OBJECTIVE:To provide suggestions and countermeasures for improving the accessibility of national essential medi-cines. METHODS:Based on the theoretical analysis,the questionnaire was designed for the pre-survey and formal survey on the experts from universities,enterprises,government agencies and non-governmental organizations,and analytic hierarchy process was used to analyze and discuss the valid questionnaire. RESULTS:Totally 35 question naires were sent out and 27 were effective-ly received with effective rate of 77.14%. The physicians and pharmacists’cognition of essential medicine system and essential medicine,and the reasonable degree of public bid prices of essential medicine,the fairness and impartiality of essential medicine bidding process were the key influential factors;the prescription,provision,reimbursement of essential medicine,and the financial compensation to primary public health care institutions that sell essential medicine by zero-slip were the secondary factors;primary health care institutions’monitoring on the use of essential medicine(such as prescription rate,etc.),the participation of social se-curity sector in bidding and purchasing of essential medicine,the reasonable degree of pricing of essential medicine,the monitoring of the price of essential medicine,and the compensation to manufacturers of essential medicine were the general factors. CONCLU-SIONS:The accessibility of essential medicine involves many stakeholders,whom impact from different levels. Therefore,all rele-vant stakeholders should be coordinated to gradually improve the accessibility of essential medicines.

Objective To discuss the medication principles of diagnosis and treatment for insomnia from spleen and stomach; To provide references for clinical treatment for insomnia.Methods Relevant articles about diagnosis and treatment forinsomnia from spleen and stomach were searched in CNKI and Wanfang Data through computers, the data were input into Traditional Chinese Medicine Inheritance Supporting System (V2.5) and then association rules, apriori arithmetic, improved mutual information method, and complex system entropy cluster methods were used to analyze the medication principles of diagnosis and treatment for insomnia from spleen and stomach. Results Through screening, totally 87 prescriptions were included, involving 165 herbal medicine. Data mining results showed that there were 30 high-frequency herbal medicine, 19 high-frequency medicinal combinations, and 4 medicinal association rules. Evolution led to 13 medicinal combinations of 2 herbal medicine and 3 new prescriptions. Conclusion The main method of diagnosis and treatment for insomnia from the spleen and stomach is regulating qi activity of spleen and stomach. The features of common medicine are invigorating spleen to reduce phlegm, clearing stomach and calming the adverse-rising energy, and tonifying qi and soothing nerves, which can offer references for clinical treatment for insomnia.

Objective To explore the protective mechanism of fructose-1, 6-disphophate on the hypoxic-ischemic brain damage of neonatal rats.Methods Seven-day-old Wistar rats were randomly divided into HIBD control group,saline-treated group, FDP-treated group. FDP-treated group was redivided into groups of high, middle and low dose.The expression of caspase-3mRNA was detected at 24h after HIBD with RT-PCR. Results There were no sifnificant differences of the caspase-3 mRNA expression among the saline-treated group, HIBD group and low dose FDP-treated group(P >0.05).The expressions of caspase-3 mRNA in the middle and high dose FDP-treated groups decreased significantly as campared to the above three groups (P < 0.05), but there was no significant difference between the two groups (P > 0.05). Conclusion The neuronal protective mechanism of FDP might be related to dewnregulate the gene expression of caspase-3 in brain tissue,and decrease the apoptosis of neuron after HIBD.

Objective To explore changes and its clinical significa nce of lymphocyte activation in patients with multiple sclerosis. Methods CD3、CD4、CD8、CD19、CD16+56、CD25、CD69、HLA-DR in peripheral blood (PB) were tested by flow cytometry. Results The percentage of CD3、CD4、CD8、CD16+56 on PB lymphocytes in MS group were lower than those in controls, CD4/CD8、CD19 on PB lymphocytes in MS group were higher than in controls. The percentage of CD69、CD25、HLA-DR、CD3/HLA-DR on PB lymphocytes of patients with relapse MS group were higher in controls and remission MS groups. The percentage of CD3/HLA-DR on PB lymphocytes of patients with remission MS group was higher than controls. Conclusion The content on PB lymphocytes in MS group were unusual. The lymphocyte activation was much higher and may be as a marker of MS.

Objective To investigate the manifestations of MRI for congenital coarctation of aorta. Methods Twenty-five patients with coarctation of aorta were studied, including 11 cases of simple type and 14 cases of complex type. All of them were examined by transthoracic echocardiography and MRI including SE sequence, Cine MRA,3 dimension dynamic contrast enhanced magnetic resonance angiography scanning. Results Among 25 cases of coarctation of aorta, MRI could directly show the whole picture of abnormality, including the scop, degree and kinds,obviously better than diagnosis by trimsthe rack echocardiography,according to operation. The accuracy of diagnosis for congenital coarctation of aorta and complicated malformation of congenital coarctation aorta was respectively 100% and 78% .Conclusion MRI examination for coarctation of aorta is important not only for diagnosis but also for the treatment and follow up,MRI can clearly show the kinds,scope and degree of congenital basically replacey X-ray angiography.

