Objective:This paper aims to analyze the monitoring model of Canadian drug price monitoring mod-el based on the international reference price, and make reference for China. Methods: Through policy analysis and literature research, the system combs the specific Canadian practices of using the international reference prices for the drug price monitoring. Results:For the introduction of new drug prices, Canada uses the international median price comparison test, the highest international price comparison test, the treatment category comparison test and the inter-national treatment category comparison test. For the listed drugs, Canada calculates the international price ratio, and then carries out bilateral comparisons and multilateral comparisons to monitor the prices of drugs already on the mar-ket. At present, Canada has achieved effective monitoring of drug prices, that is to say, the introduction of new drug prices complies with the《Excessive Price Guide》;the patented drugs prices are lower than the designed international price;the price difference between the generic drug and the international level has gradually reduced. Conclusions:The Canadian experience is worth learning, and China should add legislative about drug price monitoring, learn from this experience to identify and monitor the varieties and establish the price monitoring and early warning mechanism with the international reference price as the warning indicator.

Objective To detect the properties of new natural porcine ture bones ceramic(TBC) which were processed under different conditions. Methods Fresh porcine ribs were pretreated and divided into three groups: untreated group, deproteinization group and deproteinization and defat group. Then they were calcined under different temperature and duration to get TBC. The morphological features, constitutive components and mechanical properties were examined by scanning electron microscopy, X-rays diffraction analysis, energy dispersive X-ray microanalysis (EDX), mechanical assay and so on. Results All TBC possessed the natural porous network system of original bones. EDX showed that the all elements of TBC were Ca and P, the ratio of which was 1.72, and the major mineral composition of TBC was hydroxyapatite(HA). The TBC calcined at the higher than 900℃ temperature for 2 hours had comparative good mechanical strength, otherwise the mechanical strength was too low to act as scaffold materials. Conclusion Morphological features, constitutive components and mechanical properties of differently pretreated TBC were same. The TBC calcined at the temperature of higher than 900℃ for 2 hours had comparative good mechanical strength, and contained only HA with high crystallization. Befroe the TBC becoming an ideal scaffold material, more investigations will be necessary to detect its biocompatibility and biodegradability.

Objective To investigate whether intensive atorvastatin treatment in patients after percutaneous coro-nary intervention ( PCI) could decrease the effect of contrast medium on kidney function and the incidence of con-trast-induced acute kidney injury( CI-AKI) . Methods A total of 128 patients with PCI were randomly divided into two groups:the enhanced treatment group (n=64) and the control group(n=64). The enhanced treatment group received 80 mg atorvastatin at 12~24 h before PCI and 24,48 h after PCI. The control group was given 20 mg ator-vastatin respectively before and after PCI. The primary end point was the incidence of CI-AKI. Serum creatinine (Scr), cystatin C, glomerular filtration rate(eGFR), urinary albumin and urinary β-2 microglobulin levels were observed at 24 h before PCI and 24, 48, 72 h after PCI. Results In the enhanced treatment group 3. 1 % (n=2) of patients developed CI-AKI versus 4. 7 % (n=3) in the control group, without statistical difference (P=1.00). There was no significant difference between two groups in postoperative Scr, cystatin C, eGFR, urinary al-bumin, urinary β-2 microglobulin and creatine kinase(CK). Three days after the operation, alanine aminotrans-ferase ( ALT) elevated in two groups, and aspartate aminotransferase ( AST) increased in the enhanced treatment group (P<0. 05), but they were all in the normal range. Conclusion There has been no significant difference in decreasing the incidence of CI-AKI and the damage of contrast medium on renal function between the enhanced treatment group and the control group before PCI.

