OBJECTIVE:To understand the trend of cost and amount of consumption of antihypertensives,antidiabetics,antipsychotics and antibiotics in Shanghai.METHODS:The data of above-mentioned 4 sorts of drugs were collected from analysis system of drug-use of Shanghai in 1994～1999.The cost of each sort of drug was calculated in term of fixed price of 1994 and the amount of consumption was discount to DDDs.RESULTS:The total cost and total amount of consumption of these 4 sorts of drugs assumed a tendency towards increase and the growth rate of the former exceeded that of the latter.Antibiotics were the highest in cost;antidiabetics and antipsychotics were the highest in growth rate;antihypertensives were maximum in amount of consumption and antidiabetics were the highest in growth rate of consumption.CONCLUSION:In Shanghai,the total cost of these four sorts of drugs increased rapidly and the prices of drugs rose year by year.The spectrum of diseases has changed to some extent.

Objective: To compare utility values measured by different instruments. Methods: Different instruments were used to measure utility values in 350 patients who were diagnosed as age-related macular degeneration at the same time. The median of utility values measured by different instruments was regarded as relative standard utility value to process comparison, analysis of variance, correlation analysis and curve estimation. Results: Most differences and correlations among utility values measured by different instruments were significant, as well as equations estimated from relative standard utility value and utility values measured by different instruments, but the degree of fitting was not high. Conclusion: The utility values of the same subject measured by different instruments are quite different. The results of the study could provide correction reference to the utility value measured by single instrument in the absence of absolute standard.

Objective To explore clinical strategies of treating in bile microlithiasis-associated cholangitis and preventing the recurrence of ursodeoxycholic acid(UDCA).Methods Forty-one cases of bile microlthiasis-associated cholangitis from January 2006 to July 2007 Were analyzed and followed up.All patients underwent endoscopic therapy who were divided into UDCA group(21 cases)and non-UDCA group (20 cases)according to the use of UDCA or not besides endoscopic therapy.After using UDCA for 12 months,the complications and the incidence rate of recurrent cholangitis in each group were compared.Results Forty-one cases had no serious complications after endoscopic therapy.None had recurrent cholangitis in UDCA group,4 cases in non-UDCA group got recurrent cholangitis.One case developed pancreatitis.There was statistical significance between the two groups(P=0.021).Conclusion Endoscopic therapy is a safe and effective treatment of bile microlithiasis-associated cholangitis,and UDCA can prevent the recurrent cholangitis effectively after endoscopic therapy.

Objective:To analyze the impact of Recombinant Human Tumor Necrosis Factor-α Receptor Ⅱ:IgG Fc Fusion Protein (rhTNFR:Fc) on medical insurance budget.Methods:Rheumatic drugs were select from the IMS data 2015.The drug quantity unit was converted to defined daily dose(DDD).The quantity of rhTNFR:FC in IMS data 2015 was taken as the baseline.The expenditure growth and its impact on rheumatic drugs and all drugs were calculated under 90％ and 80％ reimbursement rate as the different incremental proportion of the quantity of rhTNFR:Fc.National health insurance expenditure data was derived from statistical data of government departments.Results:According to 90％ reimbursement rate,medical insurance expenditure increased by 5.22～10.43 billion yuan.rheumatic drugs and all medical insurance drugs expenditure increased by 63.44～126.87％ and 0.04～0.08％ respectively while the consumption of rhTNFR:Fc increased 0-100％ in 2015.The increment of medical insurance expenditure reduced accordingly under the reimbursement ratio of 80％.Conclusion:The budget impact of rhTNFR:Fc was great on medical insurance expenditure of rheumatic drugs,which was very limited on the medical insurance expenditure of all drugs.

