OBJECTIVE:To probe into the economic reasons accountable for government's failure in compulsive drug pricing and put forward the countermeasure on how to strengthen the effect of compulsive pricing of the government.METHODS:Economic model was applied in the deduction and demonstration.RESULTS & CONCLUSIONS:Government's failure in setting compulsive drug prices is rooted from the imperfect pricing system.To strengthen the effect of governmental drug pricing,it is necessary to establish some supporting measures such as to tighten control on drug recommenders,shift from governmental compulsive pricing to governmental authorization to avoid excessive competition,and give reasonable compensations for special drug manufacturers etc.

OBJECTIVE:To discuss the reasons of false drug advertisement,and to suggest the countermeasures against it.METHODS:The reasons of false drug advertisement were analyzed by using the knowledge of law,governmental admin?istration and economy.RESULTS&CONCLUSION:The countermeasures against false drug advertisement were suggested.Firstly,the regulations on defining false drug advertisement should be improved.The legal responsibilities should be specified and the punishment on the violators should be more severe.Secondly,the government should strengthen the law enforcement,and establish the credibility system and regulation for claim.Thirdly,the pharmaceutical enterprises should be self-disci?plined,and improve their professional credibility.Fourthly,the governmental departments of business administration should take a strict control on awarding advertisement license to the media.Last but not the least,the consumers should improve their common medical knowledge.

Objective: To study pharmacokinetics of lidocaine during superior laryngeal nerve block (SLNB) combined with topical anesthesia to endotracheal mucosa by thyrocricocentesis(TCC). Method: Eight patients (ASA Ⅰ-Ⅱ grade)scheduled for general anesthesia and operation were performed bilateral SLNB with 2% lidocaine 2mg/kg and TCC with 5 % lidocaine 2mg/kg within 1 min,The internal jugular venous blood samples were taken at 1,5,10,20,30, 60,120 and 180 minutes after lidocaine administrations to determine lidocaine serum concentrations using a fluoresence polarization immunoassy. Pharmacokinetics were calculated with a procedure (3p87) by computer. Result: The pharmacokinetics could be described as two-compartment model. Absorption rates of lidocaine were fast,values of t_(1/2) Ka and Tpeak were 5.0?2.5 min and 7.5?2.1 min respectively。Maximal concentrations (Cmax) of lidocaine were 3.8?0. 6?g/ml, which were within safety ranges. Conclusion: It may be safe that 2% lidccaine 2mg/kg superior laryngeal nerve block is combined with 5% lidocaine 2mg/kg topical anesthesia to endotracheal mucosa by thyrocricocentesis.

Objective To explore the expression change of intestinal epithelial tight junction (IJ)protein claudin-1 in mice with fulminant hepatic failure (FHF).Methods FHF was induced with a method that combined intraperitoneal injection of lipopolysaccharide (LPS,10 mg/kg) and D-galactosamine (GalN,800 mg/kg).Control saline (2 ml/kg,ip),LPS (10 mg/kg,ip) and GaIN (800 mg/kg,ip) were also detected.The effect of administration of anti-tumor necrosis factor alpha (TNF-α) IgG antibody (anti-TNF-α IgG,100 μg/per) on the level of TNF-α was assessed before administration of D-galactosamine/lipopolysaccharide.At the 2nd h,6th h,9th h,12th h,24th h after injection in FHF group,the 9th h after injection in control groups and 9th h after injection in anti-TNF-α IgG group,the mice were killed for the collection of large intestine specimens.Claudin-1 was analyzed with immunohistochemistry,Western blotting,and real-time quantitative PCR.Results Tight junction protein claudin-1 was localized along the apical region of the lateral plasma membrane representing the region of tight junctions in surface and crypt epithelial cells.Weakly distributed density of claudin-1 in intestinal mucosa was found in mice with FHF from the 9th h after injection.Compared to saline group,Western blotting analysis demonstrated markedly reduced claudin-1 expression in mice with FHF at the 6th h and 9th h after injection (6th h:0.8600±0.0208 vs 1.0,P ＜0.05; 9th h:0.6633 ±0.0328 vs 1.0,P ＜0.01).Furthermore,the expression of claudin-1 mRNA was markedly reduced at the 6th h,9th h,and 12th h after injection in mice with FHF (6th h:0.3067 ±0.1291 vs 1.0,P ＜0.05; 9th h:0.2233 ±0.1155 vs 1.0,P ＜0.01 ; 12th h:0.5275 ±0.1222 vs 1.0,P ＜0.05).Compared to saline group,no significant difference in claudin-1 expression was found with prophylactic treatment with anti-TNF-α-IgG antibody in mice with FHF at the 9th h after injection (protein:0.9533 ±0.0186 vs 1.0,P ＞0.05; mRNA:0.85 ±0.1437 vs 1.0,P ＞0.05).Conclusions The expression of tight junction protein claudin-1 was reduced at both protein and mRNA levels in intestinal epithelial cells that were induced by TNF-α in mice model of FHF.

