Objective: To provide policy recommendations for improving price negotiation system of patented drugs in China. Methods: This paper comparatively analyzes the commonalities and characteristics between Korea’ and Germany’s price negotiation models for patented drugs from three aspects of their goals, procedures and effects. Results:The key objective of both Korea’ and Germany’s price negotiation systems for patented drugs is to efficiently improve the utilization of national health insurance services, and responsibilities are properly assigned among differ-ent institutions to ensure the equity and efficiency of negotiations. However, due to the differences in national cir-cumstances, there is a big difference in the selection of technical assessment criteria. Conclusion: This paper sug-gests China to strengthen the convergence between price negotiations for patented drugs and medical insurance reim-bursement policy, to establish a technical assessment system with the innovation extent for patented drugs as its core, and to develop scientific and rational negotiation procedures and division of responsibilities as well.

OBJECTIVE:To evaluate the application effects of PDCA cycle management in the outpatient prescription intervention.METHODS:A total of outpatient prescriptions (pre-intervention group) during Jan.-Dec.2014 and 918 659 (intervention group) were selected during Jan.-Dec.2015 were selected from a hospital.Irrational 9utpatient prescriptions were analyzed before and after the application of PDCA cycle management,and the improvement of main indexes were compared such as unsuitable usage and dosage,incomplete clinical diagnosis writing,no physicians' signature on the prescription or inconsistent with sample.RE SULTS:Before intervention,there were 2 347 irrational prescriptions,including 1 401 nonstandard prescriptions,849 unsuitable prescriptions and 97 abnormal prescriptions.After intervention,there were 1 161 irrational prescriptions,including 695 nonstandard prescriptions,425 unsuitable prescription and 41 abnormal prescriptions,decreasing 50.53％,50.39％ 49.94％ and 57.73％,respectively.The proportion of unsuitable usage and dosage,incomplete clinical diagnosis writing,no physicians' signature on the prescription or inconsistent with sample,nonstandard prescription paper,unsuitable indications,no signature and date for prescription revision or no reason and new signature for overdose use,outpatient prescriptions more than 7 d common dose or emergency prescriptions more than 3 d common dose without special situation in total amount of outpatient prescriptions decreased from 0.72‰,0.57‰,0.45‰,0.27‰,0.20‰,0.19‰ and 0.15‰ before intervention to 0.32‰,0.25‰,0.19‰,0.11‰,0.09‰,0.08‰ and 0.07‰ after intervention.CONCLUSIONS:PDCA cycle management significantly improves the quality of outpatient prescriptions.There still are irrational outpatient prescriptions in this hospital,and it is to be intervened continuously.

Objective:To suggest approaches for the establishment of Chinese standards for defining rare disea-ses and advance corresponding Chinese legislation. Methods:By comparing the standards for defining rare diseases in Europe, the United States, and other countries and studying key influencing factors of standards, this paper proposes suggestions for the establishment of proper Chinese standards for defining rare. Results and Conclusion:Social and e-conomic development levels, medical development levels and social security levels influence the establishment of standards. It is recommended that the national conditions should be taken into consideration and the number of pa-tients, severity of the diseases and economic indicators of orphan drugs be used to define rare diseases in China.

Objective To investigate the effect of different function of sympathetic nerve on the pain of peripheral nerve chronic compression. Methods Forty-eight male Sprague-Dawley rats were made into lower trunk chronic compression models and divided into 6 groups (A1,B1,C1,A2,B2,C2) with 8 rats per group. The C8T1 dorsal root ganglions of the compressed sides of group A1 (control group), B1 (sympathetic block group)and C1 (de-sympathetic group) were harvested 3 months after compression surgery. The compressed lower trunks of group A2 (control group), B2(sympathetic block group)and C2(de-sympathetic group)were decompressed 3 months after compression surgery and bred for another month and then the C8T1 dorsal root ganglions of the compressed sides were harvested. The levels of substance P mRNA in the C8T1 dorsal root ganglions were tested with RT-PCR technique. Results the mean relative levels of substance P mRNA of group A1, B1 and C1 were (3.620 ± 0.830) × 10-2, (2.945 ± 0.724) × 10-2, (2.239 ± 0.734) × 10-2, respectively, with a significant difference (P = 0.006) and those of group A2, B2 and C2 were (3.163 ± 1.026) × 10-2, (2.355 ± 0.680) × 10-2,(1.487 ± 0.802) × 10-2, the difference among which was statistically significant (P = 0.003). Conclusion The pain of peripheral nerve chronic compression is affected by sympathetic function. The more lower the sympathetic function is, the more light the pain is. Sympathetic blockage or resection helps to relieve the pain of peripheral nerve compression disease after being decompressed.

