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.

BACKGROUND: Calcium pyruvate has great effect on reducing bodymass, and chitosan can regulate immunity system, promote bone growth, decrease blood sugar and adjust blood lipid. Calcium pyruvate and chi tosan capsule (CCC) was made by calcium pyruvate and chitosan combined with Chinese medicine, which can be used both as food and medicine. However, its effect still needs further observation. OBJECTIVE: To investigate the weight-reducing effect of CCC on obesity rats, and explore its mechanism.DESIGN: A randomized controlled trial.SETTING: Teaching and Research Section of Preventive Medicine, Department of Public Health, Xi'an Medical College, and Department of Public Health, Medical School of Xi' an Jiaotong University.MATERIALS: The experiment was conducted in the Department of Public Health, Medical School of Xi'an Jiaotong University from April to July 2001. Totally 60 healthy male weaning SD rats with body mass of 50-80 g,were provided by the Animal Center of Xi'an Jiaotong University. CCC,mainly composed of calcium pyruvate and chitosan, mixed with Chinese medicine extract after prepared with distilled water, was made by the author.METHODS: ①Grouping and modeling: The 60 rats were randomly divided into 5 groups: blank control group, model control group, high, middle and low dose CCC supplement groups, respectively with 12 rats in each group. The rats in the blank control group were fed w ith basal diet; the other groups were fed with high fat and nutrition diet to establish rat models of nutritional obesity. ②Administration: The rats in the blank and model control groups were given suspension mixed with starch matrix in capsule and distilled water at same dose. The rats in the high, middle and low dose CCC groups were intragastrically infused with 3, 1.5 and 0.75 g/kg CCC, once aily for 30 days. ③Detection: Body mass, body length and wet weight of fat tissue were measured before and after administration to calculate the obese index and ratio of fat weight/body mass. The adipocyte number and adipocyte size were observed by 400-fold microscope and ocular micrometer, respectively. The detection of serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and serum leptin levels were performed according to the leptin radioimmunity analyzer kit.MAIN OUTCOME MEASURES: ①Body mass, body length and obesity index before and after administration. ②Wet weight of fat, fat/body mass,adipocyte number and size. ③TG, TC, HDL-C and serum leptin.RESULTS: All the 60 rats were involved in the result analysis. Before administration, the body mass of the blank control group was obviously lower than other 4 groups (P ＜ 0.01), and there was no significant difference among the 4 groups (P ＞ 0.05). After administration, the mean body mass,obesity index, wet weight of fat tissue, ratio of fat/body mass and leptin level of the high, middle and low CCC groups were lower than the model group (P ＜ 0.05 or 0.01), and the adipocyte size were significantly smaller than those in the model group (P ＜ 0.05 or 0.01), but the adipocyte number was more than the model group (P ＜ 0.05 or 0.01). Meanwhile, level of TG and TC of the high and middle dose CCC groups were lower than the model group (P ＜ 0.05 or 0.01), there was no significant difference in the body length and HDL-C of each group.CONCLUSION: ①CCC shows evident weight-reducing effect on rats with nutritional obesity, which is not related to the ability of CCC to enhance the serum leptin level. ②CCC can also lower the blood lipid level.

Objective To investigate the expression of secretagogin(SCGN) and chromogranin A(CgA) in pancreatic neuroen‐docrine tumors (PNETs) .Methods Totally 54 cases of PNETs hospitalized in our hospital from October 2007 to October 2013 were enrolled in our study .Immunohistochemical detection was used to determine secretagogin and CgA .Results Secretagogin and CgA were highly expressed in all PNETs specimens .Compared with CgA ,secretagogin were highly expressed in the non‐functional PNETs ,tumor volume>30 cm3 ,the enveloped ,vascular invasion and lymph node metastasis (P<0 .05) .There were no statistically significant difference between SCGN and CgA in functional PNETs tumor volume ≤30 cm3 ,no enveloped ,no vascular invasion and lymph node metastasis(P>0 .05) .Conclusion The expression of secretagogin and CgA in tumor combined with PNETs pathologi‐cal characteristics can predict the severity of PNETs .

