The accessibility of drugs is the fundamental condition for achieving the universal health care, and price is the important factor of accessibility.It is essential to have a national price negotiations mechanism for the patented drugs and for exclusive production of drugs.As for the regular works, the national price negotiations mechanism should be ruled by law, while rules and regulations should be formulated accordingly.This paper discusses the specific content and the clarification of the legislative principle of legal framework for the negotiations, main roles, and selection of objects, procedure, results and application of the negotiations.It also analyses the existing problems are analyzed, and put forward the future legislation and corresponding rules.

Functional near-infrared spectroscopy is a non-invasive optical brain function detection technology,which can do multi-point measurement of changes on cerebral cortical area corresponding to the oxygenation of the blood hemoglobin and deoxygenated hemoglobin concentration,and then reflect the state of brain cortex function.Its greatest advantage is to allow the subjects head moving in a certain range,especially suitable for children.At present this technology could be applied to clinical pediatric,such as epilepsy,autism,attention deficit/hyperactivity disorder,neonatal disease,neurosurgery and cardiovascular surgery,etc.Functional near-infrared spectroscopy technology will have more applications in the field of research on brain function.

Objective To investigate the effect of glutamic acid (monosodium glutamate,MSG) on Tourette's syndrome (TS). Methods These rats were divided into 2 groups: one group with acute intracerebroventricularly injection (ICV) of MSG or artificial cerebrospinal fluid (CSF), and another group with chronic administration of MSG in a dose of 40 mg/kg in drinking water everyday. Observers who were blind to the two- part subjects assessed the scores of TS- like stereotyped locomotion. Results 1. These groups of 100 ?g or 200 ?g glutamic acid may induce significant TS - like stereotyped locomotion ( P

Objective To investigate the effect of the personalized nursing care plan sheet for critically ill patients in the emergency intensive care unit. Methods The personalized nursing care plan sheet including general, personalized nursing issues and related measures was designed according to the standard from the nursing department. A group of 116 critically ill patients were divided into the observational group (58 patients) and control group (58 patients) from January 2012 to September 2014. The personalized nursing care plan sheet were applied for record and hand over in the observational group, while the unified problem statement nursing care plan sheet were used in the control group. The indicators of nursing quality were observed in the two groups and the nurses′satisfaction with the nursing care plan sheets was compared. Results The nursing quality in the observational group was higher than it in the control group with the lower incidence of failure rate in fundamental nursing, professional nursing, plan sheet, disease treatment and adverse event (32.76% vs. 62.07%,37.93% vs. 67.24%,29.31% vs. 68.97%, 20.69% vs. 53.45%, 10.34% vs. 72.41%, the χ2 values were 2.98, 2.98, 4.09, 3.46 and 6.60 respctively, P<0.05). The nurses′satisfaction with the personalized nursing care plan sheet was also higher than the unified problem statement nursing care plan sheet (P<0.05). Conclusion The incidence of nursing defects could be reduced by avoiding the incomplete nursing assessment and omitted nursing plan.

Objective To explore prognostic relative factors of different therapy for patients with intracrani-al aneurysm. Methods In 93 intracranial aneurysm patients, 38 cases were managed through craniotomy, in whom the effects of operation time, intraoperative aneurysmal rupture(IAB), temporary arterial occlusion (TAO)on 30-day and 6-month prognosis were investigated; while other 67 cases experienced endovascular treatment,in whom the simi-lar parameters of the different therapy, types of endovascular treatment, and intracranial aneurysm embolization were evaluated. 30 days and 6 months prognosis were regarded as the dependent variable, and SPSS for Windows 11.5 was adopted for data processing. Chi-Square test was performed. Results IAR exerted significant difference to 30 days and 6 months prognosis in patients undergoing craniotomy and clipping, there were 42 intracranial aneurysm, of which 16 aneurysm ruptured (χ2 = 5. 203,10. 886, P < 0.05 ). For patients undergoing endovascular treatment, the new ma-terial application could improve 6 months prognosis, in whom there were totaly 74 intracranial aneurysm, of which 23 aneurysm were managed by the use of old material for endovascular treatment and 51 aneurysm were managed by the use of new material for endovascular treatment(χ2 = 5. 544 and RR = 2. 364,95% CI 1. 197～4.669 ,P < 0.05 ). Un-successful ratio in the endovascular treatment was reduced simultaneously,from 43.5% (old material group) to 18.0% ( now material group) (χ2 = 5. 542,P < 0.05). Conclusions IAR is the important risk factor, which effects 30 days or 6 months prognosis of patients with intracranial aneurysms managed through craniotomy and clipping. The new material application in the endovascular treatment improves 6 months prognosis, meanwhile unsuccessful ratio in the endovascular treatment is reduced simultaneously.

Objective:To observe the influence of Xinfeng capsule(XFC) on pulmonary HRCT images and cytokines(TNF-?,IL-10) in blood serum adjuvant arthritis rats.Methods:60 rats were averagely divided into normal control group,model control group,methotrexate(MTX) treated group,tripterygium wilfordii polycoride tablet(TPT) treated group, XFC treated group,12 in each.Except for the rats of normal group,the others were intracutaneously injected with 0.1 ml of Freund’s complete adjuvant in the right hindlimb.After 19 days,different drugs were given to all rats. Pulmonary HRCT images were obtained and the blood samples were reserved for assaying cytokines.Results:In model control group ,the lungs’ outlines weren’t clear and the blood vessels expanded with the edges of them being obscure and unregular. There were high density images shaped as rope and slip in lungs of model control group rats and the pleura near the images were a little thickening. In MTX treated group, there were high density images shaped as slice along pulmonary veins. The veins of the blood vessels were obscure and the edges were unclear. In TPT treated group,there were multiple high density images shaped as tubercle and slice and the boundary were not clear. In XFC treated group, the lungs’ outlines were clear and the veins were well-distributed. High density images shaped as spot were found in part lungs. Compared with normal control group,tumor necrosis factor-?(TNF-?) in blood serum ascended obviously in model control group(P0.05).Conclusion:XFC eliminates swelling by down-regulating the levels of TNF-?, up-regulating the levels of IL-10, restraining the inflammatory reaction.In adittion,cytokines participated in forming pulmanory fibrofication.So the changes of pulmanory HRCT images were also improved at the same time.

