OBJECTIVE:To provide references on how to avoid price war in Chinese drug retailing.METHODS:The status quo of Chinese drug retailing was analyzed,meanwhile the cause and effect of price war were discussed.RESULTS & CONCLUSION:The disadvantages of price war outweigh the advantages,which is sure to be replaced by services-based brand strategy.

Service for key subjects is important for medical information institutions nowadays.This paper discusses the necessity of providing subject-oriented service,and proposes three service modes:information transmission mode,information analysis mode and information navigation mode.In addition,the guarantee measures are also discussed,including constructing a security system for subject literature,training high-quality services team,and promoting subject information service brand.

Objective We try to find the current situation of Hangzhou health research.Methods Using established evaluation index system to evaluate 8 medical service.Results Scientific research development level of 8 medical service is unbalanced,but input-output is balance.Conclusions According to the appraisal results,we suggest reduce the gap among the scientific level of medical service,train high-level personnel,strengthen the construction of key discipline and specialties,create the atmosphere of project application,and establish scientific research incentive system.

Objective To establish a scientific evaluation index system for medical service scientific research competitiveness for government assessment.Methods The evaluation indexes and their weights were determined after two rounds Delphi consultation.Results Construct a hierachical index system composed of three groups,namely investment,output and effects,including three first class index,13 second ones and 50 third ones after two rounds Delphi consultation.Conclusions The index system has reasonable structure and comprehensive contents,reflecting the core idea of scientific research competitiveness evaluation.

To reveal the scientific research situation of general hospitals in recent years in　china,the authors retrieved papers included in CBM、CCD and ISI Web of Knowledge,and compared　the production of papers from the general hospital in 15 sub-provincial cities during the period of 2000　-2009.Also the citation frequency of all papers and the average citation frequency were compared.

Objective To explore the relationship of catheter-directed thrombolysis and deep venous thrombosis.Methods We analyzed 2267 consecutive central venous catheter attempts from January to December in2006.Results 18 patients had deep venous thrombosis,and several studies have identified factors associated with mechanical complications of central venous catheter.These factors include illness,the use of drug,mobility.Conclusion It is very important to prevent and cure deep venous thrombosis and decrease incidence of death of knowing many risk factors and clinical symptoms of catheter-directed thrombolysis.

Objective To analyze the clinical characteristics and treatment strategy of ankle supination fracture in children.Methods From January 2012 through July 2014,89 children were treated at our department for ankle fracture caused by supination sprain according to their medical history,physical examination,X-ray films and CT three-dimensional reconstruction of the ankle.Appropriate protocols were applied on the basis of Lauge-Hansen classification,type and displacement of their fractures.Of them,52 belonged to the supination-adduction type (the extramalleolus fracture was of Odgen type Ⅶ in 51 children whose epiphyseal plate of distal fibula had not been closed),35 to the supination-extorsion type (32 cases had tri-plane fracture and 3 Tillaux fracture),and the remaining 2 did not fit the Lauge-Hansen classification.Surgical treatment was applied in 32 cases and conservative treatment in 57 ones.Results All the children received outpatient follow-up from 12 to 24 months(mean,18 months).No bone nonunion,osteoarthritis,or fracture malunion was found.The American Orthopaedic Foot & Ankle Society scores averaged 92 points (range,from 88 to 100 points) at the last follow-ups.Conclusions In children whose epiphyseal plate is nearly closed,supination-adduction sprain likely causes an extramalleolus fracture of Salter-Harris type Ⅰ or type Ⅱ,but in children whose epiphyseal plate is unclosed,an epiphyseal fracture of Odgen type Ⅶ is inclined to happen.A Tillaux fracture or tri-plane fracture at the level of distal tibiofibular syndesmosis results often from supination-extorsion sprain in children.For fractures involving epiphysis or epiphyseal plate,anatomical reduction and proper fixation are critical to functional recovery and reducing complications.

ObjectiveTo investigate the relationship between syndrome differentiation types and the objective indexes of fatty liver.MethodsA cross-sectional study was adopted. Clinical observation table of fatty liver for TCM diagnostic performance was used to collect the data of patients and cluster analysis was adopted for syndrome differentiation. The difference of the objective indexes among different syndromes was studied.ResultsFatty liver showed more severity in spleen Qi deficiency and dampness group compared with heart and liver yin deficiency group(χ2=8.218,P=0.041). Patients in the spleen and stomach Qi deficiency group had less smoking history(χ2=8.416,P=0.038). Patients in the spleen Qi deficiency and dampness group had higher AST, TP, ALP and WHR indexes and lower Alb.ConclusionsDifferences of objective indexes in different fatty liver syndromes can be used for enriching syndrome differentiation contents, and provide the basis for microcosmic syndrome differentiation of fatty liver.

It has been reported that the small type of neurons in the dorsal root ganglion (DRG) play an important role in pain regulation by a presynaptic mechanism via the metabotropic type-B γ-aminobutyric acid receptors ( GABABR ). In order to understand whether the 2populations of the small type of the neurons, peptidergic and nonpeptidergic, in DRG share the same role, immunoflourescent histochemical methods and confocal laser scanning microscope were employed to investigate the expression of the GABABR in the peptidergic and nonpeptidergic small DRG neurons. The results revealed that 92% of the peptidergic and 90% of nonpeptidergic small DRG neurons express GABABR in their perikarya and central processes, which distribute in the various laminae of the spinal dorsal horn. These results suggest both the peptidergic and nonpeptidergic populations of the small neurons in the DRG share similar role in pain modulation via presynaptic mechanisms but in given laminae of the spinal dorsal horn.

Objective To investigate the changes of esophageal intraluminal baseline impedance in patients with refluxesophagitis.Methods From December 2013 to August 2014,47 patients with reflux esophagitis and 17 healthy controls were enrolled.The patients with reflux esophagitis were graded according to Los Angeles classification (LA) grading standards.All subjects accepted 24 h multichannel intraluminal impedance (MII) pH examination,and the baseline value of impedance were measured.Independent sample t test was used to compare the difference in impedance between the two groups.Spearman rank correlation coefficient was performed to analyze the correlation between acid exposure time (AET) and the baseline impedance of patients with reflux esophagitis.Kruskal-Wallis test was used to compare the differences in baseline impedance of patients with different grades of reflux esophagitis.Results The impedance baseline value of reflux esophagitis group was (1 676.72±644.41) Ω,which was lower than that of healthy control group ((2 151.27± 322.05) Ω),and the difference was statistically significant (t =-3.883,P＜0.01).The AET of esophagus was negatively correlated with the baseline impedance of the patients with reflux esophagitis (r=-0.530,P＜0.01).The baseline impedance of patients with grade LA-A and grade LA-B reflux esophagitis were 1 823.62 Ω (1 515.38 52 Ω,2 208.38 Ω) and 1 771.81 Ω(1 304.75 52 Ω,2 080.50 Ω),respectively,and the difference was not statistically significant (Z=-0.630,P=0.529).The baseline impedance of patients with grade LA C/D reflux esophagitis was 300 Ω (300 Ω,500 Ω),which was obviously lower than those of patients with grade LA-A or grade LA-B (Z=-2.647 and-2.818,both P＜0.017).Conclusion The baseline impedance of patients with reflux esophagitis is low and correlated with AET.