OBJECTIVE:To provide reference for the promotion of rational use of essential medicines and further implementa-tion of essential medicines system. METHODS:Depended on the data (including the number of species,the amount of prescrip-tion and prescription departments,etc)of essential medicines(chemical drugs and biological drugs)use in outpatient and emergen-cy departments and wards of 20 sample medical and health institutions fromThe Hospital Prescriptions Cooperation Project,statis-tical analysis was performed by using Excel and Access software. RESULTS:The proportion of the amount of essential medicines included in National Essential Medicines List(2012 edition)or Beijing Essential Medicines(Supplementary list)(2012 edition)to the amount of total medicines(hereinafter referred to as the essential medicines use ratio)in medical and health institutions of Bei-jing from 2013 to the first half year of 2014 was small and showed a slight downward trend. The essential medicines use ratio of grade 2 and grade 3 general hospitals did not reached the required ratio by former Health Department. The essential medicines use ratio in different departments showed great differences,the essential medicines use ratio in imaging department was 100%,while chemotherapy departnent was 4.04%. The essential medicines use ratio in different medicines also showed great differences,5 kinds of drugs(including sulfani lamides)was 100%,while there were 16 kinds of drugs that was less than 0.1%. CONCLUSIONS:The essential medicines use ratio is relatively low in medical and health institutions of Beijing from 2013 to the first half year of 2014 and shows great differences in different departments and different medicines. It is suggested to further improve the essential medi-cines use ratio to better benefit the majority of patients by changing the prescribing habits of physicians,strengthening the advocacy of essential medicines policy and optimizing the use of essential medicines in different departments.

OBJECTIVE:Analyze drug use of pediatrics in China,and to provide reference for promoting research,develop-ment and supply of pediatric drugs. METHODS:Analyze the data of drug use in 2 632 514 pediatric patients aged from 0 to 14 of 78 sample hospitals from Beijing,Shanghai,Tianjin,Hangzhou,Zhengzhou,Guangzhou and Chengdu in“The Hospital Prescriptions Cooperation Project”of Hospital Pharmacy Professional Committee of Chinese Pharmaceutical Association,statistical analysis was performed by using Excel and Access software. RESULTS:Pediatric patients in 78 sample hospitals of 7 regions had used 1 572 kinds of drugs from 2013 to 2014,but only 31.04%of drugs were pediatric drugs;both the ratio of pediatric drug types and the ra-tio of pediatric drugs use frequency had a great gap in different drug classifications. The ratio of drug use frequency in injection ad-ministration was 57.97%,and it was greatly higher than that of oral administration(31.04%). Among oral solid preparations,the ratio of drug use frequency for drugs with unreasonable specification was 29.57%,and ratio of drug types was 40.99%. CONCLU-SIONS:The pediatric patients had a great drug shortage in kinds,dosage forms and specifications in 78 sample hospitals of 7 re-gions during 2013-2014. Off-label drug use,high frequence of injection use,tablets used after breaking and other irrational phenom-ena were found in pediatric patients during clinical drug therapy,which reduced high risk of drug use. It is recommended that gov-ernment should strengthen and improve incentives mechanism of research,development and supply of pediatric drugs,so as to solve pediatric drug shortage in China,promote rational clinical drug therapy for children and guarantee the safety of drug use in pe-diatrics.

Objective To provide the scientific evidence for studying Alzheimer's disease (AD) and decision-making for its management by analyzing the strategic information of hotspots in studies on AD.Methods Citation strategic coordinate diagram was plotted by describing the history of studies on AD with co-citation clustering for further understanding the novelty and concern of hotspots in studies on AD.The current hotspots in studies on AD were discovered by co-words clustering and their strategic coordinates were analyzed to reveal their development periods.Results The current hotspots in studies on AD were substance metabolism in AD patients, etiology of AD and therapies for AD.The diagnosis of AD according to its clinical characteristics and hypothesis on amyloid cascade in AD patients were greatly concerned.Conclusion Citation strategic coordinate analysis and co-words strategic coordinate analysis can display the hotspots in studies on AD and their development history.

