OBJECTIVE:To study the drug price administration models in some developed countries,so as to provide ref?erence information for establishing drug price administration model in China.METHODS:The comparative method and crite?rion method were adopted to study the published literature.RESULTS&CONCLUSION:Although different countries have carried out different models,they still have similarity in some policies.Therefore,we should pay attention to learn the advan?tages in different drug administration models.

ObjectiveTo study the factors which affect the nurses' implementation of cardiac rehabilitation. MethodsData of 134 nurses who worked or are working in cardiology ward in No.1 and No.2 hospital of China Medical University was analyzed by using descriptive and inferential statistics.ResultsThe overall barriers is at a moderate level. The types of the barriers in order of mean score were no formal rehabilitation program, lack of knowledge, lack of facility, lack of support, and lack of understanding. Conclusions In order to improve the motivation of nurses to implement cardiac rehabilitation nursing, something must be done to improve nursing practice , nursing administration, and nursing education.

Objective To evaluate prognostic value of N-terminal B-type brain natriuretic peptide (NT-proBNP) combined with galectin 3 of prognostic value in patients with chronic heart failure (CHF).Methods Determination of 92 cases of CHF patients on admission and at discharge plasma NT-proBNP and galectin-3 levels,then after the patients discharge we follow up 16 months and observe the internal recurrent heart failure hospitalization rate and mortality.Results In patients the heart function of New York Heart Association (NYHA) Ⅰ,Ⅱ,Ⅲ,Ⅳ level,NT-proBNP were (351.6 ± 467.5) pg/ml,(493.2 ± 411.7) pg/ml,(1 289.6 ± 737.8) pg/ml,(2 719.2 ± 1 044.1) pg/ml,galectin-3 (12.23 ± 6.12) ng/ml,(13.59± 5.46) ng/ml,(19.18 ± 7.44) ng/ml,(26.61 ± 8.82) ng/ml as well.NT-proBNP and galectin-3 levels were increased with the depression of cardiac function.The patients who had higher NT-proBNP or galectin3 levels discharged and occurred the more probability of re-hospitalization on account of heart failure or death.Compared to those patients with one of them increased,the patients whose discharge NT-proBNP and galectin-3 value were both increased with significantly poor outcome.Conclusions Both NT-proBNP and galectin-3 were independent predictors of poor prognosis in patients with heart failure.Galectin-3 combined with NT-proBNP can assess the prognosis of patients with CHF more effectively.

Objective To observe the heart rate variability in patients with hypothyroidism, and to analyze the effect of 131Ⅰ therapy on autonomic nervous system of patients with the diseases. Methods A total of 56 cases of hyperthyroidism from the Second Affiliated Hospital of Harbin Medical University and the Second Hospital of Harbin City were enrolled as research subjects. 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were used 6 months before and after 131Ⅰ treatment, and 49 cases of healthy volunteers were selected as controls.Heart rate variability indicators observed included 24 h consecutive sinus standard deviation of R-R interval (SDNN), standard deviation of sequential five-minute R-R interval (SDANN), percentage of differences between adjacent NN intervals that > 50 ms(PNN50), root mean square standard deviation from adjacent R-R interval (rMSSD), very low frequency power(VLF), low frequency power(LF), high frequency power(HF), and low frequency power/high frequency power(LF/HF). Results In hyperthyroidism group before 131Ⅰ therapy, SDNN[(85.25 ± 13.59)ms], SDANN [( 95.47 ± 33.15)ms], PNN50 [( 15.26 ± 4.84) %], rMSSD [( 14.47 ~ 3.49) ms], LF [(435.57 ± 75.74)ms2/Hz], and HF[(129.81 ± 63.21 )ms2/Hz] were significantly lower than those of the control group [(155.24 ±15.87), ( 134.02 ± 24.15)ms, (29.41 ± 6.21 )%, (26.64 ± 6.11 )ms, (515.69 ± 74.83)ms2/Hz, and (265.93 ± 58.84)ms2/Hz, all P < 0.05], VLF[(1765.21 ± 315.22)ms2] and LF/HF(3.95 ± 1.89) were significantly higher than that of the control group[(374.25 ± 54.47)ms2, 2.94 ± 1.55, all P < 0.05]. In hyperthyroidism group after treatment,SDNN [(126.91 ± 16.32)ms], SDANN[(125.2 ± 43.22)ms], PNN50[(26.34 ~ 7.56)%], rMSSD[(24.85 ± 7.85)ms],LF [(489.35 ± 91.49)ms2/Hz], and HF [(209.45 ± 75.32)ms] were also significantly higher than those before 131Ⅰ therapy, VLF[(571.80 ± 97.41)ms] and LF/HF(2.41 ± 0.93) were lower than that before 131Ⅰ therapy,but SDNN, PNN50 and HF were lower and VLF was higher than those of the control group (all P < 0.05). Conclusions The heart rate variability in patients with hyperthyroidism is lower in the overall performance, sympathetic activity is dominate, 131Ⅰ therapy partly corrects abnormal autonomic nerve function.

