Objective To find out factors affecting physicians' prescribing conduct so as to get rid of the negative effects and reduce medical costs. Methods Analyses were conducted by reviewing relevant literature published at home and abroad. Results Factors affecting physicians' prescribing conduct include: the medical security system, the hospital compensation mechanism, the requisitioning party, pharmaceuticals per se, and promotion of sales. Conclusion To get rid of the negative effects of physicians' prescribing conduct, it is necessary to rationalize the hospital compensation mechanism, strengthen the control of drug examination, approval, purchase and sale, and provide physicians with accurate pharmaceutical information.

Humans ; Hyperparathyroidism, Secondary ; diagnosis ; Monitoring, Intraoperative ; Parathyroid Hormone ; blood ; Parathyroidectomy

Objective To evaluate the anatomic morphology of submandibular fossa. Methods Cone-beam computed tomography (CBCT) was used to analyze the anatomic morphology of submandibular fossa. Implants of various dimensions were virtually placed into the mandibular 1st and 2nd molar region. Spatial relationships among submandibular fossa , mandibular canal and implant were analyzed. Results The depth of the submandibular fossa was (1.0 ± 0.61)mm in the 1st molar region and (1.5 ± 0.61)mm in the 2nd molar region. There were no significant statistical difference in genders, sides, and tooth loss. The length of the implants was (19.7 ± 3.75)mm (d = 4 mm) and (18.6 ± 3.73)mm (d = 5 mm) in the 1st molar region and (16.2 ± 3.46) mm (d = 4 mm) and (15.2 ± 3.09)mm (d = 5 mm) in the 2nd molar region in patiens with teeth and lingual perforation; the length of the implants was (17.1 ± 3.77)mm (d = 4 mm) and (15.6 ± 3.85)mm (d = 5 mm), and (14.2 ± 4.05)mm (d = 4 mm) and (13.2 ± 4.27)mm (d = 5 mm) in patients with tooth loss, respectively. Conclusions Determination of spatial relationships among submandibular fossa , mandibular canal and implants by using CBCT has important significance in guiding dental implant surgery.

Objective To investigate the effect of growth differentiation factor 5(GDF-5)on expression of gap junctional protein,connexin 43,during ehondrogenic differentiation of bone marrow sternal cells(BMSCs)in vitro.Methods BMSCs were isolated from mouse bone marrow and cultured in vitro.The cells in passage 3 were chosen to be induced into chondrogenic differentiation.After induction for 72 hours,TypeⅡcollagen protein was examined by immunocytochemistry and the sulfate glycosaminoglycan was measured by Alcian blue staining.With induction for 24,48 and 72 hours,the proliferation effects of BMSCs were investigated by MTT assay;connexin 43 mRNA and protein were examined by RT-PCR,western blotting and immunocytochemistry respectively at different time points during induction.Results According to MTT assay,GDF-5 had no effect on the proliferation of BMSCs at different time points of induction;RT-PCR,western blotting and immunocytochemistry showed that GDF-5 could promote expressions of connexin 43 mRNA and protein at different times during induction.After 72 hours of induction,immunocytochemistry showed expression of TypeⅡcollagen protein,and AIcian blue staining of proteo- glycan revealed deposition of typical cartilage extracellular matrix.Conclusion GDF-5 can enhance chondrogenic differentiation of mouse BMSCs in vitro by up-regulating the expression of gap junctional protein,connexin 43.

Objective To study the level of serum apolipoprotein M and its disease activity index in patients with SLE.Meth-ods 65 cases of systemic lupus erythematosus patients in Shiyan City Renmin Hospital from January 2013 to December 2015 were selected.In addition,female workers 20 people as control group.Tested the level of serum lipids,Apo,CRP and ESR.Compared the expression level with Apo M and Apo A1 ,and Apo B and the degree of disease activity.Results Activi-ty group and Apo A1 ,HDL,TC,remission group,Apo and M were lower than the control group,the difference was statisti-cally significant (P<0.01).Active group,remission group LDL and Apo B was higher than the control group,and the difference was statistically significant (P<0.01).Active group and remission group TG was higher than the control group, but no significant significant differences (F=0.061,P=0.937).Apo A1 and total cholesterol,high density lipoprotein, smooth protein was positively correlated (P<0.05),and ESR was negatively correlated with the 24h urinary protein (P<0.05).Apo B was positively correlated with triglyceride,total cholesterol,and low density lipoprotein (P<0.05).Apo M and triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein,albumin was significantly posi-tively correlated,and ESR was negatively correlated with anti ds-DNA antibody (P<0.05).Conclusion The level of Apo M was significantly lower in SLE patients which showed a significant positive correlation with triglyceride,total cholesterol, low density lipoprotein,high density lipoprotein and albumin.And showed a negatively correlated with anti ds-DNA antibody and ESR.Disease activity index of Apo M is larger.

