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.

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 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.

Extracorporeal Circulation ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Retrospective Studies ; Thoracic Surgical Procedures

OBJECTIVE:To provide reference for formulating the policy of promoting the popularization and application of es-sential medicines in second grade or third grade medical institutions. METHODS:Drug purchase and warehousing data was collect-ed from 31 second grade or third grade medicinal institutions in Nanjing during Jan. 2012-Dec. 2015. Excel 2010 and SPSS 20.0 software were used to summarize and analyze statistically the purchase amount of allocation quantity of essential medicines. RE-SULTS:The proportion of essential medicine purchase amount in total medicine purchase amount during 2012-2015 were 18.33%, 18.56%,17.19%,17.53% in 31 medicinal institutions (calledthe ratio of essential medicine purchase amountfor short);the proportion of national essential medicine purchase amount in essential medicine purchase amount(calledthe ratio of essential medi-cine purchase amountfor short)were 31.14%,29.40%,25.69%,25.79%,respectively. The number of generic names for allocat-ed essential medicines were 189.84,205.58,210.26,206.65,respectively. The ratio of essential medicine purchase amount and the ratio of essential medicine purchase amount in 2014 were decreased significantly,compared to in 2013(P<0.05). The number of generic names for allocated essential medicines in 2013 was increased significantly,compared to in 2012 (P<0.05). The ratio of essential medicine purchase amount in second grade medical institutions was significantly higher than third grade medical institu-tions,the ratio of essential medicine purchase amount in general hospital was significantly higher than special hospital;the number of generic names for allocated essential medicines was significantly higher than TCM hospital and special hospital;the ratio of es-sential medicine purchase amount in second grade medical institutions with community health service center in subjection to them was significantly higher than those without community health service center in subjection to them;there was statistical significance (P<0.05). There was negative correlation between the ratio of essential medicine purchase and total purchase amount of medicine in general hospitals(P<0.05). There was positive correlation between the number of generic name of allocated essential medicines and the number of generic name of all medicines in 31 medical institutions(P<0.05). CONCLUSIONS:The ratio of essential med-icine purchase amount and national essential medicine purchase amount,the numbers of generic names of essential medicines were very different and low in these hospitals during 2012-2015. Just one or two had met the requirements of the Jiangsu provincial health and family planning commission. The grade,type,medicine purchase and allocation scale,administering community health service center all influence the purchase and allocation of essential medicines.

BACKGROUND:In recent years, the incidence of diabetic foot is sharply increasing, which tends to cause foot ulcers, amputation and death.
OBJECTIVE:To investigate the clinical therapeutic effect of autologous bone marrow stem cel transplantation combined withdanggui huoxue tangon diabetic foot.
METHODS:Sixty patients with diabetic foot accompanied by chronic lower limb ischemia were randomly divided into conventional treatment group including 20 cases with 38 affected limbs, and autologous bone marrow stem cel transplantation group (cel transplantation group) including 20 cases with 36 affected limbs, and combined group (autologous bone marrow stem cel transplantation combined withdanggui huoxue tang) including 20 cases with 39 affected limbs. After 12 weeks of treatment, indicators such as limb cold-feeling, pain, skin temperature, claudication distance and ankle brachial index were measured, and meanwhile, complications and adverse reactions were observed in the folow-up visit.
RESULTS AND CONCLUSION: In the conventional treatment group, there was no significant change before and after treatment (P > 0.05). However, these indicators were significantly improved in the other two groups after treatment (P < 0.05) as wel as compared with the conventional treatment group (P < 0.05). In addition, there was no adverse reaction in the cel transplantation group. These findings indicate that the combination of autologous bone marrow stem cel transplantation anddanggui huoxue tang has effective effects on diabetic foot.