ATP-Binding Cassette Transporters ; metabolism ; Adenocarcinoma ; genetics ; metabolism ; pathology ; Adult ; Aged ; Blotting, Western ; Female ; Humans ; Immunohistochemistry ; Lung ; metabolism ; pathology ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

By means of global budget,the disease-specific scoring method was put in place for both settlement and payment in Huaian,Jiangsu province,for the purpose of cost control by the hospitals.This reform consists of total cost accounting,rational performance-based distribution system,multi-approached regulation of medical behaviors,and individual disease management to regulate medical behavior.These efforts aim at aligning with medical insurance payment reform,so as to improve hospital management,operation quality and socio-economic outcomes.Problems found in practice were also reviewed.

The cervical sagittal balance is a description of cervical spine at the standing position. The position of cervical spine is measured by the corresponding sagittal parameters. The commonly used sagittal parameters of cervical spine include cervical lordosis (CL), cervical sagittal vertical axis (cSVA), T 1 Slope (T 1S), etc. Cervical sagittal balance is closely related to the overall balance of the spine, and the imbalance of sagittal parameter is also related to the progression of cervical disease, the choice of surgical methods and the postoperative efficacy. In recent years, more and more researchers have begun to pay attention to the sagittal balance of the cervical spine, especially the variation of sagittal parameters after cervical surgery, which can predict the postoperative neurological recovery and the change of long-term efficacy or complications. However, due to the variety of cervical surgery methods and the variety of cervical sagittal balance parameters, the existing studies can only reflect the relationship between the two from a certain aspect, while lacking overall and comprehensive description. In this paper, the relationship between sagittal plane balance and cervical surgery was reviewed by systematically searching literatures and screening relevant studies. According to our review, the cervical sagittal parameters have different tendency after different cervical surgery. Generally, anterior cervical surgery can maintain or improve the sagittal plane balance of the cervical spine, among which anterior cervical discectomy and fusion (ACDF) surgery has a best effect.After posterior cervical surgery, the cervical sagittal parameters tend to be unbalanced or compensated, and patients with preoperative sagittal imbalance, advanced age, and complex OPLL are more likely to have postoperative imbalance or imbalance aggravation. Therefore, attention should be paid to preoperative evaluation and reasonable surgical design in clinical practice to prevent the occurrence of sagittal imbalance of patients after surgery.

Peptide drugs exhibit an irreplaceable role in clinics due to their high specificity, efficiency and low toxicity. At present, more than 80 peptide drugs have been approved for marketing with global sales exceeding $50 billion in 2019. However, with large molecular weights, high hydrophilicity and instability in digestive tract, oral peptide drugs encounter substantial physiological barriers leading to low oral bioavailability. Therefore, peptide drugs are mostly administered by parenteral routes. Although parenteral delivery of peptide drugs achieves high bioavailability, this is associated with inconvenience and discomfort, even causing severe side effects compared with the oral route possessing a high degree of patient compliance. Therefore, numerous studies concentrate on novel strategies to improve the oral bioavailability of peptide drugs. Some delivery technologies such as Eligen™ and Axcess™ have been successfully applied to the oral dosage form of therapeutic peptides and have accelerated relevant oral formulations for Food and Drug Administration (FDA) approval and clinical treatment. In this review, we focus on the oral peptide delivery, mainly summarizing the progress of recent strategies used to overcome oral barriers and the commercialization applications of related patents, which could facilitate the research and development (R&D) of clinical applications of oral delivery techniques for peptide drugs.

OBJECTIVETo investigate the effects of simvastatin on the proliferation and apoptosis of prostatic epithelial RWPE-1 cells.

METHODSRWPE-1 cells cultured in vitro were treated with simvastatin at 0, 10, 20, and 40 μmol/L for 24, 48, and 72 hours followed by determination of their proliferation by MTT assay, and their apoptosis by flow cytometry. The mRNA and protein expressions of Bcl-2, Bax, and Cx43 were detected by fluorescence quantitative RT-PCR and Western blot, respectively.

RESULTSAfter 72 hours of treatment with simvastatin at 10, 20, and 40 μmol/L, the inhibition rates of the RWPE-1 cells were (21.07 ± 6.41)%, (34.87 ± 9.65)%, and (47.18 ± 10.88)%, respectively, significantly higher than (1.21 ± 0.54)% in the control group (P < 0.05) and in a dose-dependent manner (P < 0.05); the cell apoptosis rates were (0.066 ± 0.016)%, (0.126 ± 0.023)%, and (0.192 ± 0.025)%, respectively, remarkably higher than (0.015 ± 0.005)% in the control (P < 0.05) and also in a dose-dependent manner (P < 0.05); the mRNA and protein expressions of Bcl-2 were decreasing while those of Bax and Cx43 increasing with the increased concentration of simvastatin (P < 0.05). The expression of Cx43 was correlated negatively with that of Bcl-2 but positively with that of Bax.

CONCLUSIONSimvastatin inhibits the proliferation of prostate epithelial cells and induce their apoptosis by acting on the gap junctional intercellular communication.

Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Connexin 43 ; metabolism ; Drug Administration Schedule ; Epithelial Cells ; drug effects ; physiology ; Humans ; Hypolipidemic Agents ; pharmacology ; Male ; Prostate ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; RNA, Messenger ; metabolism ; Simvastatin ; pharmacology ; bcl-2-Associated X Protein ; metabolism

Hamartoma ; complications ; surgery ; Humans ; Hydrocephalus ; etiology ; Hypothalamic Diseases ; complications ; surgery ; Infant ; Male ; Postoperative Complications ; etiology ; Puberty, Precocious ; etiology ; Subdural Effusion ; etiology

OBJECTIVETo determine whether oral statins can delay the progression of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS).

METHODSWe conducted a retrospective cohort study of 50-69-year-old males who came for physical examination in our hospital between January 2003 and December 2008. We designed the inclusion criteria, followed them up for 5 years, and investigated the relationship of oral statins with the clinical progression of BPH and LUTS.

RESULTSTotally, 653 men met the inclusion criteria and were included in this study, of whom 283 were treated with oral statins (group 1) while the other 370 with none (group 2). There were no statistically significant differences between the two groups in age and baseline IPSS, Qmax, and prostate volume (PV) (P > 0.05). During the follow-up, 24 cases in group 1 and 35 cases in group 2 were excluded for obvious dys-uria. A gradual increase was observed in IPSS in both groups 1 and 2 year by year from the baseline to the 5th year of follow-up, but significantly lower in the former group (4.27 +/- 1.16, 4.63 +/- 1.05, 5.27 +/- 0.96, 6.41 +/- 1.04, 7.21 +/- 1.21, and 7.93 +/-1.50) than in the latter (4.24 +/- 1.35, 5.26 +/- 1.23, 6.84 +/- 1.20, 8.75 +/- 1.84, 10.82 +/- 3.01, and 12.98 +/- 4.21) (P < 0.01); a gradual decrease was seen in Qmax, though markedly higher in group 1 ([26.56 +/- 2.09], [24.06 +/- 1.94], [21.33 +/- 1.66], [19.24 +/- 1.54], [17.44 +/- 1.53], and [16.27 +/- 1.37] ml/s) than in group 2 ([26.74 +/- 2.40], [23.62 +/- 2.01], [20.63 +/- 1.69], [17.72 +/- 1.48], [14.82 +/- 1.11], and [11.86 +/- 1.24] ml/s) (P < 0.01); and a gradual increase was found in PV, but remarkably smaller in the former group ([19.82 +/- 4.94], [22.60 +/- 4.99], [25.80 +/- 5.20], [27.92 +/- 5.05], [29.11 +/- 5.24], and [29.97 +/- 5.26] ml) than in the latter ([20.21 +/- 4.78], [24.30 +/- 4.98], [28.50 +/- 5.14], [32.84 +/- 4.77], [36.99 +/- 4.78], and [40.90 +/- 4.78] ml) (P < 0.01). Longer medication of statins was associated with better efficacy.

CONCLUSIONOral statins can significantly delay the clinical progression of BPH and LUTS.

Aged ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Longitudinal Studies ; Lower Urinary Tract Symptoms ; drug therapy ; Male ; Middle Aged ; Prostatic Hyperplasia ; drug therapy ; Retrospective Studies

Shenfu injection is developed by improving dosage form of ancient prescription "Shenfu Tang" and is mainly derived from extracts of both traditional Chinese medicine red ginseng and prepared lateral root of monkshood with polysorbate 80 as auxiliary material. Shenfu injection may be administered through intramuscular injection, intravenous drip or intravenous injection. It produces good effects in restoring Yang and rescuing patients from collapse, tonifying Qi and preventing exhaustion. It is mainly used to treat not only syncope and prostration resulting from sudden Yang collapse (infectious, hemorrhagic and water depletion shock etc), but also pavor, palpitation, dyspnea with cough, stomachache, diarrhea and arthralgia etc caused by deficiency of Yang (deficiency of vital energy). Research group has audited the monitored hospitals and has carried out postmarketing study of Shenfu solution from many aspects including literature review, spontaneous reporting system (SRS) and hospital information system (HIS) data analysis etc. A summary is shown below.
Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Humans ; Injections ; Medicine, Chinese Traditional ; methods

Situational teaching method was implemented in clinical teaching of obstetrics and gynecology. The basis of situational teaching was established through the establishment of a typical teaching case library. Students' impression of disease diagnosis and treatment was strengthened by simulation. The students' enthusiasm was improved by their own diagnosis and treatment through the teacher's guidance. With the method of situational teaching, students had better knowledge of obstetrics and gynecology, and their clinical diagnosis and treatment capacity was improved. Situational teaching method can improve the quality of teaching and it is worthy being popularized in clinical teaching of obstetrics and gynecology.

Objective To investigate the technical feasibility of medical robot in application to vascular intervention. Methods The independent-developed medical robot was used in the glass vessel model and vascular intervention experiments in a dog. Results The process of experiments were smooth,the system movement did not have any malfunction,and the animal experiments did not have any operative complications. The operative time was 50 minutes.Conclusions The medical robot can basically meet the requirements of cerebral angiography. It has laid a foundation for further development of intracranial vascular interventional procedures and clinical application.