and 250 mg·ml-1 . Conclusion:With the water extract of humulus as the research object, the study on the in vitro bacteriostasis effect of humulus scandens is closer to the clinical application form, which provides reference for the further re-search on the related preparation of humulus scandens.

Objective:To optimize the extraction process of antitumor active ingredients in fructus ligustri lucidi. Methods:Using fructus ligustri lucidi medicinal herb as the raw material, the extraction process of luteolin and pelargidenon in the herb was screened by D-optimal design. The extraction yield of different extraction processes was compared to obtain the optimal extraction conditions. Re-sults:The best extraction conditions were as follows:adding 12-fold 95% ethanol, extracting 2 times with 60 minutes for each time. Conclusion:The optimal extraction technology can provide significant reference for the further pharmacodynamic effect development of fructus ligustri lucidi.

BACKGROUND:Exercises play an important role in the recovery of neurological function after stroke. Few studies concerned the amount of exercise in rats after stroke. Hippocampus is strongly associated with cognitive function, but no reports addressed the expression of repulsive guidance molecule A in the rat hippocampus after ischemia and reperfusion. OBJECTIVE:To explore the effects of exercise on repulsive guidance molecule A expression in the hippocampus on the ischemic side in rats after cerebral ischemia-reperfusion injury. METHODS:120 Sprague-Dawley rats were equal y and randomly divided into normal group, sham-operation group, and 7-, 14-, 28-day model groups. The model of right cerebral ischemia-reperfusion injury was induced by ligation with nylon monofilament in rats of 7-, 14-, 28-day model groups. Low exercise group received treadmil training of 5 m/min, 5 minutes;7 m/min, 5 minutes;9 m/min, 20 minutes. Moderate exercise group received treadmil training of 8 m/min, 5 minutes;10 m/min, 5 minutes;13 m/min, 20 minutes. High exercise group received treadmil training of 8 m/min, 5 minutes;11 m/min, 5 minutes;20 m/min, 20 minutes. RESULTS AND CONCLUSION:Repulsive guidance molecule A mRNA and protein expression was highest in the ischemic side of the hippocampus in the 7-day model group without excercise. Moreover, repulsive guidance molecule A relative expression gradual y reduced over time. Compared with non-exercise, repulsive guidance molecule A mRNA and protein expression significantly decreased in the 14-and 28-day model groups during moderate exercise (P<0.05), but repulsive guidance molecule A mRNA and protein expression increased during high exercise. Above data confirmed that moderate exercises could decrease repulsive guidance molecule A expression in the affected side of the hippocampus of rats with cerebral ischemia-reperfusion injury.

Objective We report the pathological features of lung in the dead patients with severe acute respiratory syndrome (SARS). Methods Post-mortem lung and pulomonary hilar lymph nodes tissues of 3 patients dead from SARS were studied by histology and immuhistochemistry with rabbit anti-Fas polyclonal antibody, mouse anti-PCNA, mouse anti- CD83,mouse anti-CD4 and mouse anti-CD8 monoclonal antibodies. Results The surface of lung from 3 cases were shown red or purplish red color. Histopathological examination showed that diffuse interstitial exudative or leakage inflammation and alveolar damages with a pronounced increase of of monocytes in the interval at various levels of progression and severity. There were hyaline-membrane formation, desquamation and apoptosis of type-2 pneumocytes in alveolar spaces. Fibrin thrombus and thrombo-embolism could be found in blood capillary and bronchial artery respectively. We observed some fibrin deposition in alveoli interval. No obviously giant-cell infiltrate within the alveolar lumen. The positive cell of proliferative cell nuclear antigen (PCNA) was rare. Fas antigen were expressed in a lot of type-2 pneumocytes, monocytes of the interval and pulomonary hilar lymph nodes. Comparison with the lymph nodes of chronic inflammation, there were obviously disorganization and attenuation of lymphocyte in lymph nodes of SARS. The proportion of CD4 positive lymphocytes were rare, but CD83 and CD8 positive lymphocyte seemed no decreased, relatively. The seminal changes such as decreased lymphocytes ,white pulp atrophy,hemorrhage and necrosis,and decreased expression of lymphocytes for CD4 antigen could also observe in spleen. Conclusions Severe damages of lung and immunological system damages might lead to death of patients with SARS.

Objective To observe pulmonary fibrosis in severe acute respiratory syndrome (SARS) and to discuss the mechanisms of pulmonary fibrosis in SARS. Methods Hematoxylin and Eosin staining (H&E), histology staining and immuno-histochemical staining (SP methods) were used to investigate the lungs from 4 autopsy cases. Antibodies against collagen type Ⅲ, ?-smooth muscle actin(?-SMA), Fas, FasL and transforming growth factor ?1(TGF-?1) were used for immunohistochemical studies. Results All these four lung tissues showed different degree of pulmonary fibrosis, including the organization of exudative fibrin, glomerulus-like fibrosis in alveolar spaces, the thickening of the alveolar septum, proliferation of fibroblasts, the hyperplasia of collagen fibers and the consolidation of lungs. Sirius red staining and collagen type Ⅲ staining showed the type Ⅲ and the type Ⅰ collagen fibers were the main components of the hyperplastic collagen fibers. ?-SMA were expressed in fibroblasts, immunoreactivity to Fas, FasL, TGF-?1 were all positive and located in plasma of pneumocytes, macrophages and lymphocytes. Conclusions The pulmonary fibrosis can be observed early in SARS patients and the pathogenesis may be involved in the co-effect of many effective cells, inflammatory mediators and cytokines.