The Risk-sharing agreements have achieved remarkable success in improving patients'access to drugs, lowering the uncertainty of the drugs cost-effectiveness, financial risk control and other aspects of medical in-surance fund , so they have attracted widespread attention by the concerned governments and insurers .This paper sys-tematically reviewed the patient access schemes in UK from several aspects , including the origin of the program , clas-sification , application processes and the implementation effects as well .The results of the research indicated that Chi-na has basically met the conditions for implementation of the risk-sharing agreements .In order to gradually promote the risk-sharing agreements implementation , this paper suggests that China should clarify the main root of risk-sharing agreements implementation , establish risk-sharing agreements standardization process and strengthen the application of health technology assessment in health resources allocation to improve the Chinese medicines bargaining system more scientifically and efficiently .

Nuclear factor-E2 related factor 2 (Nrf2)can protect the normal cells from the damage of oxidants and electrophones,preventing tumorigenesis and metastasis.However,the abnormal activation of Nrf2 in tumor cells can lead to tumor development.Chemicals acting on Nrf2 pathway include activators and inhibi-tors,Nrf2 inhibitors can increase the chemosensitivity of the tumor,providing a new idea for the drug design of high-efficiency and low-toxicity.

BACKGROUND: Patient subjective satisfaction is of great significance for the clinical use of implant denture.OBJECTIVE: To investigate the patient satisfaction with single or bridge crown for repair of consecutive missing posterior teeth in the maxilla.METHODS: We selected 203 patients with consecutive missing of maxillary first and second molar teeth, who had received single (n=99) or bridge (n=104) crown for implant restoration 1 year ago. All patients were surveyed with a subjective satisfaction questionnaire and visual analogue scale.RESULTS AND CONCLUSION: There was no significant difference in sex and age (35-64 years) between the two groups. Food impaction ratio and crown off ratio were higher in the bridge crown group than the single crown group.Noticeably, most patients did not have the habit of using dental floss. The overall satisfaction scores were 88.96% in the single crown group and 85.32% in the bridge crown group, respectively. Four indexes with less than 80 scores in the two groups were that I dare to use the implant teeth to bite hard food, my implant teeth are easily cleaned, it takes me less time to clean my implant teeth than natural teeth, and I think the dental implant price is acceptable. Results from the analysis of variance showed that food impaction influenced chewing effect (P=0.047), made the use of dental floss difficult (P=0.031), made patients discomfort (P=0.038), and the use of dental floss could enhance the cleaning effect on dental implant (P=0.019), and largely reduced brushing bleeding (P=0.029). In conclusion, patients with missing maxillary posterior teeth can obtain higher satisfaction after single crown or bridge crown repair. However, food impaction and crown off become more serious after repair with bridge crown, while the repair with single crown exhibits better performance.

OBJECTIVE:To prepare loperamide hydrochloride oral solution,to establish its quality control method,and to study its stability.METHODS:Loperamide hydrochloride oral solution was prepared by using macrogol-400as the anxiliary solvent,water as the solvent,a reversed phase HPLC method was established to determination the content of principal agent loperamide hydrochloride and the method described in Chinese Pharmacopeia was applied to study its stability.RESULTS:A good linear relationship was obtained in the loperamide hydrochloride at concentration of0.05～0.5mg/ml(r=0.9995);The average recoveries of loperamide hydrochloride at the high,medium and low concentrations were100.6%、101.5%and99.1%respectively,with RSD being1.03%、0.49%and0.56%respectively;The stability showed no evident change as compared with before.CONCLUSION:The loperamide hydrochloride oral solution shows the advantages of simple preparation procedure,satisfactory stability and controllable quality.

Sodium houttuyfonate (SH) is a derivative of effective component of a Chinese material medica, Houttuynia cordata, which is applied in anti-infection of microorganism. But, the antimicrobial mechanisms of SH still remain unclear. Here, we firstly discovered that SH effectively inhibits the three types of virulence related motility of.Pseudomonas aeruginosa, i.e., swimming, twitching and swarming. The plate assay results showed that the inhibitory action of SH against swimming and twitching in 24 h and swarming in 48 h is dose-dependent; and bacteria nearly lost all of the motile activities under the concentration of 1 x minimum inhibitory concentration (MIC) (512 mg x L(-1) same as azithromycin positive group (1 x MIC, 16 mg x L(-1)). Furthermore, we found that the expression of structural gene flgB and pilG is down-regulated by SH, which implies that inhibitory mechanism of SH against motility of P. aeruginosa may be due to the inhibition of flagella and pili bioformation of P. aeruginosa by SR Therefore, our presented results firstly demonstrate that SH effectively inhibits the motility activities of P. aeruginosa, and suggest that SH could be a promising antipseudomonas agents in clinic.
Alkanes ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; metabolism ; Biofilms ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fimbriae, Bacterial ; drug effects ; genetics ; metabolism ; Houttuynia ; chemistry ; Pseudomonas aeruginosa ; cytology ; drug effects ; genetics ; pathogenicity ; Sulfites ; pharmacology ; Virulence ; drug effects

