OBJECTIVE:To understand the status of the use of national essential medicines,and provides reference for further implementing the national essential medicine system and promoting the priority use of national essential medicines. METHODS:Ac-cording to the statistics analysis of the use of national essential medicines(for example the antihypertensives and oral hypoglycemic agents)in Beijing,Shanghai and Guangzhou areas,the related influential factors about priority use of national essential medicines were explored. RESULTS:The proportions of use amount of national essential medicines in our hospital in 2012-2013 to the total amount of medicines were 21.20% and 18.75%,respectively,with a downtrend;the proportion of antihypertension drugs to total amount was only 14.05%and 13.70%,respectively;compared with the same generic drugs with individual pricing,the GMP prod-ucts of Valsartan capsule,Bisoprilol tablet and Amlodipine tablet had no advantages in DDDs,or even lower. DDDs of individual pricing drugs of Acarbose tablet in medical institutions in Beijing area and tertiary hospitals in Shanghai and Guangzhou area in 2011-2012 were much higher than the generic GMP products with the same generic drugs. CONCLUSIONS:The clinical use of na-tional essential medicines in our hospital and parts of the country still remains to be further improved,the influential factors includ-ed reimbursement mechanism,awareness rate of related knowledge,physicians’habit to drug use and pursuing economic benefits. The propaganda and training should be strengthened,awareness rate of medical staff and publics to national essential medicines, the availability of national essential medicines and national essential medicine system and medicare reimbursement payment policy should be improved,and the priority use of national essential medicines should be promoted by more measures combination use.

Objective To investigate the clinical therapeutic effects of neuromuscular electric stimulation (NMES) on patients with swallowing disorders after stroke. MethodsA total of 98 patients with a swallowing disorder after stroke were randomly divided into an NMES group (38 cases),a rehabilitation group (30 cases) and a control group (30 cases).In the control group the patients were treated with medication only; the in rehabilitation group they were treated with medication and swallowing rehabilitation training; in the NMES group they were treated with medication and NMES.The treatments lasted for 3 weeks in all groups.The swallowing function of patients in each group were observed and assessed with dysphagia scoring pre-and post-treatment.Complications of the swallowing disorders,side effects of treatment and the stomach tube leaving rate were observed. ResultsAfter treatment,the dysphagia scores of patients in the NMES and rehabilitation groups both increased,but the average scores in the NMES group were significantly higher than in the rehabilitation and control groups.The difference in therapeutic effect between the three groups was statistically significant.After treatment,the incidence of aspiration pneumonia in the NMES group was significantly lower than that in the control and rehabilitation groups.The average stomach tube leaving rate in the NMES group was significantly lower than that in the control group,but there was no significant difference in stomach tube leaving rates between the rehabilitation group and the NMES group.There was no significant difference among the three groups in malnutrition.No side effect was observed in any group.Conclusions NMES could alleviate post-stroke dysphagia and decrease the incidence of aspiration.The short-term therapeutic effect of NMES was better than that of swallowing rehabilitation training,but the long-term therapeutic effects were about the same in the two groups.

Objective To study curative efficacy of euthyrox in treatment of hypothyroidism during pregnancy and its effect on levels of TSH , FT3 and FT4.Methods 100 patients of hypothyroidism during pregnancy who received therapy from June 2014 to June 2015 in our hospital were selected as research objects, and divited into control group and observation group,50 cases in each group.The control group was treated with Fugui Dihuang wan, while the observation group was treated with euthyrox on the basis of control group.Then the levels of TSH,FT3 and FT4, pregnancy outcome, neonatal adverse outcome, treatment outcome of two groups after treatment were compared.Results After treatment, the level of TSH in observation group was lower than the control group, the levels of FT3 and FT4 was higher than the control group ( P<0.05 ); Incidence of pregnancy complications in observation group was less than the control group [12.00%(6/50)vs 40.00%(20/40)](P<0.05);Total neonatal adverse outcomes [8.00%(4/50) vs 26.00%(13/50)](P<0.05); The total effective rate of observation group was statistically higher than that in the control group [96.00%(48/50) vs 80.00%(40/50)](P<0.05).Conclusion Euthyrox is well for hypothyroidism during pregnancy, which can improve TSH, FT3 and FT4 levels, relieve clinical symptoms.

OBJECTIVE:To explore the standardized package of Metformin tablets to meet clinical needs. METHODS:Statis-tics was conducted for the utilization data of Metformin tablets in medical and health institutions from 6 cities of China;question-naires were designed to investigate and analyze the evaluation for the suitability of physicians,pharmacists and patients in the pre-scription,deployment and use links to Metformin tablets with different packaging loaded amount in Beijing and Haikou. RE-SULTS:For 0.5 g/tablet,the daily dose of 1.5 g accounted for the largest proportion (32.23%-69.91%) in 5 cities except for Chengdu. Totally 490 questionnaires about package suitability of Metformin tablets in outpatient department were sent out,includ-ing 478 valid questionnaires with effective rate of 97.5%. Results showed that packaging quantity with 4 weeks was considered as appropriate by physicians,pharmacists and patients in Beijing;however,packaging quantity with 1-2 week(s) was considered as appropriate by physicians,pharmacists and patients in Haikou;300-500 tablets of packaging quantity were preferred to be appropri-ate with the matching degree of automatic dispensing machines in both places. CONCLUSIONS:Considering the results in 2 plac-es,for 0.5 g/tablet,2 weeks is appropriate for the packaging loaded amount in outpatient department,that is 0.5 g×45 tablets/box;and 300-500 tablets/box is appropriate for inpatient pharmacies.