Objective To find out about the increase in the expenses of drugs as well as the changes of prices, manufacturing costs, and the distribution of profits in the manufacturing process so as to provide basis for the reform and perfection of the control of drug prices. Methods Using the method of retrospective sampling, investigations were made into the prices of drugs extensively used clinically throughout the country from 1995 to 2002 and analyses were conducted into the manufacturing and operating status of 80 pharmaceutical companies in 18 provinces of the nation and profits and other relevant influencing factors in 48 drug wholesaling enterprises in 20 provinces of the nation in 1999. Results The increment speed of the expenses of drugs in the 90s of the 20 th century in China was above 10%, higher than the increment speed of the GDP; the price index of drugs was on overage higher than the general price index; and the complete manufacturing costs of drugs accounted for 54% of their retail prices. Conclusion The prices of drugs in China might be regarded as appropriate, and yet too large an amount of profits goes into the process of circulation, resulting in insufficient funds for the pharmaceutical industry to conduct research and development.

OBJECTIVE:To provide references for the controlling of reimbursement of medicare drug expenditure in urban employees in China.METHODS:Referenced experiences were summed up from classified drug reimbursement acts in other countries and areas stated in the literature review.RESULTS&CONCLUSION:It is a common international policy to clas?sify drugs by quality and adopt different reimbursement ratio;most of the countries and areas would exclude the reimburse?ments of over-the-counter drugs;the purpose of classified drug payment and reimbursement was to increase the users'payment thereby to lessen the burden of the authorities on the expenditure of social medicare drugs;concerning the controlling of drug expenditure,measures only taken from the aspects of price setting,ratio of reimbursement and quantity of drug con?sumption can that be effective;analysis about advantages and disadvantages should be considered in the making of the re?forming policies about establishing pharmaceutical reference prices and setting up prescription fee and etc.

Objective To investigate the expression of JAM-1 after microwave irradiation and its correlation with blood-brain barrier integrity. Methods A total of 160 male Wistar rats were divided into a sham radiation group and a radiation group. The radiation group was subdivided into three sub-groups treated with micrewaves at average power densities of 10, 30 and 100 mW/cm2. Rats in each group were sacrificed and their brain tissue sampled at 6 hours and 1, 3, 7 and 14 days after the irradiation. Evans blue ( EB ) dye, laser confocal microscopy,Western blotting, RT-PCR and image analysis were used to test the permeability of the blood-brain barrier and the expression of JAM-1 in protein and at the gene level in the rats' hippocampus and cortex. Results There was an increase of EB in the hippocampus 3 to 14 days after 10 and 100 mW/cm2 microwave irradiation. The EB level increased progressively in the 10 and 30 mW/cm2 groups within 7 d after irradiation but recovered by the 14th day. It also increased progressively in the 100 mW/cm2 group within 14 d after irradiation. In the hippocampus, EB was observed only in the lumens of the blood vessels in the sham group, but EB had diffused out of the blood vessels in the irradiated groups by the 3rd day after irradiation. After 10 or 30 mW/cm2 microwave irradiation, JAM-1 protein in the hippocampus and cortex decreased significantly within 7 d after irradiation but recovered by the 14th day. It decreased progressively in the 100 mW/cm2 group within 14 d after irradiation. The expression of JAM-1 mRNA in the hippocampus decreased significantly at 6 h after irradiation at all power levels, but it recovered within 7 days in the 10 and 30 mW/cm2 groups. Conclusions Microwave radiation can decrease the expression of JAM-1 in the hippocampus and cortex. The degree of decrease is positively correlated with the microwave radiation power. The change might involve increasing the permeability of the blood-brain barrier.

