Objective To evaluate the impacts of the essential medicine system in Jiangsu Province on rational drug use in community health service centers.Methods 7667 outpatient prescriptions from 6 community health service centers in Nantong were selected by cluster sampling from January 2009 to December 2011,the part of SDUIs(Selected Drug Use Indicators)developed by WHO and the self-design indicators were employed to analyze rational use of drugs.Results After implementation of the essential medicine system,the average types of drugs per prescription decreased from 3.02 to 2.74,the rate of antibiotic drugs usage dropped from 61.43％ to 51.2％,the rate of one antibiotic usage reduced from 33.94％to 28.58％,and two types from 20.43％to 15.8％,all with significant differences(P＜0.001).The average expenses in single prescription arose from RMB 69.70 to 87.28,the rate of essential medicine usage increased from 81.22％to 85.60％,the injection utilization decreased from 31.14％ to 14.13％,while TCM utilization ascended from 16.17％to 21.8％,all with significant differences(P＜0.001).Condusion The essential medicine systems has positive impacts on rational drug use,but the expenses of per prescription are higher,and irrational antibiotic drugs are still a serious problem.

OBJECTIVE:To provide reference for drug procurement and supply and rational use of lipid-regulating agents. METHODS:The epidemiological investigation was carried out among 159 506 cases from 74 hospitals in Beijing,Chengdu, Guangzhou,Hangzhou,Shanghai and Tianjin in 2013. The utilization of lipid-regulating agents was analyzed statistically in re-spects of purchase value,DDDs,DDC,actual average daily dose and sort ratio. RESULTS:The prevalence rate of hyperlipidemia was relatively high,accounting for 29.56% and showing a tendency of regional distribution and young age in all regions. The pa-tients with hypertension,diabetes and coronary heart disease had a higher incidence to suffer from hyperlipidemia. The use of atorv-astatin was in the first place,but it also had a higher DDC;while rosuvastatin hasd the advantage over aorvastatin in drug market. Simvastatin had a lower DDC and was more suitable for the patients with low income. The doses of lipid-regulating agents in other regions were lower than DDD except for those in Beijing and Tianjin. CONCLUSIONS:Statins dominate the lipid-regulating agents market. But new lipid-regulating agents and drug combination provide a new choice for clinical treatment.

[ABSTRACT]OBJECTIVETo diagnose laryngopharyngeal reflux (LPR) by using two methods: 24h pH monitoring and RSI combined with RFS scales. To research the voice characteristics of patients with LPR and changes of voice parameters before and after PPIs therapy, and to use voice parameters to help diagnosing and evaluating treatment effect of LPR.METHODSThe patients visited department of Otolaryngology head & neck surgery of Peking University Third Hospital from August 2012 to August 2013 were included in this study. There were 26 LPR patients diagnosed by 24 hr pH-MII monitoring (pH group) and 26 LPR patients diagnosed by RSI combined with RFS (questionnaire group). Another 52 subjects without laryngeal or pharyngeal symptoms were as control group. All subjects underwent MDVP examination. The patients from pH group and questionnaire group took esomeprazole 20 mg bid for one month, afterwards MDVP was examined again. The voice related parameters were compared before and after medication therapy.RESULTSComparing data between LPR patients and normal subjects, Jitter, Shimmer, NHR had significant difference (P<0.05), and F0, MPT had no significant difference (P>0.05) before treatment. After PPIs therapy there was no significant difference between each group (P>0.05).CONCLUSIONAbnormal voice parameters were existed in LPR patients. After PPIs treatment, voice related parameters improved apparently.