Objective To study the prevalence of metabolic syndrome (MS) in patients with type 2 diabetes according to three different diagnostic criteria and the effects of accumulation of MS components on blood lipid profile and to explore possible causes of their increased morbidity of cardiovascular diseases. Methods Components of MS and blood lipid profile were observed cross-sectionally in 157 patients with type 2 diabetes and analyzed using recommended diagnostic criteria by the World Health Organization (WHO, 1999), the National Cholesterol Education Program-Adult Treatment PanelⅢ( NCEP-ATPⅢ, 2001) and the Chinese Diabetes Society under Chinese Medical Association (CDS, 2004). Results Prevalence of MS was 73. 9% , 49. 7% and 52. 9% , and that of dyslipidemia was 54. 8% , 61. 2% and 54. 8% , with the criteria by WHO, NCEP-ATPⅢand CDS, respectively. Dyslipidemia was included in the most common combinations of MS. Blood level of triglycerides increased significantly, that of high density lipoprotein cholesterol ( HDL-C) decreased significantly, and size of low density lipoprotein cholesterol (LDL-C) particles decreased with the increase of the number of MS components, with a more significant coefficient of correlation by the criteria of CDS than that by the other two criteria. Conclusions In patients with type 2 diabetes, prevalence of MS could be more than 50% , most of them complicated with dyslipidemia, one of the most common components of MS, including elevated triglycerides, decreased HDL-C and decreased size of LDL-C particles, which could easily cause cardiovascular disease. The criteria by CDS could reflect the change in blood lipid profile in Chinese population more objectively.

Objective To explore the application ways of IHE XDS technology in electronic medical record (EMR) system and develop application system of clinical EMR integration. Methods The clinical EMR integration plan was worked out based on IHE XDS technical framework. Results A EMR solution based on IHE XDS was presented. It was consisted of the components of the clinical Data Entry, XDS Registry, clinical document Repository, EMR application server and the i-node accessing server. The system was tested and the result indicated that the system was effective and scalable. Conclusion IHE XDS profile can be not only used to realize the sharing of EMR documents across multiple hospital, but also support the collection clinical data within a hospital clinical system integration.

Background Sclera remodeling process in axial elongation is one of the main pathological mechanisms of axial myopia progression.Studies confirmed that transforming growth factor-β1(TGF-β1) participates in the sclera remodeling process,and Smad3 is one of TGF-β1 downstream signal gene transcriptive factors,so to explore its role in sclera remodeling process of myopic eyes is of great significance for pathogenesis and prevention research of myopia.Objective This study was to investigate the expressions of type Ⅰ collagen and Smad3,a TGF-31 downstream target,in sclera of form deprivation myopic (FDM) eyes and explore the impact of TGF-β1-Smad3-type Ⅰ collagen signaling pathway on collagen remodeling in myopic sclera.Methods Seventy-five 1-week-old guinea pigs were randomly divided into normal control group (25 guinea pigs) and FDM group (50 guinea pigs).Monocular FDM was induced by occluding the left eyes of guinea pigs in FDM group with translucent latex balloons for 2,4,6 weeks,respectively,and consecutive occluding for 4 weeks followed by uncovering for 1 week (4/-1 weeks).The refractive power was detected by retinoscopy and axial length was measured with A-type ultrasound.Immunohistochemistry and reverse transcription-PCR were employed to detect the dynamic expressions of type Ⅰ collagen and Smad3 protein ad mRNA in the sclera of guinea pigs with emmetropia and experimental myopia,ard the relationship between collagen Ⅰ and Smad3 levels was analyzed.Results The refraction was hypermetropic in both normal control group and FDM group before occluding of eyes (P＞0.05),and the hypermetropic power was gradually reduced over time in the normal control group.In the FDM group,the refractive power was gradually changed from (+2.09 ± 0.31)D before occluding to (-1.23±0.69),(-4.17±0.59),(-7.07±0.56) and (-4.30±0.58)D,and the axial length was increased from (5.93-±0.39)mm to (6.62±0.36),(7.30±0.34),(7.99--0.32),and (7.21 ±0.36) mm at weeks 2,4,6,and 4/-1 after occluding,respectively,indicating significant differences in refractive power and axial length over time in the FDM group from normal control group and self-control group (all at P＜0.05).The expressions of Smad3 and type Ⅰ collagen protein and mRNA in the sclera of the FDM group was significantly lower than those of the control group and self-control group in various time points (all at P＜0.05).The positive correlation were found in the expression of Smad3 on the myopic sclera with that of type Ⅰ collagen in both protein and mRNA levels (protein:r=0.993,P＜0.05;mRNA:r=0.954,P＜0.05).Conclusions The myopic power and ocular axis increase dependent upon occluding time,and the expressions of Smad3 and type Ⅰ collagen in the sclera are correspondingly weakened in FDM eyes.A consistent expression trend is found between Smad3 and type Ⅰ collage,suggesting Smad3 and type Ⅰ collagen participate in the regulation of sclera remodeling in myopia by TGF-β1-Smad3-Collagen Ⅰ signaling pathway.