Objective To assess the ability of pixel-based quantitative evaluation of CT values in differentiating benign and malignant cystic-solid ovarian tumors.Methods CT images of 41 cystic-solid ovarian lesions from 39 patients were reviewed,with 27 benign and 14 malignant confirmed by post-operation pathology or follow-up.Regions of interest (ROIs) were drawn along edges of tumors on all slices of contrast-enhanced images with ImageJ software.CT values of each pixel were extracted.CT values of 20,25,30,35 and 40 HU were used respectively as the threshold to divide cystic and solid components.Solid proportion,the mean and median CT values of solid component were calculated and compared between benign and malignant groups.Results Mean CT values of solid components were all higher in malignant than in benign ovarian masses under all the threshold values (P<0.05).For median CT values, the same trend existed under the threshold of 20,25,35 and 40 HU (P<0.05).For the solid proportion,difference was found only under the 40 HU threshold, with lower value in malignant group (0.67±0.25) than in benign group (0.47±0.31).ROC curves were drawn to differentiate benign and malignant lesions.The highest AUC was obtained by using the mean CT value of solid components defined by 40 HU threshold (AUC=0.735).Conclusion Pixel-based quantitative evaluation on CT images could help to define cystic and solid components of ovarian masses, with 40 HU to be an optimal threshold.Cystic-to-solid proportion and CT value of solid components derived from whole lesion can help to differentiate benign or malignant lesions.

Objective To investigate the feasibility of ADC values that derived from MR DWI with multiple b values in reflecting the amplitude of enhancement and degree of differentiation in cervical squamous cell carcinomas on 3.0T MR scanner.Methods DWI and multiple phase contrast enhanced MRI images of 31 patients with pathologically diagnosed cervical squamous cell carcinomas were retrospectively analyzed.All ADC values in different b values and the amplitude of signal intensity enhancement were measured in various areas of tumors.Correlations of differences of ADCs in high and low b values with early and late enhancement,and the relationship of ADC and differences of ADCs with pathologically tumor differentiation grades were analyzed.Results ADC value in high and low enhanced areas of cervical cancer was inversely related with different b values.Differences of ADCs between low b value (200 s/mm2) and high b values (800,1 000,1 200,1 400 s/mm2) had weak positive correlation with early enhancement (r=0.315-0.339,all P＜0.05).While b=800 s/mm2 and 1 000 s/mm2,ADCs in highly enhanced areas of tumor were significantly lower in well-differentiated cancer lesions compared with those of poorly differentiated cancer lesions.There was no statistically significant of ADC value in other b values,and also of differences of ADCs in all b values in different differentiation foci (all P＞0.05).No differences were found in ADC values under other b values in various degree of differentiation foci,nor in differences of ADCs in all b values (all P＞0.05).Conclusion Combination of multiple b values of DWI may have the potential to reflect blood supply and tumor differentiation grades in cervical squamous cell carcinomas,while low b value of 200 s/mm2 and high b values of 800 s/mm2 and 1 000 s/mm2 will be the preferable choice on 3.0T MR scanner.

Objective To study the clinical characteristics,microsurgical methods and results of treatment of the purely intrinsic third ventricular craniopharyngioma. Methods Eight cases of craniopharyngiomas located purely in intrinsic third ventricula which were treated microsurgically were analyzed retrospectively.Their clinical manifestations,endocrinal examination,CT and MRI images,choice of operactive approaches and post-operative complications were studied.Results Total tumor removals were achieved in 7 cases.and subtatol tumor removal in 1 case.Temporary central diabetes insipidus occurred in 5 cases,and perloperative water and elecctrolyte imbalance in 6 cases. No patient died in this series. Conclusion According to clinical characteristic of purely intrinsic third ventricular craniopharyngioma, microsurgical technique is a safe and effective method for treatment by a resonable surgical approaches.

Oncomodulin (OM) is known by us progressively as a Calcium binding protein.Recently, OM has been found that it is secreted by inflammatory cells (neutrophilic granulocyte), and a signal which can promote cell growth between innate immunity and neurons, and a key to regenerate the damaged optical nerves by activating inflammation.The function of promoting the regeneration progress of axons has become a hot issue in recent years.This article summarized the mechanism of OM and the relationship between inflammation-induced OM and optic nerve regeneration research and progress were reviewed.

·α-crystallin is the predominant structural protein in the lens.lt is a member of small heat shock proteins ( sHSPs) which has the common functions of HSPs.lt also has anti-apoptotic activity etc.Recently, it has been proved to combine with the cellular membrane of retinal ganglion cells ( RGCs ) to enhance the survival of RGCs and the regeneration of axons, thereby partly restore visual function.But we haven’t come to a unified conclusion of the mechanism.This review is focused on structure and functions of α-crystallin, the protection function and mechanism of α-crystallin towards RGCs after the optic nerve injury.