Sharing medical data may reduce unnecessary repetitive studies and promote the cooperation between research groups.By analyzing the mature practices of some other countries,we proposed solutions to China's current problems in sharing medical research data,such as formulating sharing policies,strengthening platform construction and enhancing international cooperation.

Objective To study the therapeutic effect of EUS-guided biliary drainage (EUS-BD) on patients with malignant obstructive jaundice when ERCP failed.Methods From January 2014 to January 2016,all patients with malignant obstructive jaundice during hospitalization underwent EUS-guided biliary drainage (group A,36 cases) or PTCD treatment (group B,30 cases) by draw after failed ERCP.Operation success rate,liver function recovery time,complication rates,length of hospital stay and hospital costs were observed and compared.Results There was no significant difference in the operation success rates between two groups [94.44％ (34/36) VS 86.67％ (26/30),P＞0 05)].And there were significant differences in liver function recovery time (25.79± 6.48 d VS 30.24 ± 8.49 d),incidence of complications [5.56％ (2/36) VS 23.33％ (7/30)],length of hospital stay (21.54±4.73 d VS 25.68 ± 8.56 d) and hospitalization costs (23.5±8.4 thousand yuan VS 32.8±6.5 thousand yuan,P＜0.05).Conclusion EUS-guided biliary drainage could be the first option for its noninvasiveness and efficacy,when ERCP failed in patients with malignant obstructive jaundice.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

As a critical part of national scientific and technology system reform, construction of national innovation system is a fundamental measure of innovation driven development strategy.Medical science and technology innovation system (MSTIS) is an important component of national innovation system (NIS).It is essential to elaborate the content, characteristics and process of the MSTIS.Based on the development status of Chinese economy and society and the framework of NIS, we evaluated the characteristics of medical science and technology development, and ultimately concluded and elaborated the content and characteristics of MSTIS from the following aspects: innovation force, innovation subjects, innovation activities, and innovation environments.We also prospected the future process of MSTIS, i.e., promotion of innovation force, ability construction of innovation subjects,scientific plan of innovation activities, and improvement of innovation environment.

Objective To investigate the clinical features of macrophage activation syndrome (MAS) associated with systemic lupus erythematosus (SLE).Method The clinical data of 15 patients with SLE-induced MAS diagnosed in Peking Union Medical College Hospital from July 2011 to December 2014 were retrospectively analyzed.Results Fourteen patients were female.The average age was 28.07.When MAS occurred,the average duration of SLE was 20.47 months,and the average SLE disease activity index (SLEDAI) was 18.4.All 15 patients developed fever,hematocytopenia and impaired liver function in the course of MAS,while patients with splenomegaly,coagulation disorders and neuropsychiatric symptoms were 11,14 and 8,respectively.All 15 patients presented leukocpenia and thrombocytopenia.Hypofibrinogenemia,elevated ferritin and hemophagocytosis in bone marrow were respectively observed in 7,11 and 12 patients.Glucocorticoids were used in all patients,among whom eight received pulse methylprednisolone therapy.Thirteen patients were treated with immunosuppressants,including cyclosporine A,tacrolimus,cyclophosphamide and mycophemolate mofetil.Complete remission was achieved in 14 patients.One patient died of MAS.Conclusions In patients with SLE,MAS was most commonly seen in young females with short SLE duration and active disease.Fever,splenomegaly,hematocytopenia,coagulation disorders and liver damage are the most remarkable clinical manifestations.Early diagnosis and intensive therapy are the key parts to improve clinical outcome.

The acceptance assessment is an important part of research project management.By analyzing the content,methods,process and model of the current acceptance assessment of medical research projects in China,we summarized and elaborated the main problems in the medical research management.By referring to the mature practices of some other countries,we proposed the solutions to improve the quality of acceptance assessment in China,i.e.,balancing the qualitative and quantitative assessment,improving the quality of peer-review,constructing information platform,introducing independent third party assessment and construing the overall process evaluation system.Our study may provide important reference for constructing the high-quality evaluation system of medical research projects in China.

Integration and sharing of biological samples are the most effective approach for making use of their stock and improving their utilization efficiency. Although great success has been achieved in development of Biolog-ical Samples Library in China, efforts are not made in promoting sample resource sharing. The problems in develop-ment of Biological Samples Library were thus summarized in this paper by content analysis, such as no unified crite-ria, poor administrative management, and imperfect ethical supervision of sample sharing.

