OBJECTIVE:To clarify the trend of drugs used in Shanghai District and the relationship between drug-use and medical insurance reformation METHODS:Data of the period 1998～2000 was analysed which was provided by hospital drug use analysis system of 46 hospitals in Shanghai District RESULTS:Total value of purchase in 2000 increased by a wide margin in comparison with those in past 2 years The increasing range of imported drugs reduced and that of domestic drugs increased year by year While the increasing rangs of joint venture products kept stable The percentages of the purchase value of the first 100 and 15 kinds of drug in total value of purchase declined year by year The sequence of drugs did not change in 2000 compared with that in 1999 CONCLUSION:There is a close relation between the trend of drug consumption and medical insurance reformation

Setting quantity and quality of services as the base, patient satisfaction as the core of the performance appraisal and salary distribution system are important content of the current comprehensive reform of township hospital. To guarantee the profits for public in township health cares, prevent profiteering behavior, mobilize the staff’s work enthusiasm and establish an effective performance appraisal and salary distribution system are the most focused and considered problems for a great number of township health cares. The example hospital introduced the “progressive scoring” and “incremental increase in return”, which had positive effect.

Objective To detect the expression of Id1 and p53 in human breast cancer and study their relationship. Methods To choose 80 cases of breast cancer from the surgical department of Tangshan people's hospital. All patients didn't get radiotherapy and chemotherapy before surgery. The expression of Idl and p53 of breast cancer were studied by using SABC immunohistochemistry. Results The expressions of Id1 were found in cytoplasm, while the expression of p53 was found in cell nucleus. The positive rates of Id1 and p53 were 87.5 %(70/80)and 90.0%(72/80) respectively in breast cancer tissues. The expression of Id1 and p53 were significantly higher in breast cancer tissue than those in adjacent non-tumor breast tissues,benign tumor tissues and normal breast tissues(P ＜0.05). The positive rates and expression intensity of Id1 in breast cancer had significant correlation with lymph node metastasis and pTNM stage of the tumor, but had no significant correlation with age, histological differentiation and tumor size. The positive rates and expression intensity of p53 in breast cancer had significant correlation with lymph node metastasis of the tumor, but had no significant correlation with age, histological differentiation,tumor size and pTNM stage. Conclusion Expression of Id1 in human breast cancer is up-regulated. Its expression is associated with lymph node metastasis and TNM stage and represents an independent marker for prognosis of breast cancer. To reduce the expression of Id1 will become the strategy of curing breast cancer. Expression of Id1 and p53 in human breast cancer have the same clinic significance. Each of them can represent an independent marker for prognosis of breast cancer.

Objective To investigate the treatment effect and some related fators of the improved lacrimal duct flushing technique for the adult patients with chronic dacryocystitis in the primary hospital.Methods Fifty -seven adult patients (fifty -seven eyes) with chronic dacryocystitis received the improved lacrimal duct flushing treatment.Fifty -seven patients were divided into two groups according to the first time to see a doctor and receive the improved lacrimal duct flushing treatment cooperated with drug application and assistant therapies.The effect and safety of the treatment and some related factors were analyzed.Results There was no statistical difference between the overall efficency of the two groups(A group 76.2%,B group 72.2%,χ2 =0.108,P =0.987 >0.05).The innero-cular pressures showed no statistical difference between pre -treatment and 1 month after treatment(the pre -treat-ment innerocular pressure:18.470,the post -treatment innerocular pressure:18.512,t =-0.315,P =0.754 >0.05).The correlation analysis between the conditions of lacrimal passages and treatment effect(r =0.814,r2 =0.663,P =0.002 <0.05),between the germiculture of the discharge of lacrimal sac and treatment effect(r =0.814, r2 =0.663,P =0.000 <0.05) showed statistical significance.Conclusion The improved lacrimal duct flushing technique cooperated with drug application and assistant therapies is safe and well effective to the adult patients with chronic dacryocystitis in the early stage.

Objective To study the change of serum procalcitonin(PCT) expression level and to investigate its clinical value for predicting the prognosis in the patients with severe acute pancreatitis (SAP) .Methods Totallay 48 inpatients with SAP in our hos‐pital from April 2012 to April 2014 were retrospectively analyzed .The PCT levels during different hospitalization period in the sur‐vial group and the death group were detected and analyzed .The scores of acute physiological and chronic health evaluation Ⅱ (A‐PACHE Ⅱ) were compared between these two groups .Results (1)The clinical characreristics of gender ,body temperature and WBC had no statistically significant differences beween the survival group and the death group (P>0 .05) ,but the PCT level had statistical differencet (P<0 .05) .(2)There was no statistically significant difference in the PCT level and APACHE Ⅱ score at ad‐mission between the two groups .In the later treatment process ,the PCT level and APACHE Ⅱ score in the survival group were progressively decreased ,while which in the death group were progressively inecreased (P<0 .05) .WT5HZ〗Conclusion PCT has an important clinical value in forcasting the prognosis of SAP .

