OBJECTIVE:To promote the development and make full use of the pharmacoeconomics(PE)in China.METHODS:The problems to be able to solved using PE,i.e the necessity of developing PE in China was discussed,and the bottleneck which will restrain or hinder the optimal utilization of PE was pointed out.RESULTS:We should strengthen the cultivation of talents engaged in PE,formulating guidelines of pharmacoeconomic evaluation and gradually apply PE into National Essential Medicine Policy.CONCLUSION:The decision-makers of health policy should have a sufficient understanding of PE so as to facilitate the utilization and sustainable development of PE in health policy-related decision-making.

Objective Direct impact is a common mechanism of injury for blunt thoracic injury, and if resulting thoracic injury is severe the mortality may be as high as 10% ～ 25% . We aim to develop a mechanical device for animal impact injury experiment, so as to establish a rodent model of severe thoracic injury. Method A spring operated mechanical device for animal impact injury experiment was developed. The device allowed for accurate controlled delivery of impact force to specific areas of the chest well, at specific velocities and degrees of chest compression. Eghty-four male Sprague-Dawley rats were anaesthetized and underwent left carotid artery cannulation. They were randomly divided into seven groups and given the following treatment: group A (Control group) were subjected to sham impact; group B to G animals were subjected to impacts on the right lateral superior chest at different velocities and degrees of chest wall compression. ( B 3 m/s, 20%; C 3 m/s 40%; D 6 m/s 20%; E 6 m/s 40%; F 9 m/s 20%; G 9 m/s 40%). Arterial blood gas samples were taken just before injury, and at 2 and 12 post injury. All rats were sacrificed at 12 hours and their degree of thoracic injury rated. Pathological examination of injured lung tissue was also performed. Results The device was able to deliver impact forces accurately, with ＜ 4% deviation from desired velocity and ＜ 3 mm deviation from target area of impact. Other than the control group, all animals experienced significant hemodynamic changes immediately post impact. Arterial blood gas analysis detected significant hypocapnia in groups B and C. Significant hypoxemia and hypocapnia was detected in groups D, E and F. In groups B,C,D and F, die impact produced a mild thoracic injury with low mortality rate at 12 hours. In group E, the impact produced severe thoracic injury with mortality rate of 33.33% at 12 hours. Group C animals sustained the most serious thoracic injury with mortality rate of 83.33% at 12 hours. Pathological examination revealed injuries from direct trauma as well as secondary lung injuries. Conclusions Our device was able to repetitively deliver accurate and precise impact forces to rats and allows us to establish a rodent model of severe thoracic injury firm blunt trauma. We found that with our device, impact force at velocity of 6 m/s and 40% chest compression produced the most severe lung injury in rats.This helps us establish a rodent model of severe thoracic injury which can be use for future research in severe blunt thoracic trauma and the secondary lung injuries.

Objective: To study the precise stress distribution in the apical foramen area of endodontic endosseous implant. Methods:After analysis of the two-dimensional endodontic endosseous implants model with finite element method, left and right areas beside the apical foramen were selected as infinite domains for calculation. Results:Under 45? axial right oblique loading, the stress concentration occurred in both infinite domains of the apical foramen. The tension stress concentrated in the infinite domain near the load side,but the other side was compress concentrated. Two stress concentration points were just at the central points, which were intersections between implant and dentin. In the implant and dentin section, the stress reduced in all directions from two stress concentration points, but in the ligament section, the result was contrary. Conclusion:It is helpful to keep the root stable when the fulcrum of the root changed to lower part after restoration. In the implant area,the diameter of implant at the apical foramen of root shouldn't be reduced for the protection of root in clinical work;It is very important to preserve the tissue of periodental ligament for endodontic endosseous implants.

砄bjective: To establish two dimensional infinite model for endodontic endosseous implants in order to set up infinite element method and study the stress distribution of the apical foramen area of endodontic endosseous implant. Methods: Based on the analysis of two dimensional endodontic endosseous implants model with finite element method, left and right areas beside the apical foramen were selected as infinite domains including implant dentin and ligament sections. D N interactive method was used to connect the finite and infinite domains. Results: After ten times interaction between finite and infinite domains with D N interactive method, the outcome approached to a stable numerical value close to the displacement of both domains. Conclusion: The infinite model of two dimensional endodontic endosseous implants established by D N interactive method is efficient and accurate.

Objective:To study the residual stress distribution through the thickness of bilayered dental ceramic subjected to thermal stress, in order to improve the restoration. Methods: The finite element model of bilayered dental ceramic was set up based on International Organization for Standardization(ISO) 96936:1999. The residual stresses were calculated in viscoelastic and elastic phases during cooling of dental ceramic to analyze the residual stress distribution. Results: The deformation of core was greater than the veneer ceramics during the cooling period of dental ceramic. The residual stress increased with the decreasing of the temperature approaching the interface of core and veneer ceramics. But it decreased with the increasing of the thickness of veneer ceramics.Conclusion: Thermal compatibility of core and veneer ceramics is very important to the residual stress distribution in the bilayered dental ceramic, which may benefit to All-ceramic restorations. The viscoelastic behavior of ceramic should be taken into account in the thermal compatibility.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

