In this paper, a systematical and retrospective review was made on how the drug purchasing system of Chinese healthcare institutions has evolved from decentralized purchasing to centralized purchasing based on four stages as budding stage, initial stage, adjustment stage and deepening stage. In each stage, the working characteris-tics, achievements and problems have been analyzed. Targeting at the problems and challenges confronted with cur-rent drug purchasing, recommendations was made to reform and improve public hospitals’ centralized purchasing sys-tem, such as persisting centralized purchasing online at provincial level, sticking to “four favorable” principles, breaking through the mechanism of compensating medical cost with drug-selling profits, promoting coordinated inter-action reforms in healthcare insurances, distribution and pricing, strengthening comprehensive services and supervi-sion, etc.

Three candidate antisense target sites of mouse Fas gene were screened by PARASS (poly-A anchored RNA accessible sites screening) technology. They were target at Fas gene 297nt-317nt, 618nt- 638nt and 662nt-682nt. Antisense oligos (A1, A2 and A3) and DNAzymes (D1, D2, and D3) for every target site were designed and synthesized. In vitro, the validation of the sites were judged by antisense oligos included RNase H splicing and the DNAzyme degradation. The results indicated that A1, A2 and A3 introduced RNase H degradation. DNAzymes D1, D2 and D3 cleaved Fas mRNA effectively. Neither degradation observed in antisense oligo RNase H group in non-target site (1211-1231nt) and 2 bases mismatched of A3, nor splicing occurred in DNzyme group in non-target site ( 1211-1231nt) and 2 bases mismatched of D3. Site 2 and 3 were at the same positions with those of ISIS Pharmaceuticals. The effective antisense oligos and DNAzymes for Fas gene could be used for the research subsequently.

OBJECTIVETo evaluate the feasibility and safety of transperitoneal laparoscopic nephrectomy in live-donors.

METHODSTwo cases of live-donor underwent laparoscopic nephrectomy in May and August 2008 respectively and both were followed up.

RESULTIn two cases the operation time was 130, 10 min; blood loss was 50 ml; warm ischemic time was 30 s and 2 min; the length of artery was 4.0 cm and 3.5 cm; the length of vein was 3.0 cm. The grafted kidneys started to produce urine at 30 s and 10 s after blood supply. Renal function of donor returned to normal after two days. The donors were discharged at 7th day after the operation. Renal function of recipient was normal after 3 days.

CONCLUSIONTransperitoneal laparoscopic nephrectomy in live-donor is a safe and effective procedure, which provides kidney with satisfactory blood vessels and ureter for graft.

Female ; Humans ; Kidney Transplantation ; Laparoscopy ; Living Donors ; Male ; Middle Aged ; Nephrectomy ; methods ; Peritoneum ; surgery ; Tissue and Organ Harvesting

OBJECTIVETo analyze characteristic CT enhancement patterns of noncalcified pulmonary tuberculomas and their pathological basis.

METHODFifty-six patients with noncalcified pulmonary tuberculomas underwent surgical resection of the tuberculomas. Enhanced CT images of these tuberculomas were reviewed and analyzed in relation to the histological findings.

RESULTSOf the 56 patients, 45 showed no enhancement in the tuberculomas, which were histologically characterized by central caseous necrosis and a poorly vascularized peripheral fibrotic zone. Eleven patients showed ring-like or eggshell enhancement, and the central low density region was histologically confirmed to be caused by caseous or liquefied necrosis, while the ring enhancement resulted pathologically from moderately or well vascularized peripheral fibrotic or granulomatous tissues.

CONCLUSIONSPulmonary tuberculomas consists mainly of caseous necrotic tissues characterized by no enhancement and ring or eggshell enhancement on dynamic contrast-enhanced CT.

