OBJECTIVE: To discuss the limitation of the current TRIPS due to local protection and to seek for a balance between drug patent protection and public health.METHODS: The related clauses in TRIPS in terms of protection on drug patent and public health were introduced,and Nordhaus' model was used to analyze the conflict between drug patent protection and public health.RESULTS: The area with minimum level of drug patent protection can't be enlarged infinitely geographically.CONCLUSIONS: Preferential policies should be given to the developing countries to secure the public health while strengthening the drug patent protection gradually.

Dyslipidemia is a well-established risk factor for atherosclerosis. Treating dyslipidemia in elderly patients requires specific knowledge and understanding of common dyslipidemias and the relative safety of various pharmacologic agents in the presence of possible multiple comorbidities. Lifestyle modification remains the first step in the treatment of dyslipidemia; however, it can be difficult to sustain and achieve acceptable compliance in the elderly and it is best used in combination with drug therapy. Statins are widely accepted as the first-line therapy. Several recent studies have demonstrated that statins are safe and effective in the elderly. However, it is important to note that there is very limited data regarding the effects of dyslipidemia treatment on morbidity and mortality in patients over 85 years of age. In summary, the clinicians must recognize that the presence of dyslipidemia in the elderly poses substantial risk of coronary events and stroke. The available evidence has demonstrated that in most elderly patients who are at increased risk for cardiovascular morbidity and mortality, treatment of dyslipidemia with appropriate therapy reduces the risk, and when used carefully with close monitoring for safety, the treatment is generally well tolerated. With increasing life expectancy, it is critical for physicians to recognize the importance of detection and treatment of dyslipidemia in the elderly.

34 patients who suffered from NVG, excluding patients with shallow anterior chamber.All patients were assigned to groups A and B according the different therapy.Group A ( 15 eyes ) was treated with Ex -PRESS glaucoma filtration device implantation. Group B ( 19 eyes ) underwent a trabeculectomy combined with mitomycin C. All the patients were followed up to 1a.The results of best-corrected visual acuity ( BCVA ) , intraocular pressure ( lOP ) , the combination of lOP lowering medications, complications were recorded statistically analyzed preoperative and 1d, 1, 4wk, 6 and 12mo after operation. · RESULTS: Mean lOP decreased significantly frompreoperative values in both groups ( P=0.01 ) .The both group had similar lOP values changes after 1, 4wk, 6, 12mo, and there were no significant difference in statistics (P=0.451).There was no significant difference in BCVA changes after operation in both groups ( P =0.832).Success rate was 66.7%and 63.1%at 1a after Ex-PRESS glaucoma filtration device and trabeculectomy, respectively. Anterior chamber bleeding occurred to 8 cases after trabeculectomy in group B and to 3 cases with Ex-PRESS glaucoma filtration device implantation in group A.Choroidal detachment occurred to 3 cases in
group A and 6 cases in group B. No other ocular or systemic adverse events were found during the follow-up duration.
·CONCLUSlON:ln the short-term, Ex-PRESS glaucoma filtration device implantation has the advantages of simpleness, safety, minimally invasive, short learning curve for neovascular glaucoma, which provides us an available strategy to conquer NVG by simply operation and less suffering.

AIM: To investigate therapeutic effects of combination therapy for neovascular glaucoma ( NVG) .
METHODS: This retrospective study comprised 34 eyes of 34 patients who suffered from NVG. All patients were assigned to group A, B, C and D according to the different combination therapies. Group A ( 11 eyes of 11 patients ) was treated with intravitreal injection of ranibizumab and panretinal photocoagulation ( PRP ) . Group B ( 10 eyes of 10 patients ) was treated with transcleral cyclophotocoagulation and PRP. Group C ( 6 eyes of 6 patients) was treated with 3 therapies together. Group D (7 eyes of 7 patients) was treated with 810nm transcleral cyclophotocoagulation and soft gas-permeable contact lenses. All the patients were followed-up for 1a. The best- corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) were recorded and analyzed prior to operation and 1, 4wk, 6 and 12mo after operation.
RESULTS: All the post treatment IOP decreased significantly ( P<0. 05 ) from the values before therapy, and the IOP values after 4wk, 6, 12mo were not significantly different ( P > 0. 05 ) in statistics. Most patients' IOP can be controlled below 23mmHg after combination therapy. The visual acuity in group A after 1, 4wk, 6mo compared with those before treatment was significantly increased ( P<0. 05 ) in statistics and other groups did not significantly change before and after treatment (P>0. 05). Anterior chamber bleeding occurred to 2 cases after 1wk of transcleral cyclophotocoagulation. No other ocular or systemic adverse events were found during the follow-up duration.
CONCLUSION: After the combination of intraocular injection of the anti - VEGF drugs, 810nm laser cyclophotocoagulation and PRP, most patients with NVG disease can be effectively treated, can effectively control IOP, and retain part of the visual function, significantly improve the quality of life. In the short - term, combination therapy is safe and effective for NVG, which provides us an available strategy to conquer NVG by simply programmable operation and less suffering.

