During radiation for head and neck cancers,part of parotids are contained in planning target volume(PTV),which lead to parotids receiving radiation as the same as PTV.Radiation for head and neck cancers will influence the parotids.In the period of radiation,many factors will influence parotids,such as age,primary parotid volume,V10-40,weight and mean radiation dose et al.These factors will result in that the parotid volume reduces nearly 50％ and moves toward the middle line of the body.As a result,the real dose of the parotid receiving is higher than prescription dose.The excretion function of the parotid will be severely damaged after radiation,which will lead to xerostomia and influence the quality of patients life.

Many specific therapeutic antibody drugs have been developed for different indications. In drug development, it has been found that the antibody isotype framework can not only affect the physical and chemical properties of therapeutic antibodies, but also influence the activity and therapeutic effect. As a result, IgG isotype selection should be considered carefully in antibody drug development strategies. Because of the unique biological characteristics, IgG4 isotype has been used in some therapeutic antibodies for which effector functions are not desired. In order to provide new ideas for the development of antibody drugs, the research and application progress of IgG4 isotype in therapeutic antibody drug development has been reviewed.
Drug Design ; Humans ; Immunoglobulin G ; chemistry ; pharmacology

The reimbursement on high-value drug expenses for patients is an important approach of catastrophic disease medical insurance.Hong Kong has established in a drug safety network, that has achieved remarkable results in improving the accessibility to high-value drugs and the burden of disease and effectively alleviated patients' financial burden.This paper systematically analyzes the history, process of adding drugs to directory, application conditions for drugs and patients, development status, and characteristics of drug safety network in Hong Kong.This study points out that although Mainland China has gradually established the high-value drug directory for catastrophic disease through the method of drug negotiation, the mechanism of high-value drug directory is not mature yet.To achieve the convergence between high-value drug directory, basic medical insurance drug directory, and new rural cooperative medical scheme drug directory, Mainland China needs to: 1) First, learn from the drug safety network in Hong Kong and establish access and exist mechanism for high-value drug directory;2) Then, expand insurance coverage of high-value drugs by establishing a multi-channel and socialized financing mechanism;3) Finally, strengthen the major disease medical insurance by adhering to the principles of buying drugs and getting drugs for free and reforming the fixed-ratio-reimbursement model.

OBJECTIVE:To provide reference for improving the rational drug use of China. METHODS:By referring to In-dia,South Africa and Argentina's policy in this regard,the rational drug policy rules and supporting measures in the national drug policy of these states were analyzed and summarized to put forward related policies for China. RESULTS & CONCLUSIONS:Pro-moting the rational drug use required multi-angle managements towards the supply-side,the demand-side as well as third-party, and relevant supporting measures needed to be improved. Firstly,the managements on the supply-side is particularly important,in-cluding measures such as strengthening prescription management,formulating and implementing the standard treatment guidelines, intensifing the functions of pharmacists,establishing serious irrational drug use and specific diseases medication management sys-tem;then,the demand-side needs the investigation and feedback about the patients with drug use to eliminate irrational drug use, and through the internet and other media to raise public awareness of the medicine information as well;besides,the third-party needs to establish a non-profit organization to regulate pharmaceutical advertisements,and increase information about rational drug use;finally,improving the rational drug policy also needs to improve needs to promote the separation of medicine,reform Medi-care payment and other supporting measures.

Objective To report the clinical outcome of dual plating in treating humeral intercondylar fractures. Methods From February 2002 to June 2003, 22 cases of humeral intercondylar fractures were treated with dual plating. It involved 15 males and 7 females, whose average age was 42.2 years with a range from 19 to 67 years. According to the AO classification, 5 cases were of type C1, 11 of C2 and 6 of C3. The posterior midline approach was selected, and the intercondylar fracture ends were exposed through the trans-olecranon osteotomy. The intercondylar fragments were fixed first, in 6 cases with C3 type fractures, the auto-grafting from the iliac bone was performed because of comminution, then the supracondylar fracture was fixed with dual plating. The semi-tubular plates was applied on the medial epicondylar crest of the humerus; and the reconstruction plate was implanted on the postero-lateral side, the two plates were kept in 90? with each other. The osteotomized ends were fixed with tension band. Results All the 22 patients were followed up for 13-29 months ( mean, 20.2 months ). By the end of the first postoperative month, the elbow flexion averaged 86.2?( range, 80?-105?), and the loss of extension averaged 40.7?(range, 30?-45?). But at the 12th month, the flexion improved to 117?(range, 95?-135?), and the extension loss decreased to 23.2?( range, 10?-35?). The averaged union time was 15.7 weeks with a range of 12 to 20 weeks. Assessed by the Jupiter scoring system, 3 cases were rated as excellent, 15 as good and 4 as fair. Complications included 4 cases of incision exudation, 3 K-wires withdrawal, 1 ulnar neuropathy and 3 heterotopic ossification. But no incision necrosis, deep infection, loosening or breakage of the internal fixators occurred. Conclusion The dual plating is able to provide stable and durable fixation for the humeral intercondylar fractures. In addition, it can prevent malunion or nonunion effectively, and decrease the related complications significantly. This method is helpful to improve the functional recovery of the elbow joint satisfactorily.

