With this retrospective study, we analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation in typical regions at home and abroad.In foreign countries, drug negotiation mechanism has been implemented for many years, and many countries have established a relatively perfect negotiation system.We selected 8 typical countries and regions for which we statistically analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation and these include the United States, Australia, Canada, France, Germany, Italy, South Korea and Taiwan.However, in recent years some Chinese medical insurance department carried out pilot works on drug negotiations, and they got some successful results of the implementation of practical experience.Eight typical Chinese regions were also selected for statistical analysis, and these include Zhejiang, Hunan, Jiangsu, Jiangxi, Chengdu and Qingdao.From the analysis of the comparison of drug negotiation mechanism in domestic and foreign typical regional, we found that foreign regional drug negotiation mechanism is more mature and perfect, while in the domestic areas the mechanism is still poor at a certain extent as compared to foreign countries.We should learn from the successful experience of foreign countries and also establish and improve the negotiation mechanism that is suitable for China''s national conditions.

Amino Acids ; urine ; Animals ; Biogenic Monoamines ; metabolism ; urine ; Male ; Microwaves ; Rats ; Rats, Wistar

OBJECTIVETo investigate the correlations of 24 biochemical markers in the seminal plasma with routine semen parameters.

METHODSAccording to the WHO5 standards, we analyzed the routine semen parameters of 66 subfertile men, including the semen volume, sperm concentration, total sperm count, sperm motility, and the percentage of progressively motile sperm (PR). Based on the calibration and quality control measures and using an automatic biochemistry analyzer or electrolyte analyzer, we detected 24 biochemical markers in the seminal plasma of the patients, including total protein (TP), albumin (Alb), globulin (Glb), uric acid (UA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), γ-glutamyltransferase (GGT), lactate dehydrogenase (LDH), creatine kinase (CK), alpha hydroxybutyrate dehydrogenase (αHBDH), adenosine deaminase (ADA), glucose (Glu), triglyeride (TG), total cholesterol (TC), urea nitrogen (UN), creatinine (Cr), high-sensitive C-reactive protein (hsCRP), K+, Na+, Cl- , Ca, Mg, and phosphorus (P). Then we analyzed the correlations of the 24 biochemical markers with routine semen parameters.

RESULTSThe levels of the TP, Alb, and Glb proteins in the seminal plasma were positively correlated with sperm concentration, so was that of Alb with the total sperm count, and the AST and LDH activities with sperm concentration and total sperm count. The AKP activity in the seminal plasma was correlated negatively with the semen volume, but positively with sperm motility. The αHBDH activity exhibited a positive correlation with both sperm concentration and total sperm count, with a coefficient of correlation (r) above 0.7. The UN level was correlated negatively with the semen volume, so was the Cr level with the semen volume, sperm concentration, and total sperm count, and the Glu level with sperm concentration and total sperm count. The TG level was correlated positively with the semen volume, but negatively with sperm motility. The levels of seminal plasma ALT, GGT, ADA, UA, TC, CK, and hsCRP showed no correlation with the above-mentioned semen parameters. None of the seminal plasma K+, Na+, Ca, Mg, and P levels was found correlated with semen parameters except the Cl- level, which was negatively correlated with the semen volume.

CONCLUSIONMany biochemical markers in the seminal plasma are closely related to routine semen parameters, indicating that these biochemical components may play roles in spermatogenesis, sperm maturation, and physiological metabolism.

Biomarkers ; chemistry ; Humans ; Male ; Semen ; chemistry ; Semen Analysis ; Sperm Count ; Sperm Motility

Objective To evaluate the clinical results of femoral-deep femoral crossover bypass in the treatment of long-segment unilateral iliac artery occlusive disease.Methods From July 1995 to December 2010,40 patients (28 males,12 females,aged from 66 to 90,with mean age of 73) with comprehensive unilateral iliac-superficial femoral arteriosclerosis obliterans were enrolled in this procedure.All patients suffered from unilateral common iliac,external iliac,common femoral,and superficial femoral arteriosclerosis obliterans.These patients were treated with femoral-deep femoral crossover bypass.Postoperative ankle-brachial index,blood flow velocity and patency rates in 5,7 and 10 years and limb salvage rates in 5,7 and 10 years were evaluated.Results There was no perioperative mortality nor extremity amputation.35 (87.5％ ) patients were followed-up from 1 to 13 years (mean 5.7 y).Anklebrachial index rose from preoperative 0.23 ± 0.10 to postoperative 0.55 ± 0.11 (t =15.91,P =0.000 ).Popliteal arterial velocity rose from preoperative ( 14 ±6) cm/s to postoperative (34 ± 10) cm/s (t =15.63,P =0.000) ; Tibial arterial velocity rose from ( 10 ±4) cm/s to (22 ±7) cm/s (t =15.71,P =0.000).The primary and secondary patency rates were 60.1％,44.3％,25.3％,and 93.5％,86.8％,57.9％ at 5,7 and 10 years,respectively.Limb salvage rates were 97.5％,95％,and 90％,at 5,7 and 10 years,respectively.Conclusions Femoral-deep femoral crossover bypass is safe and reliable in treating certain unilateral iliofemoral occlusive disease,especially for high-risk old patients or those who are not indicated for endovascular therapies or direct aortic approaches.

