OBJECTIVE:To provide reference for the implementation of national essential drugs system. METHODS:Based on the experience on the implementation of national essential drugs system in the past year,relevant policies about essential drugs system were analyzed to probe into several issues on its implementation. RESULTS & CONCLUSION:The legal place of National essential drugs system should be further confirmed and qualification authentication of pharmaceutical enterprises involved in bidding for essential drugs list need to be standardized. Subject and proportion of essential drug use must be ensured as well as the supply of essential drugs to make sure the implementation of national essential drugs system.

Liver transplantation,as a new treatment for terminal-stage liver diseases,has made remarkable strides in the past decades.Animal models play an essential part in liver transplantation research,but differ from one another and have different limits to be used in imitating human clinical conditions.Therefore,it is the base for the development of liver transplantation to build and improve animal models by correctly selecting and utilizing different characteristics of different animals.

Objective To evaluate the clinical effect of neuromatosis scoliosis treated by vascularized grafted rib Method The clinical date of 16 cases of neuromatosis scoliosis treated by surgical operation were analysed retrospectively Result Sixteen patients with scolisis caused by neurofibromatosis were treated by this technique The clinical result was satisfactory and solid fusion was observed in all patients within 6 months after operation Conclusion This operation is an effective method for the treatment of neuromatosis scoliosis

ObjectiveTo set up the porcine combined liver/small bowel orthotopic allotransplantation model.MethodThe donors including liver, about 2 to 3?m proximal jejunum, duodenum and a sma ll part of pancreas head were transplanted to the hybridized long-white recipie nt pigs after the resection of their livers and the majority of small bowels.ResultWithout using immunosuppressive drugs, the median survival time of the animals w as 92?h with the longest survival time being 196?h, and there was about 75?% of the animals lived for more than 24?h after operation.ConclusionThe successful establishment of the combined liver/small bowel transplantation m odel will do great favor to our future clinical practice and further study of th e combined liver/small bowel transplantation.

Objective To study the clinical outcome of thoracolumbar fractures treated by ante rior route decompression,bone-graft-fusion and internal fixation.Methods 51cases of thoracolumbar fractures from Jun1994to Mar 2002were treated by anterior route decompression,bone-graft-fusion and internal fixation,of w hich32cases by Kaneda system and 19cases by Z-Plate system.Their clinical data were analyzed.Results The patients were followed up from five months to eight years(average of 3.5years).45cases had a good anatomic reduction and maintain thoracic-lu mbar lordosis.48cases gained one to three Frankel grades of neurologic r e-covery as a consequence of operation.Conclusion Kaneda internal fixation has the characteristics of low cost,neurological decompression and reliable fixation;and Z-Plate systems has the advantages of simple manipul ation,intrinsic stability,less complications and good biocompatibility.

Objective To evaluate the correlation between fluid balance and myocardial function and the mortality in patients with septic shock.Methods Ninety two septic shock patients enrolled between January 2013 and January 2015 were divided into survival group and non-survival group based on 28-day mortality.Fluid balance,haemodynamic parameters and B-type natriuretic peptide (BNP) were collected on days1,3,7 after admission.Results Forty four patients survived the crisis while 48 died.The 7 day average fluid balance volume in survival group was lower than those in non-survival group [(55 ± 9)ml/kg vs.(187 ± 14)ml/kg,t =54.260,P ＜0.01].The initial left ventricle ejection fraction (LVEF) in survival group was lower than that in non-survival group [(42％ ±4％) vs.(54％ ±6％),t =10.100,P ＜0.01].Serum BNP level was significantly lower than those in non-survival group [(267 ± 54) ng/L vs.(681 ± 22) nig/L,t =48.580,P ＜0.01].Multivariate logistic regression analysis showed that fluid positive balance,LVEF and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) were the independent predictors for 28 day mortality (P ＜ 0.05).Conclusions Fluid balance and myocardial function can serve as risk predictors for septic shock patients.

The prospective evaluation of the transformation feasibility of the research achievements is an important portion of the evaluation of the medical research achievements.This study explored to set up a system with Delphi method for the evaluation guideline of the hlansformation feasibility of the medical research achievements.And it also offered some evaluating methods and theoretical guidance to carry out the transformation feasibility of the achievements in the medical scientific research.

Objective To compare the operative results of three kinds VATS on the treatment of young people with SP. Methods 108 young SP patients treated with VATS were involved in the research. 42 cases re?ceived three?port,35 cased double port and 31 cases uniport. Operation period,perioperative blood loss,time of intrathoracic drain tube,postoperative length of stay and postoperative pain were compared. Results No statistical difference was found in terms of operation duration between three?port VATS and double port VATS group (P >0.05). The postoperative pain in double port VATS and uniportal VATS lighter than uniportal VATS (P<0.05) . No statistical difference was found in terms of postoperative pain between double port VATS and uniport VATS group (P>0.05). Perioperative blood loss ,time of intrathoracic drain tube and postoperative length of stay showed no dif?ference in 3 groups (P>0.05). Conclusions Double port VATS has both the advantages of shorter operation time and lighter postoperative pain and was worth being popularized.

Objective To compare the therapeutic effects of minimally invasive percutaneous nephrolithotomy(MPCNL) and retroperitoneal laparoscopic ureterolithotomy(RLUL) in the management of impacted upper ureteral calculi.Methods A total of 72 patients with unilateral impacted upper ureteral calculi were treated with MPCNL(n=45) or RLUL(n=27).The operation time,clearance rate of the stone,and the incidence of postoperative hyperpyrexia were statistically analyzed.Results All the operations were completed.As compared to the RLUL group,the MPCNL group had a significant shorter operation time [(43?9) minutes vs(69?17) minutes,t=-11.564,P=0.000].On the day after the operation,both the groups showed a stone clearance rate of 100%.No significant difference was detected in the rate of postoperative hyperpyrexia between the two groups [13.3%(6/45) vs 11.1%(3/27),?2=0.000,P=1.000).The patients were followed up for 1 to 24 months(mean,8 months),none of them developed ureteral stricture or recurrent stones during the period.Conclusion Both MPCNL and RLUL are safe,effective,and feasible for impacted upper ureteral calculi.

Objective To explore the CT and MRI manifestations and diagnosis of primary small intestinal lymphoma( PSIL) .Methods The CT or MRI in 28 cases of PSIL confirmed by surgical pathology were retrospectively analyzed.Results 28 PSIL patients were confirmed to be non-hodgkin's lymphoma,17 cases were found in terminal ileum or ileocecal junction,11 cases were found in jejunum,near and the middle ileum.All had different degree of bowel wall thickening;CT scan displayed soft tissue density,contrast enhanced CT images demonstrated mild-to-moderate enhancement,uniform enhancement;PSIL was manifested as thick intestinal wall or a mass with slightly hypointensity signal on T1 weighted image,hyperintensity on T2 weighted images,hyperintensity on DWI images and mild to moderate homogeneous enhancement on contrast enhanced T1 weighted images.12 cases of aneurismal dilatation;manifestations were irregular round thickening of intestinal wall with infiltration with expansive;10 cases of infiltrating type,mainly for bowel wall thickening;6 cases of polypoid mass type,density of soft tissue mass,stenosis lumen.Conclusion CT and MRI has obvious advantages in the diagnosis of PSIL, plays an important role in the diagnosis and differential diagnosis.