The article presented the drugs supply management mode reform in place since 2009 in the one district of Shanghai.Authors analyzed and commented the implementation and outcomes,and studied the potentials of successful promotion nationwide.They hold that such a mode works to some extent in terms of reducing management costs of medical institutions,lowering drug purchase price,encouraging rational drug use of such institutions,and reforming the compensation manner for medical institutions.This mode,however,calls for an operating environment in need of not only funding support,but also new concepts and economic development strength of the society as a whole.This means that such a mode is only recommended in developed areas in China.

0.05) but CO, SV and CVP increased and SVR decreased significantly after AHH in both groups as compared with those before AHH. pH, Lac and COP did not change significantly after AHH. There was no significant difference in the volume of solution infused, blood loss, CO, SV, CVP and SVR between the two groups. Conclusion Age is not a primary factor negating the use of AHH. Under combined general-epidural anesthesia AHH with 6% hydroxyethyl starch (15 ml?kg-1 ) can be well tolerated by the elderly patients without cardiac and pulmonary disease.

Objective To investigate the effect of isoflurane administered before ischemia on polymorphonuclear neutrophil (PMN) infiltration and expression of adhesion molecules in the lung injured by ischemia-reperfusion.Methods One-hundred and twenty male SD rats weighing 250-350 g were randomly divided into 4 groups ( n = 30 each) :Ⅰ sham operation group (S) ;Ⅱ I/R group in which hilum of left lung was clamped for 45 min and then undamped for reperfusion; Ⅲ Iso + I/R in which 1 MAC isoflurane was inhaled for 30 min before ischemia and Ⅳ Iso + S in which 1 MAC isoflurane was inhaled for 30 min without I/R. The animals were anesthetized with intraperitoneal pentobarbital 50 mg?kg-1 then tracheostomized and mechanically ventilated with 100% O2(VT= 10-15 ml?kg-1) . PaCO2 was maintained at 35-45 mm Hg. Right jugular vein and left carotid artery were cannulated for BP monitoring, blood sampling and fluid and drug administration. Anesthesia was maintained with ketamine 10 mg?kg-1?h-1 and vecuronium 0.1 mg?kg-1?h-1. 1 MAC isoflurane (1.38% in rats) was inhaled for 30 min before hilum of left lung was clamped with an atraumatic clamp. Left lung ischemia was maintained for 45 min then the left lung was released for reperfusion. MAP was monitored and blood gases were analyzed during experiment. The animals were killed at the end of 45 minute ischemia and at 30, 60 and 120 min reperfusion and left lung was removed for: (1) determination of W/D lung weight ratio, myeloperoxidase (MPO) activity and expression of ICAM-1 mRNA; (2) light and electron microscopic examination; (3) broncho-alveolar lavage (BAL). BAL fluid (BALF) was collected and the number of cells, percentage of PMN and total protein concentration in BALF and the expression of CD18 on PMN surface were determined. Results The W/D lung weight ratio, MPO activity and expression of ICAM-1 mRNA in the lung tissue, the percentage of PMN and TP concentration in BALF and the expression of CD18 on PMN surface were all significantly increased during reperfusion in I/R group but isoflurane pretreatment significantly attenuated the I/R induced increases. Histological examination showed that the I/R induced lung injury was also ameliorated by isoflurane pretreatment. Conclusion Inhalation of isoflurane before ischemia could protect the lungs against I/R injury by inhibiting the PMN infiltration and expression of ICAM-1 mRNA and CD-18.

Objective To study the chemical constituents from the stems of Dendrobium nobile. Methods Compounds were isolated through various chromatographic techniques and identified by spectral data. Results Twelve phenolic compounds were obtained. Their structures were characterized as dihydroconiferyl dihydro-p-coumarate (Ⅰ), vanillin (Ⅱ), apocynin (Ⅲ), p-hydroxybenzaldehyde (Ⅳ), syringaldehyde (Ⅴ), syringic acid (Ⅵ), syringylethanone (Ⅶ), α-hydroxypropiosyringone (Ⅷ), coniferyl aldehyde (Ⅸ), dihydroconiferyl alcohol (Ⅹ), 2-hydroxyphenylpropanol (Ⅺ), and 3-hydroxy-4-methoxyphenylethanol (Ⅻ), respectively. Conclusion All above compounds are reported from this plant for the first time. Compounds Ⅰ and Ⅲ -Ⅻ are reported for the first time from the plants of Dendrobium Sw.

Objective To explore the clinical manifestations and the deletion mutation in NEMO gene in incontinentia pigmenti. Methods The clinical manifestations of one neonatal infant were analyzed. By long PCR ampliifcation, the deletion mutations in NEMO gene and pseudogene ΔNEMO were detected. Results The clinical manifestations were typical skin lesions. Histopathological examination showed focal edema sponge and gathered or scattered eosinophilic granulocytes. The deletion of exons 4-10 in both NEMO andΔNEMO genes were detected in the patient. Conclusions Incontinentia pigmenti is a rare X chromosome linked dominant genetic disease. It has typical clinical manifestations and pathological changes, and deletion mutation in NEMO gene.