Objective To explore the regulatory effect of Nervilia fordii Injection ( NFI ) on inflammatory cytokines in rats with lipopolysaccharide ( LPS) -induced acute lung injury ( ALI) , and to explore its possible interfering mechanism . Methods The rats were randomly divided into normal group , model group , Shenmai Injection group, and NFI group. J774 macrophages were stimulated by LPS to establish the cell model in vitro, and in vivo ALI rat model was established by injection of LPS through the sublingual veins. Electronic microscope and enzyme-linked immunosorbent assay (ELISA) were used for observing the proliferation of J774 macrophages, the levels of supernatant inflammatory cytokines secreted by J774 cells, and the levels of serum inflammatory cytokines . Results The proliferation of LPS-induced J774 macrophages was increased , and the secretion of inflammatory cytokines was disordered. Uncontrolled inflammatory reaction occurred in the lung after the rats were administrated with intravenous injection of LPS . Both NFI and Shenmai Injection could inhibit the proliferation of J774 macrophages. NFI could also significantly inhibit the levels of supernatant and serum tumor necrosis factor (TNF) -α and interleukin 6 (IL-6) expression (P<0.05 or P<0.01), and it could increase the level of supernatant IL-10 (P<0.01) and decrease the level of serum interleukin 10 (IL-10) in rats (P<0.05), but couldn’t regulate the secretion of monocyte chemoattractant protein 1 (MCP-1) (P>0.05). Conclusion NFI has better preventive and therapeutic effect for ALI than Shenmai Injection, and its possible mechanism is related with the inflammatory regulation and lung injury relief through the suppression of excessive expression of TNF-α and IL-6 .

Objective To investigate the influence factors of malnutrition risk in hospitalized children,in order to provide theoretical basis for early identifying hospitalized children at the risk of malnutrition and for guiding clinical nutritional intervention.Methods Hospitalized children in the Department of Pediatrics of our hospital from March 1st 2013 to April 30th 2014 were included and assessed using Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP).Questionnaire survey was conducted and clinical data was recorded.The children were divided into two groups according to STAMP scores upon admission,namely high malnutrition risk group and low malnutrition risk group.Comparing the differences of basic characteristics,laboratory examinations,and treatments between the two groups,associated factors of statistical significance were detected.With the associated factors identified in single factor analysis as independent variables and STAMP score-based group division as the dependent variable,multifactor unconditional Logistic regression analysis was performed to explore the independent risk factors influencing STAMP scores of hospitalized children.Results A total of 1 406 hospitalized children were included,of whom 738 were at high malnutrition risk,and the other 668 were at low malnutrition risk.Single factor analysis indicated that fever before admission (Z =-3.809,P =0.000),severity of condition (x2 =14.068,P =0.000),age (x2 =5.813,P =0.017),and length of fever before admission (t =2.793,P =0.005) were associated with high malnutrition risk of hospitalized children.Non-conditional Logistic regression suggested that severity of condition (OR =1.557,95％ CI:1.164-2.083,P =0.003),length of fever before admission (OR =1.039,95％ CI:1.011-1.068,P =0.006),and granulocyte count (OR =1.032,95％ CI:1.004-1.061,P =0.027) were risk factors of high malnutrition risk in hospitalized children,and age (OR =0.942,95％ CI:0.909-0.977,P =0.001) was protective factor.Conclusion Age,severity of condition,length of fever before admission,and granulocyte count can provide helpful information for early identification of hospitalized children at high malnutrition risk.

Objective To investigate the difference of serum prealbumin in hospitalized children and its value in Screening Tool for the Assessment of Malnutrition in Pediatrics ( STAMP) in hospital-izedchildren.Methods 867hospitalizedchildrenwererecruitedfromMarch2013toApril2014in the First Affiliated Hospital of Fujian Medical University .All the patients were assessed using STAMP and collected venous blood sample for measuring serum prealbumin within 24 hours after admission.All the patients were surveyed for information regarding gender , age, dietary changes, etc.and their clini-cal data and laboratory results during hospitalization collected .The patients were divided into high mal-nutrition risk group ( HMRG) and low malnutrition risk group ( LMRG) according to STAMP scores upon admission. Results There were 463 children ( 53.4%) in HMRG, and 404 in LMRG (46.6%).Compared with the LMRG, the HMRG had significantly lower serum prealbumin [ (144.7 ± 50.6) mg/L vs.(173.6 ±71.3) mg/L, t=6.795, P=0.000].After controlling for age, course of disease, white blood cell count, albumin, glutamic-oxalacetic transaminase, C-reactive protein in covariance analysis, the HMRG still had significantly lower serum prealbumin than the LMRG [ estimate ( 95% CI): 139.8 ( 134.9 -144.8 ) mg/L vs.157.9 ( 151.9 -163.8 ) mg/L, F =20.433 , P=0.000 ) .Clinical cure rates in HMRG with low serum prealbumin , HMRG with normal serum pre-albumin, LMRG with low serum prealbumin, and LMRG with normal serum prealbumin were 62.9%(95/151), 80.5% (251/312), 77.1% (27/35), and 98.1% (362/369) (χ2 =112.80, P=0.000 ) , respectively; incidences of hospital acquired infection were 21.9% ( 33/151 ) , 8.7%( 27/312 ) , 22.9% ( 8/35 ) , and 1.9% ( 7/369 ) (χ2 =63.55 , P =0.000 ) , respectively. Conclusion High malnutrtion could be distinguished more accurately using the combination of the as-sessment of malnutrition screening tools and serum prealbumin measurement .

