OBJECTIVE:To provide references for improving the governmental drug pricing,especially for brand-name drugs.METHODS:With the statistical data listed in the governmental drug price catalogs,the price difference rates between brand-name and generic injection were computed.RESULTS:Only 26%of the drugs were in line with the requirement on price difference rate(35%for injections)specified in governmental drug price principle,and the highest price gap between brand-name drug and generic drug was as high as over 500%.CONCLUSIONS:It is advisable for government to adopt mild method of gradual reduction of drug prices,control the preferential degree for the price of the brand- name drugs,establish a dynamic price control system,and promote the balance on the benefits of both brand-name drug manufactures and the generic drug manufacturers.

AIM: To observe the inhibitory effects of vinpocetine injection on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in the rats and to explore the underlying mechanisms.METHODS: Male Wistar rats (n=50) were randomly divided into 5 groups: control group, ALI model group, and low, medium and high doses of vinpocetine treatment groups.The rats in control group were injected with 0.9% NaCl at 5 mL/kg through femoral vein.The rats in ALI model group received LPS at 10 mg/kg through femoral vein.After injected with LPS, the rats in vinpocetine treatment groups received vinpocetine at 0.2 mg/kg, 0.7 mg/kg or 1.2 mg/kg via intraperitoneal injection.The pathological changes of the lung tissues were observed under microscope with HE staining.The cell apoptosis in the lung tissues was detected by TUNEL staining.Myeloperoxidase (MPO) activity was measured by the method of spectrophotometry.The protein expression of NF-κB, ICAM-1, VCAM-1, Bax and Bcl-2 was determined by Western blot.RESULTS: Compared with ALI group, administration of vinpocetine significantly attenuated the structural injury of the lung and the infiltration of inflammatory cells.Moreover, vinpocetine decreased cell apoptosis and MPO activity in the lung tissues of ALI rats.In addition, the protein expression of NF-κB, ICAM-1, VCAM-1 and Bax was inhibited after vinpocetin treatment, whereas Bcl-2 expression was increased.CONCLUSION: Vinpocetine attenuates LPS-lung injury by reducing MPO activity and regulating NF-κB, ICAM-1, VCAM-1, Bax and Bcl-2 protein expression.

Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.

Breast Neoplasms ; diagnosis ; Diagnostic Imaging ; methods ; standards ; Female ; Humans

Objective To understand the situation of iodine deficiency disorders of Cangzhou city, Hebei province, in order to provide the scientific basis for prevention and control of iodine deficiency disorders. Methods From 2007 to 2009, dynamic monitoring of iodine deficiency disorders was carried out in low iodized salt coverage places Hejian city and Xian county. Nine towns were randomly chosen in each county, 4 administrative villages were randomly selected in each town, 8 household salts were tested in each village. Every year, 1 - 3 copies of residents water samples were collected for determination of iodine; more than 100 students age 8 - 10 years old were checked the situation of goiter and urinary iodine, more than 40 students selected were measured iodine content of salt from their home; more than 50 women of childbearing age 18 - 40 years were tested of urinary iodine. Thyroid was examined with palpation; water iodine and urine iodine concentration were measured with arsenic-Ce catalytic spectrophotometry; salt iodine was detected by direct titration. Results From 2007 to 2009,median household salt iodine were 4.3,15.9,3.6,18.4,4.6,11.7 mg/kg in Hejian city and Xian county, respectively,iodized salt accounted for 34.03% (98/288), 78.82% (227/288), 29.86% (86/288), 84.72% (244/288), 37.15%(107/288),49.31% (142/288), respectively, the consuming rate of iodized salt were 27.08% (78/288),36.46%( 105/288 ), 28.13% (81/288 ), 49.31% ( 142/288 ), 37.15 % ( 107/288 ), 30.90% ( 89/288 ), respectively. Ten samples of drinking water were tested, water iodine were 5.5 - 34.4 μg/L. From 2007 to 2009, the goiter rate of students aged 8 - 10 years old was below 5%, the median of urinary iodine were 138.1,176.6,112.0 μg/L, ＜ 100 μg/L ratio were 31.6% ( 65/206 ), 25.0% ( 52/208 ) and 44.4% (91/205 ). The median of urinary iodine of child-bearing age women were 167.3,164.2,78.1 μg/L, ＜ 100 μg/L ratio were 28.7%(29/101 ), 19.2%(20/104) and 60.0%(60/100).Conclusions In areas with low coverage of iodized salt, iodine nutrition level are affected, the child-bearing age