Objective To investigate the autonomic nervous system function of hyperthyroidism and hyperthyroidism by analyzing the heart rate variability of patients with the diseases. Methods 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were used in 36 patients with hyperthyroidism, 30 patients with hypothyroidism and 26 cases of healthy volunteers(controls), and 24-hour electrocardiogram was analyzed.Heart rate variability indicators observed included 24 h consecutive sinus standard deviation of R-R interval (SDNN), standard deviation of sequential five-minute R-R interval (SDANN), percentage of differences between adjacent NN intervals that ＞ 50 ms(PNN50), root mean square standard deviation from adjacent R-R interval (rMSSD), low-frequency power (LF), high frequency power (HF), low frequency power/high frequency power (LF/HF). Results In hyperthyroidism group, SDNN[(80.48 ± 11.95)ms], PNN50[(18.56 ± 3.50)%], rMSSD [ ( 13.56 ± 3.45)ms] were significantly lower than those of the control group[ ( 128.06 ± 12.8)ms, (32.84 ± 7.21)%,(30.84 ± 6.12)ms, all P ＜ 0.05 ], and LF/HF(3.78 ± 1.63) were significantly higher than that of the control group (2.34 ± 1.06, P ＜ 0.05). In hypothyroidism group, SDNN[(65.65 ± 15.55)ms], SDAN[ (80.2 ± 15.72)ms],PNN50[ (16.34 ± 3.56)%], rMSSD [ (15.77 ± 3.58)ms ], LF[ (279.03 ± 91.49)ms2/Hz ] were also significantly lower than those of the control group[ (128.06 ± 12.87)ms, (132.40 ± 21.95 )ms, (32.84 ± 7.21 )%, (30.84 ± 6.12)ms, (525.60 ± 84.11)ms2/Hz, all P ＜ 0.05], but LF/HF (1.08 ± 0.73) was lower than that of the control group,however, the difference was not significant(P ＞ 0.05). Conclusions The heart rate in patients with abnormal thyroid function is lower in the overall performance, but in patients with hyperthyroidism sympathetic activity is dominate, while in patients with hypothyroidism, vagal nerve activity is dominate.

180,anti-ds-DNA,anti-Sm and lower C3,are high risk factors in the development of LN.The manifestations were various and misdiagnosis at the early stage was not uncommon.

Objective To explore MRI features of spinal canal enterogenous cysts.Methods The MRI features and differential diagnosis of 5 patients with spinal canal enterogenous cysts proved by surgery and pathology were reviewed retrospectively in combination with literature review.Results Of 5 cases,the cysts localized at cervical spine in 2,lumbar spine in 1,lumbosacral spine in 1 and the end of coccyx between rectum and cuticulum in 1.4 cysts were located at subdura,including anterior to the spinal cord in 3 and posterior to the spinal cord in 1.1 cyst located the end of coccyx between rectum and cuticulum was uncommunicated with spinal canal and 1 case associated with diastematomyelia.The spinal cords were compressed and displaced.The cysts were iso or slightly hyperintensity compared to CSF on T1WI,and similar intensity to CSF on T2WI.The cysts had no markedly enhancement on contrast-enhanced MR scan.Conclusion MRI has important value in diagnosing spinal enterogenous cysts.

