OBJECTIVE:To discuss the importance of essential drug supply system for national drug policies and the role of public governance theory in the supply of essential drugs.METHODS:In view of the status of the construction of medical insurance system in China for residents in city and countryside,some strategies for the improvement of the health service system were put forward from aspect of public governance.RESULTS:Taking service as orientation,changing the government administration to service administration,introducing non-profit organization and bringing the function of non-public ownership into full play can help improve the national essential drug policy and drug supply ensuring system and guarantee the people's accessibility to essential drugs and medication safety.CONCLUSION:It is urgent to establish the supply and marke-ting system of essential drugs.

Based on research of the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) and the related public websites of acupuncture educational institutions, the first hand information was studied, summarized and sorted on the status quo of the educational qualification or the relative authentication of education programs of ACAOM as well as the status of professional qualification and examination of NCCAOM. The education curriculum of the Master degree of Acupuncture, Master degree of Oriental Medicine Science as well as the Doctor degree of Acupuncture and Oriental Medicine were also introduced in this article including student enrollment and graduation in recent years. The developing tendency of the federal unified acupuncture education, management, professional qualification and examination system of U. S. A. were discussed and analyzed as well.
Acupuncture ; education ; manpower ; organization & administration ; Acupuncture Therapy ; standards ; Certification ; Humans ; United States

Objective To analyze the clinical manifestations and the features of brain MRI and cerebrospinal fluid (CSF) findings in adult Chinese patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods We reviewed the clinical manifestations,brain MRI and CSF examinations of 29 patients who were diagnosed as anti-NMDAR encephalitis.Results The major clinical features of anti-NMDAR encephalitis patients included psychiatric symptoms (86％,25/29),seizures (83％,24/29),decreased consciousness (55％,16/29),involuntary movements (55％,16/29),central hypoventilation (34％,10/29),and hypersalivation (17％,5/29).Some patients also experienced autonomic instability,hemiplegia and aphasia.Underlying ovarian teratoma was identified in 14％ of affected patients(4/29).Brain MRI was found abnormal in up to 62％ patients (18/29),located in the temporal lobes,hippocampus,thalamus,brain stem,cingulate gyrus,frontal and parietal cortex,corpus callosum,internal capsule,basal ganglia and periventricular area.CSF findings were abnormal in 83％ of patients with anti-NMDAR encephalitis.Oligoclonal banding in CSF was positive in 95％ patients (19/20).The recurrence rate during 3 years was 31％ (9/29).Conclusions Anti-NMDAR encephalitis is a treatable disease,yet with high recurrence rate.Its predominant clinical features are psychiatric symptoms and seizures,while involuntary movements,central hypoventilation and hypersalivation are its characteristic manifestations.Lesions in MRI are widespread,not only restricted to limbic lobe.

Purpose Polymorphisms of candidate gene Agouti was analyzed in order to reveal the molecular mech -anisms of coat color difference in chromosome engineering mice .Methods Firstly, differences of mouse coat color was detected by color measurement spectrophotometer .Then, candidate gene Agouti was found by whole genome scanning based on DNA chip.Finally, cDNA and amino acid sequence polymorphisms were analyzed , as well as the influence of protein properties and function after mutation was predicted by bioinformatics software .Results There are five SNPs in the Agou-ti cDNA sequences , resulting in three missense mutations in the amino acid sequence of Agouti signaling protein .Bioinfor-matics analysis revealed that one βsheet deletion in the secondary structure of the mutant protein , as well as tertiary struc-ture changed , leading to decrease of binding ability .Conclusion A novel missense mutation is found in candidate Agouti gene.It plays critical role in receptor binding activity , and may reflect on mice coat color changing from light gray to dark gray eventually .

