OBJECTIVE: To provide references for optimizing the selection of medical insurance drugs and drug review in China.METHODS: The Canadian common drug reviewers' basic duties and the Canadian common drug review process were introduced,and the existing problems in drug review and the countermeasures were analyzed.RESULTS & CONCLUSIONS: In view of the problems occurred in Canadian drug review such as redundant delay and tedious,lack of transparence and job responsibility system and so on,the corresponding measures had been taken such as defining drug review time,helding long range e-meeting,and establishing public committee etc.Chinese common drug review should draw experiences from the Canadian drug review to explore a more economical,timely and transparent practice in Chinese medical insurance drug selection and drug review.

The clearance of proteins differing in charge and/or size (IgG4, total IgG and albumin) was evaluated in 95 diabetic patients. Urinary IgG4 values increased in group mi-croalbuminuria. The increased urinary IgG4 excretion correlated significantly with the degree of albuminuria and diabetic retinopathy. Urinary total IgG levels increased obviously only in group with massive macroalbuminuria. The IgG4/total IgG ratio was highest in group mi-croalbuminuria, and its change had a special pattern. Urinary IgG4 and IgG4/total IgG ratio may be sensitive parameters in assessing early protein charge-selectivity impairment and in detecting incipient diabetic nephropathy.

OBJECTIVEOvertraining is a serious problem in sports, assessed by comprehensive multi-index evaluation, but so far there is still no sensitive, specific monitoring indicator or simple evaluation method to evaluate it. This research established a method for detecting plasma cell free DNA (cfDNA) of rats by real time PCR and discuss edits significance: a new molecular marker of overtraining?

METHODSTwelve male SD rats were randomly divided into control group and overtraining group. The overtraining group rats were undertaken overtraining on a motor-driven treadmill for 5 weeks, while the control group rats kept quiescent. All the rats were drawn blood at pre-and after-5 weeks to detect plasma levels of cfDNA, testosterone (T) and corticosterone (Cort) as well as peroxidation/antioxidation parameters (T-AOC, MDA, SOD, GSH-Px) and creatin kinase (CK).

RESULTS(1) Plasma cfDNA of rat was detected specifically by our real time PCR. (2) Compared with control group rats, the plasma cfDNA of overtraining rats increased obviously (about 5.43 fold). (3) Plasma cfDNA was related to plasma T, Cort, T/C ratio and MDA (correlation coefficent were -0.729, 0.854, -0.655 and 0.720, respectively) rather than plasma T-AOC, GSH-Px, SOD and CK.

CONCLUSION(1) A real time PCR method was established successfully to determine plasma cfDNA of rat. (2) A remarkable raises of plasma levels of cfDNA were found in overtraining rats which were associated with T, Cort and T/C, suggested that plasma cfDNA might be a new molecular marker of overtraining. (3) The increase of plasma cfDNA of overtraining rat might correlate with enhanced oxidative stress induced by overtraining instead of muscle damage.

Animals ; Biomarkers ; blood ; Corticosterone ; blood ; DNA ; isolation & purification ; Exercise Test ; Fatigue ; blood ; Male ; Physical Conditioning, Animal ; Plasma Cells ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Testosterone ; blood

Information Systems ; Medical Informatics ; Medical Records Systems, Computerized ; Pathology

OBJECTIVE: To assess the effect of one-stage repair of secondary nasolabial deformity and nasal septoplasty for cleft patients on nasal airway resistance (NAR). METHOD: Using active anterior rhinomanometry, NAR was measured in eighteen patients with cleft lip and palate who suffered form one-stage repair of secondary nasolabial deformity and septoplasty at per-and-post operation. RESULT: NAR was (0.664 +/- 0.200) kPa/(s x L) before operation, (0.304 +/- 0.180) kPa/(s x L) six months after operation, and (0.396 +/- 0.250) kPa/(s x L) twelve months after operation respectively. The differences are statistically significant (P < 0.01) between the NAR before and after operation. Subjective impression score of nasal patency was 7.5 +/- 1.5 before-operation, 2.1 +/- 2.0 after-operation for six months, 3.0 +/- 2.4 after-operation for twelve months. There are significant differences in the subjective impression score of nasal patency as well (P < 0.01). CONCLUSION Correction of septal deformities play a very important role in the operation for secondary nasolabial deformity, which can decrease NAR and improve the subjective impression of nasal patency.
Adolescent ; Airway Resistance ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Male ; Nasal Septum ; abnormalities ; surgery ; Nasopharynx ; surgery ; Postoperative Period ; Rhinoplasty ; Young Adult

