OBJECTIVE:To explore the issues about distribution of national essential drug system to promote the implementation of national essential drug.METHODS:The problems in the distribution of essential drug and Japan's advanced experience were analyzed in order to put forward suggestion for distribution of essential drug.RESULTS & CONCLUSION:The problems in the distribution of essential drug mainly contained low earnings,shortage of business impetus,ambiguous evaluation criteria and irrational distribution of circulation enterprise.The distribution of essential drug should be supervised strictly by absorbing the experience of Japanese pharmaceutical logistic.Rural Two Network should be improved and the logistics capabilities of pharmaceutical enterprises should be strengthened.JIT purchase mode of essential drug should be established in medical institutions as well as third party logistics.

OBJECTIVE: To explore the coexistence of "Medical Insurance List" and "Essential Drugs List". METHODS: A comparative similarities and differences analysis of the scope, role, to develop the basis for the implementation of the effectiveness between the "medical insurance directory" and "Essential Drugs List" was carried out. RESULTS & CONCLUSION: The new edition of "Essential Drugs List" is to ease the contradiction of coexistence in long-term, but they are difficult to reconcile in short-term.

Acupoints are surface reaction and treatment spots under the pathological conditions which have functions of diagnosis and treatment. For the study of acupoints, we can carry it out from the aspects of structure and function. The two aspects have a close relationship. Structure is the material basis of function, while function is the manifesta-tion of structure. Therefore, the study of acupoints is not only significant to reveal the essence of acupoint, but also has enormous value in the guidance of acu-moxibustion for clinical practice. Staring from the normality of structure and variability of function, we explored the essence of acupoints, and further revealed ordered regulation rule and its biological basis, so that the essence of acupuncture points will be illustrated with scientific evidences.

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.

Induction of immune tolerance is characterized by high efficiency,low toxicity and economic advantages,and immune tolerance has very important significance in organ transplantation.In the establishment of immune tolerance,dendritic cells (DCs) play the key roles such as clonal deletion or clonal anerge,expressing t-cell inhibiting factors,activating helper T cells electively and inducing regulatory T cells,especially CD4 + CD25 + regulatory T cells,etc.Similarly,CD4 + CD25 + regulatory T cells whose primary target point is dendritic cell also have various functions such as affecting dendritic cells'maturing,restraining dendritic cells'antigen presentation to T cells,inhibiting the activation of T cells in non-specific ways and inducing immune tolerance.Current research shows,dendritic cells and CD4 + CD25 + regulatory T cells regard each other as target point and work synergetically.Here we mainly discuss the function and interaction of dendritic cells and CD4 + CD25 + regulatory T cells in the immune tolerance.

Objective To observe the effects of Xianfu Wenyang Tongluo Drink (XFWYTLD) on ANCA associated antigen in rats with thromboangiitis obliterans;To discuss its mechanism. Methods Totally 72 SPF male Wistar rats were randomized into sham-operation group, model group, Mailuoning Granule group and XFWYTLD low, medium, and high dose groups. Method of femoral artery injecting sodium laurate was used to duplicate models. From the second day after modeling, the rats in sham-operation group and model group were fed with distilled water, while other groups received gavage with relevant medicine. 15 days later, the activity of MPO in serum was detected through the method of ultraviolet spectrophotometry;the protein expressions of PR3 and LAMP-2 in femoral artery and the surrounding tissues were detected through the method of immunohistochemisty. Results Compared with sham-operation group, the activity of MPO in serum and the protein expressions of PR3 and LAMP-2 in rats of model group were significantly higher;Compared with model group, the activity of MPO in serum and the protein expressions of PR3 and LAMP-2 in rats of all medication administration groups decreased, among which the XFWYTLD medium dose group showed the most obvious decrease. Conclusion XFWYTLD may lower levels of ANCA associated antigen, and further inhibit humoral immune function.

ObjectiveTo investigate the effects of care bundles on the lactation of mothers of preterm infants.MethodsFrom January to June 2015, postpartum women who had preterm deliveries in First Maternity and Infant Hospital Affiliated to Tongji University with the neonates hospitalized in neonatal intensive care unit were enrolled in this study. They were randomly divided into intervention group (n=25) receiving bundle care (assist the mothers to determine lactation target; pump/express breastmilk within six hours after birth and keep a lactation diary to record the times and volume of pumped/expressed milk) and control group (n=22) given normal mammary guidance only. The time of the first pumped/expressed milk, the times for pumping/expressing milk a day, the total milk volume per day and rate of breastfeeding were compared between the two groups. Statistical analyses were conducted using two independent samplest-test,Chi-square test and nonparametric test.ResultsThe initial time of pumped/expressed milk of the intervention group was (6.1±3.4) h after delivery, significantly earlier than the control group [(10.7±9.3) h](t=-2.301,P=0.026). The times for pumping/expressing milk per day were significantly more in the intervention group than in the controlgroup on the 1st, 2nd and 3rd day after delivery [(4.2±2.2) vs (3.0±1.6); (6.2±1.1) vs (4.7±1.9); and (7.1±1.9) vs (5.9±1.9) times, respectively](t=2.083, 2.564 and 2.194, allP<0.05). From the second postpartum day, the milk volume of the intervention group was more than the control group [M(range) were 10.0(25.0) vs 2.0(5.0) ml] (Z=-2.879,P=0.005); and on the 21st day, the milk volume of the intervention mothers reached 800.0(295.0) ml, still higher than the control group [300.0(155.0) ml](Z=-3.179,P=0.001). The primarily breastfeeding (adding formula milk≤2 times a day) rate in the intervention group was significantly higher than in the control group on the 42nd postpartum day [68% (17/25) vs 41% (9/22),χ2=5.874,P=0.045].ConclusionThe care bundles on lactation can improve the lactation of the mothers of preterm infants.

