OBJECTIVE:To put forward some suggestion to improve drug bidding system in China.METHODS:The process of drug bidding system reform and its common problems were analyzed.Game theory and information asymmetry theory were adopted to analyze the root of the problems and to put forward suggestions.RESULTS:Governments indiscriminately expanded the goals of bidding policy and strengthen price factor.They neglected important steps such as logistics distribution.Current single evaluation system can not count the medication order exactly.Delayed received payment of medical institution resulted in many problems of drug purchase.CONCLUSION:Centralized drug bidding system should be improved and enhanced.It also should be connected with relevant medical system reform to standardize drug circulation channels,reduce drug price and reduce the burden of patient.

Objective To study the clinical efficacy of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules combined with trimebutine maleate and psychological intervention in the treatment of functional diarrhea. Methods 100 patients with functional diarrhea treated in our hospital from May 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with trimebutine maleate treatment, the experimental group were treated with live combined bacillus subtilis and enterococcus faecium enteric-coated capsules trimebutine therapy and psychological intervention, pay attention to the psychological status of patients and patients, strengthen communication and exchanges, increase confidence in the treatment and the treatment compliance of patients. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the effective rate was 92.0％ in the experimental group and 84.0％ in the control group. The difference was statistically significant (P<0.05). There was no obvious adverse reaction in the experimental group and the control group. After treatment, the number of diarrhea in the experimental group was (3.0±0.3), significantly less than that of the control group (4.3±0.3), the difference was statistically significant (P<0.05). Conclusion The clinical effect of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules combined with trimebutine maleate and psychological intervention in the treatment of functional diarrhea is good, can improve clinical symptoms in a large extent, has the meaning of promotion.

Objective To explore the death risk factors of preterm infants with respiratory distress syndrome (RDS).Methods A retrospective analysis of 66 preterm infants with severe RDS,who admitted to our NICU between January 2010 and December 2011.The patients were divided into the death group and survival group according to the ending.Results There were a total of 24 cases died (36.36％).The death group's mechanical ventilation time,the median of base excess,the minimum median of pH,PaO2/FiO2,average gestational age,average birth weight,1 minute Apgar score and 5 minute Apgar score were all lower than those of survival group (P ＜ 0.05).In death group,the median duration of FiO2 ＞ 60％,intrauterine distress,polyembryony,sore for neonatal acute physiology perinatal extension version Ⅱ (SNAPPE-Ⅱ) score were all higher than those of survival group (P ＜ 0.05),but the mechanical ventilation complications had no difference between the two groups (P ＞ 0.05).Further Logistic regression analysis showed that independent risk factors were birth weight,1 minute Apgar score and SNAPPE-Ⅱ score,OR were 0.990,0.141 and 1.240 respectively.Receiver operating characteristic analysis of the ability of SNAPPE-Ⅱ score predicting death risk showed the area under curve was 0.86,the difference was statistically significant compared with 0.5 (P =0.000).Death risk prediction showed that the demarcation point SNAPPE-Ⅱ score =24.50 corresponded to the maximum (Youden index =0.70) correct prediction effect.Condusion Independent risk factors of died from severe RDS are birth weight,1 minute Apgar score and SNAPPE-Ⅱ scores; SNAPPE-Ⅱ score predicts risk of death from severe RDS accuracy is medium,equal to 24.50 is the best accuracy to the death risk prediction.

Objective:The effect of rat mesenchymal stem cells(MSCs)on graft versus host disease after allogeneic co-transplantation with bone marrow in rat was investigated.Methods:MSCs from bone marrow cells of rat were isolated and cultured in vitro.The purity of MSCs was identified with the spindle-fibroblastic morphological characterization and the phenotypes were analyzed with flow cytometry.The suppressive effect of MSCs on T cell proliferation was analyzed using mixed lymphocyte cultures(MLR).Allogeneic BMT model from SD rats to Wistar rats was established,and then,MSCs were co-transplanted with bone marrow cells at different ratio,the suppressive effect of MSCs on GVHD was studied by clinical symptom,Kaplan-Meier survival curve,and histological analysis.Results:In vitro,when MSC were added to the mixed lymphocyte cultures,the proliferation of T cells were inhibited markedly in a dose-dependent manner(P

