Background:In recent years, there has been rapid growth in pharmaceutical spending in China. In addition, the country faces many challenges with regards to the quality, pricing and affordability of drugs. Pricing and reimbursement are important aspects of pharmaceutical policy that must be prioritised in order to address the man-y challenges. Methods:This review draws on multiple sources of information. A review of the academic and grey lit-erature along with official government statistics were combined with informa-tion from seminars held by China's State Council Development Research Center to provide an overview of pharmaceutical pricing and reimbursement in China. Results:Pricing and reimbursement policy were analysed through a framework that incor-porates supply-side policies, proxy-demand policies and demand-side policies. China's current pharmaceutical policies interact in such a way to create dysfunction in the form of high prices, low drug quality, irrational prescribing and problems with access. Fi-nally, the country's fragmented regulatory environment hampers pharmaceutical policy reform. Conclusions:The pri-cing and reimbursement policy landscape can be improved through higher drug quality standards, greater market con-centration, an increase in government subsidies, quality-oriented tendering, wider implementation of the zero mark-up policy, through linking reimbursement with rational prescribing, and the promotion of health technology assess-ment and comparative effectiveness research. Addressing broader issues of regulatory fragmentation, the lack of trans-parency and corruption will help ensure that policies are created in a coherent, evidence-based fashion.

Type 2 diabetes is a polygenic and complex disease.Various approaches, including association analysis, positional cloning, positional candidate gene approach and genome-wide association analysis, were used to identify its susceptible genes.This article summarized the recent findings on susceptible gene mapping of type 2 diabetes.

Objective: To establish Candida albicans vaginitis in mice and explore the best modeling conditions to provide an economical and practical animal model of Candida albicans vaginitis.Methods: After given estradiol valerate respectively at low, medium and high dose (0.001 5, 0.015, 0.15 mg/10 g) by gavage for continual 7 days, Kunming female mice were inoculated Candida albicans to establish the vaginitis model.The amount of Candida albicans in vaginal lavage fluid was analyzed and the vaginal pathological changes were observed.Results: The colony count in vaginal lavage with estradiol valerate at low, medium and high dose was 124.67±19.01, 217.67±22.50 and 282.00±27.87, respectively, and compared with that in the high dose group, there were significant differences in the medium dose group and low dose group (P＜0.05 or P＜0.01).HE staining and PAS staining showed that the high dose group had more polymorphonuclear neutrophils (PMNs) infiltration and purple red line hypha.Conclusion: Estradiol valerate at high dose is the best modeling condition for Candida albicans vaginitis in mice.

Objective:To investigate the clinical efficacy of trimetazidine combined with salvia ligustrazine injections in the treat-ment of unstable angina in coronary heart disease with type 2 diabetes. Methods:Totally 76 patients of unstable angina with type 2 di-abetes were randomly divided into the control group and the observation group with 38 cases in each. The control group received trime-tazidine on the basis of the conventional treatment, 20mg,po,tid, while the patients in the observation group received salvia ligustrazine injections additionally, 10ml, ivd,qd. The treatment course was 2 weeks, and the clinical efficacy, blood fat, blood rheology and the other indices were observed after the treatment. Results:After the treatment, the effective rate of the control group and the observation group was 65. 79% and 86. 84%,respectively with statistically significant difference(P<0. 05), the improvement of blood fat and blood rheology in the observation group was better than that in the control group (P<0. 05), the angina frequency and duration, and nitroglycerin consumption in the observation group was significantly lower than those in the control group(P<0. 05). Conclusion:The combination application containing trimetazidine and salvia ligustrazine shows exact clinical efficacy with promising safety and compli-ance, which is valuable in the clinical application.

Objective To investigate the expression and clinical significance of soluble E-cadherin (sE-cad) and E-cadherin (E-cad) in acute leukemia (AL), and to explore their relationship with the pathogenesis,development and diagnosis of extra-myeloid leukemia. Methods 87 newly diagnosed or relapsed AL patients (19 cases of L1, 29 L2, 14 M2, 20 M3, 4 M4, 1 M5) were collected from hospitalized patients in hematology department of Harbin Medical University Cancer Hospital. The plasma from 20 healthy volunteers was used as control group. The bone marrow was from 15 non-AL patients hospitalized in hematology department (7 cases of thrombocytopenic purpura, 4 iron deficiency anemia, and 4 fever). The expression of sE-cad in the plasma of 47 patients and 20 healthy volunteers was detected by ELISA; the expression of E-cad on the membrane surface of bone marrow MNC in 40 patients and 15 controls was determined by flow cytometry. Results The plasma level of sE-cad in AL group was significantly higher than that in healthy control group [(66.812±52.712) ng/ml vs. (17.976±14.206) ng/ml, P<0.01]. The plasma level of sE-cad in extra-myeloid infiltration AL group was significantly higher than that in no-extra-myeloid infiltration AL group [(83.545±60.759) ng/ml vs. (42.152±22.043) ng/ml, P<0.01]. The plasma level of sE-cad in high leukocytes AL group was higher than that in no-high leukocytes AL group [(85.166±57.828) ng/ml vs. (41.933±32.064) ng/ml, P<0.05]. The percentage of E-cad expression in AL group was significantly lower than that in control group [(13.615±14.038) % vs. (31.700±16.213) %, P<0.01]. The percentage of E-cad expression in no-extra-myeloid infiltration AL group was significantly higher than that in extra-myeloid leukemia infiltration AL group[(18.691±14.917) % vs. (6.589±8.959) %,P<0.01]. The percentage of E-cad in no-high-leukocytes AL group was significantly higher in high leukocytes AL group [(20.925±12.081) % vs. (7.446±11.118) %, P<0.01]. Conclusions The expression of E-cad on the membrane surface of bone marrow MNC and the expression of sE-cad in plasma may be closely associated with the occurrence of extra-myeloid leukemia and leukocytosis, which may be one of the important molecular mechanisms of leukemic cell infiltration and leukocytosis. High expression of sE-cad in plasma can be treated as one of index to diagnose extra-myeloid leukemia.