Objective To examine the effects of the MEK inhibitor on human pancreatic cancer cells, and to explore the molecular mechanisms. Methods Human pancreatic cancer cell lines CFPANC1, PANC1 and MiaPaCa2 were treated with MEK inhibitor PD98059 or DMSO, the sensitivity was analyzed by an MTT assay, and cell cycle distribution was evaluated by flow cytometry( FCM), The transcriptional level and protein expression of tumor suppressor genes were detected by real-time RT-PCR and western blot respectively. DNA methyltransferase (Dnmt)1, 3a and 3b were also assayed by western blot, The methylation status of the promoter of the p16INK4A gene was assayed by methylation-specific PCR (MSP). Results PD98059 inhibited to various degrees the growth of three pancreatic cancer cell lines, accompanied by G0-G1 cell cycle arrest. PD98059 up-regulated the expression of p16INK4a, p21WAF1, p27KIP1 mRNA, demethylated the hypermethylation status of p16INK4a gene promoter, and decreased Dnmtl and Dnmt3b in CFPANC1 and PANC1 cell lines. PD98059 only increased the expression of p27KIP1, while the changes of p16INK4a, p21WAF1 and Dnmt were less marked in MiaPaCa2 cell line. Conclusions MEK inhibitor PD98059 down-regulate the activation of Dnmt and up-regulate tumor supress genes, along with the inhibition of cell proliferation and cell cycle progression.

Objective To determine the influence of schizophrenia patients with diabetes on cognitive function.Methods Altogether 78 schizophrenia patients with diabetes and 118 patients with schizophrenia were enrolled and Negative and Positive Syndrome Scale,Wechsler Memory Scale-Revised Visual Reproduction Test,Wechsler Adult Intelligence Scale-Revised Digit Symbol Test,Computerized Wisconsin Card Sorting Test,Trail Making Tests,Part A and B,and Wechsler Adult Intelligence Scale-Revised Digit Span Test were used to assess the clinical syndrome and to test the cognitive function.ResultsImpairment of Processing Speed,Attention/Working Memory,Executive Functioning and Visual Memory in schizophrenia patients with diabetes was significantly poorer than that of the schizophrenia patients ( all P ＜ 0.05 ).WAIS-R Digit Symbol Test score and Trail Making Test A and B scores were associated with diabetes duration and age at diabetes onset (P ＜0.01 ).Conclusion The impairment of cognitive function in schizophrenia patients with diabetes is severer than schizophrenia patients,suggesting that the prevention and management of diabetes may improve cognitive outcome in schizophrenia patients.

Objective To investigate the effects of programmed intermittent epidural bolus (PIEB) with continuous epidural infusion (CEI) at different time intervals for epidural labor analgesia.Methods One hundred and eighty-six nulliparous parturients were randomized to the groups P1, P2 and C.Epidural infusion was given initial loading dose: 10 ml (0.125% ropivacaine with 0.4 μg/ml sufentanil), followed by maintaining dose: 0.08% ropivacaine with 0.4 μg/ml sufentanil.Group P1 was given basal infusion 5 ml per 30 min, 30 min after the initial dose;group P2 was given basal infusion of 10 ml per 60 min, 60 min after the initial dose;CEI basal infusion of 10 ml/h immediately after the initial dose;PCEA (patient-controlled epidural analgesia dose) 5 ml (lockout interval: 30 min).The baseline maternal heart rate, noninvasive arterial blood pressure, SpO2, respiratory rate, and fetal heart rate tracing were recorded.The visual analog scale (VAS) was recorded during the first stage of labor and at full cervical dilation.The degree of motor block was assessed in both lower extremities using the modified Bromage score (MBS).The maximum blocked segment, the consumption of anesthetic, delivery mode, amount of oxytocin, The number of cases of motor block and intrapartum fever, the fetal Apgar scores,adverse reactions,maternal satisfaction score were recorded.Results The VAS obviously decreased in the three groups since receiving labor analgesia (P<0.05).The ratio of VAS score more than 3 scales in group PIEBⅡ was significantly lower than that in groups P1 and C (P<0.05).The maximum blocked segment increased in group P1, while The incidence of unilateral block was significantly decreased in group P2 (P<0.05).The total drug consumption.And the toatal number of PCA were decreased obviously in group PIEB (P<0.05).The initial PCA time was significantly prolonged in group P2 (P<0.05).The number of instrumental midwifery and intrapartum fever in group P2 were significantly lower than that in group C (P<0.05).Conclusion Programmed intermittent epidural bolus at the beginning 60 min intervals after the initial dose for epidural labor analgesia is scientific and effective.