OBJECTIVE:To find out an effective way to control the unreasonable increase of drug expenses.METHODS:To analyse and evaluate the role of pharmacoeconomic research in suppression of unreasonable increase of drug expenses.RESULTS:The best therapeutic scheme could be found out by pharmacoeconomic research through the way of determination of the cost and efficacy of pharmacotherapy,and the unreasonable increase of drug expenses could also be cut down in5aspects.CONCLUSION:Pharmacoeconomic research is a practical and feasible way to control unreasonable increase of medical expenses.

Acupuncture Therapy ; Adult ; Aged ; Angina, Unstable ; drug therapy ; physiopathology ; therapy ; Cardiovascular Agents ; administration & dosage ; Combined Modality Therapy ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Male ; Middle Aged

Splenectomy for patients with cirrhosis has been well established.However,many issues in relation to postoperative management of these patients remain to be elucidated,mainly including reasons for portal vein thrombosis and anticoagulant use.In light of recent progresses on this topic,the current review summaries and pinpoints influencing factors of portal vein thrombosis,anticoagulant selection and corresponding rationales,monitor measures for anticoagulation,and treatment schemes for bleeding induced by anticoagulation.Our review focuses on issues associated with the selection and withdrawal time of anticoagulant.We conclude that patients undergoing splenectomy can benefit from postoperative anticoagulation,including enhanced postoperative recovery and decreasing incidence of postoperative complications.

Objective To study the effect of danshao shugan granule combined with metformin in treatment of nonalcoholic fatty liver and its effects on lipid and uric acid metabolism.Methods 80 patients of nonalcoholic fatty liver who received therapy from February 2014 to February 2015 in our hospital were selected as research objects.According to random number table,those patients were divided into the observation group (n=40) cases in each group and the control group (n=40).The control group was treated with metformin, while the observation group was treated with danshao shugan granule combined with metformin.Then blood lipid level, FBG, FINS, IR, SUA level, SOD, MDA level, therapeutic effect of two groups after treatment were compared.Results After treatment, TG,TC in observation group was significantly less than the control group (P<0.05); FBG, FINS, IR, SUA levels in the observation group were significantly lower than the control group ( P<0.05 ); SOD level higher than the control group, MDA level significantly less than the control group (P<0.05); The total effective rate of observation group was statistically higher than that in the control group (P<0.05).Conclusion Danshao shugan granule combined with metformin is well for nonalcoholic fatty liver,which can improve the glucose, lipid, uric acid metabolism and insulin resistance, and can protect the liver function.

Objective To evaluate the relationship between NK cytotoxicity and anemia in uremia. Methods The effect of rHuEPO on natural killer (NK) cell cytotoxic activity was studied in 12 hemodialysis(HD) patients. Results The levels of hemoglobin (Hb) and NK cell activity were significantly lower in HID patients than that in healthy controls. After two months of the treatment with rHuEPO, the levels of Hb in these patients rose significantly with a parallel rise in NK cell activity. NK cell activity was not increased when they were incubated with rHuEOP but was increased with red blcxxl cells. Conclusion Improved NK cell cytotoxicity in HD patients after treatment with rHuEPO was achieved through the rise in R15C rather than through rHuEPO itself.

Objective To determine the expression of advanced glycation end products(AGE) binding proteins on human joint synovial cells for elucidating the pathobiological effects of ?2m modified with AGE(AGE-?2m) on joint resident cells. Methods Type A and type B synovial cells were isolated and cultured in vitro. The expression of AGE receptor 1 (ACE-R1 ), AGE receptor 2 (AGE-R2), AGE receptor 3 (AGE-R3) and 35 KD receptor for AGE(RAGE) on synoviocytes were detected by immunofluorescent staining using specific antibodies and flow cytometric analyses. mRNA of AGE receptors was examined by RT-PCR techniques.-Results RAGE and AGE-R3, but not AGE-R1 and AGE-R2, were constitutively expressed on the membrane surface of both type A and type B synovial cells. These two types of synovial cell also expressed mRNA of RAGE and AGE-R3. Conclusion Human joint synovial cells express specific AGE binding proteins, RAGE and AGE-R3, suggesting that these cells may be involved in AGE metabolism and might be the target of the biological effects of AGEs in dialysis-related amyloidosis.

