Objective To analyze the usage of basic drugs in non-primary health care institutions in Luzhou,Sichuan,to comment on the performance of the basic drug system,and to provide reference data for relevant ministries and departments.Methods To collect and to statistically analyze the data of the categories and sales amount of the basic drugs used by three level-3A health care institutions and nine level-2 health care institutions from Jan 1,2010 to Dec 31,2012. Results The purchasing proportion of the basic drugs in the level-3A institutions for 2010,2011,and 2012 are respectively 15.62%,17.84%,20.01%;similarly,the data for the level-2A institutions are respectively 29.35%,32.16%,35.07%;the data for the level-2B institutions are respectively 34.73%,37.05%,40.02%.The sales proportion ofthe basic drugs for the years of2010,2011,and 2012 are respectively 10.43%,12.38%,15.04% for the level-3A institutions,25.08%,27.24%,30.12% for the level-2A institutions,and 29.24%,32.08%,35.03%for the level-2B institutions.Conclusion Non-primary health care institutions should firmly execute the basic drug system, enhance the propaganda of this policy,try to increase the purchasing proportion of the basic drugs,supervise the prescription behavior of the doctors, and optimize the basic drug index in order to use drugs more appropriately and efficiently.

0.05).The costs of drug were 936.32,2 011.52 and 1 076.32 yuan respectively.CONCLUSION:Regimen of group A is same to other 2 groups in respect of therapeutic efficacy but better than them in cost of drugs.

Because of the information dissymmetry In the relationship between medical care providers and patients,patients are induction to adverse selection,and moral hazard behaviors are produced.Reasons for the information dissymmetry in the relationship between medical care providers were explored, and the main problems were expatiated in ethics opinion,some feasible suggestions were brought forward.

OBJECTIVE:To analyze the clinical application and trend of psychotherapeutic agents in our hospital.METH-ODS:The application of psychotherapeutic agents in our hospital from 2004 to 2006 was analyzed statistically in respect of drug varieties,consumption sum,DDDs and defined daily cost etc.RESULTS:The consumption sum of antipsychotic agents showed a year-on-year upward trend over the 3 year(379,100 yuan,438,800 yuan and 694,100 yuan,respectively).However,the consumption sum of antidepressants showed a downward trend over the 3 years(444,800yuan,440,200yuan,and 335,800 yuan,respectively).The total consumption of the two(antipsychotic agents and antidepressants) made up over 90% in the total psych-otherapeutic agents.CONCLUSION:Of the total consumption sum of psychotherapeutic agents,antipsychotic agents and antidepressants have made their way into the lead,of which,paroxetine,risperidone and olanzapine showing highest percentages.

Objective To observe the three-dimensional structure changes of subchondral bone in early stage knee joint instability and the effect of diphosphonate intervention so as to test the role of early three-dimensional structure changes of subchondral bone in pathogenesis of osteoarthritis (OA).Methods Sixty healthy male New Zealand white rabbits were assigned to model group (n =24),diphosphonate group (n=24) and control group (n =12) according to random number table.Rabbit right knee destabilization (anterior cruciate ligament transection) is used to induce OA.Rabbits in diphosphonate group received subcutaneous injection of 0.01 mg/kg diphosphonate (risedronate) per day.Instead,isotonic saline solution of the same volume was subcutaneously given to rabbits in model and control groups.One third of the animals in each group were killed at week 4,8 and 12 respectively.Surgical knee joint with preservation of each 2 cm bone above and below joint surface was dissected to perform Micro-CT.Bone volume fraction (BVF),trabecular thickness (Tb.Th),trabecular spacing (Tb.Sp),trabecular number (Tb.N),volumetric bone mineral density (vBMD) and tissue BMD (tBMD) were measured and analyzed statistically.Results At week 4 following operation,BVF,Tb.N and Tb.Th were lowered significantly in model group as compared to control group (P ＜0.01) ;BVF was lower in model group than in diphosphonate group (P ＜ 0.05) and lower in diphosphonate group than in control group (P ＜ 0.05) ; Tb.Sp was increased in model group as compared to diphosphonate group and control group (P ＜0.01) and had obvious increase in diphosphonate group as compared to control group (P ＜0.01) ; vBMD was significantly lower in model group than in diphosphonate group and control group (P ＜ 0.05),but there was no statistical difference between diphosphonate group and control group.At week 12 following operation,model group presented higher BVF,Tb.Th and Tb.N (P ＜0.05),significantly lower Tb.Sp (P ＜ 0.05) and significantly higher vBMD (P ＜ 0.01) as compared to diphosphonate group and control group.Conclusions In knee joint instability,variations of subchondral bone are mainly characterized by osteoclasia in the early stage,followed by osteogenesis in later stage.Diphosphonate may improve the bone architecture of subcondral bone via inhibition of bone resorption.

