OBJECTIVE: To provide proposal for government on dealing with the relationship between commercial and social property of drugs.METHODS: Multi-stakeholders subjects and their interrelation in the listing decision of drugs were investigated using game model.RESULTS & CONCLUSIONS: Innovation level of pharmaceutical industry (P),profitability of drugs operator (E),other factors affecting the proceeds of drug operators (K),additional gold cost of drugs (C1),additional cost of gold drugs sale (C2) were confirmed to be the key factors which affected the listing decision of drugs by pharmaceutical manufacturers.Governments are suggested to ensure the rational and fair use of drugs in public by policy supports,encouraging drug innovation and make-up on difference of drugs in medical institutions,optimizing benefit components of medical institutions,creating evaluation criteria for "listing value" and "necessity in clinic" of drugs.

Objective To investigate the expression and clinical significance of platelet autoantibodies in children with persistent/chronic immune thrombocytopenia (pITP/cITP).Methods Total of 34 children diagnosed with pITP/cITP(14 cases and 20 cases,respectively)in the Department of Hematology and Oncology,Shanghai Children's Hospital from December 2013 to August 2014 were enrolled as the study group,including 20 male and 14 female,the median age of 5 years old.The study also included 20 healthy children (the healthy control group) matched with gender and age,and 24 cases of newly diagnosed ITP (newly diagnosed ITP group) serving as the control groups.Platelet-associated immunoglobulin (PAIg) and platelet-specific autoantibodies on surface of platelets were mea-sured by flow cytometry or flow cytometric bead.Results Significant elevation of PAIgA,PAIgM,PAIgD and specific autoantibodies against glucoprotein(GP) Ⅲa,and GP Ⅱb were demonstrated in children with cITP,as well as specific autoantibodies against GP Ⅰ b,GP Ⅲ a,GP Ⅱ b,and granule membrane protein 140 (GMP140) in children with pITP,compared with the healthy control group(P ＜ 0.05);the levels of GPⅨ,GP Ⅲ a,GMP140 in cITP group and GP Ⅱ b in pITP showed significant declination,compared with the newly diagnosed ITP group(P ＜ 0.05);between piTP group and cITP group,autoantibodies GPⅨ,GP Ⅰ b,GP Ⅱ b,and GMP140 in the latter were much lower(P ＜ 0.05).Significant negative relation between PAIgM and platelet count was found in cITP group (P ＜ 0.05).Receiver operating characte-ristic (ROC) curve analysis showed that the area under ROC curve (AUC) of GP Ⅲ a autoantibodies was larger than that of other platelet-autoantibodies in pITP/ciTP diagnosis.Conclusions Platelet autoantibodies play a significant role in pITP/ciTP,especially platelet-specific autoantibodies,which show a declining tendency in the course and may be the main mechanism.The detection of GPⅢa specific autoantibody is more advantageous against other autoantibodies in the diagnosis of piTP/ciTP.

Objective To design two-point two-line vein pricking for avoiding pain for patients and blood osmosis out of the vein caused by the high-pressure and fast-speed of the current high-pressure injector.Methods 19G butterfly-wing vein transfusion needle in the length of 19mm was used.The first point was needled with the needle tip under the skin and the first needling line was above and parallel the blood vessel in the length of 10-12mm.The second point was needled,with the second needle tip and needle line in the blood vessel,and the length of needling is 7-9mm.Results 100 persons were subjected.All the contrast medium and the physiologic saline were injected in vein in 98 persons,among which 2 had little hard tubercle in injecting area.Conclusion The two-point two-line vein pricking is safe for high pressure injector injecting in vein,and can prevent blood osmosis out of the vein.

Objective To minimize unfavorable factors and elevate accuracy of coronary angiography, nursing must be paid more attention. Methods Siemens 64-slice dual source CT , double tube high pressure syringe of MeoRao company, electrocardiogating, non-ion constrast medium are applied. 100 patients, including 65 males and 35 females are involved. Their age ranges 35-81 years old,and average age is 58. Results 96 cases are successful, 4 cases are failed. Conclusion Nursing work is an important factor of coronary angiography. Good nursing may gurantee coronary angiography.

Objective To probe the advantages and characteristics of imaging on dual-energy CT boneless and digital sub- traction brain angiography through comparative analysis. Methods Siemens 64-slice dual-source spiral CT and double high pressure syringe; The 200 patients were randomly divided into dual-energy group(n=100) and DSACT group(n=100); Every patient was injected 50 ml contrast medium and 50ml normal saline, injection rate was 4ml/s. Results The groups of cere- bra-vascular imaging without interference, and completely boneless; but experimental group has more boneless defects and vascular surface definition less. The cerebral arteries were interfered by the venous shadow in dual-energy group, and the dual-energy group received low-dose radiation. Conclusion The DSACT imaging quality is superior to dual-energy CT boneless imaging. The radiation dose of the dual -energy CT is lower than DSACT.