Aluminum ; toxicity ; Animals ; Animals, Newborn ; Calcium ; metabolism ; Cerebral Cortex ; drug effects ; metabolism ; Dose-Response Relationship, Drug ; Female ; Male ; Rats ; Rats, Wistar

OBJECTIVETo explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty (PKP).

METHODSThe clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed, all punctures were performed unilaterally. There were 6 males, aged from 65 to 78 years old with an average of (71.83 ± 6.15) years; and 31 females, aged from 57 to 89 years old with an average of (71.06 ± 7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data, the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed; VAS score was used to evaluate the clinical effects.

RESULTSThe puncture angle of thoracic vertebrae in T8-T12 was from 28° to 33° with an average 30.4°; and the puncture angle of lumbar vertebrae in L1-L5 was from 28° to 35° with an average of 31.3°. Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97 ± 0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly (1.89 ± 1.29 vs 7.03 ± 1.42).

CONCLUSIONThrough measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation, unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Spinal Puncture ; methods ; Thoracic Vertebrae ; injuries ; surgery

Objective To dynamically investigate the effects of aluminum on the concentration of free intracellular Ca2+([Ca2+]i) and the expression of calcium channels in the hippocampus of rats. Methods Healthy 64 Wistar rats were taken as the experimental objects. And these rats were randomly divided into 16 groups according to their weights, and were instilled with AlCl3 at 0(control),37.3,74.7 and 248.7 mg/kg respectively. The experimental time exposed to AlCl3 was 45,75,120 d, among which the rats were given AlCl3 for 120 d fed normally for 30 d. The hippoeampus were segregated on day 45,75,120 and 150 d and the[Ca2+]i of hippocampus of rats were detected by fluorospectrophotometer. The expression of Ryanodine receptor 2 (RyR2) mRNA and α1C ubunit of L-type calcium ehannels(L-Ca2+α1C) mRNA were detected by RT-PCR analysis. Results [Ca2+]i was increased by AlCl3 in a dose-and time-dependant manner(F=23.136 and 19.089, P<0.01). There was a synergistic effect between the dose and time in [Ca2+]i (F=2.270, P<0.05). In time of 120,150 days, the [Ca2+]i of rats hippocampus in 37.3[(299.3±48.7), (342.7±35.3)nmol/L], 74.7[(391.2±47.9), (408.1±42.8)nmol/L] and 248.7 mg/kg group[(397.9±55.8), (405.2±22.7)nmol/L] significantly increased compared with control group [(195.1±29.9), (209.1±30.6)nmol/L; P<0.01]. The expression of RyR2 mRNA and L-Ca2+α1C mRNA were increased by AlCl3(F=23.301 and 60.812, P<0.01). The experimental time could lower the expression of L-Ca2+ α1C mRNA (F=6.088, P<0.01), but had no influences on the expression of RyR2 mR NA (F=1.361, P>0.05). There was interaction between the dose of AlCl3 and the time in the expression of L-Ca2+α1C mRNA (F=5.876,P< 0.01). On day 75,120 and 150 of the experiment, the expression of L-Ca2+α1C mRNA in rat hippocampus of 74.7 (1.03±0.16,1.18±0.18,0.92±0.11) and 248.7 mg/kg group(1.89±0.26, 1.25±0.10, 1.07±0.14) also increased compared with control group(0.63±0.09,0.78±0.16,0.69±0.11; P<0.05 or <0.01). On day 45,75, 120 and 150 of the experiment, the expression of RyR2 mRNA in 74.7(0.49±0.06,0.51±0.07,0.57±0.11, 0.47±0.11), 248.7(0.47±0.03,0.52±0.09, 0.70±0.10, 0.78±0.09)mg/kg AlCl3 groups was highly increased compared with control group (0.24±0.07, 0.32±0.04, 0.30±0.06, 0.27±0.06; P<0.05 or<0.01). Conclusion Al increases [Ca2+]i by increasing the expression of the RyR2 mRNA and L-Ca2+α1C mRNA, thus exerts an irreversible neuronal toxicity.