Objective To explore the relationship between the damage of neuromyelitis optica (NMO) astrocytes (AS) and the onset of NMO, and investigate the relevance of AS damage with the severity of the patients with functional defect. Methods The levels of aquaprin4-antibody (AQP4 -Ab), glial fibrillary acidic protein (GFAP), apolipoprotein(ApoE),interleukins-6(IL-6), interleukins-10(IL-10), tumor necrosis factor-α(TNF-α) in cerebrospinal fluid (CSF ) and serum of 30 acute NMO patients were tested by means of ELISA. The results were later compared with control group. And analysis of the relevance of the various index of the levels in CSF with the CSF AQP4-Ab level, the acute phase expanded disability status scale(EDSS) score of the NMO group were made. Results (1)The NMO group in CSF and serum AQP4-Ab, GFAP, IL-6 levels were higher than the control group (P < 0.05), and ApoE, IL-10 levels were lower than the control group (P < 0.05). (2)The CSF GFAP, ApoE, IL-6 in NMO group is higher than the serum (P < 0.05), and CSF AQP4-Ab, IL-10 levels were lower than the serum ( P < 0 . 05 ) . ( 3 ) The CSF GFAP , IL-6 levels and the CSF AQP4-Ab level were positively correlated (r=0.749, r=0.526, P<0.05), and the CSF ApoE, IL-10 levels were negatively correlated with CSF AQP4-Ab level(r = -0.571, r = -0.676, P < 0.05). (4)The CSF AQP4-Ab, GFAP, IL-6 levels and the acute phase EDSS score were positively correlated (P < 0.05), the CSF ApoE, IL-10 levels were negatively correlated with the acute phase EDSS score (P < 0.05). Conclusion The AS damage exists in the NMO and the damage severity may correlate with patient function defect. AQP4-Ab, GFAP, IL-6 may play important roles in the onset of NMO and the disease aggravating. The decrease of the ApoE and IL-10 may exacerbate NMO damage.

OBJECTIVE To assess the ultrasonographic features and clinical significance of the complications of the thyroglossal cysts. METHODS We retrospectively reviewed the ultrasonographic findings in 41 cases with complications of the thyroglossal cyst, which was confirmed surgically and pathologically. 43 cases with simple thyroglossal cyst consisted of the control group. The location, size, internal echo, internal septa, wall thickness, posterior acoustic feature, boundary, vascularity, and fistulas of the lesion were analyzed and compared with the control group. RESULTS Most of the inflammatory thyroglossal cyst showed thickening walls, indistinct boundaries, posterior echo enhancement, and peripheral vascularity on ultrasound images. There were significant differences of the thickness of the cyst wall, indistinct boundary, and peripheral vascularity between the two groups. CONCLUSION The characteristic findings of thyroglossal cyst with inflammation are thickened wall, indistinct boundary, and peripheral vascularities. Ultrasonography can be useful tool in determination of the appropriate time of the operation to reduce the recurrence rate.

The network teaching platform of ophthalmology of Qingdao University , as the basis construction of the national key discipline , forms a perfect and complete set of teaching system with the aid of part of course information, part of network teaching resources and part of answer and interaction. The network teaching platform focuses on the construction of network teaching resources and answer and interaction. In the college teaching of ophthalmology, through building clinical teaching resource database and discussing on network platform, we carry out interactive and discussion-based teaching, and students can prepare before class and discuss after class. The application of network teaching platform of ophthal-mology in classroom teaching and teaching feedback can improve the teaching methods , deepen the teach-ing content, implement the sharing of teaching resources, and lay a solid foundation for ophthalmology teaching reform.

