Antitubercular Agents ; standards ; Child ; Humans ; Tuberculosis ; drug therapy ; prevention & control

OBJECTIVE:To provide reference for perfecting the "Regulation of Drug Price Difference" issued by National Development and Reform Commission.METHODS:To review the drug price management course in China,analyze the effects and limitations since the initiation of "Regulation of Drug Price Difference" in 12 hospitals in Beijing and put forward suggestions for its improvement.RESULTS & CONCLUSIONS:"Regulation of Drug Price Difference" has contributed to the formation of unified and standard evaluation criterion and computation method or even the holistic evaluation system in drug pricing management,the lowering of the costs of human factors and administrative management in drug price management and the improvement of the governmental pricing efficiency.However,efforts should be taken to improve the unreasonable drug price difference coefficient and computation method and so on.

Objective To evaluate the early diagnosis value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in patients with sepsis-induced acute kidney injury (AKI). Methods A prospective case controlled study was conducted. Fifty-six patients with sepsis but without renal disease admitted to intensive care unit (ICU) of Shanxi People's Hospital from April 2014 to April 2015 were enrolled. Blood lactic acid and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at ICU admission were recorded. The urine output, blood urea nitrogen (BUN), serum creatinine (SCr), NGAL, IL-18 and tumor necrosis factor-α (TNF-α) were continuously monitored for 48 hours. The patients were divided into AKI group and non-AKI group according to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). The changes trend in above parameters between the two groups at different time points were compared. The early diagnostic value of NGAL, IL-18, and SCr for sepsis-induced AKI was evaluated by receiver operating characteristic curve (ROC). Results Compared with non-AKI group, with the time prolongation after ICU admission, the traditional parameters reflecting AKI urine output in sepsis-induced AKI group was decreased gradually, BUN and SCr were gradually increased, and a statistically significant difference was found at 12 hours between the two groups [BUN (mmol/L): 11.8±3.5 vs. 8.2±3.5, SCr (μmol/L): 88.6±11.3 vs. 74.0±11.0, both P < 0.01]; but the new indicators NGAL and IL-18 reflecting AKI had a statistically significant difference at 6 hours [NGAL (μg/L): 426.7±90.7 vs. 382.3±67.9, IL-18 (ng/L): 75.7±9.3 vs. 70.9±7.3, both P < 0.05]. It was shown that in AKI group, NGAL and IL-18 compared with BUN and SCr increased at least 6 hours ahead of schedule. The area under ROC curve (AUC) of 6-hour NGAL and IL-18 in patients with sepsis-induced AKI were 0.821 [95% confidence interval (95%CI) = 0.713-0.931] and 0.719 (95%CI = 0.584-0.853) respectively, superior to SCr (AUC = 0.677, 95%CI = 0.528-0.825). The cutoff value of NGAL was 363.58 μg/L, and the sensitivity and specificity were 88.0% and 86.7% respectively. Conclusions NGAL and IL-18 in the early prediction of sepsis patients with AKI are better than SCr, and NGAL was most sensitive. Therefore, NGAL can be used as an early biomarker for the diagnosis of AKI in patients with sepsis.

Objective To observe the clinical efficacy of peppermint oil capsules combined with domperi-done in the treatment of bile reflux gastritis(BRG)after gastric surgery.Methods Totally 47 patients with BRG after gastric surgery were treated with peppermint oil capsule (0.9g,tid)and domperidone(10mg,tid).Each patient's gas-troscopic manifestations and histopathology were rechecked after 4 weeks.The efficacy was observed on the improve-ment of symptoms and gastric mucosal injury,and on the reduction of bile reflux.Results 42 patients attained satis-factory therapeutic effect with the total efficiency rate of 89.4%.No adverse effects during the treatment period. Conclusion Peppermint oil capsules combined with domperidone shows better efficacy in treatment of BRG after gastric surgery.

ObjectiveTo evaluate the clinical efficacy ofYigongpowder withYupingfengpowder for syndrome of spleen deficiency in children with mycoplasma pneumoniae pneumonia.MethodsA total of 60 patients who had spleen deficiency after azithromycin injection 5 days were randomly divided into treatment group and control group according to the random number table, with 30 in each group. The patients in both received azithromycin suspension for 2 weeks, while the patients in the treatment group received azithromycin suspension and traditional Chinese medicineYigongpowder withYupingfengpowder for 2 weeks. The symptoms score was used to evaluate the clinical efficacy.ResultsThe scores of appetite loss (0.65 ± 1.00vs. 2.32 ± 1.28,t=5.631), abdominal distention (0.73 ± 0.23vs.1.33 ± 0.97,t=3.297) and fatigue (0.72 ± 0.32vs. 1.42 ± 1.18,t=3.136) in the treatment group were significantly lower than those in the control group (all P<0.05). The total effective rate for syndrome of spleen deficiency in the treatment group was significantly higher than thatin the control group(90.0%vs.66.7%;χ2=4.812,P<0.05).ConclusionYigongpowder withYupingfeng powder can significantly improve the symptoms of syndrome of spleen deficiency in children with mycoplasma pneumoniae pneumonia.

