OBJECTIVE:To provide reference for the establishment of coordinative mechanism among different interest groups during the implementation of essential drug system. METHODS:Based on game theory,game behaviors of various interest groups were studied with public medical institution as study core. Behavior relationships among various interest groups were ensured to find out equilibrium point of interests. RESULTS & CONCLUSIONS:In the implementation process of National Essential Drug System,great importance should be attached to the study on game phenomena and behavior among various interest groups to make sure implementation of National Essential Drug System.

Liver plays a central role in regulation of nutrition.Due to metabolic abnormalities,patients with end-stage liver disease often demonstrate undernutrition,which has a close relationship with the prognosis of the patients.Correct nutritional assessment and nutrition support is therefore very important.Dietary intake alone could not meet the nutritional needs of patients with end-stage liver disease.In recent years,the use of enteral and parenteral nutrition formulation has significantly improved the nutritional status of such patients,but there still lacks a gold standard. How to develop appropriate nutrition support regimens is a challenge for clinicians.This paper summarizes nutrition-related issues in patients with end-stage liver disease,aiming to provide a reference for individualized nutritional intervention for patients with end-stage liver disease.

Pulmonary valve stenosis (PS) is a relatively common congenital heart disease,and there are 2 treatment methods of surgical operation and intervention.Percutaneous balloon pulmonary valvuloplasty (PBPV) was applied successfully in children with PS for the first time by Kan.For more than 30 years,with the update of intervention equipment,improvement of operation method and accumulation of clinical experience,the application of PBPV continuously has made new progress.Most of the previous reports of the PBPV were for the immediate and short-term efficacy,while long-term follow-up data and some special types of PS review research were less.Now,combined with PBPV clinical data and long-term follow-up study in recent years,an overview of the application progress of PBPV including indications,methods,curative effect and follow-up,prevention and cure of complications and some special type of PS are provided.

Objective To evaluate the clinical value of myocardial perfusion imaging with dual-source dual-energy CT and a contrast agent at a low concen.tration in the diagnosis of myocardial infarction in the elderly Methods One-stop cardiac imaging with dual-source CT was conducted in 138 elderly patients diagnosed with myocardial infarction between October 2015 and May 2016.The patients were randomly divided into two groups,Group A and Group B,each with 69 patients.Myocardial perfusion was performed for coronary imaging,using 70 ml Visipaque(270 g/L)and 50 ml saline for Group A and 70 ml iopromide(370 g/L)and 50 ml saline for Group B.Myocardial transmural perfusion gradients(TPG)were calculated,and the total iodine dose and the rate of iodine infusion were compared between the two groups.Results The procedure was successfully carried out in all 138 patients.There was no statistically significant difference in TPG between the two groups in the right coronary artery,the anterior descending artery and the circumflex artery(P＞0.05).The total iodine dose for Group A was 18.5 g,27％ less than that for Group B(25.9 g).The rate of iodine infusion for Group A was 3.5 g/s,also 27％ less than that for GroupB(18.5 g/s).Conclusions Myocardial perfusion imaging with dual-source dual-energy CT and contrast agents at low concentrations is a promising approach,which is capable of achieving quality imaging for the assessment of myocardial infarction with reduced use of iodine and represents a clinically valuable option.

Many air anion generators have been developed which can be divided into two ty pes including the one of ultrasonic water atomization and the one of corona disc harge.Being in a priority position of market,the latter has solid,simple structu re and is convenient to operate,which can generate high-consistency air anion.

Objective To research the optimal conditions for extraction of Daoguleebusi-7 capsule. Methods A comprehensive investigation for the process of extraction by water and ethanol was made using orthogonal experiments.Results The optimal process conditions were: gardenia and another drug were added into 12 volumes of water, extracted 2 times and two hours per time; Sophorae Flavescentis and other four dugs were added into 12 volumes of 85% ethanol,extracted 3 times and two hours per time, elecampane was crushed and screened through 100 mesh sieve to electuary.Conclusion The extraction process is simple and feasible for operation.

