OBJECTIVE: To put forward proposals for improving essential medicines system in China.METHODS: The problems existing in the essential medicine system in China and the successful experience of some other countries were analyzed.RESULTS & CONCLUSION: Considering the current medical economy level and the capacity on research & development(R&D) of drugs,China should draw inspiration from WHO and other developed countries about their successful experiences on essential drugs to improve the screening methods for essential medicines list,assign legal status for essential medicines and build up system of production,procurement and distribution of essential medicines according to the basic national situation of our country and finally establish the essential medicine system suitable to our country's condition.

Objective To explore the relationship between Monoamine oxidase A (MAOA) receptor gene,catechol-O-methyltransferase (COMT) receptor gene,dopamine D3 receptor(DRD3) gene and 5-HT2C receptor gene(5-HT2c) of Han population in northern China and obsessive compulsive disorder.Methods Polymerase chain reaction amplification determination of MAOA-T1460C,COMT-Val158Met,DRD3-Ser9Gly,5-HT2c-C ys23Ser four loci receptor gene polymorphism in 164 patients with OCD patients including 103 core pedigrees of fragment length polymorphism,and association and linkage disequilibrium (TDT)analysis.Results There was no significant difference of MAOA-T1460C,COMT-Val158Met,DRD3-Ser9Gly,5-HT2c-Cys23Ser four receptor gene in the patient group and the control group of genotype and allele distribution difference(P＞0.05),four receptor gene loci were in accordance with the balance of the H-W,the MAOA-T1460C receptor gene in female patients group and control group,the early group and control group,which has forced thinking and difference of compulsive behavior group and the control group,only the obsessional group and the control group of genotype and allele distribution was statistically significant(P＜0.05),and the family group between chain(P=0.0001) ;5-HT2c-Cys23Ser receptor gene in the case group and the control group,male both forced thinking and compulsive behavior group and control group differences in genotype and allele distribution was statistically significant (P＜ 0.05),and between family groups exist chain (P=0.0389) ; COMT-Val158Met receptor gene in the control experiments were no significant difference(P＞0.05),and with the house group does not exist between the chain (P=0.0622) ;DRD3-Ser9Gly receptor gene in the control experiments were no significant difference(P＞0.05),and with the family groups there is no chain(P=0.1101).Conclusion MAOA-T1460C receptor gene polymorphism and 5-HT2c-Cys23Ser receptor gene polymorphisms may be the susceptible gene of obsessive compulsive disorder.

microRNAs (miRNAs)are endogenous non-coding RNAs,which play important roles in the regulation of gene terms.miRNAs affect almost every physiological process of the body,and many diseases are related to the disorders of miRNAs.Current studies show that the abnormal expressions of miRNAs are closely relate to the tumorigenesis,diagnosis,treatment and prognosis of gastric cancer.So miRNAs can be used as potential biomarkers and therapeutic targets for the gastric cancer.

Objective To study the value of St George's respiratory questionaire(SGRQ)in evaluating the life quality of community patients with COPD.Methods The SGRQ score,PEF% were collected from 35 patient with COPD.Paired t test was performed to evaluate the sensitivity of SGRQ to changes of disease severity.Correla- tion coefficients were calculated to evaluate the validity.Results Three parts of the SGRQ score and the total score were significantly correlated with the changes of SGRQ(P＜0.001),SGRQ was more sensitive than PEF in evalu- ating the changes of disease severity.The three part of the scale and the total scale were significantly correlated with PEF%.Conclusion SGRQ is a valid,sensitive and feasible method in measuring the quality of life in community patients with COPD.