ObjectiveTo assess the clinical efficacy and safety of donepezil in treating the mild to moderate cognitive impairment of vascular dementia.Methods60 patients with vascular dementia were randomly divided into therapy group (donepezil 5 mg/d for 4 weeks, and then increased to 10 mg/d) and control group (piracetan 800 mg,3/d). All patients were assessed with Mini Mental State Examination (MMSE), Wechsler Adult Intelligence Revised in China (WAIS-RC), Activities of daily living (ADL), and Clinical Global Impression (CGI), before and 12 weeks after treatment. ResultsMMSE scores improved significantly in both groups after the treatment. The therapy group produced significantly better scores than the control groups on the MMSE(P<0.05). WAIS-RC scores improved significantly in the therapy groups(P<0.01), but there was no significant difference for control groups(P>0.05), before and after treatment. Severity Improvement(SI) score of ADL and CGI in the both groups decreased. The total efficiencies of donepezil and piracetan groups were 86% and 56% respectively. There was no significant difference in adverse effects between two groups. ConclusionDonepezil can improve the cognitive function of patients with vascular dementia, which seems better than that of piracetan, and it is fairly safe for vascular dementia patients to take donepezil 10 mg a day.

AIM:To investigate the effect of Ahmed glaucoma drainage valve implantation on corneal endothelial cell density and intraocular pressure in patients with neovascular glaucoma.METHODS:Totally 200 cases (200 eyes) of patients with neovascular glaucoma in our hospital from June 2013 to June 2016 were enrolled in this study.All patients were treated with glaucoma drainage valve implantation.The medical records of the patients were retrospectively analyzed;the evaluation of operation completion was made;intraocular pressure at preoperative and postoperative 1wk,1mo,1a was detected using non-contact tonometry;the corneal endothelial cell density at preoperative and postoperative 1 wk,1mo and 1 a was tested by corneal endothelial microscopy,and visual acuity of patients before operation and at 1 a after operation was recorded.All patients' complications and intervention methods were followed-up and recorded.RESULTS:All patients' complete success rate was 81.0％,the conditional success rate was 92.0％.The proportion of preoperative and postoperative vision without light perception,hand moving to 0.01,0.02-0.05,0.06-＜0.10,≥0.10 had significant difference (P＞0.05).Intraocular pressure before treatment was 42.43±3.43mmHg,and were 13.45 ± 2.34mmHg,15.89 ± 2.67mmHg,16.34±2.88mmHg at 1wk,1mo and 1a after operation respectively,showing significant difference (F=4570.62,P＜ 0.001).Before treatment,corneal endothelial cell density was 2453.67± 342.34/mm2,and were 2216.67-± 332.32/mm2,2087.34 ± 326.45/mm2,1959.67±303.34/mm2 at 1wk,1mo and 1 a after operation respectively,holding significantly different (F=83.42,P＜0.001).There were macular degeneration 20 eyes of hyphema,13 eyes of low pressure,8 eyes of drainage valve displacement and 21 eyes of shallow anterior chamber.CONCLUSION:Ahmed glaucoma drainage valve implantation for neovascular glaucoma can effectively control intraocular pressure but the presence of corneal endothelial cell loss exists,can effectively protect and recover residual vision of patients,relief complications and recover it after simple intervention,it is an effective method for neovascular glaucoma.

Background The domestic and international researches discovered that many proteins and enzymes of the extracellular matrix (ECM) participate in the sclera remodeling by affecting the collagen typeⅠand fibronectin.Objective This study was to investigate the effect of matrixmetalloproteinase-2 (TIMP-2) on expression of collagen typeⅠand fibronectin of ECM in the posterior sclera by injecting liposomes containing tissue inhibitor of TIMP-2 gene into suprachoroidal space of the form-deprivation myopia in guinea pig.Methods Form-deprivation myopia was induced by translucent goggles in 36 clean guinea pig for 2 weeks.Then the animals were randomly assigned to TIMP-2 group,empty plasmid group,saline group and 12 for each group.Liposomes of 5μl containing TIMP-2 gene,empty plasmid and saline were suprachoroidally injected in the right eye respectively,and the left eyes without any treatment were used as self-control group.Other 12 matched guinea pigs only covered the right eyes through out the experimental duration as model control group.The guinea pigs were sacrificed and the posterior sclera tissue of the eyeballs were collected at 2,7 and 14 days after injection of drug.The expressions of collagen typeⅠmRNA and fibronectin mRNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).This study followed the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The expression level of collagen type Ⅰ mRNA in the posterior sclera of guinea pig was lower but that of fibronectin mRNA was higher in TIMP-2 group than self-control group,showing significant differences between them (P＜0.05).The expression level of collagen type Ⅰ mRNA in the posterior scleral tissue began to increase from the 2nd day after drug injection and was obviously elevated at the 7th day and then gradually decreased at the 14th day.However,the expression level of fibronectin mRNA in the posterior scleral tissue showed the opposite pattern.The expression levels of collagen typeⅠmRNA and fibronectin mRNA at the 7th after drug injection were significantly lower than that at the 2nd day or 14th day (P＜0.01).Conclusion Suprachoroidal injection of TIMP-2 in form-deprivation myopia could up-regulate the expression of collagen typeⅠmRNA and down-regulate the expression of fibronectin mRNA in the posterior scleral tissue.It may slow down the sclera remodeling of form-deprivation myopia in guinea pig in the early stage.