Excision repair cross complementing group 1 (ERCC1) gene is an enzyme of the speed limit of DNA repair protein in nucleotide excision repair (NER) pathways.Researches suggest that ERCC1 has been associated with cisplatin resistance in non-small cell lung cancer (NSCLC) patients.Thus,ERCC1 gene is a new target in malignant tumor gene therapy research,providing a new approach for the treatment of malignant,especially NSCLC.

Matrix metallopmteinase 9(MMP-9) is one kind of matrix metalloproteinases and plays a role in the process of breast cancer metastasis. It can not only degrade the basement membrane and the extracellular matrix around tumor tissue but also promote angiogenesis, even create conditions for the growth of tumors, local invasion and distant metastasis. Current study shows that the over-expression of MMP-9 can significantly speed up the breast lymph node metastasis and the relevant research will provide guidance for clinical treatment and prognosis of breast cancer.

Objective To investigate the correlation between clinicopathological parameters and the expressions of inhibitor of differentiation/DNA binding 3 (Id3), vascular endothelial growth factor (VEGF) and human epidermal growth factor receptor-2 (HER-2/C-erbB-2) in patients with breast cancer. Methods The protein expressions of Id3, VEGF and C-erbB-2 were detected by SABC immunohistochemistry in 70 spceimens of breast cancer, 40 specimens of tissue adjacent to breast cancer, 20 specimens of fibroadenoma and 20 specimens of normal breast tissue. Results The expressions of Id3, VEGF and C-erbB-2 in breast cancer tissue (88.6%, 95.7% and 20.0%, respectively) were significantly higher than that in the other tissues (P0.05), while the expression of C-erbB-2 protein substantially varied among the patients of breast cancer in different pTNM stages (P

Objective To study the correlation between abdominal near-infrared spectroscopy monitoring and the risk of necrotizing enterocolitis (NEC) in preterm infants.Method From September 2015 to June 2016,preterm infants admitted to the NICU of our hospital were enrolled in this study.Nearinfrared spectroscopy (NIRS) was used to monitor the tissue oxygen saturation (StO2) of lower right abdomen of the patients.These preterm infants were assigned into NEC group and non-NEC group depending on whether NEC was developed during hospitalization.The abdominal StO2 within the first week after birth were compared between the two groups.Result A total of 77 infants were enrolled in this study,18 preterm infants in the NEC group and 59 in the non-NEC group.The gestational age and birth weight of the patients in the NEC group were lower than the non-NEC group.The NEC gioup had significantly higher incidences of mechanical ventilation,vasoactive agent usage and comorbidity of infection than the non-NEC group (P ＜0.05).No significant differences in the proportion of gender,application of umbilical venous catheters and the incidence of patent ductus arteriosus between the two groups (P ＞ 0.05).The abdominal StO2 of the NEC group was significantly lower than the non-NEC group (69.0％ ± 5.8％ vs 82.8％ ± 6.7％,P ＜0.001).Multivariate logistic regression analysis showed that lower abdominal StO2 is an independent risk factor for NEC (OR =0.676,95％ CI 0.548 ～ 0.834,P ＜ 0.001).Conclusion Abdominal NIRS monitoring may be helpful for the early diagnosis of NEC.

BACKGROUND:Smoking is one of the major risk factors for the formation of atherosclerosis. OBJECTIVE:To investigate the effect of cigarette smoke extract on the concentration of GATA-2 in the vascular smooth muscle cells and in which the role of the early growth response factor-1. METHODS:Vascular smooth muscle cells were cultured in vitro. The vascular smooth muscle cells were treated with various concentrations of cigarette smoke extract (0, 5%, 10%, 20%), then the reverse transcription PCR was applied to detect the mRNA expression of GATA-2. The vascular smooth muscle cells were treated with cigarette smoke extracts in the optimal concentration for 0, 4, 8, 12 and 24 hours, and then the expression of GATA-2 mRNA was observed, as wel as the changes of expression of GATA-2 mRNA after added with growth response factor-1. RESULTS AND CONCLUSION:Compared to the 0 concentration group, the expression of GATA-2 mRNA after treated with low concentration (5%) of cigarette smoke extract was increased more significantly than moderate concentration (10%) and high concentration (20%). The vascular smooth muscle cells in 0 hour group expressed GATA-2 mRNA at low level. The GATA-2 mRNA began to increase within 4 hours and reached peak at the 8 hours after stimulated with cigarette smoke extract of 5%concentration. After added with growth response factor-1 inhibitors, the expression of GATA-2 mRNA in 5%cigarette smoke extract induced vascular smooth muscle cells was decreased. Cigarette smoke extract can promote the increasing of GATA-2 by growth response factor-1, while the GATA-2 expression is reduced after the inhibition of growth response factor-1.