Objective To evaluate the effect of dexmedetomidine on necroptosis during liver injury in septic rats.Methods Eighteen SPF adult male Sprague-Dawley rats,weighing 200-220 g,were divided into 3 groups (n=6 each) using a random number table:sham operation group (group SH),sepsis group (group SEP) and dexmedetomidine group (group DEX).Sepsis was induced by cecal ligation and puncture in chloral hydrate-anesthetized rats in SEP and DEX groups.Dexmedetomidine 5 μg/kg was injected via the caudal vein at 1 h before operation in group DEX.Blood samples were collected from the caudal vein at 6 h after operation for determination of serum aspartate amino-transferase (AST) and alanine aminotransferase (ALT) concentrations.The rats were then sacrificed and livers were removed for determination of the level of reactive oxygen species (ROS) in liver tissues (using chemiluminescence assay) and expression of receptor-interacting protein 1 (RIP1),RIP3,mixed lineage kinase domain-like (MLKL),high-mobility group box 1 protein (HMGB1) and dynamin-related protein 1 (Drpl) in liver tissues (by Western blot).Results Compared with group SH,the serum AST and ALT concentrations were significantly increased,the expression of RIP1,RIP3,MLKL,HMGB1 and Drpl in liver tissues was up-regulated,and the level of ROS in liver tissues was increased in SEP and DEX groups (P＜0.05).Compared with group SEP,the serum AST and ALT concentrations were significantly decreased,the expression of RIP1,RIP3,MLKL,HMGB1 and Drp1 in liver tissues was down-regulated,and the level of ROS in liver tissues was decreased in group DEX (P＜0.05).Conclusion The mechanism by which dexmedetomidine attenuates liver injury may be related to inhibition of necroptosis in septic rats.

Objective To evaluate the role of D-serine in nerve cell apoptosis induced by multiple exposures to sevoflurane anesthesia in newborn mice and its relationship with glycogen synthase kinase-3 beta (GSK-3β).Methods Thirty healthy male C57B/L6 mice,aged 6 days,weighing 3.5-4.5 g,were divided into 3 groups (n =10 each) using a random number table:control group (group C),multiple exposures to sevoflurane anesthesia group (group S) and D-serine group (group D).On postnatal days 6,7 and 8,3％ sevoflurane in 30％ oxygen was inhaled for 2 h starting from 10:00 daily,and normal saline 0.1 ml and D-serine 500 mg/kg were intraperitoneally injected at 30 min before inhalation in S and D groups,respectively.In group C,30％ oxygen was inhaled for 2 h starting from 10:00 daily,and normal saline 0.1 ml was intraperitoneally injected at 30 min before inhalation.The animals were sacrificed after the end of oxygen or sevoflurane inhalation on postnatal day 8,and the brains were removed for determination of the expression of phosphorylated GSK-3β (pGSK-3β) and activated caspase-3 in brain tissues by Western blot.Results Compared with group C,the expression of pGSK-3β in brain tissues was significantly down-regulated,and the expression of activated caspase-3 in brain tissues was up-regulated in group S (P＜ 0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Compared with group S,the expression of pGSK-3β in brain tissues was significantly up-regulated,and the expression of activated caspase-3 in brain tissues was down-regulated in group D (P＜0.05).Conclusion D-serine is involved in the nerve cell apoptosis induced by multiple exposures to sevoflurane anesthesia through inhibiting the activation of GSK-3β in newborn mice.

Objective: To observe the effect of the intravenous infusion of vasostatin-2 (VS-2) on hemodynamics in experimental rats with spontaneous hypertension (SH).
Methods: A total of 36 (14-16) weeks male SH rats with the mean body weight at (160-250) g were randomly divided into 6 groups:①Control group, the rats received normal saline (100μl/kg),②Catestatin (20μg/kg) group,③VS-2 (5μg/kg) group,④VS-2 (10μg/kg) group,⑤VS-2 (20μg/kg) group and⑥VS-2 (40μg/kg) group. n=6 in each group. The average blood pressure (BP), heart rate (HR) and barorelfex sensitivity (BRS) were monitored and compared upon VS-2 treatment and between VS-2 and catestatin treatments in conscious and freelance rats.
Results: Compared with prior treatment, VS-2 (20μg/kg) and VS-2 (40μg/kg) could obviously decrease the HR, BP and BRS in SH rats. In VS-2 (20μg/kg) group, HR by bpm was (341.3 ± 19.3) vs (365.5 ± 25.5), BP by mmHg was (133.0 ± 8.9) vs (147.5 ± 11.2) and BRS by ms/mmHg was (0.52 ± 0.18) vs (0.37 ± 0.12);in VS-2 (40μg/kg) group, HR was (348.8 ± 30.8) vs (374.5 ± 34.8), BP was (131.5 ± 9.3) vs (151.7 ± 10.8) and BRS was (0.53 ± 0.05) vs (0.38 ± 0.03), all P<0.01. Catestatin treatment could also decrease the HR as (318.7 ± 13.4) vs (365.5 ± 25.5), BP as (119.7 ± 7.3) vs (147.5 ± 11.2) and BRS as (0.58 ± 0.15) vs (0.35 ± 0.11), all P<0.01. Compared with catestatin (20μg/kg), the rats received VS-2 (20μg/kg) had the weaker reduction of HR as (318.7 ± 13.4) vs (341.3 ± 19.3), BP as (119.7 ± 7.3) vs (133.0 ± 8.9), all P<0.01, while BRS was similar as (0.58 ± 0.15) vs (0.52 ± 0.18), P>0.05.
Conclusion: Intravenous infusion of VS-2 may obviously affect HR, BP and BRS in experimental SH rats;compared with the same dosage of catestatin, VS-2 had the weaker reduction of HR, BP and BRS.