Objective Comparing the effects of steam sterilization on cyclic fatigue of stainless steel files. Meth-ods Fifty instruments of 25# stainless steel K files were randomly divided into 5 groups, which include 10 in each group. Group 1 was the blank control group, group 2 to 5 were subjected to 1, 3, 4, 5 steam sterilization cycles, then the files were tested by a custom-made device to assess cyclic fatigue and the number of cycles of failure (NCF) was calculated. Microstruc-ture of each file’s fracture surface was analyzed by Scanning Electron microscope (SEM). Results NCF in the 5 groups were 4 345.2 ± 384.2,3 937.9 ± 645.4,3 812.9 ± 532.5,3 626.2 ± 380.0,3 625.9 ± 565.6 respectively, and the differences among 5 groups were significantly different(F=2.598, P<0.05). After 4 or 5 times of steam sterilization, cyclic fatigue de-creased if compared with that in control group (P<0.05). Fracture surface in group 1 and group 2 was tough dimple structure and large numbers of regular, deep dimples were distributed on the surface. You could also see micro cavities clearly formed by fracture;Fracture surface in group 4 was dimple structure in brittle intergranular morphology. It is characterized by the presence of thin brittle precipitates, clean and smooth crystal interface, and a great sense of polyhedral stereo. Conclusion After 4 times of steam sterilization, cyclic fatigue strength of 25# stainless steel K files declined, which possessed the poten-tial risk of fracture.