Objective To evaluate the clinical efficacy of multiple target burst frequency thermocoagulation in treatment of lumbar disc herniation.Methods One hundred and twelve patients suffering from lumbar disc herniation were treated with stepped heating multiple target burst frequency thermocoagulation using of domestic R-2000B radiofrequency ablation machine.The visual analogue scale (VAS) score,Oswestry disability index (ODI) and effect of grade before operation and after operation were compared.Results The VAS score before operation was (7.60 ± 1.12) scores,3 d after operation was (3.10 ± 1.05) scores,6 months after operation was (2.90 ± 0.92) scores,there was significant difference between before operation and 3 d,6 months after operation (P ＜ 0.05).The ODI before operation was 47.6 ± 8.3,3 months after operation was 25.5 ± 6.7,6 months after operation was 23.7 ± 6.2,there was significant difference between before operation and 3,6 months after operation (P ＜0.05).The clinical efficacy:excellent grade was in 66 cases,the good was in 32 cases,the improvement was in 10 cases,the inefficacy was in 4 cases,the excellent and good rate was 87.5％ (98/112).There was no nerve injury,infection or death after operation.Conclusion Multiple target burst frequency thermocoagulation in the treatment of lumbar disc herniation has the advantages of little incision and tissue damage,fast recovery,good clinical outcome,it is worth to clinical practice.

Objective To investigate the pathological features and clinical characteristics of primary mitochondrial myopathy and encephalomyopathy. Methods 11 cases of mitochondrial myopathy and encephalomyopathy were analyzed on clinical features, histochemical changes and ultrastructure observations of muscles. Results RRFs were found in all 11 cases by muscle staining of MGT under light microscope. 7 cases were only afflicated with muscle weakness, 4 cases also having impairment of central nervous system. The proportion of RRFs was 6.4% to 10.3%. We observed these cases under electronic microscope. In 9 cases,the ultrastructural alterations included subsarcolemmal accumulation of mitochondria,increases of the number,abnormal shape,disarrangement of cristae and paracrystaline inclusion bodies. In 2 cases the increase of mitochondrial number is only the alteration. Conclusions Typical RRF is valuable for diagnoses of mitochondrial myopathy and encephalomyopathy under light microscope. The accumulation of abnormal mitochondrials beneath sarcolemal,especially the paracrystaline inclusion bodies are significant in making a definite diagnosis of this disease under electronic microscope.

0.05). Results Compared with the Open Group, the VATS Group presented significantly shorter operation time (101.4?25.2 h vs 139.6?42.5 h,t=-4.086,P=0.000), duration of postoperative chest drainage (2.2?0.8 d vs 3.0?0.9 d,t=-3.498,P=0.000), analgesic requirement time (3.0?0.5 d vs 5.5?1.2 d,t=-9.578,P=0.000), and length of hospitalization (8.0?2.4 d vs 11.2?2.3 d,t=-4.993,P=0.000). The intraoperative blood loss (185.2?153.4 ml vs 393.6?296.9 ml,t=-3.300,P=0.002) and the postoperative drainage volume (158.8?75.2 ml vs 248.2?191.7 ml,t=-2.298,P=0.025) was dramatically less in the VATS Group than in the Open Group. All the patients were cured. Follow-up observations for 1~3 months found no hemothorax, empyema, or fibrothorax in both groups. Conclusions VATS can be safely used in hemodynamically stable patients or hypotensive patients who respond to crystalloid fluids. VATS has many advantages, such as minimal invasion, little blood loss, short operating time, and quick recovery.

Objective:To investigate the influencing factors for orthostatic hypotension(OH)in elderly patients with hypertension.Methods:This was a case-control study.A total of 224 patients with hypertension aged over 65 years were included.After resting for more than 5 minutes, subjects had their blood pressures measured in the supine and standing position at 0 min, 1 min, 2 min and 3 min.OH was defined as a fall in systolic BP of more 20 mmHg(1 mmHg=0.133 kPa)and/or diastolic BP below 10 mmHg of baseline within 3 min in the upright position.Subjects were divided into the OH group( n=34)and the non-OH group( n=190). Baseline data, comorbidities and differences in medications were compare between the OH group and the non-OH group, and the influencing factors for OH were analyzed. Results:The proportion of drinkers was higher in the OH group than in the non-OH group(29.4% or 10/34 vs.7.4% or 14/190, χ2=14.649, P<0.01). Both systolic pressure(139.0±22.1 mmHg vs.124.5±16.3 mmHg, t=-3.661, P<0.01)and diastolic pressure(77.6±6.3 mmHg vs.69.2±9.0 mmHg, t=-6.696, P<0.01)in the supine position were higher in the OH group than in the non-OH group.The proportions of patients with diabetes(47.1% or 16/34 vs.25.3% or 48/190, χ2=6.731, P<0.05)and stroke(41.2% or 14/34 vs.24.2% or 46/190, χ2=4.233, P<0.05)were higher in the OH group than in the non-OH group.The proportion of patients receiving α receptor blockers was higher in the OH group than in the non-OH group(23.5% or 8/34 vs.4.2% or 8/190, χ2=16.228, P<0.01). After adjusting for factors such as alcohol consumption, diabetes, stroke and other differences between the OH and non-OH group, logistic regression found patients with alcohol intake( OR=5.274, 95% CI: 1.990~13.982, P<0.01), diabetes( OR=2.744, 95% CI: 1.213~6.208, P<0.05)and using α receptor blockers( OR=8.812, 95% CI: 2.835~27.383, P<0.01)had a higher risk of OH. Conclusions:OH is very common in elderly patients with hypertension.Alcohol consumption, diabetes mellitus and the application of α receptor blockers can increase the risk of OH.