BACKGROUND: The etiology and pathogenesis of Tourette syndrome(TS)is still unacknowledged, and related studies on the relationship between TS and hypoironemia are unavailable. Since hypoironemia has been found existed in children with TS who showed better outcomes after receiving adjuvant ferralium, thereby this study was designed to investigate the relationship between TS and serum iron.OBJECTIVE: To study the relationship between TS and serum iron.SETTING: At a nursing science department of a university-affiliated hospital, pediatric department of a university affiliated hospital and sectional hospital.PARTICIPANTS: Between June 1997 and December 2000, 45 children with TS received treatment at pediatric clinic of Chenghai sectional people' s hospital, Shantou city, who accorded with the diagnostic standards of the second edition of Chinese Psychopathy Category and Diagnostic Standards,those who were confirmed as brain organic diseases by CT and MIR were excluded.METHODS: Serum iron, hemoglobin and the number of red blood cells were determined in 45 TS children and compared with that in 38 controls.MAIN OUTCOME MEASURES: Difference of the level of serum iron and the incidence of hypoironemia between two groups.RESULTS: The level of serum iron was(12.79 ±0.67) μmol/L in experimental group, obviously lower than(19.26 ± 5.38) μmol/L in control.group( P ＜ 0. 005), the incidence of hypoironemia was 42% significantly higher than13% of control group( P ＜ 0. 005).CONCLUSION: Quite a lot of children with TS have hypoironemia that might be one of the pathogenesis factors, the possible mechanism is, as the result of hypoironemia, decreased activity of monoamine oxidase led to abnormal monoamine neurotransmitter.

ObjectiveTo study the toxic effect of bupivacaine encapsulated in liposomes on spinal cord in rats.MethodsOne hundred and eight SD rats (200-225 g) in which intrathecal (IT) catheter was successfully implanted without complications were randomly divided into 6 groups ( n =18 each):control group (group C) ; liposome group (group L) ; 0.5％ and 1.0％ bupivacaine groups (groups B1 and B2 ) and 0.5％ and 1.0％ bupivacaine encapsulated in liposomes groups (groups LB1 and LB2 ).In groups L,B1,B2,LB1 and LB2,liposome,0.5 ％ bupivacaine,1.0 ％ bupivacaine,0.5 ％ liposomal bypivacaine and 1.0 ％ liposomal bupivacaine 20 μl were injected IT respectively once a day for 7 consecutive days,while in group C nothing was injected IT.Pain threshold was measured by mechanical stimulation of the plantar surface of hindpaw.Motor function of the hindlimbs was also assessed.The animals were sacrificed at 8 day after IT injection.The lumbar segment of the spinal cord was removed for microscopic examination,detection of neuronal apoptosis (by flow cytometry) and Fos protein expression (by immuno-histochemistry).Results1.0％ bupivacaine IT significantly increased the percentage of apoptotic neurons in group B2 as compared with control group.0.5％ and 1.0％ bupivacaine IT significantly increased the number Fos protein positive cells in group B1 and B2 as compared with group C.1.0％ bupivacaine IT induced severe histologic damage including shrinkage of nucleus and vacuole formation in mitochondria.Encapsulation of bupivacaine in liposomes significantly attenuated bupivacaine-induced increase in apoptosis and Fos protein expression and histologic damage in group LB2 as compared with group B2.ConclusionThe encapsulation in liposomes can decrease the neurotoxicity of 1.0 ％ bupivacaine administered IT in rats.

Objective To observe the effect of montelukast on bronchial asthma and influence on the immune state , in order to provide support for the treatment of montelukast.Methods 92 patients with bronchial asthma in our hospital from December 2014 to January 2016 were selected in the study and randomLy divided into two group.The control group was treated with the conventional therapy of bronchial dilation and glucocorticoid inhalation , and on this basis, the treatment group was loaded with montelukast, 10 mg/times, one times of one day, and the course of treatment was one months.Then the frequency of acute attack of asthma and the number of beta receptor agonist were before and after treatment were recorded , and the lung function the level of T lymphocyte subsets and the levels of inflammatory cytokines before treatment and after treatment were detected , and the difference between the two groups was compared.Results After treatment, t the frequency of acute attack of asthma of day and night and the number of beta receptor agonist of the treatment group were significantly lower than the control group, the FEV1%, FVC% and PEF% of the treatment group were significantly higher than the control group, the level of CD8 + was significantly lower than the control group, the ratio of CD4 +/CD8 + was higher than the control group; the levels of IL-2, INF-γwere higher than the control group, while the levels of IL-4, IL-8 were lower than the control group (P<0.05).Conclusion The montelukast has certain regulation effect on imbalance of CD4 +/CD8 +and Th1/Th2 in children with bronchial asthma, and have a good effect on the prevention of asthma.