Objective To assess the efficacy of high intensity focused ultrasound (HIFU) for the ablation of feeding-artery in uterine fibroids.Methods A total of 45 women with uterine fibroids who had children accepted HIFU treatment.Color Doppler and contrast-enhanced ultrasound were used to target the supply vessels entered the fibroid.HIFU treatment was focused primarily on locations where supplying vessels entered the fibroid.Conventional ultrasound,color Doppler ultrasound,contrast-enhanced ultrasound and MRI were performed before and after HIFU treatment to observe the changes of imaging.Results After HIFU treatment,the volume of uterine fibroids decreased to certain extent.The blood signals decreased or disappeared in the treated regions.Bewteen two groups of the uterine fibroids diamete ≥5 cm and ＜5 cm,there were significant differences in the percentage of the nonperfusion regions in the volume of uterine fibroids (≥70％,P ＜0.05).Conclusions Ablation of feeding artery by HIFU is an effective treatment for the uterine fibroids.HIFU treatment is effective for the ablation of feeding-artery in uterine fibroids whose diameter less than 5 cm.

Objective To investigate the feasibility of contrast-enhanced ultrasound-directed nosejujunium tube placement.Methods Twenty-four patients hospitalized in ICU who need support from enteral feeding were collected for this study.Flocare spiral nose-jejunium tube was placed into stomach with guide wire.Real-time ultrasound was used after injection of SonoVue for monitoring the passage of feeding tube from pylorus to duodenum-jejunum segment which was pushed down if without strong resistant force.Finnally,the guide wire was drawed out and enteral feeding was conducted with ascertainment of abdominal X-ray photograph for suitable site in intestinal tract.Results Contrast ultrasound -directed nose-jejunum tube placement procedure was conducted in 24 cases.Twenty-one cases (87.5%) was accomplished successfully,and 3 cases (12.5%) was failed.No special change was observed in the procedure of all patients.Conclusions Contrast ultrasound -directed nose-jejunum tube placement procedure can be regarded as a convenient,safe,and reliable insertion technology,which provide an effective means for early enteral nutrition for critical patients.

BACKGROUND: The reason for the short of cornea donator is the olden donating conception or the limit knowledge of cornea transplantation remains poorly understood. OBJECTIVE: To explore the awareness level of the medical staff to corneal transplantation and corneal donation. METHODS: The study consisted of 820 medical staff from different departments of 5 hospitals, including doctor, nurse, technician, and administrator. Awareness level was evaluated with an interviewer-study. RESULTS AND CONCLUSION: Totally 805 interviewer-studies were effect. The correct answer fill rate in department of ophthalmology was higher than other departments. Different measures should be taken to teach the medical staff to improve the awareness level of the transplantation and corneal donation.