Objective: To obtain the optimum prescription of the rhubarb lactobacillin dispersible tablets.Methods: The kind and amount of the excipient were investigated by using the disintegrating time to establish the optimum prescription and preparation process.Results: The tablets were prepared by compressing moist granulation with the PVPP and CMS-Na as the disintegrant,MCC as diluent,sodium alginate as sweller,magnesium stearate as lubricant and 80% alcohol as adhesive agent.The preparation complied with the requirement of Pharmacopeia of the People's Republic of China(2005edition).Conclusion: This prescription of the tablet is reasonable and the preparation process is feasible.

Protozoans,the natural host of the facultative intracellular pathogen Legionella species,play an important role in survival,proliferation,virulence and stress resistance of Legionella species. By repeating transformation and selection,a spontaneous mutant of plasmid over expressing green fluorescent protein was obtained. This mutant replicates and is maintained stably in Legionella cells. The colonies of L. pneumophila harbouring the mutated plasmid were intense green in colour even under the daylight. After feeding BF1 strain of Tetrahymena thermophila with transformed L. pneumophila,the intracellular dynamic of changing of bacterial shape,bacterial proliferation and lysis of the host cell due to the bacterial proliferation were observed clearly under fluorescent microscopy. Thus,the present paper provides a simple and intuitionistic strategy for investigating the ecological and cellular relationship between L. pneumophila and its host.

Objective:To investigate the complications of spastic cerebral palsy with selective posterior rhizotomy (SPR).Methods:In the study, 2 593 patients who had undergone SPR from January 2000 to September 2012 were followed-up for at least one year .The complications were classified .Results:Peri-operative complications:pulmonary system complications including bronchial spasm (5 cases, 0.19%) and aspiration pneumonia (4 cases, 0.15%);digestive system complications including abdominal bloa-ting (145 cases, 5.6%) and colic (80 cases, 3.1%);urinary system complications including tempora-ry bladder dysfunction (54 cases, 2.1%) and urinary tract infection (6 cases, 0.23%); peripheral nervous system complications including lower extremity weakness ( 327 cases, 12.6%) and lower extremity sensory disturbances ( 140 cases, 5.4%); central nervous system complications including headache (112 cases, 4.3%) and epileptic seizures (4 cases, 0.15%).None spinal or intracranial in-fection, intraspinal hematoma or intracranial hemorrhage were identified .General surgery complications including back pain (1 382 cases, 53.3%), delay wound healing caused by infection (5 cases, 0.19%) and cerebrospinal fluid leakage (8 cases, 0.31%).Long-term follow-up complications inclu-ding lower limb decreased exercise capacity ( incidence: 7.33%) and lower extremity sensory distur-bance (incidence:5.59%).Urination occurred in only one case and defecation function disturbance with no sexual dysfunction was identified .The incidences of scoliosis , thoracic kyphosis , spondylolisthe-sis and long-term back pain were 7.23%(31/429), 4.2%(18/429), 10.49%(45/429) and 9.72%respectively .Conclusion:SPR is one of the effective and safe surgical treatments for spastic cerebral pal-sy.Valid methods should be applied to reduce the incidence of postoperative complications , such as choosing the appropriate patients , meticulously operating in the surgery , assistance of electrophysiological guidance , reinforcing perioperative management and regular rehabilitation training after operation .

Objective To investigate the analgesic effect of oxysophoridine(OSR)and the influence of verapamil(Ver)on the antinociception of OSR when two drugs were co-administrated in mice.Methods The number of writhing within 15 min after ip different doses of OSR was observed in painful mouse mo- dels caused by acetic acid.The hot plate method was used to assess nociceptive sensitivity of CaCl_2 and Ver before ip OSR.Nitric oxide(NO)in serum was measured by spectrophotometry.Results The number of writhing was decreased and the latency of licking the hind paws was prolonged in a dose-dependent manner after ip OSR.The antinociception of OSR could be antagonized by CaCl_2 and enhanced by Ver.No inter- ference was detected in serum volume of NO.Conclusion These results suggest that OSR can antagonize the acute pain caused by acetic acid and hot plate in a dose-dependent manner in mice.Calcium channel blocker could enhance the effect of OSR.