Objective To investigate the relationship between lower limb artherosclerosis and cardiac function in elderly patients with diabetes mellitus(DM)complicated with coronary heart disease (CHD). Methods 441 cases of elderly patients were divided into four groups: the group with CHD (n=117), the group with DM(n=42), the group with DM compllicated with CHD( DM±CHD, n=132),the group without DM and CHD(NC,n=150). Systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure (PP), braehial-ankle pulse wave velocity (baPWV), ankle-brachial index(ABl) and toe-brachial index(TBI) were measured by the auto-survey artherosclerosis apparatus.Left ventricular posterior wall (LVPW), left atrium (LA), fractional shortening (FS), ejection fraction(EF) and EF slope were measured by the two-dimensional echocardiography. Results The baPWV was significantly higher in DM+CHD group than in DM group and NC group[(20125±354)cm/s vs (1849±467)cm/s, (1863±347) cm/s. P<0.05]. The ABI was significantly lower in DM±CHD group compared with NC, CHD and DM groups (0.91±0.23 vs 1.15±0.11,1.07±0.16 and 1.06±0.14. all P＜0.05). There were significant differences in TBI among four groups(all P<0.05) :NC group(0.905±0.15)>CHD group(0.805±0.16)>DM group(0.71±0.17)>DM+CHD group(0.625±0.17). The LA and the LVPW were significantly higher in DM+CHD group than in NC group(P<0.05). The FS and EF slopes were significantly lower in the DM+CHD group than in DM group (P<0.05) and NC group(P<0.05). The EF in DM+CHD group was significantly lower than that in other three groups (P<0.05). BaPWV showed a strong negative association with FS,EF and EF slope(r:-0.112,-0.151,-0.275. all P<0.05). ABI showed a strong positive association with FS,EF and EF slope(r:0.150,0.186,0.260. all P<0.01) ,TBI was found to have strong negative association with LA and LVPW ( r:-0.158,-0.171;all P<0.01) and have strong positive association with FS,EF and EF slope(r:0.163,0.197,0.243.all P<0.01). Conclusions The lower limb artherosclerosis is serious and cardiac function is significantly decreased in elderly patients with diabetes mellitus complicated with coronary heart disease. PWV,ABI and TBI are closely related with cardiac function and can reflect the state of cardiac function in some extent.

OBJECTIVETo explore the effect differences between twirling-rotating reinforcing and reducing technique of acupuncture on cardiac damage in spontaneous hypertensive rats (SHR).

METHODSSixty male 11-week-old SHR were randomly divided into four groups: a model control group (group A), a twirling-rotating reinforcing technique group (group B), a twirling-rotating reducing technique group (group C) and a needle retaining group (group D), 15 rats in each one. In addition, twelve male 11-week-old Wistar rats were used as a blank control group (group E). Acupuncture was not used in group A and group E, only with grasp, capture and binding stimulation that was also adapted in the rest groups. Rats in the group B were treated with acupuncture at "Taichong" (LR 3) by twirling-rotating reinforcing technique for 1 min and then the needles were retained for 9 min; rats in the group C were treated with acupuncture at "Taichong" (LR 3) by twirling-rotating reducing technique for 1 min and then the needles were retained for 9 min; rats in the group D were treated with acupuncture at "Taichong" (LR 3) but without any technique and then needles were retained for 10 min. Before and after acupuncture, blood pressure monitor was used to measure the rats' systolic pressure and diastolic pressure every 6 days. Twenty-eight days after the treatment, HE and Masson staining were adopted to observe the status of left ventricular hypertrophy and myocardial fibrosis. ELISA method was applied to test the content of endothelin-1 (ET-1). PCR semiquantitative method was used to analyze Type I and III collagen mRNA in the left ventricular.