OBJECTIVE: To explore the therapeutic methods and effect of pingyangmycin injection in huge hemangioma at Hypopharynx and laryngeal under suspension laryngoscopy. METHOD: To ananysize the medical records of 12 Patients with giant hemangioma at hypopharynx and laryngeal. Patients were underwent polysomnography before operation. Inseted the suspension laryngoscopy to pars laryngea by mouth to exposing the hemangioma under general anaesthesia, then injected Pingyangmycin by a long-tube needling (one time per three weeks, accumulated dose less than 50 mg). RESULT: Among all patients, ten were cured and two showed obvious improvement. The data of PSG after operation indicates that the symptom of anoxia of post-operation were significantly ameliorated than that of pre-operation, no recurrence occurred during one year follow-up of the hemangioma. CONCLUSION The methods of pingyangmycin injection under suspension laryngoscopic surgery is significantly enhanced clinical effect and improved the life quality of patients with huge hemangioma, which with low risk, high security, can ameliorating anoxia, complete cure, and is a ideal therapeutic measure.
Adult ; Bleomycin ; administration & dosage ; analogs & derivatives ; Female ; Hemangioma ; therapy ; Humans ; Hypopharynx ; pathology ; Laryngoscopy ; Larynx ; pathology ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To investigate the feasibility of laparoscopic surgery for hydronephrosis caused by retroper-itoneal fibrosis.Methods Reported the diagnosis and treatment procedure and result of 1 case of hydronephrosis caused by retroperitoneal fibrosis on left side,who underwent laparoscopie surgery.Investigated the feasibility of hydronephrosis caused by retroperitoneal fibrosis with literature review.A 55-year-old female patient had interrupt-able left lower extremity swollen with nausea and vomiting for five months.The blood test showed progressive eleva-ting of creatinine and urea nitrogen.The highest creatinine value was 503 μmol/L.The computerized tomography showed renal atrophy on right side and there was a stenosis on crossing place between inferior segment on left ureter and iliac blood vessels,also there is a soft tissue image in front of aorta and around iliac blood vessels,the superior ureter was dilated.We set double J tube into left ureter before surgery with semi-reclining position toward right side,set trocar cannula through 1 era,4 em below the umbilicus as well as the same two points on lateral external oblique muscle of abdomen,set laparoscope from 1 cm below the umbilicus.We found the abdominal membrane pale and touch as tabular.There was serious eonglutination between middle segment ureter and around iliac blood vessels after we cut open retroperitoneal membrane.We carefully dissected the ureter for 9 cm and soluted the eonglutination a-round the ureter,then set the ureter into abdominal cavity and closed retroperitoneal membrane.Results The pa-tient recover well after surgery and sutured out after 5 days,pulled out the double J tube after I month.The patient had low back pain ,fever and oliguria after the double J tube was pulled out and recovered with spasmolysis,analge-sia and antibiosis treatment after 2 days.The voiding volume and renal function became normal.The B-type ultra-sound test showed hydronephrosis on left side was lessened.The ultrasound test after 3 months result showed hydro-nephrosis was significantly lessened than before surgery and renal function was normal.Conclusions The laparo-scopic ureterolysis surgery for retroperitoneal fibrosis is minimally invasive,less suffering and quick recovery.Be-cause of few case report and short follow-up time is more eases and long-term follow-up are needed to elucidate the therapeutic efficacy of this treatment.

