OBJECTIVE:To put forward advices to make sure the rational application of essential medicine in medical institutions.METHODS:The difficulties about the use of essential medicine in hospitals in China were analyzed to provide suggestions and measures for guaranteeing the rational use of essential medicine in hospitals.RESULTS&CONCLUSIONS:By reforming the mode of clinical payment,consummating the medical insurance system,making using rule of essential medicine,strictly managing medical institutions can ensure the appropriate use of essential medicine.

Microcalcifications are among the most common imaging findings of breast cancer. This article reviews the recent liter-ature regarding the foci of microcalcifications in breast cancer. In particular, we summarize the composition, formation mechanism, and biopsy method of the microcalcifications;the relationship between the foci and clinicopathologic indicators;and the influence of neoad-juvant chemotherapy on the foci.

Small cell lung cancer (SCLC) is an aggressive malignancy with fairly poor prognosis. Innovative treatment based on improved understanding of the genetic alterations of SCLC is awaited. Recently, a number of potential targets or important oncogenic pathways have been identified by the next generation sequencing or other systematic genomic analysis in SCLC. In this review, we summarised the new ifndings of genetic characteristics in SCLC.

Chop and Grp78 genes are key genes in endoplasmic reticulum stress(ERS).To explore the gene alteration of Chop and Grp78 in embryo with spina bifida,we studied Chop and Grp78 gene expression by qRT-PCR in neural tube of rat with spina bifida in E12 and primary cultured neuroepithelial stem cells(NEP).We found higher expression of both Chop and Grp78 in neural tube of rat with spina bifida than normal rats.While Chop and Grp78 genes were up-regulated after NEP differentiated into neuron.The up-regulation of Chop and Grp78 genes in neural rube of rat and NEP might be involved in the abnormal apoptosis in spina bifida related with ERS.And we found the primary culture of NEP provided a good model for embryo early development research.

MicroRNAs (miRNAs) are a class of highly conserved small noncoding single stranded RNAs.They participate in the regulation of target genes through the degradation of mRNA and/or inhibition of translation.As the most abundant miRNAs in the central nervous system,miRNA-124 (miR-124) has been widely given attention in recent years.The recent research suggests that miR-124 is closely associated with ischemic cerebral injury,but its specific regulation mechanism remains unclear.This article reviews the roles of miR-124 in ischemic cerebral injury.

Objective To study the expression of metallothionein(MT),Ki 67 in renal cell carcinoma(RCC) and to evaluate their biological significance. Methods The expression of MT and Ki 67 were assayed by means of immunohistochemical technique in RCC tissues and normal renal tissues.DNA content and S phase fraction(SPF) were measured by flow cytometry(FCM). Results The positive expression rates of MT in RCC tissues and normal renal tissues were 52.5%,78.9% respectively( P

Objective To find a new operation based on the themy of NOTES,through the way of mouth floor-pretracheal space-retrosternal space,instead of through esophagus or the trachea.Methods We anesthetized six mongrel dogs with endotracheal intubation,then cut the tissue between the incisors and the glossodesmus.The retrosternal space was separated slowly by the balloon expander,and cut the right mediastinal fascia,and went through thorax,then cut a small piece of lung tissue,which would be used to biopsied.Results All of the 6 operations were successfully completed,without any arrhythmia,serious bleeding,airway obstruction and death.Conclusion It doesn't need the soft endoscope in the new operation,which will have bigger operating space and to be safer,just with pin type thoracoscope and related apparatus.

10.3969/j.issn.1000-3606.2013.06.013

Objective:Pathological nipple discharge (PND) is commonly associated with benign breast disorders. However, PND lesions can also be malignant and can be the initial or unique presenting symptom of breast cancer. This study aimed to investigate the relationship between the clinical factors and the character of PND lesions. Methods:The clinical data of 207 patients with PND as their primary complaint were retrospectively analyzed. Results:Univariate analysis showed that the risk factors for breast cancer usually increase in patients with PND accompanied by a breast lump or breast calcification or those aged over 50 (P<0.05). The characteristics and course of PND were not correlated with the diagnoses of benign and malignant degrees of PND (P>0.05). Multivariate analysis indicated that patients aged over 50 with PND accompanied by a breast lump or breast calcification have a higher risk of suffering from breast cancer. Conclusion:The ages of patients with PND accompanied by a breast lump or breast calcification may significantly affect the diagnosis of benign and malignant PND lesions.

Objective:To investigate the changes of serum neopterin (NPT) level in adults patients with Kashin-Beck disease (KBD) in Qinghai Province.Methods:In July 2018, according to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), in KBD endemic region of Xinghai and Guide counties in Hainan Tibetan Autonomous Prefecture of Qinghai Province, adult KBD patients and healthy people over 20 years old were selected as KBD group and internal control group, respectively. At the same time, healthy people over 20 years old were selected as the external control group in non-KBD endemic region of Xunhua County with similar production scale and lifestyle. Fasting elbow vein blood samples of the 3 groups of people were collected, serum NPT levels were determined by enzyme linked immunosorbent assay (ELISA).Results:Totally 272 people were enrolled in the study, 104 cases (50 males and 54 females) in KBD group, aged (47.61 ± 12.72) years old; 95 cases (35 males and 60 females) in internal control group, aged (48.28 ± 14.87) years old; and 73 cases (35 males and 38 females) in external control group, aged (51.88 ± 13.93) years old. There were no significant differences in gender composition and age among the 3 groups (χ 2 = 3.135, F = 2.236, P > 0.05). The serum NPT levels of KBD, internal control, and external control groups were (504.35 ± 413.92), (417.34 ± 109.90) and (397.49 ± 118.07) ng/L, respectively, and the difference among the 3 groups was statistically significant ( F = 4.129, P < 0.05). Among them, the serum NPT level of KBD group was significantly higher than that of internal control group and external control group ( P < 0.05); there was no significant difference in the serum NPT level between internal control group and external control group ( P > 0.05). Conclusion:The serum NPT level of adult KBD patients in Qinghai Province is elevated.