OBJECTIVE: To conduct the economic evaluation of recombinant human type Ⅱ tumor necrosis factor receptorantibody fusion protein (trade name: Etanercept) in the treatment of rheumatoid arthritis.METHODS: By literature retrieval, foreign literatures about Etanercept "head to head" research or Chinese literatures about the comparison of recombinant human type Ⅱ tumor necrosis factor receptor-antibody fusion protein with infliximab and adalimumab were collected. The costs were localized, indicators of effectiveness were converted into quality-adjusted life year (QALY), then cost-utility analysis (CUA) and incremental cost-utility ratio (ICUR) were conducted. RESULTS: Three qualified literatures were acquired. The translational research of the first report of WU B and so forth (2012 year) showed that CUA of Etanercept, infliximab and adalimumab were 48. 2, 36. 6 and 104. 6 thousand yuan/QALY, and ICUR were 119. 8, 116. 4 and 313. 4 thousand yuan/QALY, respectively. The translational research of the second report of Santos-Moreno P and so forth (2015 year) showed that CUA of Etanercept, infliximab and adalimumab were 93. 1, 118. 2 and 249. 2 thousand yuan/QALY, and ICUR were 117. 5, 151. 3 and 327. 9 thousand yuan/QALY, respectively. The translational research of the third report of Santos-Moreno P and so forth (2016 year) showed that CUA of Etanercept, infliximab and adalimumab were 107. 0, 131. 6 and 273. 8 thousand yuan/QALY, and ICUR were 139. 6, 172. 5 and 369. 8 thousand yuan/QALY, respectively. ICUR of Etanercept were all smaller than 3 times of GDP 148. 1 thousand yuan in 2015. CONCLUSIONS: From the results of the study of these 3 literatures, compared with infliximab and adalimumab, Etanercept shows economy for rheumatoid arthritis.

Objective To study changes and significance of endothelin(ET) in rat cerebral concussion.Methods 80 Wistar male rats were used for animal model of cerebral concussion,which were sacrificed on 1,3,7,14 and 30 days after injury and the brain tissue were taken off. The expression of ET was studied in the course of cerebral concussion by means of immunohistochemistry.Results Typical clinical manifestation was observed in the 100 g group in which the pathological changes included cerebral vascular constriction and dilatation,congestion and edema of cerebral tissue,neuronal degeneration,necrosis,and obviously decreased even disappeared Nissl bodies.Increased expression of ET was observed on the first day,the positive area was seen in the plasma of endothelial cells in cerebral cortex,hippocampus,cerebellum and thalamus.ET expression peak occurred on the 7th day,the positive area was also found in the plasma of Purkinje cells in the cerebellum.Decreased ET expression was found on 14th day and returned to normal level on the 30th day.Conclusion The main pathological changes of cerebral concussion contained blood circulation disorder,and degeneration and necrosis of substantial cells.ET was involved in the brain tissue injury during the pathological process of cerebral concussion and might be related to regulation of cerebral vascular reaction,and neuron degeneration and necrosis.

OBJECTIVETo investigate the role of apoptosis in radiation-induced mouse thymus lymphocyte damage and repair and provide the basis for understanding the molecular mechanism of radiation-induced lymphocyte damage and repair as well as the prevention and treatment of acute radiation sickness.

METHODSWe studied the dynamic changes of apoptosis of mouse thymus lymphocytes and the expression of bax and bcl-2 gene products after 2, 4, 6 and 8 Gy of whole body gamma-irradiation using in situ terminal labeling, DNA electrophoresis and immunohistochemical techniques.

RESULTSAt the early stage after irradiation, the percentage of apoptotic lymphocytes increased rapidly in accordance with the increasing of radiation doses, while the counts of the thymus and peripheral lymphocytes decreased sharply, showing an opposite change to lymphocyte apoptosis. After 6 Gy gamma-irradiation, typical morphological characteristics of thymus apoptotic lymphocytes in early, middle and late stages were found by transmission electron microscopy. The thymus lymphocytes displayed characteristic DNA ladders 4 hr and 8 hr after 2-6 Gy gamma-irradiation,using DNA gel electrophoresis techniques. Abnormal expression of bcl-2 and bax gene products were shown in irradiated lymphocytes.

CONCLUSIONSApoptosis plays an important role in the process of radiation-induced mouse thymus lymphocyte damage and repair. Bcl-2 and Bax proteins may regulate the process of lymphocyte apoptosis.

Animals ; Apoptosis ; radiation effects ; Dose-Response Relationship, Radiation ; Gamma Rays ; Lymphocytes ; physiology ; radiation effects ; Male ; Mice ; Proto-Oncogene Proteins ; analysis ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Thymus Gland ; pathology ; radiation effects ; Time Factors ; bcl-2-Associated X Protein