Objective To describe the clinical and imaging manifestations of patients with synovitis acne pustulosis hyperostosis osteomyelitis (SAPHO) syndrome,and to analyze the diagnostic importance of different clinical and imaging manifestations for SAPHO syndrome. Methods Seventeen patients (7 males and 10 females) with SAPHO syndrome were recruited in this study.Age ranged from 36 to 67 years with a mean age of (48 ± 8) years. All patients fulfilled the diagnostic criteria of Benhamou. Serum HLA B27 antigen records were reviewed for all patients. Imaging data of the abnormal bone sites were collected by conventional radiograph in all patients,CT in 13 patients as well as MR in 3 patients.Average time to take for a definite diagnosis of the syndrome was 3.7 years (ranged from O.5 to 13 years).Results Serum HLA B27 antigen was positive in all patients. Both skin and bone abnornalities were found in all patients.Ten patients had skin palmoplantar pustulosis and two patients had acne. Involving sites of bone and joints include sacroiliac joints,anterior chest and limbs.Sacroiliac joints were asymmetrically involved with imaging features in all patients.Eight patients exhibited anterior chest wall involvement. Five patients had osteomyelitis at limbs. For all images of 17 patients,CT was superior to conventional radiography in detecting abnormal changes of bone erosion and soft tissue swelling.MR imaging was able to depict edema changes that was not detectable by CT and radiography.Conclusion SAPHO syndrome is a rare disease,but for patients with skin and bone-joint abnormalities,especially with skin palmoplantar pustulosis,acne as well as with imaging features at the sacroiliac joint and anterior chest wall,SAPHO syndrome should be taken into a diagnostic consideration.

Objective To investigate the influence of panton-valentine leucocidin (PVL) on expression of Toll like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB) signals and IL-8,IL-6 in THP-1 macrophages,and to study the mechanism of PVL-related lung tissue damage.Methods THP-1 cells were cultured in the presence of 100 nmol/L phorbol-12-myristate 3-acetate (PMA) for 48 h to induce monocytemacrophage differentiation.rPVL-F and rPVL-S were induced and expressed from the recombinant plasmid,respectively purified with chromatographic column. After that,THP-1 macrophages were incubated with rPVL,and then ELISA was performed to test expression of IL-8 and L-6 in supernatants fluid; RT-PCR was performed to detect expression of IL-8,L-6 and TLR4 ; NF-κB was analyzed by Western blot and immunohistochemistry method.Results PVL was able to induce expression of IL-8 and IL-6 in THP-1 macrophages in time-and concentration-dependent manners.PVL could also significantly promote the activation of TLR4/NF-κB signals.Conclusion PVL can activate the expression of TLR4/NF-κB signals,and increased the high expression of inflammatory cytokines.Maybe it's the mechanism of action of PVL exerts the function of lung tissue damage.

ObjectiveTo investigate the value of high-frequency ultrasound in assessment of the therapeutic efifcacy of traditional Chinese medicine in patients with breast dysplasia using.MethodsFrom March to September in 2014, 50 patients with breast dysplasia in the Third Affiliated Hospital of Beijing University of Chinese Medicine were enrolled in the study. In addition, they were treated with Xiaozheng pills. Before and after treatment, these patients were examined using ultrasound. The thickness of the breast gland layer in each patient was measured. When the dilated ducts lactiferous, cysts, hypoechoic areas, or nodules of the breast were detected, the diameter or volume was measured or calculated. A grading system of the breast dysplasia was used to evaluate the disease degree, and the quadrants of the breast dysplasia were counted. The thickness of the breast gland layer, the volume of cysts and nodules, the diameter of hypoechoic areas and the dilated ducts lactiferous, the number of the breast dysplasia were compared with the pairedt-test. The grading of the breast dysplasia was compared with rank sum test.ResultsThere were significant decreases in the thickness of the grand layer, the diameters of the ducts lactiferous and the hypoechoic area after treatments [(15.92±4.73) mm vs(13.02±4.20) mm,t=2.240,P<0.01; (2.26±0.58) mm vs (1.71±0.47) mm,t=5.202,P<0.01; (21.14±5.57) mm vs(17.80±4.63) mm,t=5.529,P<0.01]. However, there were no significant differences in the volume of cysts and nodules. The grading of the breast dysplasia showed statistical difference (z=-5.667,P<0.01), and the number of the breast dysplasia quadrants was reduced markedly (5.38±1.85 vs3.28±1.97,t=7.566,P<0.01).ConclusionsUltrasound can be an effective method in assessment of patients with breast dysplasia treated with the traditional Chinese medicine. The assessment can be based on some signs, including the thickness of the grand layer, the diameters of the ducts lactiferous, and the diameters of the hypoechoic area. The grading system and breast quadrants counting in these patients may be added as supplementary criteria to make a complete therapeutic evaluation.

ObjectiveTo explore the relationship between the weight-bearing of affected side and the functional mobility in stroke patients.Methods36 hemiparetic stroke patients participated in this study. They were asked to measure the ration of the weight-bearing of affected side on the undisturbed and maximum situations, as well as the time for Timed "Up and Go" Test (TUGT) and Sit-to-Stand Test. The correlation between the ration of the weight-bearing of affected side on maximum situations and the time for the TUGT and Sit-to-Stand Test were analysed statistically with Spearman's correlation in those stroke patients whose ration of the weight-bearing of affected side on undisturbed situations was less than 50%.ResultsThere were correlation between the ration of the weight-baring of affected side on maximum situations and the time for the TUGT (r=-0.605, P<0.01) and the time for the Sit-to-Stand Test (r=-0.456, P<0.05).ConclusionA good relationship exists between the weight-bearing of affected side and the functional mobility in stroke patients.

Child ; Cryptococcosis ; diagnosis ; therapy ; Humans ; Lung Diseases, Fungal ; diagnosis ; therapy