OBJECTIVE:To study the dermal pharmacokinetic difference of triptolide in normal and diabetic rats,and to pro-vide reference for rational drug use in the clinic. METHODS:12 Wistar rats were randomly divided into normal group and diabetic model group(0.1%streptozotocin intraperitoneally),with 6 rats in each group. Both group were given Triptolide cream 0.5 g to ab-dominal skin,and dialysate was collected by microdialysis every 30 min for consecutive 12 h. Subcutaneous concentration was de-tected by HPLC-MS,and subcutaneous concentration-time curves were analyzed and compared between two groups,and Winnon-lin 5.0.1 software was used to calculate pharmacokinetic parameters. RESULTS:The pharmacokinetic parameters of normal group and diabetic model group were that cmax were(1.54±0.37)and(5.12±1.34)μg/ml;tmax were(7.32±0.24)and(6.21±0.35)h;AUC0-12 h were (12.65 ± 4.64) and (37.43 ± 5.23)μg·h/ml,with statistical significance (P<0.05). CONCLUSIONS:The change of dermal structure caused by diabetes can increase percutaneous penetration amount of triptolide in rats,and drug dosage should be reduced according to circumstances so as to reduce side effects.

Objective The contents of total sugar,polysaccharide,amino acid,betaine,carotenoid,flavone,hundred-seed weight of Lycium barbarum fruits from eight different habitats in first stubble,prosperous time,and autumn were determined and the ratios of total sugar to betaine were analyzed,in order to classify these indexes,and investigate the relationship with the soil fertility factors.MethodsHPLC and UV-spectrophotometry methods were used to determine the contents and the results were analyzed adopting the clustering,correlation,and variance analysis.Results All the indexes were divided into three parts which were total sugar,betaine,and carotenoid.Various indexes were affected in different degrees by the soil fertility factors.Conclusion The contents of total sugar,betaine,carotenoid,and the ratios of total sugar to betaine could be used to assay the quality of L.barbarum fruits reasonably;The accumulation of each ingredient in L.barbarum fruits is affected by the synergistic effects of all the soil fertility factors,not a single role.It would be beneficial to the fertilization and improvement for the quality of L.barbarum.

To gain a better understanding of the genetic diversity and evolution of PRRSV in the Ningxia Hui Nationality Autonomous Region (Ningxia) of China, the nsp2 genes from a series of PRRSV strains collected from the region in 2007 were partially sequenced. These sequences were then analyzed along with the classical strain (ch-la) and two other epidemic strains SD (3) and SD2006. Comparison of the nucleotide sequence with ch-la indicated that nsp2 genes of seventeen Ningxia isolates (NX strain) have deletions of 87 nucleotides. Sequence analysis indicated that homology between the Ningxia strain and ch-la was 60.3%-79.9% in the nucleotide sequence, and homology between the NX strains and SD strains was 80.3%-98.8% in the nucleotide sequence. The nsp2 genes of the seventeen isolates had 74.9%-100% nucleotide sequence identities with each other. This study was undertaken to assess the regional variation of prevalent PRRSV and to establish a sequence database for PRRSV molecular epidemiological studies.

Objective To evaluate the schistosomiasis control effect of the measures of replacing cattle with machine for cul?tivation and forbidding depasturage of livestock on marshlands in marshland and lake regions. Methods The retrospective re?view and field survey were implemented in the Jiangling and Gongan counties of Hubei Province where were implemented with the measure of replacing cattle with machine for cultivation,and Yuanjiang and Huarong counties of Hunan Province where were implemented with the measure of forbidding the depasturage of livestock on marshlands. The schistosome infection status of hu?man,cattle,and Oncomelania hupensis snails,and schistosome?infested field excreta were surveyed from 2007 to 2013. The ef?fects of the interventions were compared before and after their implementations. Results The 6 villages of Hubei Province were implemented with the measure of replacing cattle with machine for cultivation,and 7 villages of Hunan Province were imple? mented with the measure of forbidding the depasturage of livestock on marshlands. From 2007 to 2013,the schistosome infection rates of residents declined from 3.95%to 0.70%(χ2 =128.376,P<0.05),with the descend range of 82.53%. The descend ranges of the measures of replacing cattle with machine for cultivation and forbidding the depasturage of livestock on marshlands were 83.081%and 81.62%respectively,and there was no significant difference between the two measures(χ2 =0.132,P>0.05). The infection rate of cattle decreased from 3.66%in 2007 to 0.65%in 2013,and the descend range was 82.24%(χ2=13.692,P<0.05). The field excreta was surveyed in the snail breeding place in 2013. The investigated area was 157.435 hm2, and 625 samples of field feces of cattle were collected with the density of field excreta of 3.97/hm2,and the positive rate was 1.12%(7/625). The schistosome infection rate of snails and the density of infected snails decreased successively from 2007, and no infected snails were detected from 2011 to 2013. Conclusions The schistosomiasis endemic situation are decreased sig?nificantly after the interventions of replacing cattle with machine for cultivation and forbidding the depasturage of livestock on marshlands. Therefore,schistosomiasis control effect of these measures is notable in the marshland and lake regions.