Objective To investigate the efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin versus cisplatin for patients with middle-advanced stage uterine cervical carcinoma.Methods 180 patients with middle-advanced stage uterine cervical carcinoma were randomized into concurrent chemoradiotherapy with nedaplatin group (nedaplatin group) and concurrent chemoradiotherapy with cisplatin group (cisplatin group).The short-term efficacy and the toxicity were observed.Results In the nedaplatin group,the short-term response rate、the one-year relapse-free surviva l、one-yea metastasis-free survival、the two-year relapse-free survival、the two-year metastasis-free survival were 98.85％、89.66、86.21％ 、85.06％ 和 80.46％,But in the cisplatin group,the short-term response rate 、the one-year relapse-free surviva l、one-yea metastasis-free survival、the twoyear relapse-free survival、the two-year metastasis-free survival were 97.60％ (x2 =3.07,P ＞ 0.05) 、81.93％(x2 =3.07,P ＞0.05) 、83.13％ (x2 =0.31,P ＞0.05) 、78.31％ (x2 =1.30,P ＞0.05) 和 80.72％ (x2 =0.00,P ＞ 0.05),so there was no significant difference.The incidences of nausea and vomiting in the cisplatin group were 52.27％ (grade Ⅰ ～ Ⅳ toxicities),12.50％ (grade Ⅲ ～ Ⅳ toxicities),which were higher than those in the nedaplatin group 27.27％ (grade Ⅱ ～ Ⅳ toxicities),6.82％ (grade Ⅲ ～ Ⅳ toxicities) (P ＜ 0.05),while there were no significant difference in the other toxicities such as anemia,granulocytopenia,thrombocytopenia,diarrhoea between the two groups (x2 =12.18,P ＞ 0.05).Conclusion The efficacy of concurrent chemoradiotherapy with nedaplatin is the same as that of concurrent chemoradiotherapy with cisplatin,and its toxicity is well-tolerated.

Objective:To investigate the IRF5 rs2004640,rs10954213,rs4728142 loci gene polymorphisms in the progress of Systemic lupus erythematosus(SLE),and explore the influence of the IRF5 gene polymorphisms to the SLE.Methods:218 patients with SLE and 200 health controls were analyzed by using TaqMan-PCR.And all allele frequencies were calculated.The risk factors were compared between cases and controls.At the same time,antinuclear antibodies and double-stranded DNA antibody of 218 SLE cases were analysed with indirect immunefluorescence method,specific autoantibodies in plasma spectrometry were determined using linear immunoassay in plasma.Results:T allele frequency of IRF5 rs2004640 loci in SLE was higher than the controls,allele frequency of the G/T distribution differences in two groups were statistically significant(χ2=6.809,P=0.009).The GG/TT genotype frequencies between the control and the SLE were statistically significant(χ2=5.111,5.035;P=0.024,0.025).Compared control group with SLE group,G allele frequency of IRF5 rs10954213 loci in SLE group was higher than the controls,the difference was statistically significant(χ2=4.332,P=0.037).And GG genotype distribution had significant difference in the two groups(χ2=5.805,P=0.016).SLE group AA/AG/GG genotype distribution of IRF5 rs4728142 loci,compared with control group,there were no statistically difference(χ2=1.273,0.902,1.853;P=0.259,0.342,0.173).And allele frequency A/G also were not statistically differences in two groups(χ2=2.651,P=0.104).The T allele frequency of IRF5 rs2004640 and autoantibodies(anti-Sm,anti-Rib-P)significant associations were found with SLE patient.There were no statistically significant difference between IRF5 rs10954213 with autoantibodies.Compared with SLE remission patients,ANA,ds-DNA increased obviously.Anti-NUC,anti-His,anti-Rib-P were higher,there were statistically significant differences betwen two groups.Conclusion:The GG/GT/TT polymorphism of IRF5 rs2004640,GG/GA/AA polymorphism of rs10954213 were related to SLE.But the GG/GA/AA polymorphism of IRF5 rs4728142 were not significant difference.IRF5 rs2004640 T comtributed to the anti-Sm,anti-Rib-P.In active SLE patients,anti-ds-DNA,anti-NUC,anti-His,anti-Rib-P were higher than the other group.

Objective To investigate the correlation between single nucleotide polymorphism rs13146124 of interferon regu‐latory factor2(IRF2) on type Ⅰ interferon pathway and systemic lupus erythematosus(SLE) in a population from Guizhou Prov‐ince .Methods The polymorphism IRF2(rs13146124) was detected by using Taqman‐PCR in 366 cases of patients with SLE and 218 healthy controls .The genotype and allele frequencies were calculated and analyzed .Results The genotype frequencies of AA , AG and GG in IRF2 rs13142164 site in patients with SLE were 0 .011 ,0 .246 and 0 .743 respectively ,compared with the control group ,the difference was not statistically significant (χ2 =0 .093 ,0 .205 ,0 .136 ;P=0 .761 ,0 .651 ,0 .712) .The allele frequencies of A and G in IRF2 rs13146124 site in SLE patients were 0 .13 ,0 .87 respectively ,compared with the control group ,the difference was not statistically significant(χ2 =0 .071 ,P=0 .790) .There was no significant difference between the allele frequencies of A and G in IRF2 rs13146124 site in SLE and ANA ,dsDNA and other specific antibodies .There was no correlation between the allele frequen‐cies of A and G in IRF2 rs13146124 site in SLE and clinical features such as arthritis ,kidney damage ,etc .Conclusion The poly‐morphism of rs13146124 in IRF2 may not be associated with SLE in the population from Guizhou Province .

Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.

50Gy gave better survivals.Conclusion Age,tumor histology,ex- tent of resection,interval time of postoperative radiotherapy and the dosage of target were related to survival.