Objective To observe the antioxidant activities of whey protein peptides (WPP) in aged mice.Method The subacute aged model mice were made by neck back subcutaneous injection of D-galactose every day.Compared with VE as positive control,the mice were given three different doses of WPP,100,200,400 mg/(kg bw?d) respectively,the effect of WPP on the content of catalase (CAT),malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-PX)in serum,liver and brain were observed after 45 d.Results The CAT,SOD and GSH-PX activities in aged model group were significantly decreased,but MDA was significantly increased as compared to normal mice.While in the aged mice treated with WPP 200 and 400 mg/(kg bw?d),the activity of CAT,SOD and GSH-PX were significantly increased and the content of MDA significantly decreased as compared to aged mice.Conclusion WPP shows dose-dependant antioxidant effect in aged mice.

Objective To investigate the expression and importance of basic fibroblast growth factor(bFGF)in renal tissue of doxorubicin-induced nephropathy rats,and discuss its possible role in minimal change nephrotic syndrome(MCNS).Methods Fifty male Wistar rats were enrolled in this study.They were randomly divided into normal group(n=10)and nephropathic group(n=40).The nephropathic group was established by a single intraperitoneal injection of doxorubicin 5 mg/kg.The rats of nephropathic group were killed on the 3rd,7th,14th and 28th day and 24 h urinary protein of all rats was measured.Normal group rats were killed on the 28th day.bFGF level in renal tissue was determined with immunohistochemistry assays,and was quantitatively analyzed with color image analysis system.The SPSS 10.0 software was used to obtain t-test of various groups and correlation analysis of 2 variables.Results 1.The 24 h urinary protein of nephropathy rats increased gradually on the 7th,14th and 28th day,and it was greatly higher than that in control group(Pa

Objective To study the effects of high matrix metalloproteinase 9 (MMP 9 ) on the biological behaviors of fibroblasts,in order to clarify the possible mechanisms in the wound healing of diabetic foot.Methods Establish the cell model of skin fibroblast with high expression of MMP 9 by high glucose (22.0 mmol/L) and high homocysteine (100 μmol/L) co-culture.Control group was incubated with normal glucose (5.5 mmol/L).Realtime PCR,ELISA and gelatin zymography were used to detect the MMP 9 mRNA,protein expression and activity of MMP 9.Flow cytometry,CCK-8,ELISA assay,scratch test and transwell were used to detect cell proliferation,viability,collagen (hydroxyproline) secretion,horizontal migration and vertical migration of cells.Results Data were expressed as (x- ± s).Differences were considered significant if their P value was ＜ 0.05.Results The expression of MMP 9 mRNA,protein levels and the activity of MMP 9 in high MMP 9 group were 6.05 folds,4.12 folds and 1.58 folds higher than those in control group (P ＜ 0.01,respectively).The proportion of S phase cells,proliferation index,cell viability,collagen (hydroxyproline) secretion,6 h horizontal migration rate and the number of vertical migration cells in high MMP9 group decreased by 29.8 ％,18.1％,23.3 ％,68.7 ％,45.0 ％ and 21.4 ％ than those in control group (P ＜ 0.01,respectively ). Conclusions Fibroblast with high expression of MMP 9 have decreased proliferation,activity,collagen secretion and reduced migration,which suggests that MMP 9 may inhibit the biological behaviors of fibroblasts.