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.

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 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.

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 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.

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 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 association between the types of response to head-up tilt test (HUTT) and levels of various vitamins in children and adolescents with orthostatic intolerance.Methods:Sixty-five cases of children and adolescents 35 males and 30 females aged 5-14 (10.5±2.0) years old who complained orthostatic intolerance symptoms, including syncope, dizziness, headache, and chest tightness, in Children′s Medical Center, the Se-cond Xiangya Hospital, Central South University between November 2018 and April 2019, were enrolled.By comprehensive history, physical examination, and necessary laboratory testing, heart, cerebrovascular and other system diseases were excluded.According to HUTT result, these patients were divided into 2 groups, namely negative HUTT group and positive HUTT group.The serum levels of vitamin A 1, B 1, B 2, B 6, B 9, B 12, C, and E were compared between the 2 groups.Continuous data were analyzed by conducting t-test and categorical data were analyzed by performing χ2 test. Results:(1) There were 32 cases (18 males and 14 females) in negative HUTT group and 33 cases (17 males and 16 females) in positive HUTT groups, with 28 cases of vaso vagal syncope and 5 cases of postural tachycardia syndrome.There were no significant differences in age, gender ratio, and body mass index between the negative HUTT group and positive HUTT group.(2) The serum level of vitamin B 1 of positive HUTT group was lower than that of negative HUTT group [(77.43±16.70) nmol/L vs.(88.56±18.98) nmol/L, t=-2.513, P<0.05], while the levels of vitamin A 1, B 2, B 6, B 9, B 12, C, and E had no significant differences between the two groups (all P>0.05). Conclusions:Patients with positive responses to HUTT relatively lacked vitamin B 1, suggesting the role of vitamin B 1 in the pathophysiological process of neurally mediated syncope.

Objective:To study the diagnostic efficacy and prognostic evaluation value of QT interval dispersion (QTd) in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).Methods:From July 2010 to January 2020, 80 children and adolescents who received their first visit or admission to the Pediatric Syncope Clinic of The Second Xiangya Hospital of Central South University and definite diagnosed of VVS-CI due to syncope or presyncope were selected as the VVS-CI group, meanwhile, 80 children and adolescents who had physical examination in the hospital were selected as the control group.QT interval were measured by 12-lead electrocardiogram at the baseline.Results:(1) Comparison between the two groups: Compared with the control group, the VVS-CI group had a significantly lower heart rate ( P<0.05) and significantly longer QT interval, such as the maximum QT interval (QTmax), minimum QT interval (QTmin), QTd, corrected maximum QT interval (QTcmax) and corrected QT interval dispersion (QTcd) ( P<0.05). After follow-up 84 (45, 127) days, compared with the responsive group, the non-responsive group had a significantly longer QT interval, such as QTmax, QTd, QTcmax, corrected minimum QT interval (QTcmin)and QTcd ( P<0.05). (2) Diagnostic efficiency: QTmax, QTmin, QTd, QTcmax and QTcd had a certain diagnostic value in children and adolescents with VVS-CI ( P<0.001). QTd had the largest area under the curve (AUC) (0.914), and had a sensitivity of 86.30% and a specificity of 84.95% at the optimal cut-off value of 28.50 ms for VVS-CI diagnosis.(3) Prognostic evaluation value: QTmax, QTd, QTcmax, QTcmin, QTcd had an estimated value for the prognosis of VVS-CI in children and adolescents ( P<0.05 or 0.01). QTd had the largest AUC (0.906) and the best cut-off value was 34.50 ms, the sensitivity to predict response to VVS-CI intervention was 90.00%, and the specificity was 82.35%. Conclusion:QTd of electrocardiogram has a good estimation value in the diagnosis and prognosis of VVS-CI in children and adolescents.

Acute poisoning is a component of emergency medicine and a key public health problem in clinical toxicology. In recent years, the research and development of industrial chemicals and drugs have developed rapidly, and the incidence of acute drug poisoning has been increasing. It is very important to strengthen the application research of clinical toxicology in acute poisoning, to identify rare and new toxic drugs, and to create conditions for rapid detection of toxic substances. Therefore, this article reviews the types of acute poisoning, the epidemiological characteristics, the detection technology and significance of clinical toxicology, the role of clinical toxicology in the treatment of acute poisoning and its application.