Objective To evaluate the application of endoscopic needle- knife precut sphincterotomy (PST) in treating acute suppurative cholangitis. Methods After failure of routine papillary intubation during encoscopic retrograde cholangio-pancreatography (ERCP) in papillary incarcerated stone or inflammatory stenosis cases, needle-knife PST was applied to find the lower opening of the common bile duct. After that, routine papillary sphincterotomy or balloon dilation followed. Then net basket for stone extraction and nasobiliary catheter for drainage were made. Results Eleven of the 12 cases′ stones were extracted successfully, the success rate was 91.7%. In the 11 cases, 5 cases′ incarcerated stones dropped into duodenum automatically after sphincterotomy; 9 cases′ stones were extracted successfully in one treatment while 2 cases′ stones were extracted secondarily after stents were implanted; 1 case′s stone could not be extracted and need surgical treatment after nasobiliary catheter drainage because of stenosis of the lower part of the common bile duct. There was no dead case in all the cases. Conclusions Acute suppurative cholangitis patients, who have papillary incarcerated stones or inflammatory stenosis, can receive more efficacious diagnosis and treatment by applying PST when routine endoscopic papillary intubation fails. PST is an important endoscopic treatment for acute calculous suppurative cholangitis

Objective To investigate the changes in the expression of keratin genes in renal tissues during renal ischemia-reperfusion (I/R) injury in mice.Methods Six wild type male C57/B6 mice,aged 50 days,weighing 20-30 g,were divided into 2 groups (n=3 each) using a random number table:sham operation group (Sham group) and I/R group.Right renal arteries and veins were clamped for 1 h followed by reperfusion,and the left kidneys were removed to establish the model of renal I/R injury.At 24 h of reperfusion,blood samples were collected from the left ventricle for determination of serum creatinine and urea nitrogen concentrations by colorimetric method.The right kidney specimens were obtained for pathologic examination and for determination of the expression of kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin mRNA (by quantitative real-time polymerase chain reaction [qRT-PCR]) and keratin genes (by Affemetrixc DNA microarray).The differentially expressed genes identified were further confirmed by qRT-PCR.Results Compared with Sham group,the serum creatinine and urea nitrogen concentrations were significantly increased,the expression of kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin mRNA was up-regulated (P＜0.05),and the damage to the renal tubules was aggravated in I/R group.The results of microarray analysis showed that only keratin 20 gene (the expresion was up-regulated) was the differentially expressed gene (P＜0.05),and the results measured by qRT-PCR were consistent with those measured by Affemetrixc DNA microarray.Conclusion Keratin 20 gene expression in renal tissues is up-regulated during renal I/R injury in mice,and the change may be involved in the endogenous protective mechanism during renal I/R injury.

AIM: To research the development of the content of total saponin in Platycodon grandifloeum(Jacq.) A.DC.and Platycodon grandifloeum(Jacq.) A.DC.var.Hort so that the best harvest time was found. METHODS: Using the methods of cluster analysis and according to the examination method ruled in the 2005 version 〈The People's Republic of China Prarmacopoeia〉,the content of total saponin in Platycodon grandiflorum in different harvest time was compared. RESULTS: Platycodon grandifloeum(Jacq.) A.DC and Platycodongrandifloeum(Jacq.) A.DC.var.Hort respectively on September 20,September 30 are the largest yield and the largest content of total saponin in root,that time is the best harvest time. CONCLUSION: The method is simple,accurate and reliable.

China ; Hepatectomy ; methods ; Humans ; Liver Transplantation ; methods ; Living Donors

Purpose:To investigate the relationship between cell apoptosis and dephosphorylated RB protein in human breast cancer. Methods:In our work,human breast cell lines (MCF-7/S,the chemosensitive cell line and MCF-7/ADR,the chemoresistent cell line)were evaluated. Chemosensitivity of two cell lines was evaluated by the MTT colorimetric assay;the expressive levels of dephosphorylated RB protein were detected with immunocytochemistry. Apoptosis rates were determined by flow cytometry(FCM). Results:ADR inhibited proliferation of chemosensitive cell line MCF-7/S ,the 50% inhibition concentration (IC 50 ) was 0.128 ?g/ml;And IC 50 of MCF-7/ADR was 10.89 ?g/ml. The chemotherapeutic sensitivity of MCF-7/S was more than that of MCF-7/ADR by 86 times . Before treatment with ADR,phosphorylated RB protein was positive in two cell lines,but dephosphorylated RB protein was negative;After treatment of different concentration ADR,when the concentration of ADR was increased,expression of dephosphorylated RB protein elevated accordingly in MCF-7/S,but no significant change in MCF-7/ADR. Apoptosis and cell cycle was detected by FCM assays shows ADR induced apoptosis of MCF-7/S more than MCF-7/ADR(P0.05).