Clinical Trials as Topic ; Dentistry ; Humans

OBJECTIVE:To introduce high-value drug insurance access mechanism in Australia,and to provide suggestion for improving orphan drug medical insurance access in China. METHODS:By literature study and policy analysis,access principle, risk-sharing mechanism and restricted use principle of high-value drug insurance access in Australia were summarized and analyzed, so as to evaluate the effects of high-value drug insurance access mechanism. RESULTS & CONCLUSIONS:The inclusion of high-value drug in Australian National Formulary considers not only the cost-effectiveness ratio,but also the drug’s clinical effica-cy,irreplaceability and the social principles;risk-sharing mechanism and restricted use principle achieve a good balance between the accessibility of patient’s medication and the sustainability of health insurance fund;remarkable results are achieved in guarantee-ing patient’s medication and strengthening basic medical insurance. It is recommended to perfect orphan drugs medical insurance ac-cess standard,introduce risk-sharing mechanism and standardize the use of orphan drugs and reimbursement in China.

Objective To study the deficiency of serf-regulation in impulsivity children with attention deficit hyperactivity disorder(ADHD)based on both procedures of action and inhibitory control.The event related potentials(ERPs)component P3 in Go/NoGo tasks was analyzed.Methods There were 15 impulsive children with ADHD and15 normal children in control group.Their age was from seven years old to eleven years old.The Go/NoGo stimulate-response model was adopted in the ERPs test.The occurrence of Go and NoGo trials was equal probability(each of 50%).Results(1)The high impulsive children had slower Go-RTs(reaction times)in making correct response than normal children,tended to be faster of NoGo-RTs in making error response and had lower correct rate.(2)P3amplitudes in both control and ADHD children had the tendency of Go-P3 > NoGo-P3,especially significant at CPz and Pz in ADHD children,showed the trend of parietal central to parietal maximum and the frontal minimum,The NoGo-P3 amplitude of ADHD group was smaller especially significant at FCz and Cz,and tended to be smaller than control on left hemisphere.(3)NoGo-P3 is smaller in impulsive children with ADHD than normal children,most significant at FCz.(4)Brain maps showed that impulsive children with ADHD were lower activation significantly in the right frontal area.Conclusions The efficiency of ADHD in action is lower.The behavior regulation in impulsive children is limited.Go/NoGo-P3 reflects action processing and attention.The left parietal lobe to central area is engaged much more in action procedure and attention.This research shows the evidence of weakened parietal cortex and right frontal cortex in impulsive children with ADHD.

Objective To investigate the influence of human chorionic gonadotropin on testicular germ cell apoptosis of bilateral cryptorchidism in rats.Methods Immature male rats (22 day-old Sprague Dawley) were subjected to bilateral cryptorchidism and injected with 20 U human chorionic gonadotropin from the 22th day to the 34th day every other day. Sham operation rats were as control group. At age 35 days and 60 days, rats were sacrificed for detection germ cell apoptosis by terminal- deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL). Results There were significant difference of apoptosis index (AI) between bilateral cryptorchidism and sham operation groups(P0.05).Conclusion AI of cryptorchidism increases and HCG addes the number of apoptotic germ cells.

Objective To investigate the correlation between the expressions of tumour suppressor gene PTEN and oncogene C-myc in colorectal carcinoma.Methods The expressions of PTEN and C-myc protein in normal colorectal mucosa(n=8), adjacent non-cancerous tissues(n=10) and primary colorectal carcinoma tissues(n=60) were observed by S-P immunohistochemical assay.Results Of 60 colorectal carcinoma tissues,C-myc protein was detected in 46 cases.The expression rate of C-myc in the primary colorectal carcinoma tissues(76.70%) was significantly higher than that in the normal(0) and adjacent non-cancerous tissues(10%)(P0.05).The positive expression rate of PTEN protein in the primary colorectal carcinoma tissues(25.00%,15/60) was significantly lower than that in the normal(100%) and adjacent non-cancerous tissues(90%)(P

Adenofibroma ; metabolism ; pathology ; Antigens, CD34 ; metabolism ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; surgery ; Nephroma, Mesoblastic ; metabolism ; pathology ; Sarcoma, Clear Cell ; metabolism ; pathology ; Stromal Cells ; metabolism ; pathology ; Vimentin ; metabolism

Objective To explore the influence of human chorionic gonadotropin(HCG)on testicular germ cell apoptosis of experimental unilateral cryptorchidism in rats.Methods Forty immature male Sprague-Dawley rats were randomly divided into unilateral cryptorchi-dism group(n=20) and sham operation group(n=20).The 2 groups were divided into group treated with HCG and group without HCG.At age 21 days,unilateral cryptorchidism was produced.Half of the rats were injected with 20 U HCG from day 22 to 34 every other day.At age of 35 d and 60 d,rats were sacrificed for detection germ cell apoptosis by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL).Results Apoptosis index(AI) of cryptorchidism testis were higher compared with the scrotal testis in sham operation group(P0.05).AI of the scrotal testis of sham operation group and unilateral cryptorchidism group with HCG was higher compared with the correspond groups without HCG,and there were significant difference of AI between sham operation group and the correspond group without HCG at age 35 days(P0.05).Conclusions AI of testicular is increased both in cryptorchidism testis and scrotal testis in experimental unilateral cryptorchidism;HCG adds the number of apoptotic germ cells,and histology damage of testis is not completely recovery after stop using HCG.So clinical application of HCG must be cautious and operation ought to be done as early as possible in cryptorchidism.