This study was aimed to choose the best fixing method of electrocardiogram (ECG) measurement in mice by comparison of ECG index in three different fixing ways. Changes of ST amplitude and heart rate in ECG were measured in the self-made mouse sets, tape bundling or breathing anesthesia state. The amplitudes of the ST seg-ment in C57BL6 mice and β1/β2-AR double knockout mice were elevated in tape bundling or breathing anesthesia state in comparison with that in the self-made mouse sets (all P < 0.01). The heart rate under the tape bundling state in C57BL6 mice was significantly faster than that in the self-made mouse sets (P< 0.05 or P< 0.01). And the heart rate under anesthesia in β1/β2-AR double knockout mice was significantly slower than that in tape bundling state or the self-made mouse sets (both P < 0.01). It was concluded that relative to the binding and anesthesia method, fixing mouse in the self-made mouse sets, which can more truly reflect the physiological or pathological states, is a relatively good fixing method of ECG measurement in experimental study.

Objective To evaluate the right heart dysfunction in SLE patients with/ without pulmonary arterial hypertension (PAH) using the parameters recommended by the American Society of Echocardiography (ASE),and to examine whether the right heart dysfunction is directly related to elevated pulmonary arterial systolic pressure(PASP) and pulmonary vascular resistance(PVR).Methods Study population composited of 43 patients with SLE.The patients were divided into two groups according to the PASP measured by echocardiography:Group A was 24 patients with PASP ≤35 mm Hg,Group B was 19patients with PASP＞35 mm Hg.Twenty-two healthy subjects with age and gender matched were set as control group.Routine transthoracic echocardiography study was performed on all patients and 26 parameters were measured in order to compare the differences of the parameters among the three groups.Results There were significant differences in 17 parameters among the three groups (P ＜0.05).Tricuspid annular plane systolic excurtion(TAPSE) and E/A ratio of tricuspid flow velocities in SLE patients without PAH significantly decreased compared to control group (P =0.04 and 0.03).There were significant differences in 11 parameters between SLE with and without PAH group (P ＜0.05).Multivariate logistic regression analysis indicated that after adjustment for age and gender,the patients with elevated PVR associated with a 6.18-fold increase in right ventricular dysfunction compared to the patients with normal PVR (P =0.02).Conclusions The impairment of right ventricular function in SLE patients was directly related to PVR and PASP.Elevation of PVR was an important predictor for right heart dysfunction.

Objective To study the clinical efficacy of tolterodine tartrate combined with transcutaneous electrical nerve stimulation(TENS)in the treatment of elderly female patients with overactive bladder(OAB).Methods 30 patients with OAB were randomly divided into single treatment with tolterodine tartrate and combination treatment of tolterodine tartrate and TENS for 10d.The efficacy was evaluated by overactive bladder symptom score(OABSS),patient perception of bladder condition(PPBC),quality of life(QOL),visual analogy scale(VAS)and 5 grade pain scores.Results The post-treatment symptoms of urgent urination and urinary incontinence,OABSS,PPBC,QOL,VAS and 5 grade pain scores in single treatment group[(1.67±1.45)times /d,(1.53±1.25)times /week,(6.67±2.55)scores,(2.07±0.96)scores,(2.07±1.03)scores,(3.67±0.90)scores and(4.07±0.80)scores]were improved as compared with pre-treatment[(6.40±1.45)times /d,(3.93±1.03)times/week,(13.00±1.00)scores,(4.20±0.68)scores,(3.80±0.68)scores,(7.13± 1.19)scores and(9.40± 1.55)](t=8.94,5.74,8.94,7.03,5.44,9.01 and 11.85,all P＜0.01).The above indexes in combination treatment group after treatment[(1.27±0.80)times/d,(1.20±0.77)times/week,(5.33±1.72)scores,(1.67±0.62)scores,(1.47±0.52)scores,(2.93±0.80)scores and(3.40±0.99)scores]were also improved as compared with pretreatment[(6.20±1.26)times/d,(4.00±1.25)times/week,(12.73±1.03)scores,(4.07±0.80)scores,(4.00±0.65)scores,(7.47±0.74)scores and(9.67±1.35)scores](t=12.77,7.36,14.29,9.21,11.77,16.09 and 14.55,all P＜0.01).The VAS and 5 grade pain scores were higher in combination treatment group than in single treatment group(t=4.879 and 2.746,P＜0.01).Conclusions Tolterodine tartrate combined with TENS is safe and effective for the treatment of elderly female patients with OAB,and may alleviate pain and improve quality of life.