The human brain-derived neurotrophic factor (hBDNF) gene was cloned by polymerase chain reaction and the recombinant adeno-associated viral vector inserted with hBDNF gene (AAV-hBDNF) was constructed. Cultured rat hippocampal neurons were treated with Abeta(25-35) and serued as the experimental Abeta-induced neuronal damage model (AD model), and the AD model was infected with AAV-hBDNF to explore neuroprotective effects of expression of BDNF. Cell viability was assayed by MTT. The expression of bcl-2 anti-apoptosis protein was detected by immunocytochemical staining. The change of intracellular free Ca ion ([Ca2+]i) was measured by laser scanning confocal microscopy. The results showed that BDNF had protective effects against A-induced neuronal damage. The expression of the bcl-2 anti-apoptosis protein was raised significantly and the balance of [Ca2+]i was maintained in the AAv-hBDNF treatment group as compared with AD model group. These data suggested that recombinant AAV mediated a stable expression of hBDNF in cultured hippocampal neurons and resulted in significant neuron protective effects in AD model. The BDNF may reduce neuron apoptosis through increasing the expression of the bcl-2 anti-apoptosis protein and inhibiting intracellular calcium overload. The viral vector-mediated gene expression of BDNF may pave the way of a novel therapeutic strategy for the treatment of neurodegenerative diseases such as Alzheimer's disease.

Objective To summarize the experiences of Nuss procedure with thoracoscope for repairing pectus excavatum.Methods 21 cases of pectus excavatum were treated by Nuss procedure with thoracoscope.In these patients,10 had symmetric pectus excavatum and 11 had asymmetric one.Results The operation in all patients were successful.The mean operating time wag(70.7±9.6)min and the mean intraoperative blood loss was(20.3±10.9)ml.The average hospital length of stay was(5.3±1.1)days,the average durante dolors was(6.9±4.0)days.The exceUent rate was 81.0%(17/21),including 90.0%(9/10)in symmetric pectus excavatum and 72.7%(8/11)in asymmetric pectus cxcavatum.Conclusion Nuss procedure is easy to perform,with minimal invasion,short operating time,and less blood loss.Nuss procedure is suitable for the symmetric pectus excavatum.

Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.

BACKGROUND: In clinical, propofol can contract cerebral vessels, decrease cerebral blood flow, decrease brain metabolic oxygen consumption,which can decrease pressure in brain. Studies prove that propofol can protect endothelial cell that may be injuried by active oxygen injury and also decrease nerves injury of experimental rats with cerebral ischemia.OBJECTIVE: To investigate the protective effects of propofol on cerebral ischemia-reperfusion injury in rat and its mechanism.DESIGN: Randomized and controlled study.SETTING:Anesthesiological Department of the Second Affiliated Hospital of Xi'an Jiaotong University.PARTICIPANTS: The experiment was conducted at Pharmacological Laboratory of Medical College of Xi' an Jiaotong University in 2004. Totally 40 healthy male SD rats, aged 3-4 months, weighting 200-300 g, were divided randomly into four groups: Model group, control group, nimodipine group and propofol group, with 10 in each group.METHODS: The rats were anesthetized by intraperitoneal methods with ketamine and propofol separately. When righting reflex was abolished, external carotid artery was separated and ligated. A nylon thread was put at the stump site of external carotid artery without ligation. Model group: 10 mL normal saline was injected into intraperitone in 10 minutes before ischemia.Control group: 10 mL normal saline was injected into intraperitone at the end of operation. Nimodipine group: 10 g/L nimodipine (1 mg/kg) was injected into intraperitone in10 minutes before ischemia. Propofol group: 10 g/L propofol (110 mg/Kg) was injected into intraperitone in 10 minutes before ischemia. When ischemia was lasted for 3 hours, nylon thread was with drawed for reperfusion. When reperfusion was lasted for 3 hours, blood samples were obtained from orbit. Skulls were opened and brains were removed.Effect of propofol on cerebral ischemia-reperfusion injury was observed.MAIN OUTCOME MEASURES: Infarction area, cerebral water content,serum lactate dehydrogenase (LDH) and creatine kinase (CK) levels, brain superoxide dismutase (SOD) activity, malondialdehyde (MDA) and Ca2+levels were measured. Ultrastructure of brain tissue was examined under electron microscope.RESULTS: ①Infarct area in propofol group was significantly smaller than that in model group [(10.45±3.65, 19.68±4.03)%, (t=3.493,P ＜ 0.01)]. ② CK level was lower in propofol group than that in model group [(471±200,1 930±917) IU/L, (t=3.493, P ＜ 0.01)]; and LDH level in propofol group [(8 240±2 580) U/L] was significantly different from that in model group [(15 470±2 680) U/L, (t=3.441, P ＜ 0.01)]; And water content in brain tissue was lower in propofol group than that in model group [(78.2±2.4,82.9±2.9)%, (t=3.321, P ＜ 0.01)]. ③ The death rate of rats was 13.6%in propofol group, and 47.6% in model group, the former was decreased obviously as compared with the latter, and the difference was significant (t=6.21,P ＜ 0.05). ④ SOD activity was (1 690±780) U/g in propofol group and (830±110) U/g in model group, the difference was significant (t=3.420, P ＜ 0.01); but MDA content was obviously lower in propofol group than that in model group [(0.058±0.014, 0.115±0.047) μmol/g, (t=3.336, P ＜ 0.01)].CONCLUSION: Propofol has protective effect on cerebral ischemia-reper fusion injury in rats, and the mechanism is related with inhibition of Ca2+overloading and lipid peroxidation.