Objective To investigate the effects of a novel |3 titanium fixation with high strength and low elastic modulus on bone healing of osteoporotic fracture and its effects on stress shielding.Methods Forty female Sprague-Dawley rats were oophorectomized before establishment of femur fracture model.The fracture of left femur was stabilized by titanium alloy pin with high elastic modulus (110 Gpa,high elasticity modulus group) and the fracture of right femur by titanium alloy pin with low elastic modu-lus (30 Gpa, low elasticity modulus group).Six and 12 weeks later, the bone volume (BV) , total vol-ume (TV) and bone volume fraction (BVF) were detected by Micro-CT, and the maximum load was de-tected by biomechanical test.The effects of two titanium alloy pins on formation of bony calluses and me-chanical properties of bones were compared.Results Compared with the low elasticity modulus group, more collagen and bony callus, thicker bone trabeculae and more regular lamellar bone were found in the high elasticity modulus group.In low elasticity modulus group, TV (ROI1) was increased obvious-ly at week 6, with no statistical differences in BV (ROI 1), BV (ROI 2) and maximum load between two groups (P < 0.05).TV and BV in region ROI 1 in the low elasticity modulus group were significantly higher than that in high elasticity modulus group (P < 0.05) , while BV in region ROI 2 in low elasticity modulus group was significantly higher than that in high elasticity modulus group at week 12 postoperative-ly (P<0.05).Biomechnical test indicated that the maximum load in low elasticity modulus group was higher than that in high elasticity modulus group.Conclusions The novel B titanium alloy with high strength and low elastic modulus helps reduce effects of stress shielding, diminish bone resorption, in-crease the fibrous callus formation at the initial phase and improve the quality of bone healing at the later phase.

Objective To investigate the incidence,etiology and risk factors of activity of daily life (ADL) deterioration during recovery in patients with ischemic stroke.Methods Consecutive inpatients with acute ischemic stroke from Dongguan area were enrolled prospectively.The demographic,clinical and imaging data were documented,and the patients were followed-up for 6 months.The modified Rankin Scale (mRS) 9Q was used to evaluate ADL.The mRS score 0-2 was defined as independency,and the mRS score ＞2 was defined as dependency,and the ADL deterioration was defined as transition from independency to dependency.A multivariate logistic regression model was established to analyze the factors associated with ADL deterioration.Results A total of 362 patients completed the 6-month follow-up,50 patients (13.8％) had ADL deterioration,among them,14 (3.9％) attributed to early stroke recurrence and 12 (3.3％)attributed to cognitive impairment after ischemic stroke.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.099,95％ confidence interval [CI] 1.049-1.152;P ＜0.001),female (OR] 2.026,95％ CI 1.068-6.437;P =0.035),previous stroke history (OR 1.251,95％ CI 1.024-1.530;P=0.029),and higher baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.167,95％ CI 1.016-1.284;P =0.001) were the independent risk factors for ADL deterioration.Conchtsions The ADL deterioration deterioration during recovery in patients with ischemic stroke is not uncommon.Advanced age,female,previous stroke history and higher baseline NIHSS score are the independent risk factors for ADL deterioration during recovery in patients with ischemic stroke.

Objective To investigate the relationship of the neutrophil to lymphocyte ratio (NLR)with stroke in elderly persons with CDK.Methods Totally 220 subjects with stage 3-5 CKD were followed.Fatal and nonfatal cerebrovascular event (CVE) were recorded during this period.NLR at baseline was determined from complete blood count differential.We investigated if NLR could predict stroke.Resuits Median NLR was 2.13.NLR was equally associated with estimated glomerular flitrationrate (eGFR).Totally 116 strokes occurred during follow-up period.NLR could predict stroke independently.Increased NLR over 2.13 was related to a significantly decreased survival time (log-rank Chi-square =4.963,P =0.026).Multivariate Cox regression analysis showed that the risk factor of ischemic stroke in CKD patients was high NLR,hazard ratio (HR) 1.11 [95％ confidence interval (CI) 1.007 to 1.223,P =0.035].Conclusions NLR could independently predict stroke in elderly patients with moderate to severe CKD.