Objective To explore the impact of hyperglycemia on Hypersensitive C-reaction protein (hsCRP),B-type natriuretic peptide(BNP) and ventricular remodeling in elder patients with acute myocardial infarction(AMI).Methods One hundred and twenty elder patients with AMI are divided into hyperglycemia group(blood sugar in admission ＞ 7.8 mmol/L) and non-glycemia group(blood sugar in admission ≤7.8 mmol/L).The levels of blood sugar in admission,hsCRP,BNP were detected.LVEF,LVEDD,LVESD,WMS were observed by cardiac echo in admission and two weeks after therapy.Results The blood sugar in admission,hsCRP and BNP of the patients in hyperglycemia group were (9.6 ± 0.6) mmol/L,(1 750.6 ±677.1) ng/L,(56.1 ±38.6) ng/L,higher than those in non-glycemia group (t =38.679 and P =0.000; t =11.941 and P =0.000; t =3.288 and P ＜0.01,respectively).LVEF,LVEDD,LVESD and WMS of patients in hyperglycemia group didn't show statistical significance before and after therapy.However,there were significant in hyperglycemia group (t =2.049 and P =0.043,t =2.836 and P =0.005,t =3.814 and P =0.000,t =2.086 and P =0.039,respectively).Conclusion Hyperglycemia can reduce the increase of hsCRP and BNP,which has an impact on hsCRP,BNP and ventricular remodeling in elder patients with acute myocardial infarction,but the mechanism need to further research.

Objective To screen and determine the effective silencing targets of β2-microglobulin(B2m)gene at the cellular level in marmoset.Methods By homology comparison of the b2m gene in human and the B2m gene in marmoset, choose homology small hairpin RNA(shRNA)sequences targeting marmoset B2m gene were designed, We choose homology small hairpin RNA(shRNA)sequences targeting designed B2m gene to make homology analysis, and insert into lentivirus-based gene silencing constructs FUGW-TDT.The vectors were transfected into HEK293T cells induced by polyethylenimine(PEI).The suppression of B2m mRNA was detected by real-time PCR.Results Two gene-silencing sequences were screened that lied in 290~310 bp and 665~685 bp of the marmoset B2m mRNA, and have statistical significance in the silencing rate:(46.54±7.91)% (P < 0.05) and(83.22±4.37)%(P < 0.0001).Conclusions Two effective silencing target sequences are screened at cellular level, which can be further used in studies on gene silencing in marmoset.

Tumor-associated macrophage (TAM) is a macrophage infiltrating around tumor cells, which can be divided into two categories including classical activated macrophages (M1) and alternately activated macrophages (M2). On the whole, it shows the phenotype of M2 macrophages that promote immune escape of tumor cells. With the in-depth study of the immune function of the body, the studies have indicated that TAM is highly malleable and can be transformed into each other with the change of tumor microenvironment. TAM plays a very important role in tumor occurrence, development, invasion and metastasis, and its classification and quantity may also be used as an index to judge the prognosis of tumors. Therefore, TAM is a feasible potential target for the treatment of cancer. This paper reviews the role of TAM in tumorigenesis and development.

Objective To decrease the p53 gene expression at cellular and animal levels in marmoset using RNA interference technique.Methods The shRNA interference sequences were designed and inserted into the adeno-associated virus vector plasmid after bioinformatics analysis.The plasmids were transfected into African green monkey kidney cos-7 cells.The suppression of p53 mRNA was detected by real-time PCR, and the changes of p53 protein expression were detected by Western bolt.The adeno-associated virus-8 was injected through the hind leg vein.The changes of p53 protein expression in the liver tissue was detected by Western blot and immunohistochemistry.Results We screened two RNA interference effective arget sequences.The expression of p53 mRNA was suppressed ( 82.7 ±8.1 )% and ( 80.7 ± 7.5)%, respectively (P<0.05), and the expression of p53 protein was decreased (77.3 ±11.5)% and (73.7 ± 10.7)%, respectively (P<0.05).The two marmosets after virus infection showed that there were virus distributions in the liver, testes, and neck detected by in vivo fluorescence imaging.The expression of p53 in the marmoset liver was detected by western blot, immunohistochemistry analysis showing no obvious changes.Conclusions In the present study, the decrease of P53 gene expression at cellular level is achieved, however, the liver P53 protein in the marmoset liver is not significantly changes.Further optimization of the way of infection is needed in the future.