Objective To investigate the impact on renal fibrosis by inhibition of connective tissue growth factor( CTGF) by RNA interference in spontaneous hypertension rat( SHR) . Method Twenty SHR were randomly (random number) divided into SHR group ( n = 10) and RNAi group ( n = 10), eight Wistar-Kyoto rats were set as control. At the end of RNA interference procedure, all the rats were sacrificed and the kidneys were harvested. The mRNA and plasmosin of CTGF and fibronectin(FN) of renal tissue were extracted and measured by RT-PCR and Western Blotting. And the localization of CTGF and FN were analyzed with immunohistochernistry technique. The collagen deposition(shown as collagen volume traction, CVF) were evaluated with 0.1% sirius-picric staining, and the hydroxyproline of myocardium were detected by colorimetry. Results The mRNA and protein expression of CTGF decreased 66% and 62% in RNAi group (P < 0.01). The mRNA and protein expression of FN decreased 56% and 51% in RNAi group.The same inhibition effect was observed by hislological analysis. Immuno-histochemistry showed that CTGF localized both in renal parenchyma and renal interstitium, whereas FN majorly expressed in renal interstitium. Observation with light microscope showed that collagen deposition(CVF)decreased sharply in RNAi group versus SHR group. And the same effect was viewed in hydroxypnoline assay[SHR group: (0.596 ± 0.067) μg/mg, RNAi group: (0.368±0.084) μg/mg, P < 0.01 ] .Further study by polarized microscope displayed that RNA interference mainly suppressed type I collagen synthesis. Conclusions Targeted inhibition of CTGF by RNA interference leads significant decrease of extracellular matrix deposition in kidney. And the anti-fibrotic effect independent of lower the blood pressure. This study indicated CTGF take a key role in the development and progress of renal fibrosis.

Objective To evaluate the expression of Sp3 gene of peripheral blood mononuclear cells (PBMC) in multiple sclerosis (MS) patients in Guizhou and the relationship between Sp3 gene expression and immunological function. Methods Two pairs of primers were used to amplify cDNAs generated from 31 MS patients and 30 healthy controls. The serum levels of sIL-2R were measured in 27 patients with MS and 30 healthy controls by sandwiched ELISA. Results The deficient expression of Sp3 gene in MS patients was significantly higher than that in control (41.9% ( 12/31 ) vs 6. 7% (2/30) ,x2 =7. 133 ,P =0. 008). The sIL-2R levels in MS patients were significantly higher than those in control (( 2788.5 ± 1079. 8 ), ( 1270. 7 ± 489. 4) μg/L, t = 6. 170, P = 0. 001 ). The concentration of sIL-2R in MS with negative ((3364.0 ± 1252.3) μg/L) and positive((2450.0 ± 827.0) μg/L) expression of Sp3 gene were significantly increased compared with control (F = 32. 059, P < 0. 05 ). The sIL-2R levels were significantly rising in MS patients with negative expression of Sp3 gene compared with MS patients with positive expression of Sp3 gene ( q = 4. 213, P < 0. 05 ). Conclusions A remarkable deficient expression of Sp3 gene in PBMC has been found in MS patients in Guizhou. sIL-2R may take part in the process of MS. The expression of Sp3 gene is not affected by immune state, however, MS patients with Sp3 deficient expression tend to have a more serious impairment in immunological functions.

Objective To study the clinical presentation and pathological features of rare nonepithelial vulvar tumors. Methods The clinical data of 42 patients with nonepithelial vulvar tumors who were operated on during 1986 to 2007 in Peking Union Medical College Hospital were analyzed. Results The average age of 42 patients was 44. 1 years. There were 32 eases (76%) with a vulvar mass. Twenty one of these 42 patients (50%) complained of associated symptoms of itch and pain Surgical treatment was the chief treatment of nonepithelial vulvar tumors, which included local excision (40, 95%), simple vulvectomy ( 1,2% ) and radical vulveetomy ( 1,2% ). Among the pathological diagnoses after operation,the most common benign histological subtypes were hidradenoma and haemangioma, while the must common malignant histological subtypes were leiomyosarcoma and aggressive angiomyxoma. Conclusions Most of the nonepithelial vulvar tumors are mesenehymal tumors. The clinical presentation has no special characteristics. Diagnosis of nonepithelial vulvar tumors can be made based on histological inspection.Surgical treatment is the treatment of choice.