OBJECTIVE:To provide reference for solving the shortage of national essential medicines in Changchun. METH-ODS:According to preliminary work,a questionnaire was conducted to investigate and statistically analyze the shortage situation of essential medicines in 22 higher than secondary and 50 basic medical and health institutions in Changchun;ABC analysis was used to analyze the national essential medicines in shortage;the bid results and shortage causes of the primary and secondary nation-al essential medicines in shortage were inquired. RESULTS:Totally 72 questionnaire were send out,and 72 were recycled with ef-fective recovery of 100%. The investigation results showed there were 19 shortage breeds(22 dosage forms),which lost the bid-ding,and 99 breeds(111 dosage forms)of national essential medicines in shortage,which won the bidding,including 85 kinds of chemical medicines and biological products,14 kinds of Chinese patent medicine in Changchun. Cardiovascular system drugs shows the largest number in the bid chemical medicines and biological products,and the Chinese patent medicine were mainly Fu-zheng agent and Quyu agent(internal medicine). Results of ABC analysis showed,among the 111 bid shortage dosage forms,17 were primary and 23 were secondary. The main causes for them were price raising in raw materials,lack of production,no produc-ing in manufacturers and purchase price higher than winning bids. CONCLUSIONS:Low accessibility of raw material drugs,low enthusiasm to production,lower drug price than a reasonable level,and small clinical requirements can lead to the shortage of na-tional essential medicines. It is suggested to intensify in supervising the raw materials’marketing,raising the enthusiasm of manu-facturers,perfecting the system of drug bidding,developing fixed-point production and building drug reserve system to guarantee the production and supply of national essential medicines,and satisfy clinical demands.

Objective To compare the safety of dopamine ( DA) and norepinephrine ( NE) in hypovolemic shock , and the impact on the stability of blood pressure and haemodynamics .Methods Eighty two patients with hypovolemic shock were given fluid resuscitation . All the patients were divided into two groups including DA group (n=41) and NE group(n=41).Recovery of blood pressure, hemody-namic parameters were observed at different time point , and the complications and mortality of two groups were recorded .Results Blood pressure of all the patients returned to normal in 15min after the medication, and became stable after 30min.There was no significant difference in the blood pressure in both groups except that of 15min.Compared with T0, There were higher in the numerous of CVP , CI, ELWI, ITBI.The ELWL at T2 in DA group was higher than that of NE group , while there was no significant difference in the other time points between the two groups(P>0.05).After treatment for 24 h, blood oxygen saturation, urine volume in two groups were significantly increased, blood lactic acid markedly reduced , but lactic acid in NE group was obviously lower than that in DA group (P<0.05).Com-pared with DA group, the incidence of arrhythmia cordis , 2-week mortality in NE group were significantly reduced (P<0.05), while the acute kidney injury in two group was not statistically different (P>0.05).Conclusion The effect of NE and DA in maintaining the stability of blood pressure and hemodynamic are equivalent , and NE did not increase the risk of acute kidney injury , but can effectively improve tissue perfusion , reduce arrhythmia and case fatality rate , improve clinical outcomes .

Objective To describe our experience and method of reconstruction after resection of tumors around inner canthus and nasion in the elderly. Methods The line between outer and inner canthus was considered during reconstruction.If the surface of wound after resection was above this line,glabellar flap was used to reconstruct the upper part and the residual defect was repaired with advancement of lower eyelid and rotation of flap.If the surface of wound was below this line,lower eyelid flap was used and the residual defect was reconstructed with glabellar flap. Results All flaps survived without any significant complications.9 cases among 15 patients were followed up from 1 to 24 months.Repaired tissues all matched well with surrounding tissue in color,texture,and outline.Eyelid and medial canthal were not disturbed and there was no tumor recurrence.Scars were smoothy,soft and hidden with satisfactory appearance and vision. Conclusions Single local flap or combined local skin flaps around the nasion and inner canthus is one of reconstruction methods to get satisfactory cosmetic effect or facial morphology.

Objective To investigate the inhibition of pathogenic viral gene expression in HPV6bE6-positive cell line by specific siRNA, which might have great potential for clinical use. Methods B16 cells were transfected with recombinant plasmid pcDNA3.1(+)-GFP/HPV6bE6, and the positive cell clones were selected by fluorescence protein observation and RT-PCR. Four specific siRNAs, none of which shares homology with exons of known human genes, were designed and synthesized to target HPV6bE6 mRNA. Quantitative real-time PCR was performed to measure the inhibition rates of target gene expression by comparing HPV6bE6 mRNA concentrations before siRNA transfection with those after transfection. The inhibition rates of target gene expression with different siRNA concentrations of 0.2 nmol/L, 1 nmol/L, 10 nmol/L, 50 nmol/L, 150 nmol/L and with different treatment time at 24 h, 48 h, 72 h and 96 h after transfection were measured respectively. Results More than 90% reduction of HPV6bE6 mRNA was observed following treatment with HPV6bE6-siRNA, and HPV-negative cells were apparently unaffected by HPV6bE6-siRNA. The decrease of HPV6bE6 mRNA was maximal at 24 h after siRNA treatment and sustained for at least 4 days. The minimal level of siRNA to efficiently silence the homogeneous target gene HPV6bE6 was 1 nmol/L. Conclusion HPV6bE6-siRNA can efficiently and specifically silence target genes and may be developed as a potential therapeutic approach for HPV infection.

