The rational drug use of elderly patients with chronic diseases had many problems which seriously affect the live and life safety of patients.To convey the importance of rational drug use from the perspective of humanistic care for patients can help to improve the treatment compliance of patients,promote the ability of self-management and build a harmonious doctor-patient relationship.Medical staff should pay attention to enhance the care for the elderly patients,optimize drug treatment programs,improve diversified social support systems and use various medium and forms to propaganda the knowledge of rational drug use.

OBJECTIVE:To explore the issues about distribution of national essential drug system to promote the implementation of national essential drug.METHODS:The problems in the distribution of essential drug and Japan's advanced experience were analyzed in order to put forward suggestion for distribution of essential drug.RESULTS & CONCLUSION:The problems in the distribution of essential drug mainly contained low earnings,shortage of business impetus,ambiguous evaluation criteria and irrational distribution of circulation enterprise.The distribution of essential drug should be supervised strictly by absorbing the experience of Japanese pharmaceutical logistic.Rural Two Network should be improved and the logistics capabilities of pharmaceutical enterprises should be strengthened.JIT purchase mode of essential drug should be established in medical institutions as well as third party logistics.

OBJECTIVE: To explore the coexistence of "Medical Insurance List" and "Essential Drugs List". METHODS: A comparative similarities and differences analysis of the scope, role, to develop the basis for the implementation of the effectiveness between the "medical insurance directory" and "Essential Drugs List" was carried out. RESULTS & CONCLUSION: The new edition of "Essential Drugs List" is to ease the contradiction of coexistence in long-term, but they are difficult to reconcile in short-term.

OBJECTIVE:To promote the adjustment of National Essential Drug List and implementation of Essential Drug List. METHODS:National Essential Drug List was compared with Essential Drug List issued by WHO. Retrieved from statistical results conducted by State Food and Drug Administration, the problem that there were large number of drug in China while little category were included in National Essential Drug List was analyzed, according to practice in China. RESULTS & CONCLUSION: Drug enterprises increased the dosage form and category of preparation blindly because of huge raw drug market, various dosage forms and weak administration to drug enterprises. The characteristics of drug were cheap, high quality, acceptance by state, which decided that the category of drug in Essential Drug List should not be too much. It is necessary to adjust Essential Drug List as the change of situation so as to meet the requirement of public health.

Objective To review the experiences of 31 cases of totally thoracoscopic cardiac surgery of cardiopulmonary bypass in children with congenital heart disease.Methods Thirty one children with congenital heart disease received totally thoracoscopic cardiac surgery procedures during the period from October 2012 to May 2016.The ages of these children were ranged from 2 years and 7 months old to 6 years old with average value (4.6 ± 1.4)years old.The body weights were ranged from 12 ～ 24 kg with average value (17 ± 3.5) kg.Among 31 children,there were 12 cases of atrial septal defect,and 19 cases of ventricular septal defect.Through three-hole shape incision at the right chest wall,each hole was 1.5 to 2.0 cm long,and operation field were revealed totally by thoracoscope.Cardiopulmonary bypass was built through femoral arteriovenous intubation.Results Thirty one children were all cured.None of them suffered severe complications such as renal failure,respiratory failure,low cardiac output syndrome,atrioventricular block,and residual shunt.Duration of cardiopulmonary bypass was 62 ～ 185 (126.4 ± 45.2) min,and duration of myocardial ischemia was 18 ～ 118 (53.4 ± 31.2)min.Duration of Postoperative mechanical ventilation was 2 ～ 7 (5.3 ±-1.5) h.Duration of intensive care unit (ICU) stay was 15 ～ 21 (19 ± 1.3) h.Drainage volume of 24 hours after operation was 0～ 130(57 ± 36.2)ml.Volume of red blood cell transfusion was 0 ～ 2 (1.2 ± 0.8) U.Postoperative hospital stay was 4 ～ 7 (6.2 ± 1.2) d.Conclusions For children with congenital heart disease as simple atrial septal defect or ventricular septal defect,thoracoscopic surgical repair can be achieved the same therapeutic results as traditional median sternotomy surgery while having advantages such as smaller incision,less bleeding and none sternal maluniorts.