SUMMARY In recent years, successful pregnancies in renal transplant women have been reported worldwide. However, pregnancy in renal trasplant recipient is relatively rare in China. This paper reported a case of pregnancy 2 years post renal transplant. At the end of 28 weeks' gestation she had abnormal liver and renal function complicated with severe preeclampsia. Literatures were reviewed on considerations about pregnancy in renal transplant women. Maternal and neonatal outcomes can be improved by intensive care during pregnancy, proper immunosupression and timely termination of pregnancy.

Objective To investigate the correlation between urinary calculi and upper urinary tract infections.Methods Twenty-six patients underwent lithiasis in upper urinary tract accompanied with infectious symptoms were enrolled in this study (test group).Blood culture was obtained in peak temperature before lithotrity,urine sample was obtained for bacterial culture.Thirty patients with calculi in upper urinary react accompanied no infectious symptoms in the same period were enrolled in control group.Calculi were pestled for bacterial culture and analyzed the components after the calculi were removed.Results In test group,the positive of blood,urine,calculi culture were 4,23,18 patients.The prominent component of calculi was hexahydrate magnesium ammonium phosphate.Bacteria in 13 positive urine sample had the same property with the calculi samples which came from the same cases.In control group,the positive of urine,calculi culture were 4,4 patients.The prominent component of calculi were calcium oxalate calculi and uricite calculi.The morbidity of upper urinary tract infections in test group was significantly higher than that in control group [69.2％(18/26) vs.13.3％(4/30)] (P ＜ 0.05).The coincidence of urine culture and calculi culture in test group was significantly higher than that in control group [72.2％(13/18) vs.25.0％(1/4)](P＜0.05).Conclusions Infectious calculi can easily result in upper urinary tract infections.Hexahydrate magnesium ammonium phosphate can make the prominent component in infectious calculi.

Objective: To analyze the application status of the EQ-5D and SF-6D in cost-utility analysis ( CUA) . Methods: The data from PubMed data base from 2003-2012 was conducted as the main resource in econometric analysis. Results: There is no certain increasing trend of literature quantity in the recent 10 years’ application of EQ-5D and SF-6D in the CUA. The main published language was English and the main country was the United Kingdom. The core authors of researches on the CUA estimated by EQ-5D and SF-6D had not been formed, however, the core periodicals had been formed. The literatures involve wide-spread diseases, mainly known as Motion system and pain diseases. Most of the effectiveness could be calculated with quality adjusted life year ( QALY) , the object of CUA is mainly on the medicine, operation and health intervention. Conclusion: Appicating EQ-5D and SF-6D in CUA and research content of the literatures has wide distribution width, although it has shown centralized trend, which still needs more studies by related researchers.

Gene therapy of spinal cord injury (SCI) is the most promising method compared with the others, because it doesn't involve the problems of resource and higher exclusion which respectively exists in fetal nerve transplantation and peripheral nerve transplantation. There are two ways of gene therapy to be chosen: one is to transfer objective genes to the target-cells in vivo directly; the other is to transfer objective genes to one proper kind of transplantable cells firstly, then graft the highest expressing cells to the target-cells in vivo. To realize the transfer of genes to cells, two measures are used in common: physical or chemical measure such as micro infection et al and biochemical measure i. e. gene modified defective virus. Although there are some questions unresolved in this field, the clinical value of gene therapy of SCI in the future is depended.

Objective:To determine the changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration. Methods:Nineteen cases of severe head trauma patients were enrolled, their pHi were determined at different time point with tonometry. The pH of gastric juice and plasma gastrin concentrations were monitored for 7 days. Results:Five cases(bleeding group) developed stress ulcer bleeding. On admission, the pHi were not significantly different in the non bleeding group, but the differences between two groups at 12 hours, 24 hours, the 3rd day, the 5th day, the 7th day after admission were significant, pHi in the bleeding group was statistically lower than non bleeding group. The pH values of gastric juice and the plasma gastrin concentrations were not different significantly between two groups during each therapeutic periods. Conclusion:Bleeding group had significantly lower pHi than non bleeding group during the therapeutic periods. pHi was predictive for bleeding from stress ulceration after severe craniocerebral injury.