BACKGROUND: Root canal files fracture is a kind of common oral clinical complications. Therefore, it is of clinical importance to study the cyclic fatigue of different types of stainless steel root canal files.OBJECTIVE: To explore the effect of the bending angle and cross-sectional area of root canal instruments on cyclic fatigue of stainless steel files.METHODS: Thirty 25# stainless steel K files (25 mm in length) were selected, the same to 30# and 35#. And these three kinds of files were respectively randomized into three groups (n=10 per subgroup). In the nine subgroups, the files were placed into self-made root canals at the bending angle of 45°, 60°, 90°, and driven by a 16:1 reducer (350 r/min).Fracture time in each subgroup was recorded and converted into the number of rotations. The microstructure of the fracture end of the files was observed under scanning electron microscope. Fractured files were collected and the crack tip length was measured by an electronic caliper.RESULTS AND CONCLUSION: At the same bending angle, the number of rotations resulting in file fracture was significantly reduced with the increasing of the cross-sectional area of the files (P < 0.05). When the type and cross-sectional area were same, the number of rotations resulting in file fracture was significantly reduced with the increasing of the bending angle of the root canals (P < 0.05), indicating a reduction in the cyclic fatigue performance of the files. Toughness fracture occurred in all the files, and circular or oval roughness nests with different sizes and microcavities formed on the fracture surface. In addition, brittle surfaces could be detective between the roughness nests. The diameter of roughness nests was gradually increased with the increasing of the bending angle of the root canals. For 30# and 35# files, the number of brittle surfaces was gradually increased with the increasing of the bending angle of the root canals. For 25# files, the crack tip length was gradually decreased with the increasing of the bending angle of the root canals, but there was no significant difference (P > 0.05). For 30# and 35# files, the crack tip length was significantly shortened with the increasing of the bending angle of the root canals (P < 0.05). But there were no significant changes in the 35#-60° and 35#-90° groups (P=0.095). At the same bending angle, there were no regular changes in the crack tip length in the different types of files. In conclusion, with the increasing of the cross-sectional area, the cyclic fatigue performance of the files with the same length and taper is reduced and the files become easy to be fractured; with the increasing of the bending angle of the root canals, the files with the same types are apt to be fractured near the root tip, indicating the shorter length of the crack tip indicates the more difficulty in the removal of the broken files.

Objective To study the role of cell density in the tyrosol production and morphology for Candida albicans biofilms. Methods C. albicans SC5314 and clinical isolates were propagated in yeast peptone dextrose (YPD) medium. Cells were collected by centrifugation and washed twice in sterile phosphate-buffered saline (PBS) before this study, then resuspended in RPMI 1640 supplemented with L-glutamine and adjusted to a desired concentration of 5 × 10~6 cells/ml, 5×10~5 cells/ml, 5 × 10~4 cells/ml, 5 × 10~3 cells/ml after counting with a hematocytometer. Standardized C. albicans cells were prepared as above description and 2000 μl of this standardized cell suspension was dispensed into the wells, then C. albicans biofilms were formed on the bottom of the polystyrene wells. In this study, tyrosol synthesized by SC5314 and clinical isolates of C. albicans biofilm was quantified by high performance liquid chromatography (HPLC). The effects of tyrosol on morphology of C. albicans biofilms were investigated by scanning electron microscopy (SEM). Results Tyrosol production of C. albicans biofilms was affected by cell densities. At lower inoculation size(5 μ 10~3 cells/ml), there was too less tyrosol production to be detected at the early stage of the biofilms formation. At higher inoculation size (5 μ10~6 cells/ml), tyrosol can be detectable at the early stage or at the mature stage of biofilms formation. There was a sharp increase in tyrosol concentration at 24 h, while there was a decrease in tyrosol concentration after that time from the strains when the strains were at an inoculation size of 5 × 10~6 cells/ml and 5 × 10~5 cells/ml. Cell densities affected the morphology formation of the C. albicans biofilms. At the early stage of the biofilms formation, C. albicans grew less germ tube at lower cell densities than that at the higher cell densities. With the mature of the biofilms, C. albicarts grew more hyphae at higher cell densities than that at the lower cell densities. All these above showed that cell densities played an important role in the propagation for the C. albi-cans in the biofilm formation. Conclusion Cell density play an important role in the formation of the C. albi-cans biofilms and the production of the tyrosol.

The cytolytic effect of perforin is a mechanism of anti-virus,killing microbial-infected cells and tumor cells.Perforin is a very important non-specific immune factors in fish.In order to understand the function of perforin,the cDNA of grass carp perforin C-terminal peptide was amplified from grass carp liver and kidney cDNA library.It contains a protein kinase C conserved region 2(C2).The cDNA was connected with pET32a,and transformed to expression bacteria DE3.PFP-C was expressed by a prokaryotic expression system and then purified by affinity chromatography.It showed a significant haemolytic activity when tested with rabbit red cells,the optimal pH for haemolytic activity was 7.5,and its haemolytic function dependents on Ca2+ apparently.