Objective To explore the relationship between the anastomotic plane and gastric esophageal reflux by analysizing three different anastomotic plan pressure and esophageal 24 h dynamic pH.Methods From June 2011 to March 2012, 45 patients with esophageal cancer had undergone radical surgery.According to the different locations of esophageal carcinoma, we divided patients into three groups(cervical esophagogastrostomy group, above aortic arches for esophagogastrostomy group, low aortic arches for esophagogastrostomy group).we monitored the LESP, esophageal wet swallowing peristalsis amplitude and 24 h dynamic pH value two days before surgery, and monitored the anastomotic plane pressure, residual esophageal wet swallowing peristalsis amplitude and 24 h dynamic pH value 1 month and 2 months after surgery in the same way.Results Three groups' difference of LESP, esophageal wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜4in preoperative was not statistically significant.The difference of esophagogastrostomy plane pressure in postoperative was not statistically significant, but the wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜ 4 in postoperative was statistically significant.Three groups' difference of LESP(compared with esophagogastrostomy plane pressure), wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜ 4 between preoperative and postoperative was also statistically significant.Conclusion For patients with esophageal neoplasms, we should completely resection the tumor, and remain esophagus as much as possible.

Objective To investigate clinical efficacy of Easy First strategy in laparoscopic pancreaticoduodenectomy (PD) for borderline resectable pancreatic cancer.Methods The clinical data of 9 patients with borderline resectable pancreatic cancer who were admitted to the Sir Run Run Shaw Hospital of Zhejiang University (8 patients) and Zhejiang Provincial People's Hospital (1 patient) from June 2013 to March 2015 were retrospectively analyzed.Nine patients underwent laparoscopic pancreaticoduodenectomy based on the Easy First strategy (to sequentially dissect and amputate jejunum,stomach,hepatoduodenal ligament,common bile duct,main portal vein,head of pancreas,second segment and third segment of the duodenum,uncinate process and neck of pancreas).The operation time,volume of intraoperative blood loss,postoperative pathological examination,complications and duration of hospital stay were recorded.Patients were followed up once every 3 months by outpatient examination and telephone interview up to June 2015.Results Of 9 patients,4 received totally laparoscopic PD (2 received partial resection and repair of portal venous wall),1 received laparoscopic assisted resection and digestive tract reconstruction,and 4 received laparoscopic transection of jejunum,bile tract and stomach and conversion to open surgery for resection and digestive tract reconstruction (1 with severe adhesion between tumor and portal vein,3 with bleeding due to dissection of neck and unciform process of pancreas).The operation time and volume of intraoperative blood loss in all patients and in 4 patients with totally laparoscopic PD were (404 ± 49) minutes and (456 ± 348) mL,(395 ± 61) minutes and (188 ± 25) mL,respectively.Of 9 patients,5 with postoperative complications were cured without perioperative death,including 2 with Grade B pancreatic fistula,1 with biliary leakage,1 receiving reoperation due to gastric stump bleeding at postoperative day 7 and 1 with abdominal infection.The extubation time of right drainage tube and left drainage tube was (9 ± 5) days and (11 ± 4) days,respectively.The duration of hospital stay was (24 ± 10)days.All patients were diagnosed as with pancreatic cancer by pathological examinations with the tumor diameter of (3.2 ± 0.8) cm.The number of harvested lymph nodes in all patients and in 4 patients with totally laparoscopic PD were 16.8 (range,6.0-25.0) and 19.8 (range,15.0-25.0).All the patients were followed up for mean time of 12 months (range,4-24 months),including 1 death at postoperative month 3,1 with tumor survival of 20 months and others with tumor-free survival.The postoperative survival time of 4 patients was more than 18 months at the end of follow-up.Conclusion Easy First strategy in laparoscopic PD is safe,feasible and practical for borderline resectable pancreatic cancer.

Objective To compare the effects of isoflurane or sevoflurane in combination with remifentanil anesthesia on blood amyloid beta protein (Aβ) in the elderly patients undergoing abdominal surgery.Methods Two hundred patients of both sexes,aged 65-75 yr,weighing 51-76 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective abdominal surgery under general anesthesia,were randomly divided into 2 groups (n =100 each) using a random number table:isoflurane combined with remifentanil anesthesia group (IR group) and sevoflurane combined with remifentanil anesthesia group (SR group).Fifty healthy elderly subjects served as control group (group C).After anesthesia was induced with iv penehyclidine,sufentanil,propofol and vecuronium,the patients were endotracheally intubated and mechanically ventilated.In group IR,anesthesia was maintained with inhalation of isoflurane (end-tidal concentration 1.68 ％,in IR group) or sevoflurane (end-tidal concentration 1.71％,in SR group),and target-controlled infusion of remifentanil (target plasma concentration 2-6 ng/ml).At l day before surgery and 3 days after surgery,the patients' cognitive function was assessed using Mini-Mental State Examination (MMSE),the development of postoperative cognitive dysfunction (POCD) was recorded,and blood samples were taken for determination of serum Aβ40 and Aβ42 concentrations.Results The incidence of POCD was 5％ (in C group),56％ (in IR group) or 22％ (in SR group),and there was no significant difference among the three groups.There were no significant differences in the serum Aβ42 and Aβ40 concentrations after surgery among the three groups.Conclusion The mechanism by which sevoflurane or isoflurane in combination with remifentanil anesthesia results in POCD is not related to the levels of blood Aβ40 or Aβ42 in the elderly patients undergoing abdominal surgery.