The clinical efficacy of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) in reducing major cardiovascular adverse events related to atherosclerotic cardiovascular disease (ASCVD) has been well established in recent large randomized outcome trials. Although the cardiovascular and all-cause mortality benefit of PCSK9i remains inconclusive, current cholesterol management guidelines have been modified toward more aggressive goals for lowering low-density lipoprotein cholesterol (LDL-C). Consequently, the emerging concept of "the lower the better" has become the paradigm of ASCVD prevention. However, there is evidence from observational studies of a U-shaped association between baseline LDL-C levels and all-cause mortality in population-based cohorts. Among East Asian populations, low LDL-C was associated with an increased risk for hemorrhagic stroke in patients not on antithrombotic therapy. Accumulating evidence showed that low LDL-C was associated with an enhanced bleeding risk in patients on dual antiplatelet therapy following percutaneous coronary intervention. Additionally, low LDL-C was associated with a higher risk for incident atrial fibrillation and thereby, a possible increase in the risk for intracranial hemorrhage after initiation of anticoagulation therapy. The mechanism of low-LDL-C-related bleeding risk has not been fully elucidated. This review summarizes recent evidence of low-LDL-C-related bleeding risk in patients on antithrombotic therapy and discusses potential measures for reducing this risk, underscoring the importance of carefully weighing the pros and cons of aggressive LDL-C lowering in patients on antithrombotic therapy.

Objective:To establish a new model for the prediction of severe outcomes of COVID-19 patients and provide more comprehensive, accurate and timely indicators for the early identification of severe COVID-19 patients.Methods:Based on the patients’ admission detection indicators, mild or severe status of COVID-19, and dynamic changes in admission indicators (the differences between indicators of two measurements) and other input variables, XGBoost method was applied to establish a prediction model to evaluate the risk of severe outcomes of the COVID-19 patients after admission. Follow up was done for the selected patients from admission to discharge, and their outcomes were observed to evaluate the predicted results of this model.Results:In the training set of 100 COVID-19 patients, six predictors with higher scores were screened and a prediction model was established. The high-risk range of the predictor variables was calculated as: blood oxygen saturation <94 %, peripheral white blood cells count >8.0×10 9, change in systolic blood pressure <-2.5 mmHg, heart rate >90 beats/min, multiple small patchy shadows, age >30 years, and change in heart rate <12.5 beats/min. The prediction sensitivity of the model based on the training set was 61.7 %, and the missed diagnosis rate was 38.3 %. The prediction sensitivity of the model based on the test set was 75.0 %, and the missed diagnosis rate was 25.0 %. Conclusions:Compared with the traditional prediction (i.e. using indicators from the first test at admission and the critical admission conditions to assess whether patients are in mild or severe status), the new model’s prediction additionally takes into account of the baseline physiological indicators and dynamic changes of COVID-19 patients, so it can predict the risk of severe outcomes in COVID-19 patients more comprehensively and accurately to reduce the missed diagnosis of severe COVID-19.