Objective To investigate the dynamic changes of Th 17 ,NK and IFN-γ,IL-17 in periop-erative patients with lung cancer .Methods Twenty cases of patients with lung cancer surgery were chosen ran-domly.Ten cases of healthy were used as control .We detected the express of Th17,NK,IFN-γand IL-17.Re-sults Compared with the control group , the levels of Th17 and IL -17 increased significantly in lung cancer group(P<0.05);Compared with the pre -operation,the levels of Th17 and IL-17 increased significantly after 1st day of lung cancer surgery .However,the levels of NK and IFN -γdecreased significantly .The expression of Th17 and IL-17 decreased obviously after 5 days of lung cancer surgery .However,the levels of IFN -γin-creased significantly(P<0.05).The correlation analysis showed that there was a positive correlation between Th17 and IL-17A,NK and IFN-γof peripheral blood with lung cancer patients (P<0.01),negative correla-tion between Th17 and NK,IFN-γof peripheral blood with lung cancer patients (P<0.05).Conclusion The immune suppress before activating at perioperative ,it is important for lung cancer patients to detect the levels of Th17,IL-17,NK,IFN-γin peripheral blood .

Objective To study the changes of CD4 +/CD8 +T cells ratio and TGF -β,IL-4,IL-6 levels in lung cancer patients during the perioperative period and to analyze the clinical significance .Methods Flow cytometer and Elisa were used to analyze the CD 4 +/CD8 +T cells ratio and TGF-β,IL-4,IL-6 levels in peripheral blood sapmles from 20 patients with lung cancer during the perioperative period and 10 healthy con-trolsR. esults Before operation ,the ratios of CD4 +T and CD8 +T cells from 20 patients with lung cancer were (46.26 ±4.26)%and(43.15 ±5.18)%, respectively.On the fifth day after operation ,the ratios of CD4 +T and CD8 +T cells were(44.30 ±4.25)%and(39.80 ±2.53)%.TGF-β,IL-4 and IL-6 levels in 20lung cancer patients were(240.51 ±46.37)pg/mL,(19.85 ±2.52)pg/mL,and(129.28 ±33.06)pg/mL,respectively.On the fifth day after operation,TGF-β,IL-4 and IL-6 levels were(210.79 ±36.94)pg/mL,(17.37 ±2.57) pg/mL,and(107.28 ±27.83) pg/mL.The differences of above parameters between the preoperative period and the fifth day after operation were statistically significant ( P<0.05) . Conclusion The immune suppression oc-curs before its recovery during perioperative period ,the changes of CD4 +/CD8 +T cells ratio and TGF-β,IL-4 and IL-6 levels have significance on monitoring the progress and prognosis of patients with tumor .

years ago, Noma first applicated the patch\|clamp technique to CN\|treated mamammalian heart cells,evealed specific K + channels which were depressed by intracellular ATP at level greater than 1 mM.He suggested the ATP-sensitive channels are important for regulating cellular energy metabolism in the control of membrane exitability.Recent studies supported the hypothesis and suggested that ATP-sensitive channels play an important role in hypoxia,myocardial ischemia/reperfusion and is chemic preconditioning.

AIM: To determine the effects of phospholipase A 2 (PLA 2) and K ATP on rat ischemia/reperfusion(I/R)-induced arrhythmia. METHODS: Myocardial ischemia and reperfusion were produced by occlusion and reirregation of the left anterior descending artery(LAD). An inhibitor of PLA 2, 5,5-dithio-bis(2-nitrobenzoic acid) (DTNB) (16 mg /kg), a K ATP opener pinacidil (0.2 mg/kg), a K ATP blocker glibenclamide (0.3 mg/kg) was used 5 min prior to 10 min regional ischemia and 10 min reperfusion. RESULTS: DTNB (16 mg/kg) reduced the scores of arrhythmia, creatine kinase (CPK) and lactate dehydrogenase(LDH) (P