Objective To investigate the differential expression of synaptophysin(SYN)in the developing rat cochlea,to analyze the relationship between the expression of SYN and auditory functional development,and to explore the source of the adenosine triphosphate(ATP)in the cochlea.Methods The immunofluorescence was applied to observe the differential expression of SYN in the cochlea of SD rats on different days(p1,p5,p10,p14 and p28)after parturition.Results No significant stain was observed in the Kolliker organ or the Corti's organ of P1,P5 and the top turn of the cochlea in P10.The SYN expression was turned on the outer spiral bundle,the inner spiral bundle,and the medial wall of the Deiters' cell of the cochlea in P14,P28 and the second or the third turn of Corti's organ of P10.All the spiral ganglion neurons(SGN)were stained in different aged cochlea.Conclusion The expression of SYN was different during development of rat cochlea.This difference was in favor of the configuration constructed between nerve endings and target cells.It also played a key role in the formation of correct auditory coding during auditory system development.The hair cells and the supporting cells,possible the source of ATP in the cochlea,contained ATP that maybe existed in a non-vesicular form or specific staining of non-SYN.

Adult ; Ethylene Glycol ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Young Adult

There are necessities to the legislation of new rural area cooperative medical system as it impelled nationwide.For it is the system that guarantees peasants' basic medical rights and turns out to be part of China's social security.The key of the system construction is its legislation aspect.The first thing to consider is the necessity and feasibility of its legislation.Then comes to its legislative principles from the standpoint of legislative ethics,which is determined by its particularity that it faces to a majority of peasants concerning their public interest and so on.

The crowd were divided to 3 groups according to glucose tolerance:normal glucose tolerance,impaired glucose regulation,and new type 2 diabetes,the data was analyzed.The result showed that as the severity of abnormal glucose metabolism,the serum GGT gradually advanced,early insulin secretion index descended,The levels of resistance index,fasting and postprandial blood sugar,and glycosylated hemoglobin all raised.The serum GGT and early insulin secretion index was inversely correlated.The higher GGT level was an independent risk factors of abnormal glucose metabolism.

Objective:To establish a headspace capillary gas chromatography method for the determination of residual solvents in clindamycin hydrochloride. Methods:A headspace gas chromatography was used to separate the residual solvents on a DB-624 capillary column with an FID detector. The carried gas was nitrogen at a flow rate of 2ml·min-1 . The split ratio was 1∶1. The temperature of the injector was 200℃ and that of the FID was 300℃. The programmed column temperature was set as follows:maintained at 40℃ for 5 min and then raised to 200℃ at the rate of 20℃·min-1 and maintained for 10 min. The containers of headspace injector were in e-quilibrium at 80℃ for 30 min. Water was used as the solvent. The amounts of the residual solvents such as methanol,ethanol,acetone, chloroform and N,N-dimethyformamide were calculated by an external standard method. Results:The detected solvents were separated completely. The calibration curve of each solvent showed a good linear relationship (r=0. 999 1 ~0. 999 9). The average recovery was within the range of 97. 2% ~101. 2% and RSD was within the range of 0. 68% ~1. 98%(n=9). Conclusion:The method is suit-able for the determination of residual solvents in clindamycin hydrochloride.

OBJECTIVE To study the bactericidal efficacy of glutaraldehyde,and its stability and change in pH value.METHODS The carrier quantity bactericidal test,field mimic bactericidal test,stability test,pH value detection,periodical biological surveillance and follow-up investigation of hospital infection were used.RESULTS After using of 20 000 mg/L of neutral glutaraldehyde on Candida albicans(ATCC 10231),Pseudomonas aeruginosa(ATCC27853),Escherichia coli(ATCC 25922) and other 3 clinical isolates separately for 3,5,and 10 min,the average killing rate was 97.90%,99.83% and 100.00%;on the field mimic bactericidal test with MRSA contaminated gastroscope,the average killing rate was 87.84%,99.50%,and 100.00%,respectively.The concentration of disinfectant after storaging 14d on 54℃ was decreased,only loss 1.46%,the concentration loss of disinfectant on using endoscope 5,7,and 14d after disinfection was 2.64%,0.69% and 0.94%,respectively.The value of pH was decreased from 7.22 to 6.00,6.50,and 6.20.The qualification rate of 260 various endoscopes after surveillance was 100.00%.Their was one of hospital infection happened among 3 200 patients after endoscopy which were followed up.CONCLUSIONS The results show that,only under the following circumstances,namely the concentration of glutaraldehyde being no less than 20 000mg/L and the action time being no less than 10 min,timely alteration of glutaraldehyde,and regular biological and concentration monitoring could the disinfection of endoscope be qualified so that hospital infection can be prevented,and medical dispute may be put to an end.