Objective To elucidate the mechanism of accelerated apoptosis of monocytes in patients with lupus nephritis (LN). Methods 17 LN patients were enrolled in the study and 15 healthy volunteers were selected as controls. The expression of Faa and Fas ligand (FasL) was examined by immunofluorescent staining and flow cytometer analysis. The apoptosis and survival rate of monocytes cultured in vitro with human FasL (rHu-FasL) was analyzed by flow cytometer analysis and 5-diphenyl tetrazolium bromide (MTT) staining, respectively. Results Faa expression on monocytes was significantly higher in LN patients than that in healthy subjects. There was no difference of monocytes Fas expression between active LN patients and silent LN patients. There was no detectable FasL expression on monocytes from both LN patients and healthy controls. When monocytes cultured in vitro with rHu-FasL, there was a significantly increasing apoptosis and a decreasing survival rate of monocytes in LN patients as compared to healthy controls. Conclusion The up-regulated expression of functional Fas on monocytes may contribute to the accelerated apoptosis of monocytes in LN patients.

To elucidate the effects of pro inflammatory mediators on mRNA expression of AGE receptors in type B synovial cells, type B synovial cells from normal subjects were isolated and cultured in vitro with human serum albumin modified with advanced glycation end products (AGE HSA), tumor necrosis factor ?(TNF ?)and interleukin 1?(IL 1?). The expression of RAGE mRNA and AGE R3 mRNA was examined by RT PCR techniques. TNF ?, AGE HSA and IL 1? up regulated the expression of AGE R3 mRNA in type B synovial cells in a dose and time dependent manner. In contrast, TNF ? and AGE HSA down regulated the expression of RAGE mRNA in a dose and time dependent manner. IL 1? had no effect on RAGE mRNA expression. The regulatory responses induced by AGE HSA were blocked by a neutralizing polyclonal anti human TNF ? antibody, suggesting that the effects of AGE HSA were mediated by TNF ?. The proinflammatory mediators may regulate the gene expression of AGE receptors in type B synovial cells, and the regulatory role of these receptors is different in response to the proinflammatory mediators.

The purpose of this study was to explore the incidence of tuberculosis (TB) in chronic renal failure (CRF) patients with or without renal replacement therapy and to evaluate the effect of chemoprophylaxis on incidence of active TB. A total of 3360 CRF patients from April 1989 to Sept. 2002 were enrolled in this study. Chemoprophylaxis for TB was given to the patients with increased serum anti PPD IgG levels from Jan. 1995 to Sept. 2002. The prevalence of active TB during this period was compared with that of the historical control group from April 1989 to Dec. 1998 (without prophylaxis). The results showed that the overall incidence of active TB in all patients was 2 4% (82/3360). Extrapulmonary TB was the most common feature (75 6%) with the major infective sites in pleura (20 7%) and lymph node (17 7%). There were 58 5% patients with active TB showing increased serum and/or serous exudate anti PPD IgG levels and 24 2% patients showing positive TB bacillus DNA (PCR). The total incidences of TB (1 76%) and disseminated TB (2 3%) in the chemoprophylaxis group were significantly lower than those in the non chemoprophylaxis group (4 1% and 7 5%, respectively, P

Objective: Enhanced expression of adhesion molecules on synovial tissu e has been demonstrated in patients with dialysis-related amyloidosis (DRA). T he study was conducted to elucidate the mechanisms by which the expression of adh esion molecules on synovial cells was up-regulated.Methods: Human type-B synov ial cells were cultured in vitro with β2-microglobulin modified with adva nced glycation end products (AGE-β2m) , native β2-microglobulin (β2 m) , tumor necrosis factor-α（TNF-α）and interleukin -1β（ IL-1β）. The expression of intercellular adhesion molecule-1(ICAM-1), vasc ular cell adhesion molecule-1(VCAM-1), and E-selectin was examined by immunofluor esc enct staining and flow cytometer analysis. Results:ICAM-1 and VCAM-1, but not E -selectin, were constitutively expressed on human type-B synovial cells. TNF -α a nd IL-1β enhanced the expression of ICAM-1 and VCAM-1 in a dose- and time - depen dent manner. Neither of these cytokines appeared to induce the expression of E - selectin. Both β2m and AGE-β2m had no direct effect on the expression of the a dhesion molecules.Conclusion: Elevated level of IL-1β and TNF-α in the synov ial tissue may up-regulate the expression of adhesion molecules on synovial cel ls and therefore promote local monocytes infiltration.