RESULTS(1) Blood pressure: after the treatment, the systolic pressure and diastolic pressure were both increased in the group A and the group B (P < 0.05); while the two pressures were both lowered in the group C and the group D (P < 0.05), which was more obvious in the group C (P < 0.05). (2) According to HE and Masson staining, except for the group E, the myocardial hypertrophy and fibrosis could be found in the rest groups, in which the group C was the modest, followed by the group D, while the group A and the group B were more severe. (3) Concentration of ET-1: there were differences of concentration of ET-1 among 5 groups (P < 0.05), and the concentration value from high to low was the group A, B, C, D and E. (4) Type I collagen mRNA: the difference of level of Type I collagen mRNA between group C and D was not statistically significant (P > 0.05); compared with the group A and B, the level was lower in the group C; the level was the lowest in the group E. Type III collagen mRNA: the difference between the group A and B was not statistically significant (P > 0.05); compared with the group A, B and D, the level was lower in the group C.

CONCLUSIONThe twirling-rotating reducing could reduce the systolic pressure and diastolic pressure in SHR, effectively prohibit the production of ET-1 and expression of Type I and III collagen mRNA, and it has more obvious inhibiting effect on Type III collagen mRNA. There is biological effect difference between twirling-rotating reinforcing and reducing technique.

Acupuncture Therapy ; instrumentation ; methods ; Animals ; Collagen ; genetics ; metabolism ; Endothelin-1 ; genetics ; metabolism ; Heart Ventricles ; metabolism ; pathology ; Humans ; Hypertension ; genetics ; metabolism ; pathology ; therapy ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar

Objective To evaluate the relationship of central aortic pressure (CAP) with atherosclerosis and left ventricular function in elderly patients with essential hypertension. Methods A total of 155 elderly hypertensive patients were divided into two groups: aged 60-79 years group (n = 71) and aged 80-95 years group (n= 84). Central aortic waveforms were generated using pulse wave analysis, then CAP and augmentation index (AI) were determined. Auto-survey atherosclerosis apparatus was applied to examine brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and toe-brachial index (TBI). Interventricular septal thickness at end diastole (IVSd), left ventricular end-diastolic dimension (LVDd), left ventricular posterior wall thickness at end diastole (LVPWd), relative left ventricle thickness (RLVT), left ventricular mass index (LVMI), Ejection fraction(EF) slope, left ventricle ejection fraction (LVEF) and fractional shortening (FS) were measured by the two-dimensional echoeardiography. Results Systolic pressure (SBP), pulse pressure (PP), CAP, AI and baPWV were significantly higher in aged 80-95 years group than in aged 60-79 years group (all P<0.05), ABI and TBI were significantly lower oppositely (both P<0. 01). IVSd, LVPWd, RLVT and LVMI were all significantly higher and EF slope was lower in aged 80-95 years group than in aged 60-79 years group (all P<0. 057. There were no significant differences in LVDd, LVEF and FS between the two groups (both P>0. 05). CAP had positive association with PP, AI and baPWV (r=0. 505,0. 284,all P<0.01). After adjustment for age, gender, smoking, body mass index, fasting blood sugar, creatinine, uric acid, cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, there was no significant relationship between CAP and ABI or TBI (both P>0. 05). There was also positive association of CAP with IVSd, LVPWd, RLVT, LVMI, while negative associations of CAP with EF slope (all P<0. 01). There were no significant relationship between CAP and LVEF, FS, LVDd (all P> 0.05). Conclusions CAP and degree of artherosclerosis increase with aging in elderly patients with essential hypertension, which contributes to left ventricular hypertrophy and the decreased diastolic function. CAP helps to make an early diagnosis of or screening arteriosclerosis, and it is an important forecast factor for cardiovascular disease.