OBJECTIVE:To discuss the management tactics and developmental prospects of fair-price drug stores in China.METHODS:To analyze the advantages and disadvantages of fair-price drug stores and countermeasure.RESULTS&CONCLUSION:Development of fair-price drug stores need not only support of governments but also the improvement of drug and service quality by strengthening physical distributions,renewing management methods and bringing up specialists.

Objective To study the echocardiographic characteristics and its diagnosis value on congenital supravalvular aortic stenosis (SVAS) in children. Methods Thirty-one patients with SVAS diagnosed by multiplane echocardiography were enrolled in the study. Their echocardiographic characteristics were compared with cardiac catheterization, operation, and gene detection results. Echocardiographic changes were mainly observed in aortic valve, supravalve, descending aortic arch, pulmonary artery valve, main pulmonary artery and its branches,and coronary artery. Results Of the 31 patients,26 had hourglass type SVAS,4 hypoplastic type,and 1 membranous type; 2 patients had extremely mild stenosis (defined as a Doppler gradient <25 mm Hg) ,20 mild (25～49 mm Hg) ,5 moderate (50～75 mm Hg) ,and 4 severe C>75 mm Hg) ones. Nineteen patients were diagnosed with Williams syndrome by gene detection. Three patients were associated with aortic valve stenosis including one missed at the initial diagnosis; 10(32.26%) patients with pulmonary stenosis, including pulmonary valve stenosis in 6, left and right pulmonary artery stenosis in 3 ,and branch stenosis in 1:6 patients with coronary stenosis. Conclusions The sternal border and five chamber apical views are the best to detect SVAS. Williams syndrome patients are prone to SVAS.Pulmonary stenosis echocardiography forms a great proportion of the SVAS patients. Routine examination is necessary for coronary stenosis in cases of SVAS.

Objective:The paper aims to evaluate the impacts of the urban residents’ basic medical insurance on the medical treatment and preventive care services utilization through quantitative evaluation. Methods:The China Health and Nutrition Surveys ( CHNS) Data collected from 2006 to 2011 were used to compare the difference between medical treatment and preventive care services utilization adopting the difference-in-difference method and the Probit model. The control group urban residents did not participate in the basic medical insurance while their treatment group participated. Results:The medical treatment and preventive care services utilization were more for the treat-ment group than they were for the control one. The age, education level, annual per capita income and hypertension influenced the medical services utilization, and the annual per capita income was a protective factor. The age and ed-ucation level also influenced the preventive care services utilization. Conclusion: The urban resident basic medical insurance plays an important role in the medical treatment and preventive care services utilization. Meanwhile, this factor continuously enhanced the coverage and the per capita income protection for medical services.

Objective To assess the value of the adjacent vessel sign (AVS)in differentiating malignant from benign lesions on breast MRI at 3.0 T.Methods Total 64 patients with 64 breast lesions including 35 malignant and 29 benign ones,underwent breast dynamic contrast enhanced MR scan.The 3D maximum intensity projection images were gotten and used to review the lesions.Sen-sitivity and specificity of the AVS were evaluated,and the reasons of the false positive and false negative lesions were also analyzed. Results The AVS differed significantly between benign and malignant lesions (P<0.001;positive-predictive-value:88.6%,sensi-tivity:88.6%,specificity:75.9%).Conclusion The adjacent vessel sign is significantly associated with malignancy.Thus,there is of great importance of this sign in differentiation of begnign and malignant lesions.