ObjectiveTo discuss the relationship between patella location and chondromalacia patella,explore its mechanism and clinical significance.Methods Knee joint MRI was performed in 1052 patients (506 men and 546 female).Among them,there were 299 patients( 100 men and 199 female)with chondromalacia patella.They were divide into the group of 1-19,the group of 20-39,the group of 40-59 years old and the group of older than 60 years to compute the positive rate respectively.Insall-Salvati method was used to measure the length of chondromalacia ligaments(L) and the length of chondromalacia path(P).The relationship between patella location and chondromalacia was tested by using t test and x2 test.ResultsThe total positive rate of chondromalacia patella was 28.4％ (299/1052).In female it was 36.4％ (199/546) and in men was 19.8％ (100/506).The group of 1-19 years old had 16 patients ( 16.8％,16/95).The group of 20-39 years old had 71 patients( 17.9％,71/396).The group of 40-59 years old had 116 patients ( 33.2％,116/349 ).The group of older than 60 years had 96 patients (45.3％,96/212).The positive rate of chondromalacia patella increased with age.The L/P value of normal group and chondromalacia patella group were 1.15 ±0.15 and 1.24 ±0.17 respectively.The L/P value of normal group of men and women were 1.13 ± 0.15 and 1.17 ± 0.14 respectively.The L/P value of chondromalacia patella group of men and women were 1.20 ±0.17 and 1.26 ±0.16 respectively.The InsallSalvati index of age groups showed significant differences.The L/P value of pathological changes group and normal group of 1-19 years old were 1.38 ± 0.25 and 1.24 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 20-39 years old were 1.24 ± 0.17 and 1.15 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 40-59 years old were 1.24 ±0.16 and 1.12 ±0.12 respectively.The L/p value of pathological changes group and normal group of older than 60 years were 1.21 ±0.16 and 1.12 ±0.12 respectively.All of them had significant differences (P ＜ 0.01 ).ConclusionsThe positive rate of chondromalacia patella for female is higher than that for men,which also increases with age.High patella location is relevant to chondromalacia patella.

Aim To explore the role of nicotinamide adenine dinucleotide phosphate ( NADPH ) oxidase in high glucose-induced injury in H9c2 cardiac cells. Methods H9 c2 cardiac cells were exposed to differ-ent concentrations of high glucose(5. 5 mmol·L-1 ,11 mmol · L-1 ,22 mmol · L-1 ,33 mmol · L-1 ,44 mmol ·L-1 , 55 mmol · L-1 ) for 24 h and different time pints of high glucose(0 h,12 h,24 h,36 h,48 h,72 h) . Cell viability was measured by MTT colorimetry, the protein expression of Bcl-2 , Bax and NADPH oxi-dase submits such as p22 phox , p47 phox and p67 phox were determined by western blotting. Results H9c2 cardi-ac cells exposure to high glucose for 24 h showed on decrease in cell survival and the Bcl-2 expression while an increase in the Bax expression ( P<0. 05 ) . Moreo-ver, high glucose could markedly up-regulate the activ-ity of NADPH oxidase characterized by the enhanced expression of p22 phox , p47 phox and p67 phox ( P<0. 05 ) . Conclusion Activating NADPH oxidase may play an important role in high glucose-induced injury in H9 c2 cells.

OBJECTIVE:To provide reference for the price management of medicines in Chinese mainland by inquiring into rel-ative management in Hong Kong. METHODS:Based on the steps of price management and the value chain of medicines in Hong Kong,the management mechanism of medicine pricing,circulation and compensation were researched. RESULTS & CONCLU-SIONS:The prices of the medicines in Hong Kong are mainly determined by the tender between Hospital Authority and the pharma-ceutical suppliers. In circulation,medicine payer as main body in bidding and purchase conducthigh qualitybidding andmasspurchase,and price remained the same in public hospital. On the basis of the purchase price,the price that actually paid by pa-tients is the result of government compensation. Chinese mainland can draw lessons from such drug bidding mode in Hong Kong which will lead health care department to act as the main body in bidding,weaken the relationship between the hospitals and the drug dealers or manufacturers,and expand the government's financial investment in public medical institutions to improve reim-bursement.

OBJECTIVE:To explore price management mechanism of medical service in Macau of China,and to provide refer-ence for the formulation of price management mechanism of medical service in the mainland area of China. METHODS:From two key links of pricing and compensation,price management mechanism of medical service in Macau was introduced. RESULTS &CONCLUSIONS:In respect of pricing,Macau Health Bureau as pricing subject set up guide price for public health institutions by marginal cost pricing,which focused on technology value and labor value of medical staff,and graded pricing for health institu-tions at various levels. In respect of compensation,compensation subjects included government,social security funds,charitable or-ganization,etc. The government provided fixed-rate compensation for citizen by allocating funds for public health institutions,so as to improve compensation level for primary health institutions. The social security funds extended sick benefit to insured patients, and compensated patients at fixed rate. Charitable organization subsidized private health institutions to reduce medical service price. Finally,actual price has been formulated through pricing and compensation links,and the experience is worthy of learning by the mainland of China.

AIM: To establish HPLC fingerprint to make the difference between pre-and post processed Radix et Rhizoma Gentiana rigescen with wine-fried method. METHODS: Chromatographic fingerprint between pre-and post processed Radix et Rhizoma Gentiana rigescen with wine-fried was investigated by RP-HPLC and the gradient elution with acetonitrile and 0.1% phosphoric acid was applied to chromatographic separation(Alltima C_18(4.6 mm ?250 mm,5 ?m) column) for 65 min,and detection wavelength of 225 nm.Data were analysed by fingerprint similarity evaluation software to compare the similarity among the samples. RESULTS: The similitude degree of the10 batches of pre-and post processed Radix et Rhizoma Gentiana rigescen with wine-fried method were between 0.935-0.997 and 0.964-0.999,respectively.Comparing with the common processing of the HPLC fingerprint of Radix et Rhizoma Gentiana rigescen,the similarity of Radix et Rhizoma Gentiana rigescen processed with wine-fried was greater than 0.900. CONCLUSION: There have no significant deviation between semipolarity components of the pre-and post processed Radix et Rhizoma Gentiana rigescen with wine-fried method. The proportion of the main relative peak area has changed.