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.

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.

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.

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 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:To investigate the effects of celecoxib and anti-osteogenesis tablets on urinary biomarkers pyridinoline (PYD) and deoxypyridinoline (DPD) in adult patients with Kashin-Beck disease (KBD) in Qinghai Province, and to provide scientific basis for treatment of adult KBD.Methods:According to the "Diagnosis of Kaschin-Beck disease" (WS/T 207-2010), in July 2017, 120 cases of adult KBD that were selected from the KBD area in Qinghai Province were divided into non-drug treatment group ( n = 66) and drug treatment group ( n = 54), and 89 healthy adults were selected as control group. The drug treatment group was taken celecoxib and anti-osteogenesis tablets for 6 months. Morning urine samples were collected from the three groups. The contentss of PYD and DPD in urine were detected by enzyme linked immunosorbent assay (ELISA), and the test results were corrected with creatinine (Cre). Results:There were no statistically significant differences in gender ratio and age among non-drug treatment group, drug treatment group and control group (χ 2 = 0.820, F = 0.379, P > 0.05). The medians of urinary PYD in the three groups were 1 106.39, 812.18, 702.53 ng/μmol Cre, and the medians of DPD were 1 325.58, 802.54, 752.38 ng/μmol Cre, respectively. The differences were statistically significant among the three groups ( H = 13.849, 34.621, P < 0.01). The contents of PYD and DPD in drug treatment group were lower than those in non-drug treatment group ( P < 0.05). Conclusion:Celecoxib and anti-osteogenesis tablets can reduce the urinary levels of PYD and DPD in adult patients with KBD.

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.

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.

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