Objective To evaluate the clinical efficacy and safety of iMliximab (IFX) in the treatment of Crohn's disease (CD).Methods From February 2009 to March 2013,the clinical data of 62 CD patients with IFX treatment were retrospectively analyzed.At week 14th after IFX injection and the end of follow-up of this study (March 2013) were two observation points.At week 14th after IFX injection (three times of IFX injection),C reactive protein (CRP) level,Crohn's disease activity index (CDAI) score and clinical remission were investigated.At the end of follow-up,clinical remission,fistula closure,mucosal healing and side effects were inspected.Normal distribution data were expressed as 2±s,which were compared with t test.Non normal distribution data were expressed as M (QL-QU) and compared with Wilcoxon test.Results Four cases without complete three times of IFX injection and one case lost to follow-up were eliminated.And nine postoperation cases with IFX treatment to prevent recurrence after surgery were excluded.A total of 48 cases of CD in active period were enrolled in this study on efficacy.At week 14th,CRP level of 48 patients [1.9(0.5,5.4) mg/L]decreased compared with that before treatment [28.9(6.4,51.1) mg/L] (Z=-5.468,P＜0.01);CDAI score (87.0±35.8) also decreased compared with that before treatment (245.1±59.1) (t=18.579,P＜0.01).At week 14th,46 patients in active period achieved clinical remission and the remission rate was 95.8％.By the end of follow-up,38 patients were still in remission period and the remission rate was 79.2％.Among 26 patients with anal fistula before IFX treatment,seven cases (26.9％) were completely closed,17 cases (65.4％) was partially closed and two cases was responseless.Fifteen patients were reviewed by colonoscopic examination after more than six times of IFX treatment.The median of simple endoscopic score for Crohn's disease (SES-CD) was 3 (0,5)after treatment,which decreased compared with that before treatment (8(7,9),Z=-3.306,P=0.001).Twenty-two of 48 cases in active period received,step-up strategy and 26 cases received with top-down strategy.At week 14th,20 cases (90.9％) of group with step-up strategy and 26 cases (100.0％) of group with top-down strategy were in remission period.By the end of follow-up,14 cases (63.6％) of group with step-up strategy and 24 cases (92.3％) of group with top down strategy maintained remission.Among 26 cases with anal fistula,two cases without response were treated with step-up strategy and seven cases with complete closure were all with top-down strategy.Among 62 patients,five had side effects,three of whom had acute infusion reaction,one had delayed infusion reaction and the other had anemia.Conclusions IFX had good clinical efficacy in controlling inflammation,inducing clinical remission,promoting fistula closure and mucosal healing in CD patients.For some CD patients with high risk,the initial top-down strategy showed good clinical efficacy.

Objective To study the chemical constituents in the leaves of Piper laetispicum.Methods Compounds were separated and purified by silica gel column and macroporous resin.Their structures were identified on the basis of spectral methods.Results Sixteen compounds were isolated and identified from the leaves of P.laetispicum:(2E,4E)-N-isobutyl-11-phenylundecadienamide(Ⅰ),(2E,4E)-N-isobutyl-15-phenylpentadecadienamide(Ⅱ),laetispicine(Ⅲ),(2E,4E)-N-isobutyl-7-(3',4'-methylene-dioxyphenyl)heptadienamide(Ⅳ),brachystamide A(Ⅴ),dihydropipercide(Ⅵ),pipermacramide A [(2E,4E)-N-isobutyleicosadienamide,Ⅶ],(+)-spathulenol(Ⅷ),d-sesamin(Ⅸ),piperitol(Ⅹ),vitexin(Ⅺ),vitexin-2″-O-?-D-glucoside(ⅩⅡ),N-p-coumaroyltyramine(ⅩⅢ),?-sitosterol(ⅩⅣ),stigmasterol(ⅩⅤ),and 1-dotriacontanol(ⅩⅥ).Conclusion Compounds Ⅰ and Ⅱ are isolated for the first time as natural substance,compounds Ⅴ,Ⅵ,and Ⅷ are first isolated from P.laetispicum,compounds Ⅺ,ⅩⅡ,and ⅩⅥ are obtained from the plants of Piper L.for the first time.

Objective To explore the clinical features and the management of incision of scalp pain after craniotomy. Methods 129 patients after craniotomy without postoperative neuralgia were involved. The onset, severity, and characteristics of the pain were recorded within 1 week after the craniotomy. Patients with moderate-severe pain were given oxycodone and acetaminophen (treatment group) or rotundine (control) for 3 d. Results 39.5%（51/129）of patients experienced moderate to severe postoperative pain. After treatment, 76.9% （20/26） in treatment group and 36.0% （9/25） in control were released from the pain (P<0.01). The pain intensity differences and sum of pain intensity differences were more in treatment than in control (P<0.01). Conclusion Incision of scalp pain is common after craniotomy. Oxycodone and acetaminophen, called multimodal analgesia is efficacious and safe for it.