Objective:To discuss the effects of recombinant IFN-α-IL-18 fusion protein on chicken lymphocyte histamine induced and the NF-κB p65 activation and nucleo-cytoplasmic transport.Methods: The healthy chickens blood was sterile adopted with anticoagulant,then separation of the chicken peripheral blood lymphocyte and divided into 10 groups:The yeast expression and purification protein IFN-α-IL-18,IL-18,IFN-α were added with 250 ng/ml,500 ng/ml and 1 000 ng/ml respectively while the control was only added RPMI1640 with 3 repetitions for each group.Then the histidine decarboxylase activity,histamine,IFN-γ,PI3K,MAPK and NF-κB p65 in cell nucleus were detected.Results: The recombinant IFN-α-IL-18 and IL-18 could significantly promote the activity of histidine decarboxylase (P<0.01),increase the contents of histamine (P<0.01),induce IFN-γ (P<0.01),improve the contents of PI3K (P<0.01) and the NF-κB p65 levels in nucleus (P<0.01),and the higher concentration of IFN-α had a similar effect to lymphocytes.The effects of IFN-α-IL-18,IL-18 and IFN-α on MAPK was acratia.Conclusion: IFN-α-IL-18 and IL-18 can stimulate chicken peripheral blood lymphocyte populations increased histamine contents significantly and promote the induction of IFN-γ.IFN-α-IL-18,IL-18 and IFN-α increase PI3K expression in lymphocyte associated with the NF-κB activation and NF-κB p65 nucleo-cytoplasmic transport.The study built foundation for the function of IFN-α-IL-18 and the exploration of the mechanism of controlling epidemic diseases.

Objective:To discuss the effects of recombinant IFN-α-IL-18 fusion protein on chicken lymphocyte transformation and the chicken nuclear factor kappa B ( NF-κB ) activity.Methods: The recombinant plasmids pPICZ-IFN-α, pPICZ-IL-18 and pPICZ-IFN-α-IL-18 were constructed,and transformed into P.Pastoris X-33 strain by electroporation.The recombinant proteins were ex-pressed under the induction of 1% methanol,and detected by SDS-PAGE and Western blot.The biological activities of the expressed products were detected by the lymphocyte transformation test,the NF-κB concentration in chicken lymphocyte and lymphocytic nucleus were detected at different times with ELISA.Results:SDS-PAGE and Western blot showed that the expressed products existed in super-natant,and the molecular weights were about 22 kD,23 kD and 43 kD,respectively.The expressed products IL-18 and IFN-α-IL-18 could stimulate chicken lymphocyte transformation (P<0.05),the biological activity of IFN-αstimulating lymphocyte transform was feeble (P>0.05).Compared with the control group,the total NF-κB concentration in chicken lymphocyte induced by IL-18 and IFN-α-IL-18 were increased (P<0.05),and the NF-κB in lymphocytic nucleus was increased significantly (P<0.01).Otherwise,the total NF-κB in lymphocyte induced by IFN-αincrease was limited (P>0.05),but the NF-κB in lymphocytic nucleus showed the remarkable increase ( P<0.05 ) .Conclusion: IFN-α-IL-18 and IL-18 can promote lymphocyte transformation significantly, the activity of IFN-αinduced lymphocyte transformation is imperfect.The biological activity of stimulating lymphocyte transformation is associated with the NF-κB expression,activation and nucleo-cytoplasmic transport.The study built foundation for the function of IFN-α-IL-18 fusion protein and the exploration of the role of controlling epidemic diseases.

Objective:To investigate the clinical efficacy and patient and partner's satisfaction with penile prosthesis implantation(PPI) for treating Chinese patients with severe erectile dysfunction(SED).Methods:One hundred and sixty-eight SED patients were successfully treated by PPI from July 2000 to June 2010.Of the 146(86.9%) patients who had been followed up over 6 months post-operation,36(24.7%) had been implanted with one piece malleable prosthesis(AMS650) and 110(75.3%) with three piece inflatable prosthesis(AMS700CXM).All the patients had been followed up by using international index of erectile dysfunction(IIEF5),Quality of Life Score(QOL) for evaluating clinical efficacy and using Visual Analogue Scale(VAS) for evaluating patient and partner's satisfaction and the duration of the follow-up was 6 to 119 months.Results:The mean age of patients was 35.9?12.1 years(20 to 75 years),All the operations were successful and sexual intercourse with PPI was performed post 4 to 6 weeks without severe complications like infection and erosion.The prosthesis survive rate and frequent sexual intercourse rate were 98.6% and 87.7% respectively.IIEF5 scores pre and post PPI were 6.3?1.7 and 21.3?1.6 respectively,the QOL scores pre and post PPI were 5.1?0.9 and 1.5?0.5 respectively,and both of them showed significant improvement(P