The prescriptions including Polygoni Multiflori Caulis that built by Pro. Yan were collected to build a database based on traditional Chinese medicine (TCM) inheritance assist system. The method of association rules with apriori algorithm was used to achieve frequency of single medicine, frequency of drug combinations, association rules between drugs and core drug combinations. The datamining results indicated that in the prescriptions that including Polygoni Multiflori Caulis, the highest frequency used drugs were parched Ziziphi Spinosae Semen, Ostreae Concha, Ossis Mastodi Fossilia, Salviae Miltiorrhizae Radix Et Rhizoma, Paeoniae Rubra Radix, and so on. The most frequent drug combinations were "Polygoni Multiflori Caulis-parched Ziziphi Spinosae Semen", "Ostreae Concha-Polygoni Multiflori Caulis", and "Polygoni Multiflori Caulis-Ossis Mastodi Fossilia". The drug association rules of confidence coefficient 1 were "Ostreae Concha-->Polygoni Multiflori Caulis", "Poria-->Polygoni Multiflori Caulis", "parched Ziziphi Spinosae Semen-->Polygoni Multiflori Caulis", and "Paeoniae Alba Radix-->Polygoni Multiflori Caulis". The core drug combinations in the treatment of insomnia were Ossis Mastodi Fossilia, Polygoni Multiflori Caulis, Salviae Miltiorrhizae Radix et Rhizoma, Ostreae Concha, Polygalae Radix, Margaritifera Concha, Poria, and parched Ziziphi Spinosae Semen. And the core drug combinations in the treatment of obstruction of Qi in chest were Salviae Miltiorrhizae Radix Et Rhizoma, Polygoni Multiflori Caulis, parched Ziziphi Spinosae Semen, Trichosanthis Fructus, Allii Macrostemonis Bulbus, and Paeoniae Rubra Radix.
Data Mining ; methods ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional ; methods ; Plant Stems ; chemistry ; Polygonaceae ; chemistry ; Prescriptions

OBJECTIVETo observe effects and mechanism of Dinggui gel paste analgesic anti-inflammatory.

METHODSEighty-four male KM mice weighted from 18 to 22 g and aged 4 to 5 weeks were randomly divided into 7 groups, named blank group, model group, matrix control group, Votalin group, high dosage of Dinggui gel paste group with group, equivalent dosage of Dinggui gel paste group, Dinggui gel paste group, 12 mice in each group. Except blank and model group, the other groups were paste ointment for 7 days, and one time a day, matrix control group were pasted isodose blank matrix gel patch. Pain threshold were tested at 30, 60, 90 and 120 min after the last ad-ministration. Hot plate test were performed by injection of 5% formalin for 20 µL on right hindfoot sole after the last administration. The cumulative time of mice licking right rear foot were observed at stage of I and II, and content of IL-1, TNF-α were tested by ELISA method. Differences of weight between right and left ears were measured by ear swelling method and anti-inflammation experiment.

RESULTSIn hot plate test at 90 min, pain threshold in equivalent dosage of Dinggui gel paste group was (24.87 ± 14.67) s and (15.28 ± 8.23) s in model group; (26.33 ± 15.45) s in high dosage of Dinggui gel paste group and (15.31 ± 5.02) s in model group at 120 min in hot plate test, there were no statistical differences between two groups. Pain period at stage I, licking cumulative time in high dosage of Dinggui gel paste group was (66.70 ± 22.83) s and (101.80 ± 33.65) s in model group,and had significant differences between two groups; there were statistical differences in licking cumulative time at stage I of pain period among high dosage of Dinggui gel paste group (51.30 ± 43.60)s, equivalent dosage of Dinggui gel paste group (64.00 ± 47.27) sand model group (109.50 ± 36.78) s. Content of IL-1 in model group was (28.70 ± 8.24) ng/L and (13.33 ± 2.20) ng/L in high dosage of Dinggui gel paste group, there was obvious meaning between two groups; There were significant differences in TNF-α content among model group (93.60 ± 23.65) ng/L,high dosage of Dinggui gel paste group (63.21 ± 10.54)ng/L and equivalent dosage of Dinggui gel paste group (72.69 ± 16.26) ng/L; while there were no statistical meaning in ear swelling degree among model group (5.73 ± 0.80) mg,high dosage of Dinggui gel paste group (5.42 ± 0.68) mg and equivalent dosage of Dinggui gel paste group (4.98 ± 1.52) mg.