Objective To observe the biomechanical changes of subchondral bone in the early stage of knee joint instability and effect of diphosphonate therapy so as to investigate the role of the early biomechanical changes of subchondral bone in the onset and development of osteoarthritis (OA).Methods Sixty healthy male New Zealand white rabbits were assigned to model group (n =24),diphosphonate group (n =24) and control group (n =12) according to random number table.Joint destabilization by anterior cruciate ligament transection of the right knee of the rabbits was performed to induce OA models.Rabbits in diphosphonate group received subcutaneous injection of 0.01 mg/kg diphosphonate (risedronate) per day,and isotonic saline solution of the same volume was subcutaneously given to rabbits in model and control groups.Half the animals in each group were killed by aeroembolism at postoperative 4 weeks and 12 weeks respectively.Surgical knee joint with preservation of each 2 cm bone above and below joint surface was dissected to perform gross scoring.Thereafter,two-dimensional image profile was achieved by Micro-CT examination and converted into Ansys for limit element analysis after fitting in Mimics software.Results At four weeks,bone volume fraction (BVF),elastic modulus (EM),reaction force (RF),and mean Von Mises stress were all declined in three groups,the lowest level in the model group (P ＜ 0.01).The diphosphonate group also had lower levels than the control group,with insignificant difference.Bone mineral density (BMD) in the model group was obviously declined in contrast with the diphosphonate and control groups (P ＜ 0.01),but there were no significant difference between the diphosphonate group and the control group.At 12 weeks,the model group showed higher level of BVF and BMD,but lower level of EM,RF and Von Mises stress in comparison with the control and diphosphonate groups (P ＜ 0.01).EM,RF,and Von Mises stress were lower in the diphosphonate group than those in the control group as well,but the difference was statistically insignificant.The model group showed that BVF,BMD,EM,RF,and Von Mises stress at 12 weeks were improved from those at 4 weeks (P ＜ 0.01).Conclusions Biomechanical properties of subchondral bone are affected in the early stage of knee joint instability and a notable decrease of EM is observed in the early stage,followed by an enhancement in late stage.It means that the biomechanical changes of subchondra,l bone in the early stage of knee joint instability may be connected with the bone resorption resulting from abnormal stress.On the contrary,diphosphonate may markedly improve EM of subchondral bone through inhibiting bone resorption.

Objective To compare the effects of different doses of propofol on cardiac pump function in morbidly obese patients. Methods Forty morbidly obese patients undergoing laparoscopic Roux-en-Y gastric by-pass were randomly divided into lean body weight(LBW)group and total body weight(TBW)group,with 20 cases in each group.In LBW group,patients were induced by propofol with a dose according to LBW(kg)×2.0 mg/kg but in TBW group,patients were induced by propofol depending on TBW of the patients.We monitored the changes of left ventricular ejection fraction(LVEF)and stroke volume(SV)in patients before anesthetic induction(T1)and at 1 min(T2)after propofol administration.At the same time,we monitored invasive arterial pressure,noninvasive arterial pressure,BIS,and SpO2.Results Compared with those measured at T1,LVEF and SV were decreased af-ter the induction of anesthesia in the 2 groups(P < 0.05);compared with LBW,TBW had greater influence on LVEF and SV after the induction of anesthesia(P<0.05);compared with those at T1,non invasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure decreased after theinduction of anesthesia (P<0.05);compared with LBW,TBW had no significant effect on noninvasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure after the induction of anesthesia(P < 0.05);BIS was less than 50 after the induction of anesthesia in 2 groups. Conclusion Propofol induction with a LBW-dependent dose has less influence on cardiac pump function in morbidly obese patients while ensuring the depth of anesthesia.

Background:In patients with diffuse large B?cell lymphoma (DLBCL), central nervous system (CNS) relapse is uncom?mon but is nearly always fatal. This study aimed to determine the risk factors for CNS relapse in DLBCL patients and to evaluate the effcacy of rituximab and intrathecal chemotherapy prophylaxis for CNS relapse reduction. Methods:A total of 511 patients with newly diagnosed DLBCL treated at the Sun Yat?sen University Cancer Center between January 2003 and December 2012 were included in the study. Among these patients, 376 received R?CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) as primary treatment, and 135 received CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone) as primary treatment. Intrathe?cal chemotherapy prophylaxis (methotrexate plus cytarabine) was administered to those who were deemed at high risk for CNS relapse. In the entire cohort and in the R?CHOP set in particular, the Kaplan–Meier method coupled with the log?rank test was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis. Differences were evaluated using a two?tailed test, andP<0.05 was considered signiifcant. Results:At a median follow?up of 46months, 25 (4.9%) patients experienced CNS relapse. There was a trend of reduced occurrence of CNS relapse in patients treated with rituximab; the 3?year cumulative CNS relapse rates were 7.1% in CHOP group and 2.7% in R?CHOP group (P=0.045). Intrathecal chemotherapy prophylaxis did not confer much beneift in terms of preventing CNS relapse. Bone involvement [hazard ratio (HR)=4.21, 95% conifdence interval (CI) 1.38–12.77], renal involvement (HR=3.85, 95% CI 1.05–14.19), alkaline phosphatase (ALP) >110U/L (HR=3.59, 95% CI 1.25–10.34), serum albumin (ALB) <35g/L (HR=3.63, 95% CI 1.25–10.51), treatment with rituxi?mab (HR=0.34, 95% CI 0.12–0.96), and a time to complete remission≤ 108days (HR=0.22, 95% CI 0.06–0.78) were independent predictive factors for CNS relapse in the entire cohort. Bone involvement (HR=4.44, 95% CI 1.08–18.35), bone marrow involvement (HR=11.70, 95% CI 2.24–60.99), and renal involvement (HR=10.83, 95% CI 2.27–51.65) were independent risk factors for CNS relapse in the R?CHOP set. Conclusions:In the present study, rituximab decreased the CNS relapse rate of DLBCL, whereas intrathecal chemo?therapy prophylaxis alone was not suffcient for preventing CNS relapse. Serum levels of ALB and ALP, and the time to complete remission were new independent predictive factors for CNS relapse in the patients with DLBCL. In the patients received R?CHOP regimen, a trend of increased CNS relapse was found to be associated with extranodal lesions.