Objective:To investigate the infusion methods of postoperative enteral nutrition in patients with gastric cancer.Methods:86 patients with gastric cancer received radical operationin our hospital from January 2014 and December 2015 were enrolled for the study and randomly divided into continuous infusion group and periodic infusion group,each group with 43 cases.Patients in continuous infusion group were given postoperative continuous enteral nutrition for 24 h in one day,while cases in periodic infusion group were given postoperative continuous enteral nutrition for 15-17 h in one day.Results of enteral nutrition,physical indicators including upper arm skinfold,diameter of midpoint of upper arm and grip strength,nutritional indexes including total protein (TP),hemoglobin (Hb),albumin (AIb),prealbumin (PA) and transferrin(TF),immune indicators including immunoglobulin G(IgG),immunoglobulin M (IgM),immunoglobulin A (IgA),CD4+,CD8+ and CD4+/CD8+were compared between two groups before and after operation.Results:Intolerance of enteral nutrition occurred in 1 case(2.3％) of continuous infusion group and 3 cases(7.0％) of periodic infusiongroup,and there was no significant difference between them (P＞0.05).Time of transition to full enteral nutrition and taking off the tube to self-feeding incontinuous infusion group were significantly smaller than that in periodic infusion group (P＜0.05).There were no significant difference in baseline data,physical indicators,nutritional indexes and immune indicators between them before operation (P＞0.05).PA level at 5 d,10 d after operation in continuous infusion group were significantly higher than that in periodic infusion group (P＜0.05),and there were no significant difference in physical indicators,other nutritional indexes and immune indicators between them after operation(P＞0.05).Conclusion:Compared with periodic infusion,continuous infusion method could shorten the time of transition to full enteral nutrition and taking off the tube to self-feeding in patients after radical operation of gastric cancer,and had more significant effect of improvement of nutritional status,worthy of clinical popularization and application.

Objective To compare the curative effects between domestic and imported monosialotetrahexosyl ganglioside sodium (GM 1) on neonatal hypoxic ischemic encephalopathy(HIE).Methods 104 neonates with HIE were randomly divided into Shenjie group(domestic GM 1,53 cases )and Pharma group (imported GM 1,51 cases).At the basic of conventional therapy,the two groups received domestic or imported GM 1 20 mg /d intravenous infusion for 7～ 28 d,rspectively.The curative effects and adverse reaction were observed.Results The total effective rates in Shenjie group and Pharma group were 98.11% and 88.24%,respectively.There was no significant difference between the two groups.While,there was no obvious adverse reaction in the two groups.Conclusion Both the domestic and imported GM 1 have the same good curative effects and safety on neonatal HIE.

OBJECTIVE To investigate the clinical feature and antimicrobial susceptibility of Stenotrophomonas maltophilia nosocomial infection or colonization,so as to give guidence of preventing and treating of it.METHODS The clinical and laboratory data of 128 cases with S.maltophilia nosocomial infection or colonization from Jan 1998 to Aug 2006 were reviewed retrospectively.RESULTS Of the total 128 strains,94.5% were isolated from lower respiratory tract and 68.8% were colonization.All of the strains,88.3% were isolated from intensive care unit,97.7% had the invasive operation,100% had the serious underlying diseases and 100% once applied the broad spectrum antibiotics,S.maltophilia was multi-drug resistant,its resistance rate to gentamicin,tobramycin,amikacin,cefepime,ceftazidine,ceftriuxone,imipenem,aztreonam,piperacillin were 92.2%,87.5%,82.0%,79.5%,55.1%,93.7%,99.2%,97.7% and 73.4% respectively.CONCLUSIONS The most of infections are in lower respiratory tract and the pathogens were colonized.The independent risk factor is staying in the ICU and another is treatment with broad spectrum antibiotics,especially used carbapenems.The S.maltophilia isolates are multi-drug resistant.ICU environment disinfection and the medical appliance sterilization,staff′s aseptic consciousness,the standardized operation and the reasonable antibiotics application are the effective actions for reducing S.maltophilia nosocomial infection or colonization.

Objective: To observe the effects of Chinese nutgalls ex tr acts on the secretion of IL-6 from monocytes induced by lipopolysaccharide (LPS ) of Porphyromonas gingivalis (Pg). Methods:Monocytes ob tained by separating human blood cells were stimulated with LPS of Pg at 25 ?g/ml, radioimmunoassay (RIA) was used to examine the effect of Chinese nutgal ls extracts at the concentrations of 6.25-100 ?g/ml on the secretion of IL-6 in the supernatant of the cell culture. Results:Chinese nutgalls extracts at the concentrations(?g/ml) of 6.25,12.50, 25.00 ,50.00 and 100.00 inhibited IL-6 secretion from monocytes by(%) 34.6,46.4,48.5,52.7 and 54.9 res pectively.Conclusions:Extracts from Chinese nutgalls may inhibit the secretion of IL-6 from monocyte induced by LPS of Pg in a dose-depend ent manner.