Objective To investigate the effect of ultrasound-guided subcostal transverses abdominis plane (TAP) block with dexmedetomidine after laparoscopic radical operation. Methods 40 patients underwent laparoscopic radical operation for colorectal cancer were randomized into dexmedetomidine group (group DEX) and control group (group CON). All the patients received ultrasound-guided subcostal TAP block after operation, Group DEX with dexmedetomidine 1 μg/kg and 0.25% ropivacaine to 20 ml, and group CON with 0.25% ropivacaine 20 ml. All the patients were assessed with Ramsay scores and the pain at rest and on coughing were assessed with Visual Analogue Scale (VAS), 2, 6, 12, 24 and 24 hours after operation. The highest level and the duration of sensory blockade, the first time and the total times of pressing the analgesia pump in the first day after operation, and the requirements of sufentanil were recorded. First flatus time, first diet time and the length of hospital stay were compared. Results The scores of VAS were significantly less (P<0.001), and the Ramsay scores were more in the group DEX than in the group CON (P<0.01) 2, 6 and 12 hours after operation; with the longer time of sensory blockade (P<0.001), the later to first press the analgesia pump (P<0.001), the less frequence of pressing the analgesia pump (P<0.001), and less dosage of sufentanil (P<0.001). The first flatus time, first diet time were significantly earlier in the group DEX than in the group CON (P<0.001), with the less length of total hospital stay (P<0.001). Conclusion Dexmedetomidine can promote the anaesthesia of ultrasound-guided subcostal TAP block with ropivacaine and improve the recovery after laparoscopic radical operation.

Objective To observe the expressions of Th1 cytokin [interleukin (IL)-12] and Th2 cytokin (IL-4) in gut of the mouse model of postinfcctious irritable bowel syndrome (PI-IBS). Methods Thirty mice were divided into control group (n=8) and model group (n=22,infected with Trichinella spiralis). The weight of the mouse was measured weekly after infection. Visceral sensitivity of colorectal distention in mouse was accessed by abdominal withdrawal reflex (AWR) at 0 and 8 weeks after infection. All mice were sacrificed at the 8th week, and tissues of jejunum, terminal ileum, proximal colon and distal colon were observed for inflammation with HE staining. The mRNA and protein expressions of IL-12 and IL-4 were examined by RT-PCR and Western blotting, respectively. Results Two weeks after infection, body weight was decreased in model group compared with control group ( -1.08%±1.08 % vs 3.09%±1.85%, P<0.05), but there was no significant difference at the 8th week between two groups (P>0.05). Severe inflammation was observed in the gut of mouse 2 weeks after infection, however it was recovered at the 8th week. The score of AWR was higher in model group at 30,45 and 60 mmHg in comparison with control group (P<0.05), whereas the perceptual threshold was lower in model group than in the control group (P<0.05). In comparison with control group, increased expressions of IL-12 mRNA and protein in ileocecum and proximal colon as well as decreased expressions of IL-4 mRNA and protein in all parts of gut were found in model group (P<0.05). Conclusion Th1/Th2 shift may involve in gut of PI-IBS mouse, which provides a new idea for treatment of PI-IBS.

As the active ingredient of traditional Chinese medicine Scutellaria baicalensis Georgi, baicalin has a variety of pharma-cological effects. In recent years, baicalin has made significant achievement in the prevention and treatment of central nervous system diseases, such as ischemic brain injury, hemorrhagic brain injury, Parkinson' s disease and spinal cord injury. Numerous studies showed that baicalin could prevent oxygen free radical injury, inhibit nerve cell apoptosis, inhibit inflammation factor expression, pro-tect the mitochondrial energy metabolism, inhibit thrombin receptor and adjust the balance of excitatory amino acid and inhibitory amino acid. Based on the neuroprotective effect of baicalin, it may be a potential medicine for the treatment of central nervous system disea-ses.