Adult ; Calcinosis ; Contrast Media ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Tuberculoma ; diagnostic imaging ; metabolism ; Tuberculosis, Pulmonary ; diagnostic imaging ; metabolism ; Young Adult

A high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) method was developed and validated for the determination of mizoribine in human serum using thiamphenicol as internal standard (IS). The serum samples of mizoribine were precipitated with acetonitrile and separated by HPLC on a reversed phase C18 column with a mobile phase of 0.1% ammonium acetate water solution-methanol (47:53, v/v). Mizoribine and IS were detected in the multiple reaction monitoring mode with precursor/product ion transitions of m/z 258.2/126.0 and 354.1/185.2, respectively. The calibration curves were linear over the range of 0.02-2 microg mL(-1) for mizoribine. The limit of quantification (LOQ) was 0.02 microg mL(-1) with acceptable precision and accuracy. The validated method was successfully applied for the evaluation of a bioequivalence study on Chinese healthy volunteers. The main pharmacokinetics parameters after oral administration of 100 mg mizoribine test or reference formulation were as follows: Cmax (1.00 +/- 0.21), (1.00 +/- 0.22) microg mL(-1); AUC(0-infinity) (6.72 +/- 1.39), (6.48 +/- 1.44) microg h mL(-1); t1/2 (2.77 +/- 0.26), (2.66 +/- 0.29) h; tmax (2.95 +/- 0.78), (2.84 +/- 0.50) h.
Adult ; Area Under Curve ; Asian Continental Ancestry Group ; Chromatography, High Pressure Liquid ; methods ; Confidence Intervals ; Enzyme Inhibitors ; blood ; pharmacokinetics ; Humans ; Immunosuppressive Agents ; blood ; pharmacokinetics ; Male ; Ribonucleosides ; blood ; pharmacokinetics ; Spectrometry, Mass, Electrospray Ionization ; methods ; Therapeutic Equivalency ; Young Adult

OBJECTIVETo develop a standard duck hepatitis B virus (DHBV) animal model using a local Hubei species of duck, Ma Ya, and use it as an in vivo experimental system to study antiviral strategies against hepatitis B.

METHODSTwo-day-old Ma Ya ducklings were experimentally infected via intraperitoneal injection with the DHBV inocula which was collected from the transfected culture supernatant of 1.5-fold-overlength genome recombinant plasmid. Blood samples were taken twice or thrice a week during post-inoculation for 50 days. Viremia was quantified by serum real-time PCR to show the peak. Antiviral treatment of the DHBV-infected ducklings was started 3 d post-inoculation. The animals received oral administration of lamivudine (3TC) at a dose of 25 mg/kg/d for 5 d, followed by a maintenance therapy thrice weekly for 3 more weeks. Serum was quantified to show the viremia peak and liver biopsy specimens were analysed by Southern blotting and in-situ hybridization at the end of antiviral drug treatment.

RESULTSThe experimental infection rate of 2-day-old ducklings was 87.5%. Viremia started to be detectable on day 7 and reached a peak on day 11 post-inoculation, followed by a decrease and fluctuations. Four weeks of oral administration of 3TC led to a significant decrease in viremia peak during. This effect was not sustained, as a rebound in viremia was observed after drug withdrawal. Similarly, the analysis of liver biopsies at the end of 3TC treatment showed a marked decrease in DHBV DNA. However, after drug withdrawal a rebound of intrahepatic DHBV DNA was observed in duck livers.

CONCLUSIONThe Hubei duck model with experimental DHBV infection of transfected supernatant is more suitable for the hepadnavirus biologic research due to its stability and practicability.

Animals ; Animals, Newborn ; DNA, Viral ; genetics ; metabolism ; Disease Models, Animal ; Ducks ; Hepadnaviridae Infections ; blood ; drug therapy ; virology ; Hepatitis B Virus, Duck ; drug effects ; genetics ; growth & development ; Hepatitis, Viral, Animal ; blood ; drug therapy ; virology ; Lamivudine ; pharmacology ; Liver ; drug effects ; pathology ; virology ; Reverse Transcriptase Inhibitors ; pharmacology ; Viremia ; blood

OBJECTIVETo study the chemical constituents of unsaponifiable matter from the seed oil of Momordica cochinchinensis.