Objective To repair the experimental femoral head necrosis with the implantation of tricalcium phosphate (TCP) loaded with human bone morphogenetic protein-2(hBMP-2) gene transfected bone marrow derived mesenchymal stem cells(BMSCs). Methods Established the animal models of femoral head necrosis in 22 goats by the ligation of the lateral and medial circumflex femoral arteries and delivery of liquid nitrogen into femoral head. 4 goats served as the control group without any treatment. 3 weeks after surgery, necrotic bone in the other 18 goats were removed and TCP loaded gene transfer cells were implanted into the femoral head with BMP-2 gene transfected BMSCs in right side and ?-gal gene transfected BMSCs in left side. BMP-2 concentrations in femoral head were tested by the ELISA at 1st, 2nd, 3rd week after implantation. Histological observation was done before and at 6th, 10th, 16th week after implantation. New bone volumes (NBV) were measured at 16th week after implantation by the histomorphometry method. X-ray was taken at 16th week after operation in untreated group and after treatment in BMP-2 group and ?-gal group. Results The concentration of BMP-2 in femoral head of BMP-2 group was higher than that of ?-gal group at different time point. Empty lacunae and fibrotic marrow were demonstrated before implantation. New bone was evident in the implantation field of BMP-2 group while fibrous tissues were evident in that of ?-gal group at 6th, 10th and 16th week after treatment. Histomorphology analysis indicated that the NBV in BMP-2 group was significantly higher than that in ?-gal group. Articular surface collapse were observed in the X-ray photograph of untreated group. Regular shape and normal density of femoral head in BMP-2 group compared with the irregular shape and low density of femoral head in ?-gal group could be demonstrated in the X-ray photograph 16 weeks after treatment. Conclusion Implantation of the TCP loaded with human BMP-2 gene transfected BMSCs could repair early-stage experimental femoral head necrosis.

Objective To evaluate effects of ropivacaine combined with different concentrations of fentanyl for epidural labor analgesia. Methods In this multicenter double-blinded randomized study 128 parturients at full term and 2-3 cm of cervical dilatation who requested epidural analgesia were randomly allocated to one of 4 groups: group F0 received epidural ropivacaine alone (n = 33); group F1 received epidural ropivacaine with fentanyl 1 ?g?ml-1 (n = 30) ; group F2 epidural ropivacaine + fentanyl 2?g?ml-1(n = 33) and group F3 epidural ropivacaine + fentanyl 3 ?g?ml-1(n = 32). Epidural catheter was placed at L2,3 and advanced 4 cm into the epidural space in cephalad direction. A bolus of 15 ml of ropivacaine alone or with fentanyl was given after correct epidural placement was confirmed. EC50 of epidural ropivacaine was determined by up-and-down sequential experiment. The initial concentration of epidural ropivacaine was 0. 12% . If effective the next parturient received ropivacaine of lower concentration; if ineffective the ropivacaine concentration was increased. Each time the concentration of epidural ropivacaine increased/decreased by 0.01% . The analgesia was assessed using VAS score (0-10 0 = no pain, 10 = worst pain) . If VAS score was less than 3 within 30 min of ropivacaine administration, analgesia was defined as effective. EC50 of ropivacaine was calculated according to Dixon and Massey. Results Four of the 128 parturients enrolled were excluded because of uncertain results of interrupted observation. The EC50 of epidural ropivacaine for labor analgesia and the 95% confidence interval (95% CI) of EC50 were 0.110% (95% CI 0.109 0%-0.111 6%) in group F0; 0.089% (95% CI 0.087 7%-0.091 1%) in group F1; 0.073% (95% CI 0. 071 7%-0.0744%) in group F2 and 0.060% (95% CI 0.056 0%-0.634%) in group F3 respectively. The EC50 was significantly higher in group F0 than in group F1, F2 and F3 (P0.05) . The incidence of side-effect was significantly higher in group F3 than in group F0(P