Objective To investigate the effect of tetramethylpyrazine pretreatment on the expression of cfos and heat shock protein (HSP70) during hypoxia-reoxygenation (H/R) in cultured fetal rat hippocampal neurons. Methods After the neurons were cultured and identified, they were randomly divided into 5 groups ( n = 24each): control group (group C), H/R group, and low, median and high concentration of tetramethylpyrazine pretreatment groups (group L, M and H). The neurons were exposed to 2 h of hypoxia followed by 24 h of reoxygenation. Tetramethylpyrazine was added with the final concentrations of 60, 200 and 800 μg/ml in group L, M and H respectively, and then the neurons were incubated for 1 h before H/R. The apoptosis rate, cell viability and expression of c-fos and HSP70 were detected. Results The cell viability was significantly lower, while the apoptosis rate was significantly higher in group A/R, L and H than in group C (P ＜0.01). The cell viability and HSP70expression were significantly higher, while the apoptosis rate and c-fos expression were significantly lower in group L, M and H than in group A/R, and in group M and H than in group L (P＜ 0.05). The cell viability and HSP70expression were significantly lower, while the apoptosis rate and c-fos expression were significantly higher in group H than in group M ( P ＜ 0.01 ).Conclusion The mechanism by which tetramethylpyrazine pretreatment inhibits the apoptosis in cultured fetal rat hippocampal neurons during H/R may be related to the dowm-regulation of c-fos expression and up-regulation of HSP70 expression.

Objective To compare the efficacy of tamsulosin and nifedipine for the adjunctive expulsive therapy in patients with lower ureteral stones. Methods A total of 180 patients with stones (0.4-1.0 cm in diameter) located in the lower ureter (juxtavesical or intramural tract) were randomly divided into 3 groups (60 cases in each group). Group 1 served as controls; group 2 received nifedipine (10mg, 3 times daily) ; and group 3 received tamsulosin (0.4 mg, once daily). All patients were observed for 2 weeks. Results During 2 weeks, expulsion of stones was observed in 26 cases (43. 3% ) of group 1, in 44 (73. 3% ) of group 2, and 49 (81. 1% ) of group 3. The difference in expulsion rates between groups 2, 3 and group 1 was statistically significant (P 0. 05). In groups 1 , 2 and 3, renal colic recurred within 2 weeks and analgesics were used in 5 cases (8.3%), 1 (1.7% ) and 0, respectively, with significant difference between the groups (P

Objective:To investigate the diagnostic value of serum GP73 combined with Dickkopf-1 and AFP in hepatocellular carcinoma.Methods:117 cases of hepatocellular carcinoma in our hospital were collected as hepatocellular carcinoma group,80 patients with hepatitis B virus as the hepatitis group,and randomly selected 80 healthy subjects as the control group from September 2014 to September 2016.The serums GP73,Dickkopf-1,AFP level of every group were detected by the enzyme-linked immunosorbent assay (ELISA),and the relationship between the GP73,Dickkopf-1,AFP between clinicopathological features were analyzed,the diagnostic value of GP73,Dickkopf-1 and AFP in hepatocellular carcinoma were analyzed.Results:The serums GP73,Dickkopf-1,AFP level of hepatocellular carcinoma group were higher than those of hepatitis group,control group,and the serum AFP level of hepatitis group was higher than that of control group,the difference was statistically significant (P＜0.05).The GP73,Dickkopf-1,AFP in patients with classification B～C were higher than those in classification A among the Child Pugh classification,the difference was statistically significant (P＜0.05).No statistical significance on difference of GP73,Dickkopf-1,AFP between different differentiation,tumor size,number of tumors was found (P＞0.05).The sensitivity,specificity,positice predictive value,negative predictive value,and accuracy of GP73+Dickkopf-1+AFP in the diagnosis of hepatocellular carcinoma were higher than those of GP73,Dickkopf-1,AFP respectively,the difference was statistically significant (P＜0.05).Conclusion:Serums GP73,Dickkopf-1,AFP in patients with hepatocellular carcinoma have high expression levels,combined with the three indicators can obviously improve the diagnostic value of hepatocellular carcinoma,which has clinically important reference value.