Objective To compare the Legionella contaminative status of the cooling water system with freezing water system in central air conditioning system. Methods Legionella was tested in water and samples of all components from the cooling tower, condenser, swelling water box and evaporator of central air conditioning among 26 public places. Results The total detected rate of Legionella was 64.0% among 100 samples from two kinds of water system, 71 strains of Pneumophila legionella were separated. The detected rates were 75.0% and 52.1% in the cooling water systems and freezing water systems respectively. The amount of Legionella was more than 100 per milliliter in the cooling water systems. The detection rate of cooling tower water and swelling water box water was 100% in the air conditioning system run for over 10 years and 5-10 years. Concordance rate of consequence was 50.0% in cooling tower water and condenser water of the cooling water systems, the rate was 55.0% in swelling water box water and evaporator water of the freezing water systems. Conclusion This study suggested that more attention should be paid to the contaminative status of Legionella in freezing water system of central air conditioning system. Cooling tower and swelling water box should be the key parts in cleaning and disinfection of air conditioning system.

Objective To improve the diagnosis and treatment for malignant adrenal tumors. Methods Clinical data of 50 cases of malignant adrenal tumors were retrospectively analyzed.Of them 7 cases of corticoadrenal carcinoma with endocrine function presented with relevant symptoms and endocrine abnormality.Among 23 cases of malignant pheochromocytoma high blood pressure existed in 19 and 18 had a high level of urinary catecholamine.Fifteen cases had corticoadrenal carcinoma without endocrine function and 5 cases developed adrenal metastic carcinoma.All of the patients underwent endocrinological and image examination before operation. Results Among the 27 cases of corticoadrenal carcinoma or metastasis,25 were confirmed by pathology and 2 were confirmed during follow-up.Of the 23 patients who were diagnosed as malignant pheochromocytoma,11 were confirmed to have extensive tumorous infiltration or metastasis by imaging procedures and operations and 12 were detected by follow-up to have metastasis.Tumors were resected in 14 cases of corticoadrenal carcinoma,8 of whom survived for 1～5 years.Twelve cases of malignant pheochromocytoma underwent radical operations with a survival of 1～14 years. Conclusions Most cases of corticoadrenal carcinoma can be diagnosed by pathology or image findings of metastasis.Pheochromocytoma is more likely to be malignant when it recurs,expecially for the extro-adrenal pheochromocytoma.The diagnosis of malignant pheochromocytoma must depend on the evidence of tumorous infiltration or invasion of the tissue without para ganglions found by imaging procedures or pathology.The prognosis of the late-stage corticoadrenal carcinoma is poor.For the cases of late-stage malignant pheochromocytoma dibenzyline or 131 I-MIBG treatment can extend their lives.

Objective To investigate the adverse reactions induced by statins when combined with other drugs and its influencing factors,so as to provide reference for clinical rational drug use.Methods The clinical data of 78 patients with adverse reactions caused by statins combined with other drugs in our hospital from June 2011 to June 2016 were reviewed and analyzed.Results The adverse reactions of the 78 cases of patients were manifested as muscle toxicity,liver toxicity,digestive discomfort,respiratory discomfort,et al; Inwhich muscle toxicity and liver toxicity were the most common adverse reactions.The incidence rate of rhabdomyolysis was 20.51％,which was significantly higher than that of the other adverse reactions(P<0.05).The incidence rates of adverse reactions induced by simvastatin and atorvastatin were 44.87％and 28.21％,significantly higher than other statins(P<0.05).The incidence of side effects was the highest(30.77％)when the statins combined with antihypertensive drugs and anti myocardial drugs,and the incidence of adverse reactions was 20.51％when combined with lipid-lowering drugs.Conclusion The adverse reaction rate is relatively high when statins,especially simvastatin and atorvastatin combined with antihypertensive,anti-myocardial and lipid-lowering drugs,and the adverse reactions to liver toxicity and muscle toxicity are the main performance.Therefore a standardized and rational medication regimen should be made based on the clinical characteristics of patients and the type of drug in the clinical use of statins,in order to reduce the incidence of adverse reactions to the maximum limit.

Objective To discuss the techniques of ventricular endoscopy for obstructive hydrocephalus.Methods A total of 33 patients with obstructive hydrocephalus were treated by ventriculostomy using ventricular endoscopy from June 2003 to December 2006.The patients had received CT,MRI,and 99mTc-DTPA cistern SPECT before the surgery.Results Endoscopic third ventriculostomy was performed successfully in 32 patients,the other patient died of hemorrhage under the third ventricle fistula.Postoperative fever occurred in 13 patients.One patient developed bilateral chronic subdural hematoma 6 months after the operation,and was cured by drill and drainage.Three patients developed subdural hydroma 6 months postoperation without showing symptoms.They were monitored without any treatment.The 32 patients were followed up for 2-42 months(mean,16.7 months),all of them achieved clinical relieve.In the patients,the intracranial pressure(ICP) was 26(16-39) cm H2O before the operation,and was significantly decreased to 22(12-28) cm H2O 7 days after the operation(t=2.903,0.005