OBJECTIVETo evaluate the outcome of Titanium elastic intramedullary nailing (TEN) for the treatment of displaced midclavicular fractures.

METHODSBetween February 2010 and February 2013, 62 patients with displaced midclavicular fractures were treated by TEN, including 27 males and 35 females with an average age of 37.6 years old ranging from 15 to 67 years. The course of disease was from 1 to 9 days (means 2.7 days). Thirty-nine cases were treated by closed reduction and 23 cases by assistant small incision. Based on OTA (the Orthopaedic Trauma Association classification) classification, 31 cases of simple fractures involved 5 cases of 06-A1,15 cases of 06-A2,11 cases of 06-A3; 31 cases of wedge fractures involved 4 cases of 06-B1,12 cases of 06-B2,15 cases of 06-B3. Postoperative pain relief were evaluated by VAS score,and operation time,fracture healing time were recorded. After 6 weeks and after removing internal fixation shoulder joint function was evaluated by Constant score, and shoulder joint function were assessed by Herscovici score after 6 weeks.

RESULTSExcept 2 cases were lost to follow-up, 2 cases did not remove internal fixation, 3 cases' fractures were nonunion, the remaining 55 patients received follow-up for an average time of 11.4 months. The average preoperative VAS score was 5.20±0.71, and it turned to be 1.550.59 at 3 days after operation. The average operative duration was 40 min (15 to 65 min). The average bone healing time was (2.71±0.54) months (2 to 5 months). No difference about bone healing time was found between simple fractures and wedge fractures,and between the patients treated by closed reduction and assistant small incision. According to Herscovici standard, the shoulder function was excellent in 49 cases, good in 4, fair in 1, and poor in 1. Simple fractures achieved better Constant score than wedge fractures at 6 weeks postoperatively, whereas no difference was found at 4 weeks after fixation removal.

CONCLUSIONTitanium elastic nails (TEN) for treatment of displaced midclavicular fractures has advantages of good clinical effect,rapid pain relief,fast recovery of shoulder joint function. For OTA classification type B patients with comminuted fracture can replace steel to achieve very good effect, but to grasp the appropriate.

Adolescent ; Adult ; Clavicle ; injuries ; surgery ; Female ; Fracture Fixation, Intramedullary ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the feasibility of using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people.

METHODSFrom June 2011 to May 2013, 91 patients with closed and fresh Barton fracture were analyzed retrospectively which information was complete. According to different methods these patients were divided into three groups: 33 patients in group A were treated by simplex fixation of gypsum or splint after manipulative reduction, including 20 males and 13 females with an average age of (63.27 ± 5.83) years old; 35 patients in group B were treated by percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation, including 23 males and 12 females with an average age of (64.25 ± 4.53) years old; 23 patients in group C were treated by open reduction and internal fixation including 15 males and 8 females with an average age of (64.04 ± 4.83) years old.

RESULTSAll the patients were followed up for 10 to 16 months with an average of 12 months by the method of recheckging in outpatient clinic. According Dienst scoring system: in group A, the result was excellent in 15 cases, good in 7 cases, fair in 11 cases; in group B, excellent in 25 cases, good in 6 cases, fair in 4 cases; in group C, excellent in 16 cases, good in 5 cases, fair in 2 cases. The excellent and good rate of group C was better than that of group B and A, further more group B is better than group A. According to X- ray standard, in group A, 26 patients were acceptable, 7 patients were unacceptable; in group B,28 patients were acceptable, 7 patients were uacceptable; in group C, 19 patients were acceptable,4 patients were unacceptable; there were no statistical significant difference (P > 0.05). There were 18 patients with emerging recrispation in group A, 10 patients in group B, 6 patients in group C, the result of group B and C was better than that of group A, and there was no statistically significant between group B and C (P > 0.05).

CONCLUSIONUsing percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people is an effective method, it has advantages of micro-invasived, reliable fixation, less complication, not need to fix wrist joint and early functional exercise.

Aged ; Bone Wires ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Radius Fractures ; therapy ; Retrospective Studies ; Splints