Objective:To introduce the Australian Life Saving Drugs Program ( LSDP) and provide references for medical assistance system for the rare diseases in China. Methods:The main content and characteristics of LSDP were analyzed and compared with the Chinese status quo valuation. Results:Through the orphan drug designation and cost-effectiveness evaluation, eligible drugs are included in LSDP and funded to the rare disease patients. LSDP stip-ulated the strict funding criteria and conditions, established the Guidelines and Disease Advisory Committees, and processed the post-market reviews program in order to guarantee the medication requirements of the patients. Conclu-sions:The Australian experience is worth learning and China should implement a country-led management system for the rare disease and orphan drugs, and explore a medical assisstance system in line with the Chinese national condi-tion based on the catastrophic medical insurances.

Task-driven teaching method is a kind of exploration.The prospective research on the application of task-driven teaching method in social medical insurance course is helpful to setting up a teaching situation,constructing a relaxed study environment,stiring up students’interest in the study and improving students’initiatives and creativity.

Objective To investigate the immunity effects of quorum sensing in the pulmonary infection in rats due to Pseudomonas aeruginosa.Method(1)300 healthy,clean Sprague-Dawley rats were divided into 3 groups randomly:two different Pseudomonas aeruginosa(the wide-type Pseudomonas aeruginosa PAO1 and its double mutant PAO-JP2,in which the quorum sensing systems were defective,embedded in minute seaweed algiante beads which was made by an ejection set with an acuminate hole were inoculated to Sprague-Dawley rats to establish animal model of chronic pulmonary infection.The control group were dealed with the same methods using the sterile brine instead.(2)The levels of antibody IgG,IgM,IgG1,IgG2a to Pseudomonas aeruginosa in sera and cytokines including interferon-?(IFN-?),Interleukin-4(IL-4)in lung homogenate was measured at 3,7,14,28 days after infection.Results(1)The mortality in the PAO1-JP2-infected group(11.0%)was significantly lower than that of the PAO1-infected group(29.7%)and the control group(4.21%).(2) Compared with the PAO-JP2 group,during the early stages of infection(3 days after infection),the IFN-?level in lung homogenates was significantly higher;during the middle stages of infection(7 days after infection),the levels of IFN-?and IL-4 of PAO1-infected rats were significantly higher;In the later stages of infection(14 to 28 days after infection),levles of IFN-?,IgG2a were lower,while levels of IL-4,IgG,IgG1 were higher persistantly in PAO1-infected rats.Conclusions Quorum sensing system play an important role in pathogenesis and immunity effects of pseudomonas aeruginosa infection via modulating the expression of virulence factors and interfering with the immune system of hosts.

Objective To study the significance and feasibility of modified early warning scores (MEWS) assessing the conditions and death prediction among the pre-hospital acute poisoning patients.Methods We performed a prospective,observational study of the pre-hospital acute poisoning patients between January 1,2010 and December 31,2010.Data was collected to calculate the MEWS.Numeration data was presented in percentage by using chi-square test,and measurement data was expressed in mean with standard deviation,and P ＜ 0.05 was considered to be different with statistical significance.Observation lasted for 90 days after admission to get the results as observation index and ROC was drew and the area under the curve and the predicting index were calculated.The patients without vital signs and unsuccessful resuscitation were not included in this study.Results It showed 287 person times with 0 ～ 6 scores,accounting 94.4％,17 person times with 7-13 scores,accounting 5.59％,among the dead patients,MEWS were more than those of the survival group with statistical significance (P ＜ 0.05).The area under ROC was 0.99 indicating that MEWS≥7 was the board line for severe pre-hospital acute poisoning patients with sensitivity of 91.7％,specificity of 97.9％,accuracy of 97.7％ and Youden of 0.896 for predicting death.It showed high significance of the application of MEWS in assessing acute poisoning patients and death prediction.Conclusions MEWS assess pre-hospital acute poisoning patients and predict death with good resolution and strong application significance,which is simple,practical and applicable.