This study was aimed to summarize the adverse drug reaction (ADR) caused by the toxicity of Tripterygium Wilfordiiand its preparations, in order to explore possible relationship betweenTripterygium Wilfordiifactors and reported ADR. Relevant articles on toxicity ofTripterygium Wilfordiiand its preparations were systematically searched in 5 databases, including the Pubmed, CNKI,Wanfang Data, VIP Data and Sinomed from the database was established until Feb 25th, 2014. And then, the randomized controlled trials (RCTs) were systematically collected, analyzed and summarized. The results showed that there were 260 RCTs with 13301 patients included. The outcome of data analysis showed that ADR rates of digestive system and reproductive system of RCT1 and RCT2 were different. ADR rates (per hundred people) in RCT1 and RCT2 were as follows: digestive system were 14.73 and 12.26, reproductive system were 8.25 and 8.00, liver was 6.50 and 5.66, kidneys were 6.79 and 3.03, blood system were 6.73 and 6.50, cardiovascular system were 2.35 and 0.67, skin and mucous system were 11.42 and 4.78, respectively. Articles on rheumatoid arthritis (RA) of both RCT1 and RCT2 were the highest, which occupied 22.17% in RCT1 and 63.16% in RCT2. The corresponding ADR rates were 34.18 and 27.26. The standard deviation (SD) of 7 disease types, which were RA, IgA nephropathy, nephritis, nephrotic syndrome (NS), diabetic nephropathy, psoriasis, lichen and rashes, as well as uterine fibroids, was 8.69 in RCT1. The SD of RA, IgA nephropathy, psoriasis, lichen and rashes was 7.11 in RCT2. It was concluded that the possible ADR distribution ofTripterygium Wilfordiiand its preparations were the highest in the digestive system, reproductive system and liver. Besides, different diseases (i.e., RA, nephritis, NS, and etc.) had huge differences with their correspondent ADR rates. Therefore, it was suggested that specific measures should be taken to select the appropriateTripterygium Wilfordiipreparation, protect the stomach and liver during the application ofTripterygium Wilfordiiand its preparations. During medication, attentions should be paid to the reaction of patients. Stop the medication when necessary to minimize ADR rates to the lowest.

Objective To investigate the protective effect of sulodexide (SDX) on oxidized low density lipoprotein (ox-LDL) induced damage to human umbilical vein endothelial cell (HUVEC),and to discuss its mechanism.Methods By using CCK-8 method,the ox-LDL intervention HUVEC dose and the concentration of SDX were determined.The reactive oxygen species (ROS) assay kit was used to verify the protective effect of SDX on HUVEC.Real time fluorescent quantitation-polymerase chain reaction (RT-PCR) was employed to test the endothelial nitric oxide synthase (eNOS) and caveolin-1 mRNA expression;immunoblot assay was adopted to check the protein expression of phosphorylated eNOS (p-eNOS) and caveolin-1.The ability of cell migration was assessed by Transwell assay.Results Stimulated by 100 μg/ml concentration of ox-LDL,the cell viability of HUVEC decreased significantly (P＜0.01).After adding 125 LRU/ml concentration of LDX,the cell viability of HUVEC was remarkably improved (P＜0.01) and the production of ROS was strikingly decreased (P＜0.01).SDX could down-regulate the expression of caveolin-1 (P＜0.05) and up-regulate the expression of eNOS mRNA and p-eNOS (P＜0.05) for ox-LDL-damaged HUVEC,and markedly improve the migration ability of damaged HUVEC (P＜0.01).Conclusion By regulating the caveolin-1/eNOS signal route,SDX can improve impaired HUVEC cell migration ability,thus,to protect endothelial cells.

Objective To investigate the cellular immune response to the recombinant DNA vaccine CRT120/HPV6bE7 in mice. Methods The recombinant encoding HPV6bE7, linked with CRT120, was constructed in pcDNA3.1 eukaryotic vector with the report gene GFP. The pcDNA3.1-GFP -HPV6bE7 was transfected into B16 cells by a lipofectamine kit. The C57BL/6 mice were vaccinated with recombinant DNA plamids. The T-cell phenotype in the peripheral blood lymphocytes of the immunized mice was measured by flow cytometry. The CTL activity of the lymphocytes from the spleens and lymph nodes, and the levels of IL-2 and IFN-? were analyzed. Results The constructed recombinant plasmid CRT120/HPV6bE7 was analyzed. Positive transfected cell clones were established and could stably express the target gene HPV6bE7. Compared with HPV6bE7, CRT120/HPV6bE7 plasmid enhanced to a greater extent CD8+ T-lymphocyte differentiation, the number of TCR?? T-lymphocytes and the levels of IL-2 and IFN-? (all P