Objective:To investigate the value and effectiveness of the case-based learning assisted by several internet platforms for medical interns in interactive teaching for undergraduate students in the clerkship of cardiovascular surgery.Methods:Ninety-six undergraduates were randomly divided into control group ( n = 48) and experiment group ( n = 48). The control group received traditional teaching, and the experiment group received case-based learning with the aid of WeChat and Sojump questionnaires. The theoretical and clinic operating scores, classroom atmosphere, learning interest, learning efficiency, learning ability improvement, theoretical knowledge mastery and clinical skills improvement were were compared between the two groups. SPSS 19.0 was used for t test and chi-square test. Results:The clinic operating scores, classroom atmosphere, learning interest, learning efficiency, learning ability improvement, theoretical knowledge mastery and clinical skills improvement were statistically higher in experiment group than in control group ( P < 0.05). Conclusion:The application of case-based learning combined with internet platforms has achieved a good teaching effect in interactive teaching for undergraduate students in the clerkship of cardiovascular surgery and is worthy of popularizing.

?Retinoblastoma is a common eye malignant tumor which has high degree of malignancy.The traditional treatment methods are destructive, and the prognosis is poor. Hypoxia-inducible factor-1αhighly express in retinoblastoma and regulate the development and progression of retinoblastoma ( by influencing the proliferation and differentiation of tumor cells and involving in the generation of vascular mimicry ) . This article reviewed the role of hypoxia inducible factor-1αin the development of retinoblastoma which will initiate a new avenue for the treatment of retinoblastoma.

Objective To identify the effect of decreasing the rejection using the biological semipermeable membrane combined with the privileged site xenotransplantation. Methods The rat ICCs encapsulated by biological semipermeable membrane were xenotransplanted into dog's brain. The pathological changes of implants and surrounding cerebral tissues were observed under light and electric microscopy. The ?-cells of implants were identified by immunohistochemistry. Results After 2 months of transplantation, The ?-cells were observed and the lymphocytes were dispersed in the grafts.The brain tissues near the grafts showed slight edema and glial hyperplasia. Conclusion The method using the biological semipermeable membrane in combination with the privileged site xenotransplantation have a beneficial effect on the inhibition of the rejection of heterogeneous ICCs implant.

Objective To isolate endophytic fungi from the rare medicinal plants ephedra, detect the production of ephedrine alkaloids, and explore the optimum fermentation conditions.Methods The endophytic fungi were isolated from the herbaceous stems treated.The ephedrine alkaloids were preliminarily detected by Dragendorff's reagent.The fungi strains producing ephedrine alkaloids were screened by HPLC method with reference substance of ephedrine, pseudoephedrine and methephedrine.After the optimum carbon source and nitrogen source were determined with total ephedrine alkaloids as evaluation indicators by HPLC, the orthogonal test of L16 (45) was designed to investigate five levels of carbon source amount, nitrogen source amount, pH value, temperature, fermentation time.Results The ephedra herbaceous stems endophytic fungus-Es2 mycelium extract after fermentation contained ephedrine, pseudoephedrine and methephedrine.Es3 mycelium extract containing pseudoephedrine after fermentation.Lactose and ammonium sulfate were as the most suitable carbon source and nitrogen source of Es2 fermentation to produce ephedrine alkaloids.Es produced the highest yield of ephedra alkaloids when the carbon source 30 g/L, nitrogen source 4 g/L, pH5.0, temperature 30℃, fermented for 8 days.Conclusion The ephedrine alkaloids of industrial production could be realized by microorganism fermentation method, which has very important significance to alleviate the ephedrine market demand pressure on the environment.

Objective To evaluate the efficacy and safety of levonorgestrel combined with danazol capsules in the treatment of endometriosis patients.Methods Ninety patients with endometriosis were randomLy divided into experimental group and control group(45 cases).The control group was treated with danazol capsules.The experimental group was treated with levonorgestrel on the basis of the control group.The clinical efficacy and serum CA125,CA199,ovarian function,and ovarian function were observed before and one month and three months after treatment.Adverse reaction rate.Results After three months of treatment,the clinical symptoms of the experimental group were lower than the control group(P<0.05); serum CA125,CA199 levels decreased,compared with the control group,the test group decreased significantly(P<0.05); ovarian function recovery Compared with the control group,the difference was statistically significant(P<0.05).two group compared with the incidence of adverse reactions,the difference was not statistically significant.Conclusion Levonorgestrel danazol capsules treatment of endometriosis Bitter patients than the use of danazol capsules better treatment,higher safety,worthy of clinical application to promote.