Objective: To explore the impact of antibiotic exposure on human fertility, so as to provide the reference for related research on risk factors and prevention of infertility. Methods: Publications pertaining to antibiotic exposure and human fertility were retrived in CNKI, Wanfang Data, VIP, PubMed, Embase and Web of Science from inception to March 2024. Two reviewers independently conducted literature screening, data extraction, and quality assessment. A qualitative analysis was performed to investigate the effect of antibiotic exposure on human fertility. Results: A total of 11 623 articles were retrieved, and 31 of them were finally included. Among them, 19 were quasi-experimental studies (4 high-quality and 15 medium-quality), 6 were observational studies (5 high-quality and 1 medium-quality), and 6 were randomized controlled trials (RCTs) with high risks of implementation bias and measurement bias. Sixteen quasi-experimental studies and five RCTs found that the use of sensitive antibiotics such as doxycycline for the treatment of reproductive system infections improved female pregnancy rates or male semen quality. Two quasi-experimental studies and one RCT suggested that antibiotics (such as sirolimus or sulfasalazine) used to treat other systemic diseases might cause adverse effects on the reproductive system. Four observational studies indicated that exposure to antibiotics such as sulfonamides, macrolides, and tetracyclines increased the risk of infertility or prostate cancer. Two observational studies found a dual effect of antibiotics on infertility. Conclusions Antibiotic exposure appears to have either beneficial or harmful effects on fertility, depending on the antibiotic types, doses, and indication. However, these studies have limitations such as small sample size, selection bias, and the inability to achieve randomization and blind methods. Further research with optimized designs is necessary to explore the relationship between antibiotic exposure and fertility.

Objective To evaluate 16-SCT in diagnosing aeute appendicitis.Methods The CT findings of 34 cases were retrospectively analyzed.These cases were all proved acute appendicitis by surgical-pathology.Results 30 cases were confirmed by CT,with accuracy 88% (30/34).The diameter of 28 appendix was more than 6mm;2 collapsed with thickening wall.Periappendiceal fat stranding could be seen in 25 cases.Perforated appendicitis happened in 4 cases.Abscess performed in 2 cases.3 cases were missed,1 misdiagnosed.Conclusion 16-SCT could confirm acute appendicitis and its complication timely and accurately.

The purpose of this study is to investigate the enantioselectivity of norgestrel (NG) transdermal permeation and the potential influence of linalool and lipids on the enantioselectivity. In vitro skin permeation studies of NG across the excised rat skins were performed with Valia-Chien diffusion cells, and the permeation samples were analyzed by enantioselective HPLC. The possible enantioselective permeation of NG across intact rat back skin and lipids extracted rat back skin and the influence of linalool were evaluated. The skin permeation rate of dl-NG was two times higher than that of l-NG when donor solutions (EtOH/H2O 2 : 8, v/v) containing l-NG or dl-NG. It may be mainly attributed to the solubility discrepancy between enantiomer and racemate. The enantioselective permeation of dl-NG across intact rat skin was observed when the donor solutions containing dl-linalool. The permeation flux of l-NG was 22% higher than that of d-NG. But interestingly, the enantioselective permeation of dl-NG disappeared under the same experimental condition except that the lipid extracted rat skin was used. Attenuated total reflection-fourier transform infrared spectroscopy analysis of stratum corneum showed that the wave number for asymmetric CH2 stretching vibrations of lipids treated with dl-linalool was greater than that of the control. The results indicated that the enantioselective permeation of NG may be contributed by the interaction between dl-linalool and lipids. More than half of lipids were composed of ceramides. The stereospecific interaction maybe existed among chiral enhancer (linalool), lipids (ceramides) and/or chiral drugs (NG).

Objective To improve the diagnosis of cytomegalovirus pneumonia in patients who have undergone kidney transplantation. Methods The CT appearances of 10 cases were retrospectively analyzed. Results Ground glass opacity was seen in all cases, and disseminated several lobes were seen in 7 cases, diffuse distribution was seen in 3 cases. In addition,lung fibrosis happened in 3 cases,nodule in 2 cases,and consolidation in 3 cases.Conclusion Multi-slice CT could provide very valuable information for early diagnosis of cytomegalovirus pneumonia.

Objective To investigate the expression and clinical significance of Ku70 in nasopha ryngeal oarcinoma(NPC).Methods The expression of Ku70 protein in 223 specimens of nasopharyngeal carcinoma was examined by immunohistochemistry.Based on the levels of ku70 immunoreactivities,the 223 specimens were divided into high Ku70 expression group and low Ku70 expression group.The correlation of Ku70 expression with clinicopathologic features and prognosis of NPC was analyzed according to the clinical data. Results The rate of high Ku70 expression was 63.7%.Univariate survival analysis suggested that the overall survival rate was significantly lower in high KuTO expression group than in low Ku70 expression group (X2 = 7.88,P = 0.005).Cox multivariate analysis indicated that T stage,N stage and M stage were the independent prognostic predictors (X2 = 8.02,7.22,36.86;P =0.005,0.007,0.000),but not with gender, age or pathological type(X2 = 0.08 ,1.04,2.34;P = 0.780,0.308,0.126),the influence of Ku70 on the o verall survival rate was close to critical value(P = 0.085).Conclusions Ku70 is positively expressed in the majority of NPC.KuT0 expression has significant correlations with T stage and N stage.The results of our study suggest that Ku70 is a valuable prognostic factor of NPC.