Objective To investigate the application value of three-dimensional (3D) visualization technology in the resectability assessment and surgical planning for huge hepatic carcinoma.Methods The retrospective cross-sectional study was conducted.The clinical data of 48 patients with huge hepatic carcinoma who were admitted to the Zhujiang Hospital of Southern Medical University between January 2012 and June 2015 were collected.The preoperative image of computed tomography (CT) was converted to 3D reconstruction,visual observations and simulated surgery for assessing the tumor resectability through MI-3DVS,and corresponding treatments were performed according to the results of assessment.Observation indicators:(1) 3D reconstruction situations;(2) tumor resectability assessment through simulated surgery:tumor diameter,tumor volume,preoperative standard liver volume (SLV),tumor-free liver volume after simulated resection,future liver remnant (FLR) after simulated resection,hepatic resection rate (HRR);(3) surgical and postoperative situations:surgical procedures,resection extent,operation time,volume of intraoperative blood loss,complications,duration of postoperative hospital stay;(4) typical case analysis;(5) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence or metastasis up to June 2016.Measurement data with normal distribution were represented as(-x) ± s.Results (1) Three-D reconstruction situations:48 patients with huge hepatic carcinoma received successful 3D reconstruction and visual observations.Portal vein branches and hepatic vein branches reached level 4 through 3D reconstruction,and spacial position relationship between tumor and intrahepatic vascular backbones or branches can be clearly observed,as well as location and degree of vascular compression and invasion.(2) Tumor resectability assessment through simulated surgery:of 48 patients receiving simulated hepatectomy,26 underwent hepatectomy and 22 didn't undergo hepatectomy based on the assessment of resectability.Tumor diameter,tumor volume,preoperative SLV,tumor-free liver volume after simulated resection,FLR after simulated resection and HRR through assessment of 3D reconstruction and simulated surgery were (12.3-± 2.0) cm,(838 ± 284) mL,(1 884 ± 391) mL,(494 ± 140) mL,(551 ± 184) mL,46％ ± 12％ in 26 patients with resectable tumor and (14.0 ± 2.0) cm,(1 877 ± 1 240) mL,(2 945 ± 1 194) mL,(666 ± 206) mL,(402 ± 86) mL,62％ ± 9％ in 22 patients with unresectable tumor,respectively.(3) Surgical and postoperative situations:26 patients with resectable tumor underwent hepatectomy,without occurrence of death.Of 26 patients,21 underwent anatomic hepatectomy,including 12 undergoing right hemihepatectomy,3 undergoing left hemihepatectomy,2 undergoing right lobectomy of the liver,2 undergoing right posterior lobectomy of the liver,1 undergoing left lobectomy of the liver and 1 undergoing resection of hepatic segment Ⅴ + Ⅵ.And 5 underwent non-anatomic hepatectomy,including 2 with reduced right hemihepatectomy,1 with resection of hepatic segment Ⅱ + Ⅲ and partial segment Ⅳ,1 with resection of hepatic segment Ⅵ + Ⅶ and partial segment Ⅴ and 1 with resection of hepatic segment Ⅴ + Ⅵ and partial segment Ⅶ.Operation time and volume of intraoperative blood loss in 26 patients were respectively (6.4 ± 1.3) hours and (712 ±633)mL.Three patients with postoperative pleural effusion and 1 with postoperative bile leakage were cured by symptomatic treatment,without the occurrence of hepatic dysfunction.Duration of postoperative hospital stay was (19 ± 8) days.Of 22 patients with unresectable tumor,14 underwent transcatheter hepatic arterial chemoembolization (TACE),4 underwent portal vein ligation,1 underwent portal vein embolization and 3 abandoned treatment.(4) Typical case analysis:results of 3D reconstruction through MI-3DVS showed that patients underwent portal vein right anterior branch-preserving expanded right posterior lobectomy of the liver,with a smooth recovery.Patients were followed up for 14.0 months,with a good survival and without tumor recurrence and metastasis.(5) Follow-up:40 of 48 patients were followed up for 6.0-33.0 months with a median time of 13.0 months,including 26 with surgery and 14 without surgery.During the follow-up,the median survival time of patients with and without surgery was 20.0 months and 10.5 months,respectively.Twelve patients with surgery had tumor recurrence and metastasis.Conclusion Three-dimensional visualization technology is safe and feasible in the resectability assessment and surgical planning for huge hepatic carcinoma,and it will benefit to reduce risk of surgery.

Objective To investigate the prevalence of hyperuricemia and its associated factors including dietary and Metabolic Syndrome in populations of Dongcheng district in Beijing.Methods A cross-section study of hyperuricemia was carried out in volunteers who had diabetes screening from 2003 to 2004.The prevalence of hyperuricemia was calculated in the population.Applying the form of food frequency to know the intake of nutrition-rich dietary.Results The prevalence of hyperuricemia in this population was 4.3%.In male and female were 10.7% and 1.07% respectively.Bivariate and rank analysis found that hypertriglyceride were associated with increased prevalence of hyperuricemia(P

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.

