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

Humans ; Otitis Media ; classification ; surgery ; Practice Guidelines as Topic

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 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 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 analyze the diagnostic values of plasma albumin and total bilirubin, serum uric acid and inflammatory cytokines levels in patients with bipolar disorder.Methods A total of 48 cases of bipolar disorder patients were selected as research subjects ( study group) , and 45 cases of healthy people in the same period were chosen as control group.The plasma albumin, total bilirubin and serum IL-1β, IL-4, uric acid levels were compared and analyzed between two groups.Results The serum albumin, total bilirubin levels in study group were significantly lower than those in healthy control group, with significant difference (P<0.05).The serum IL-1β, IL-4 levels in study group were significantly higher than those in healthy control group, with a statistically significant difference (P<0.05).The serum uric acid levels in study group was significantly higher than that in healthy control group, with significant difference (P<0.05).Conclusion The serum albumin, total bilirubin and serum IL-1β, IL-4, uric acid levels can be used as a diagnostic reference index for bipolar disorder.

Objective:To investigate the function of the quality factor in the growth of the total heath expenditure, in order to provide references for making the object of the health policy. Methods: Through the decomposition the identical equation of the growth of the total expenditure on health, to analyze the contribution of medical service quality and its factor. Results: The sustaining improvement of medical service quality in the important factor on the constant growth of the total expenditure on health. Conclusion: The primary objective of health policy is to improve the quality of medical services, and the secondary is to control the expense.

Objective To explore the applicability of the Perceived Stress Scale(PSS) in Chinese medical students.Methods 773 medical students completed the PSS and the Depression Anxiety Stress Scale (DASS).The reliability and validity of the PSS were analyzed.Results The exploratory factor analysis showed that two factors were extracted from the scale,which could explain 53.74％ of the total variance.The confirmatory factor analysis verified that the structure of the PSS was two-dimensional (x2/df =2.863,CFI =0.943,TLI =0.924,GFI =0.951,AGFI =0.921,RMSEA =0.07).The internal consistency coefficient of the PSS,the perceived stress subscale and the perceived coping ability subscale were 0.858,0.852 and 0.750.The relationship between the PSS and the DASS was significant,which demonstrated that the PSS had a good criterion-related validity.In addition,t-test showed that girls had a higher level of the perceived stress than boys (t =-2.574,P =0.01),and students who lived in rural had a higher level of the perceived stress than students who lived in urban (t =2.788,P =0.005).Conclusion The study indicates that the PSS has a high level of the reliability and validity,and it is worthy of exploring the perceived stress in medical students.