CONCLUSIONDinggui gel paste could increase pain threshold, reduce licking accumulative time, and decrease ear swelling degree, and relief pain by regulating level of TNF-α and IL-1.

Analgesics ; administration & dosage ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; Dosage Forms ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Interleukin-1beta ; genetics ; immunology ; Interleukin-6 ; genetics ; immunology ; Male ; Mice ; Ointments ; Pain ; genetics ; immunology ; Pain Management ; Tumor Necrosis Factor-alpha ; genetics ; immunology

OBJECTIVE:To systematically review the efficacy and safety of pirfenidone in the treatment of idiopathic pulmo-nary fibrosis (IPF),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library, PubMed,EMBase,CJFD,CBM,VIP Database and Wanfang Database,randomized controlled trials (RCT) about the efficacy and safety of pirfenidone (test group) versus placebo (control group) in the treatment of IPF were collected,and Meta-analysis was performed by using Rev Man 5.1.7 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 4 RCTs were enrolled,involving 1 153 patients. Results of Meta-analysis showed the decrease value of lung capacity [WMD=0.39,95%CI(0.16,0.61), P<0.001] and decrease value of the percentage of forced vital capacity to expected value [RR=0.68, 95%CI(0.53,0.87),P=0.002] in test group were lower than control group,there was significant difference between 2 groups;there was no significant difference in the lowest oxygen saturation [WMD=0.53,95%CI(-0.78,1.84),P=0.43] between 2 groups,however,the results of subgroup analysis showed the remission degree of 1 200 mg/d PFD for the decrease of lowest oxy-gen saturation was superior to placebo group,there was significant difference between 2 groups [WMD=1.72,95%CI(1.33,2.10), P<0.001],but therewas no significant difference between the remission degree of 1800 mg/d and placebo;and there was no signifi-cant difference in the incidence of adverse reactions between 2 groups [RR=1.70,95%CI(0.46,6.31),P=0.43],but the incidence of photosensitivity veactions in test group was significantly higher than that of control group,there was significant difference [RR=9.35,95%CI(4.23,20.67),P<0.001]. CONCLUSIONS:The efficacy of pirfenidone in the treatment of IPF is good,but the inci-dence of photosensitivity reactions should be noticed.

Objective:To investigate the efficacy of single time intra-articular different concentration of allogeneic bone marrow mesenchymal stem cells ( BM-MSCs ) injection in the treatment of Sprague-Dawley ( SD) rat model of osteoarthritis ( OA) .Methods: In the study, 32 SD rats were equally ran-domized into 4 groups:control group, high concentration group (1 ×107/mL BM-MSCs), low concentra-tion group (5 ×106/mL BM-MSCs) and high vs.low concentration group.The two knees of each rat were set up to a pair.The induction of OA was performed surgically randomly at one side in model group, and bilaterally in the other groups, which were through anterior cruciate ligament transaction ( ACLT) and medial meniscus excising.After the operation, the SD rats were allowed free movement.Four weeks later, different concentrations of allogeneic BM-MSCs isolated from the SD rats, expanded in vitro and suspended in phosphate buffered solution( PBS) were delivered in the articular cavity of both knees;PBS was used as the control.After injection, we excised the femoral nerve and sciatic nerve to disuse the low limb.The cartilage histological sections of knees were scored by Mankin scoring system to assess the se-verity of the pathology.mRNA of collagen Ⅱwas detected by real time polymerase chain reaction ( RT-PCR) .eGFP was detected by fluorescence microscope.Assessments were carried out 4 weeks after the operation in model group, and 3 weeks after injection in the other groups.Results:Mankin scores of the BM-MSCs side and control side were 6.60 ±0.40 vs.10.00 ±0.32 in low concentration group ( P<0.05), and 5.40 ±0.51 vs.9.60 ±0.51 in high concentration group (P<0.05).Mankin scores of high sv.low concentration group were 6.40 ±0.51 vs.7.60 ±0.75 (P>0.05).mRNA expression of collagen Ⅱ of the BM-MSCs side in low concentration group was 106%±1%in contrast to the control side.As in high concentration group it was 108%±1%, and 102%±1%in high vs. low concentra-tion group.Labeled BM-MSCs were detected unexpectedly in the synovial membrane but not in cartilage tissue three weeks from injection.Conclusion:BM-MSCs could promote cartilage repair and inhibit OA progression through a trophic mechanism.There was no difference between the two concentrations.