The "Xiang" in traditional Chinese medicine (TCM) contains various meanings such as phenomena, image and symbols. When we consider it as a thinking mode, "Xiang" permeates into all TCM aspects from natural phenomena, anatomical structures of human tissues to physiological functions as well as pathological manifestations of zang-fu organs. In addition, it may have profound but different connotations. The authors of this article analyzed the "Xiang" in TCM according to the "Xiang" of nature, "Xiang" of zang-organs, "Xiang" of spirit, "Xiang" of pulse (pulse conditions) and "Xiang" of tongue (tongue conditions).

Objective To investigate the outcome and the management of pregnant women with Eisenmenger syndrome during perinatal period to reduce the maternal fatality rate.Methods The clinical data of 23 pregnant women with Eisenmenger syndrome admitted into Beijing Anzhen Hospital Capital Medical University from January 1st,2001 to December 31st,2009 were retrospectively analyzed.Gestational week,primary disease of the heart,pulmonary hypertension,oxygen saturation and heart function of the patients were compared with Chi-square test or Fisher's exact test.Results (1) The gestational week of 23 patients with Eisenmenger syndrome were between 15 to 38 weeks,among which 11 cases in the midterm pregnancy and 12 in the last term pregnancy.The severity of pulmonary hypertension,heart function and pregnant outcomes have no difference in patients with differeut gestational weeks (P＞0.05).(2) Ventricular septal defect (VSD) were the most common disease (65.2％,15/23) among the four primary heart diseases of the patients.The heart function of the patients with VSD decreased most severely after pregnancy,and the fatality rate of the heart function Ⅳ was up to 73.3％ (11/15).The incidence of severe pulmonary hypertension was 20.0％ (3/15).The decreasing of the heart function of the patients with different primary heart diseases were different (P＜0.05).(3) Among the pulmonary hypertension patients,there were 7 mild cases (30.4％),12 moderate cases (52.2％) and 4 severe cases (17.4％).The severity of the pulmonary hypertension of the patients correlated to the incidence of postpartum heart failure and death (P＜ 0.05).The outcomes of four patients with severe pulmonary hypertension were the worst and all were reported to be dead (4/4).(4) Oxygen saturation related to the mortality of perinatal infants,incidence of premature birth and spontaneous abortion (P＜0.05).As oxygen saturation decreased to the lowest level,the fatality rate of perinatal infants increased to the highest (5.3 ％,1/19),so did the incidence of the premature birth (84.2％,16/19) and spontaneous abortion ( 10.5％,2/19).Conclusions The key point to increase the safety of patients with Eisenmenger syndrome during perinatal period was to strengthen monitoring,decrease the pulmonary hypertension and terminate pregnancy timely.

Aim To establish the dementia mice models induced by intracerebroventricular infusion of ?-Amyloid peptide and related measuring index. Methods The mice models were made by intracerebroventricular infusion of long fragment of soluble?-Amyloid peptide with micropump, intracerebroventricular injection of long soluble?-Amyloid peptide fragment and short insoluble ?-Amyloid peptide fragment,and intracerebroventricular injection of ?-Amyloid peptide combining with transforming growth factor. Results Compared with normal control, the learning and memory ability was decreased in all above model mice. the ChAT activity in both hippocampus and cortex of model mice decreased, the hippocampal neuron were depleted and the content of apoptosis associated protein Bal-2?BAX and p53 were increased. Conclusions All above mice models could be choose as the dementia models which were simulating the pathological charactoristics of the Alzheimer's disease.

Objective: High performance liquid chromatography-evaporative light scattering detector (HPLC-ELSD) method was used to establish the determination method for the three kinds of saponins (astragaloside I, II, and IV) in Compound Shiwei Tablets (CST), and investigate the three saponins components’ s transfer rate in the preparation process of CST in order to improve the quality control method of CST. Methods: A HPLC-ELSD method was operated on the column of Agilent 5-HC C18 (2) (250 mm × 4.6 mm, 5 μm), with acetonitrile-water as the mobile phase for gradient elution, at a flow rate of 1.0 mL/min, with column temperature of 30 ℃ and injection volume of 20 μL. The ELSD parameters were as follow: the carrier gas flow rate was 1.5 L/min, the drift tube temperature was 90 ℃. Determinate the content of astragaloside I, II, and IV in products, granules and extracts of CST, and calculate the transfer rate of three saponins in the preparation process of CST. Results: A method for the determination of astragaloside I, II, and IV in CST was established. Under this condition, all three components reached baseline separation with good linear relationship. The average recovery rates were 99.58%, 99.31% and 99.51%, and RSD values were 3.0%, 2.5% and 2.5%, respectively. Astragaloside I had lower transfer rate during the preparation process, and the transfer rate of astragaloside IV was the higher in the preparation process, both of which were greater than 100%. Conclusion: This study established a method for simultaneous determination of three kinds of saponins of astragaloside I, II, and IV in CST. The method has good reproducibility and strong specificity, which is simple and easy,and can be used to inspect the transfer rates of three kinds of saponins in the preparation process and improve the quality control standard of saponins in CST, and provide reference for the quality control of other traditional Chinese medicine preparations containing astragalus.