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.

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 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.

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.

This study examined the effect of resveratrol on the secretion of vascular endothelial growth factor (VEGF) and subsequent proliferation of human leukemia U937 cells, and explored the mechanisms involved. Human leukemia U937 cells were treated with resveratrol of different concentrations (12.5-200 micromol/L) for different time lengths (12-48 h). The proliferation of the U937 leukemic cells was determined by MTT assay. Apoptosis was observed by Annexin-V-FIFC/PI double staining and flow cytometry (FCM). Cells cycle was analyzed by PI staining and FCM. The content of VEGF was determined by ELISA. Human umbilical vein endothelial cells were examined for vasoformation in vitro after exposures to resveratrol of various concentrations. The results showed that resveratrol inhibited the proliferation of U937 leukemia cells in a dose-and time-dependent manner. Resveratrol induced apoptosis and S-phase cell cycle arrest in human leukemic U937 cells. Resveratrol inhibited the secretion of VEGF in U937 cells. Resveratrol inhibited the vasoformation of human vein endothelial cells in a dose-dependent manner. It was concluded that resveratrol could down-regulate the secretion of VEGF, induce apoptosis and suppress the proliferation of U937 cells.
Angiogenesis Inhibitors/*pharmacology ; Antineoplastic Agents, Phytogenic/pharmacology ; Apoptosis/*drug effects ; Cell Proliferation/drug effects ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Stilbenes/*pharmacology ; U937 Cells ; Vascular Endothelial Growth Factor A/*secretion

Objective To investigate the specific CT findings of gastrointestinal stromal tumors (GIST).Methods The CT imaging of 12 cases of GISTs confirmed operatively and pathologically were reviewed and analyzed.The gross pathologic findings of the tumors were compared with the manifestations of CT study.Results Two of the GIST were from the stomach,2 from the duodenum,4 from jejunum,and 1 from the junction of jejunum and ileum,ileum,rectum and mesenterium respectively.5 of 8 cases with GIST from intestine had history of hemafecia or positive of fecal occult blood test.9 of the 12 GISTs were malignant,1 of them was potentially malignant,1 was not sure to be malignant or benign.CT studies of 11 of the 12 tumors showed as exogenous mass of 3-20 cm,only 1 with less than 5 cm and 8 of them with over 5 cm.in the max diameter the tumors were cystic-solid with inhomogenous attenuation.The solid potion of tumors enhanced moderately to markedly after the contrast media administered.Ulcer was seen in the tumors of 2 cases,and the diameter of both of them were over 12 cm.Punctate calcification was seen in 1 GIST.Conclusion CT findings of GIST were specific to a certainty.CT study is helpful for locating the tumor and observation of the relationship of the tumor and surrounding structures.

Objective To investigate the role of Ezrin and its phosphorylation(p-Ezrin)in the modulation of rat pulmonary microvascular endothelial cell(PMVEC)injury induced by tumor necrosis factor-α(TNF-α)and the impact of Rac 1. Methods Cultured PMVECs of Sprague-Dawley(SD)rats were randomly divided into time-dependent injury group induced by TNF-αand intervention group in which cells were pretreated with Rac 1 inhibitor (NSC 23766).①In the time-dependent injury group, Western Blot was used to detect the expression of Ezrin and p-Ezrin after 10μg/L TNF-αstimulation for 0,0.25,0.5,1,3,6,12,24 hours.②In the intervention group,after pre-treatment with 200μmol/L NSC 23766 for 0.5 h,PMVECs were treated with 10μg/L TNF-α,and the expression of p-Ezrin was detected by Western Blot after 3 hours. Besides these groups,there were control(1% fetal bovine serum simulation),single NSC 23766 or TNF-α simulation groups. Results ① Few Ezrin expression was found in PMVEC,and TNF-α could not affect Ezrin expression. p-Ezrin protein expression(p-Ezrin/Ezrin,gray scale) of PMVECs at 0 hour after TNF-αstimulation was 0.21±0.03,and elevated at 0.25 hour(0.53±0.19),peaked at 3 hours(1.68±0.30),then it was gradually lowered,but it remained at higher level at 24 hours(0.87±0.18)with significant difference(F=62.200,P=0.000). It demonstrated that TNF-αcould increase Ezrin phosphorylation in a time-dependent manner.②Compared with blank control group,in single NSC 23766 or TNF-αsimulation group, p-Ezrin expression was induced(TNF-αgroup:0.92±0.12 vs. 0.68±0.16,t=-2.864,P=0.020;NSC 23766 group:1.33±0.24 vs. 0.68±0.16,t=-5.429,P=0.000. When NSC 23766 was pre-treated with PMVECs,the expression of p-Ezrin was significantly increased compared with that in single TNF-αsimulation group(2.14±0.18 vs. 0.92±0.12,t=-14.670,P=0.000)with significant difference(F=73.810,P=0.000). Conclusion Ezrin proteins are phosphorylated by TNF-α. Rac 1 signaling pathway inhibition plays an important role in TNF-α-induced injury by up-regulation of p-Ezrin in PMVECs.

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 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 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.