Objective: The effect of Liuwei Dihuang decoctio n (LW) on the function of splenic T helper cells (Th) was studied and compared w ith those of the immune inhibitors such as cyclophosphamide (Cy) and cyclosporin A (CsA) in AA rats. Methods: The expression of mRNA for IFN- γ,IL-2, IL-4 and IL-10 in splenic T-Lymphocytes of adjuvant arthritis (AA) rats was evaluated using reverse transcription polymerase chain reaction (RT-PC R) technique. Results: mRNA expression level of IL-2 had a te ndency to elevate, but the mRNA expression levels of IFN-γ,IL-4 and IL-10 we re significantly decreased in AA rats in comparison with control groups. LW trea tment significantly inhibited the mRNA expression of IL-2 and promoted the expr ession of IFN-γ,IL-4 and IL-10 in splenocytes of AA rats, with an obvious ch aracteristic as compared with that of Cy or CsA. Conclusion: L W can correct the imdifferent balance of the functions of splenocyte Th1/Th2 in AA rats.

Objective To investigate the accuracy of serum S-100β protein and neuron specific enolase (NSE) level in predication of postoperative delirium (PD) in patients of different ages.Methods Four hundred ASA Ⅰ -Ⅳ patients of both sexes weighing 40-82 kg undergoing abdominal surgery performed under general anesthesia were divided into 4 age groups:group Ⅰ 18-44 yr; group Ⅱ 45-59 yr; group Ⅲ 60-74 yr and group Ⅳ ≥75 yr.The diagnosis of PD was made by using confusion assessment method.The incidence of PD was recorded within 72 h after operation.Each group was further divided into PD and non-PD subgroups.Blood samples were taken at 1 day before operation (T1),during their stay in PACU (T2) and at 24 and 72 h after operation (T3,4 ) for determination of serum S-100β protein and NSE concentrations.The receiver operating characteristic (ROC) curve for serum S-100β protein concentration in determining the PD efficacy was plotted.Results The incidence of PD was significantly higher and the duration was significantly longer in groups Ⅲ and Ⅳ than in groups Ⅰ and Ⅱ,and in group Ⅳ than in group Ⅲ (P ＜ 0.05).There was no significant difference in the serum S-100β protein concentration between PD subgroup and non-PD subgroup in groups Ⅰ - Ⅲ ( P ＞ 0.05).Compared with that at T1 and in nonPD subgroup,the serum S-100β protein concentration was significantly increased in PD subgroup in group Ⅳ,and the serum NSE concentration was significantly decreased at T2,3 in PD subgroup in group Ⅰ (P ＜ 0.05).There was no significant difference in the serum NSE concentration between PD subgroup and non-PD subgroup in groups Ⅱ -Ⅳ.The analysis results of the ROC curve showed that:the area under the curve for the serum S-100β protein concentration and 95％ confidence interval were 0.329 (0.127-0.531),0.352 (0.168-0.536),0.619 (0.466- 0.772) and 0.921 (0.846-0.995),the sensitivity was 50％,50％,56％ and 88％,and the specificity was 29％,22％,46％ and 86％ in groups Ⅰ-Ⅳ respectively.Conclusion Increase in the serum S-100β protein concentration can be used in predicting the development of PD in patients ≥75 yr,but the serum NSE protein concentration can not be used.

Objective To explore the relationship between myocardial glucose metabolism in the right heart and cardiac function in patients with idiopathic dilated cardiomyopathy (IDCM).Methods From October 2010 to May 2013,64 consecutive patients (45 males,19 females; mean age:(53 ± 12) years) with IDCM were enrolled in this study.All patients underwent 18F-FDG myocardial PET imaging,late-gadolinium enhancement cardiac MRI (cMRI-LGE) and UCG.TrueD software was used to determine the SUVmax in right (SUV-R) and left (SUV-L) ventricular free wall,and the ratio of SUV-R to SUV-L (SUV-R/L) was calculated.The cMRI-LGE was used to evaluate LVEF,RVEF and LGE in left heart.Pulmonary artery systolic pressure (PASP) was measured by UCG.Two-sample t test and Pearson correlation analysis were used to analyze the data.Results Both SUV-R and SUV-R/L had negative correlation with LVEF (r=-0.48,-0.33; both P＜0.01) and also with RVEF (r=-0.45,-0.44; both P＜0.01).SUV-R/L positively correlated with PASP (r =0.58,P＜0.01).SUV-R/L of patients with and without LGE were statistically different (0.45±0.18 vs 0.36±0.12; t=2.50,P＜0.05).SUV-R and SUV-L of patients with LGE were 2.0±0.9 and 4.7±1.6,and those of patients without LGE were 1.7±0.9 and 5.0±2.8.Both differences of SUV-R and SUV-L between the two groups were not statistically significant (t=0.54 and 0.63,both P＞0.05).Conclusions Myocardial glucose metabolism in right heart is closely correlated with left and right ventricular function.The assessment of 18F-FDG uptake in right heart by PET imaging is potentially useful for evaluation of the severity and prognosis in IDCM patients.