METHODThe fatty oil from the seeds of M. cochinchinensis was extracted with petroleum ether, and the saponification was carried out with potassium hydroxide. The unsaponifiable matter was isolated and purified by silica gel column chromatography, and the structures of their constituents were elucidated by means of IR, MS, 1H-NMR, and authentic chemicals.

RESULTKarounidiol (1), isokarounidiol (2), 5-dehydrokarounidiol (3), 7-oxodihydrokarounidiol (4), beta-sitosterol (5), stigmast-7-en-3beta-ol (6), and stigmast-7,22-dien-3beta-ol (7) were elucidated.

CONCLUSIONThese compounds were found in this plant for the first time.

Molecular Structure ; Momordica ; chemistry ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Oils ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Seeds ; chemistry ; Triterpenes ; chemistry ; isolation & purification

Child, Preschool ; Humans ; Infant ; Male ; Penis ; abnormalities ; surgery ; Retrospective Studies ; Urologic Surgical Procedures, Male ; methods

OBJECTIVETo determine differences in adherence to secondary prevention guidelines (pharmacological interventions) among coronary heart disease (CHD) patients between a Chinese medicine (CM) hospital and a general hospital in a Chinese city.

METHODSMedical records of 200 patients consecutively discharged from the CM hospital and the general hospital for CHD were reviewed to determine the proportions of eligible patients who received antiplatelet agents, β-blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) and statins at discharge. The effects of patient characteristics and hospital type on the use of these medicines were estimated using logistic regression models.

RESULTSPatients discharged from the CM hospitals were older; more likely females; had greater history of hyperlipidemia, cerebrovascular diseases and less smoker (P<0.01 or P<0.05). They were less likely to receive coronary angiography and percutaneous coronary intervention, and had a longer length of stay than those discharged from the general hospital (P<0.01 or P<0.05). There were no significant differences in antiplatelet agents (96% vs. 100%, P=0.121) or statins (97.9% vs. 100%, P=0.149) use between the CM hospital and the general hospital. In multivariable analyses that adjusted for patient characteristics and hospital type, there was no significant difference in use of β-blockers between the CM hospital and the general hospital. In contrast, patients discharged from the CM hospital were less likely to receive ACE inhibitors/ARBs compared with those discharged from the general hospital (odds ratio: 0.3, 95% confidence interval: 0.105-0.854).

CONCLUSIONIn this study, the CM hospital provides the same quality of care in CHD for prescribing evidence-based medications at discharge compared with another general hospital except for ACE inhibitors/ARBs use.

Aged ; Coronary Disease ; drug therapy ; prevention & control ; Evidence-Based Medicine ; Female ; Hospitals, General ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Secondary Prevention

OBJECTIVETo study the influence of cow's milk protein allergy (CMPA) on the diagnosis of functional gastrointestinal diseases (FGID) based on the Rome IV standard in infants and young children.

METHODSA total of 84 children aged 1 month to 3 years who were diagnosed with CMPA were enrolled as the case group, and 84 infants and young children who underwent physical examination and had no CMPA were enrolled as the control group. The pediatricians specializing in gastroenterology asked parents using a questionnaire for the diagnosis of FGID based on the Rome IV standard to assess clinical symptoms and to diagnose FGID.

RESULTSThe case group had a significantly higher incidence rate of a family history of allergies than the control group (P<0.05). In the case group, 38 (45%) met the Rome IV standard for the diagnosis of FGID, while in the control group, 13 (15%) met this standard (P<0.05). According to the Rome IV standard for FGID, the case group had significantly higher diagnostic rates of reflex, functional diarrhea, difficult defecation, and functional constipation than the control group (P<0.05). The children who were diagnosed with FIGD in the control group were given conventional treatment, and those in the case group were asked to avoid the intake of cow's milk protein in addition to the conventional treatment. After 3 months of treatment, the case group had a significantly higher response rate to the treatment than the control group (P<0.05).

CONCLUSIONSIn infants and young children, CMPA has great influence on the diagnosis of FGID based on the Rome IV standard. The possibility of CMPA should be considered during the diagnosis of FGID.