Objective:To compare the efficacy of internal fixation using cannulated screw combined with fibular allograft and internal fixation using cannulated screw alone in the treatment of femoral neck fracture in young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 75 young and middle-aged patients with femoral neck fracture admitted to the Third Hospital of Hebei Medical University from January 2020 to December 2022, including 44 males and 31 females, aged 34-56 years [(46.1±12.7)years]. According to Garden classification, 26 patients were classified as type II, 35 type III and 14 type IV. According to the Pauwels classification, 9 patients were classified as type I, 31 type II and 35 type III. Forty-nine patients were treated with internal fixation using three cannulated screws alone (cannulated screw group) and 26 with internal fixation using three cannulated screws combined with double-barrel fibular allograft (cannulated screw combined with bone grafting group). The operation time, intraoperative blood loss, length of hospital stay, and quality of fracture reduction were compared between the two groups. At 4, 8 months after operation and at the last follow-up, grading of femoral neck shortening, number of patients walking with crutches, Barthel index, and Harris hip function score were evaluated. The incidence of complications was measured at the last follow-up.Results:All the patients were followed up for 16-37 months [(23.2±4.5)months]. The operation time of the cannulated screw combined with bone grafting group was (86.3±16.1)minutes, longer than (76.9±20.8)minutes of the cannulated screw group ( P<0.05). The intraoperative blood loss was 100.0(50.0, 200.0)ml in the cannulated screw combined with bone grafting group, more than 50.0(50.0, 100.0)ml in the cannulated screw group ( P<0.01). There were no significant differences in the length of hospital stay or the quality of fracture reduction between the two groups ( P>0.05). At 4 months after operation, grading of the femoral neck shortening in the cannulated screw combined with bone grafting group [24 patients (92.3%) with grade 1, 2(7.7%) with grade 2, and 0(0.0%) with grade 3] was better than that in the cannulated screw group [18 patients (36.7%) with grade 1, 28(57.1%) with grade 2, and 3(6.2%) with grade 3] ( P<0.01). At 8 months after operation, grading of femoral neck shortening in the cannulated screw combined with bone grafting group [22 patients (84.6%) with grade 1, 3(11.5%) with grade 2, and 1(3.8%) with grade 3] was better than that in the cannulated screw group [13 patients (26.5%) with grade 1, 27(55.1%) with grade 2, and 9(18.4%) with grade 3] ( P<0.01). At the last follow-up, grading of femoral neck shortening in the cannulated screw combined with bone grafting group [19 patients (73.0%) with grade 1, 5(19.2%) with grade 2, and 2(7.6%) with grade 3] was better than that in the cannulated screw group [8 patients (16.3%) with grade 1, 31(63.2%) with grade 2, and 10(20.4%) with grade 3] ( P<0.01). At 4, 8 months after operation and at the last follow-up, 12(46.2%), 8(30.8%) and 5(19.2%) patients in the cannulated screw combined with bone grafting group and 38(77.6%), 27(55.1%) and 20(40.8%) patients in the cannulated screw group had to walk with crutches, respectively, showing significant difference between the two groups at the other two time points ( P<0.05 or 0.01) except for at the last follow-up ( P>0.05). The Barthel index values were 85.3±3.2, 90.3±4.3, and 95.3±3.9 in the cannulated screw combined with bone grafting group at 4, 8 months after operation and at the last follow-up, significantly higher than 80.8±7.3, 85.4±7.4, and 90.9±7.8 in the cannulated screw group ( P<0.05 or 0.01). The Harris hip scores were (87.0±2.9)points, (92.0±2.9)points and (91.3±2.4)points in the cannulated screw combined with bone grafting group at 4, 8 months after operation and at the last follow-up, significantly higher than (81.0±6.1)points, (85.7±5.8)points, and (89.6±2.0)points in the cannulated screw group ( P<0.01). At the last follow-up, the complication rate was 3.8%(1/26) in the cannulated screw combined with bone grafting group, significantly lower than 22.4%(11/49) in the cannulated screw group ( P<0.05). Conclusion:For femoral neck fractures in young and middle-aged patients, compared with internal fixation using cannulated screw alone, internal fixation using cannulated screw combined with fibular allograft has more advantages in correcting femoral neck shortening, restoring independent living activities and hip joint function, and reducing the incidence of complications despite its longer operation time and more intraoperative blood loss.