Objective:To explore the clinical value of T 1 mapping/indexed extracellular volume fraction (iECV) quantified with cardiac MR (CMR) parameters, and its correlation with traditional indicators of myocardial dysfunction in aortic insufficiency (AI) patients. Methods:A total of 36 patients clinically and radiologically diagnosed with chronic AI in our hospital between May 2012 and February 2016 were retrospectively selected. All AI patients underwent conventional CMR protocol, native and post T 1 mapping. CMR parameters, such as aortic regurgitant fraction (RF), late gadolinium enhancement (LGE) mass fraction, myocardial extracellular volume fraction (ECV) and iECV. Based on the values of aortic RF, AI patients were divided into mild AI group (9 cases), moderate AI group (14 cases) and severe AI group (13 cases). The clinical characteristics were teased from the patients′ electronic medical records. Univariate analysis of variance was used to compare the measurement data of native T 1 mapping, post-contrast T 1 mapping, ECV, and iECV. LSD test was used for pair wise comparison between the mild AI, moderate AI and severe AI groups. Data about cardiovascular history, New York Heart Association (NYHA) heart function classification, and LGE were compared by chi-square test or Fisher exact test. The correlation between left ventricle ejection fraction (LVEF) and iECV was evaluated by Spearman correlation analysis. Results:There was no difference in age, sex, cardiovascular history among the three groups. Comparison of patients with different severity of AI in the three groups: (1) There was statistically significant difference in the LGE positive rate among the three groups ( P=0.023), while the myocardial replacement of fibrosis increased with the grade of aortic regurgitation. (2) There was no statistically significant difference in the measurement data of native T 1 mapping, post-contrast T 1 mapping, ECV among the three groups ( H=1.815, 0.929, 2.496, all P values>0.05), while the diffuse myocardial fibrosis tended to increase with the degree of aortic regurgitation. There was statistically significant difference in iECV among the three groups ( H=16.725, P<0.001). The measurement data of iECV in the severe AI group was significantly higher than those in the other two groups ( P<0.05). LVEF value was inversely correlated with iECV ( r=-0.649, P<0.001). Conclusions:Quantitative T 1 mapping/iECV can serve as a parameter to noninvasively identify diffuse myocardial fibrosis in AI patients of different severities. It changes with LVEF and can manifest the reversible stage of left ventricular decompensation.

Background and purpose: Astrocytoma is the most common neuroepithelial neoplasm, and its grading has profound effect on its treatment and prognosis. To investigate the application of stepwise discriminant analysis in grading astrocytomas, this study developed two models of stepwise discriminant analysis according to relevant factors of astrocytoma. Methods: From January 2008 to April 2009, 111 primary astrocytoma patients were enrolled. Each patient was scored based on location, signal intensity on T1WI, signal intensity on T2WI, enhancement, edema, border, cyst or solidness, and mass effect of their magnetic resonance images. With their age score of grading, Fisher stepwise discriminant analysis and the Logistic discdminant were used. The results from the two models were then evaluated and compared. Results: According to Fisher stepwise diseriminant analysis, the predictive accuracy was 87.7% with 80.0% sensitivity, 91.5% specificity and 0.942 area of ROC curve. However, the predictive accuracy of Logistic discriminant analysis was 84.9% with 80.0% sensitivity, 86.8% specificity and 0.940 area of ROC curve. There were no statistically significant differences in terms of accuracy (P=0.250) and areas under ROC curve (Z=0.433, P=0.665) between the two models. Conclusion: Two stepwise discriminant analysis models are meaningful to predict the grading of astrocytoms, and the application of Fisher stepwise discriminant analysis is simpler than the Logistic discriminant analysis.

BACKGROUND: In the field of organ transplantation, patients often take immunosuppressants after organ transplantation, such as CsA, FK506, DEX and MPA. However, their mechanisms of immunosuppression are different. The effect of immunosuppressive drugs on monocyte chemoattractant protein-1 (MCP-1) remains poorly understood. OBJECTIVE: To investigate the effects of different immunosuppressants on the secretions of MCP-1 in whole blood. METHODS: The whole blood of healthy volunteers was mixed with different immunosuppressants for 6 hours, such as CsA, FK506, DEX and MPA, which included low, middle and high concentrations, followed by PMA and IONO stimulation for 6 hours. MCP-1 levels in whole blood samples were compared. The whole blood cultured alone served as control. RESULTS AND CONCLUSION: MCP-1 secretion was inhibited by DEX (1, 10 mg/L) and CsA (0.25,1.25 mg/L)- However, FK and MPA exhibited no such effect. Therefore, DEX and CsA may inhibit the function of monocytes and macrophages in immune system by diminishing the secretion of MCP-1. The combination of FK (5 μg/L), MPA (10 mg/L) and DEX (1 mg/L) or CsA (0.25 mg/L), MPA (10 mg/L) and DEX (1 mg/L) can inhibit the secretion of MCP-1, but only DEX among all the immunosuppressants mentioned above exhibited significant effect on inhibiting the secretion of MCP-1 when using alone.

Objective To investigate the protective effect of the combined application of carlbachol and compound dietary fiber on the intestinal barrier function in burn rats.Methods The 30％ total body surface area (TBSA) Ⅲ scald Wistar rats were randomly divided into four groups.Rats in group A were fed with physiological saline,in group B were fed with compound dietary fiber,in group C were fed with carlbachol and in group D were fed with carlbachol and compound dietary fiber.The rats were sacrificed at 6,12 and 24 hours after treatment,and selected normal rats for control group.Blood samples were taken for detecting plasma endotoxin,D-lactic acid,D-lactic acid content.Tissue samples were harvested from the small intestine for pathological study under light microscopy.Results (1) The damage of the structure of small intestine mucosa was different among 4 groups,and the most obvious was at 24 h after treatment.(2)The level plasma of endotoxin in Group D was (0.517±0.034) EU/L,significant lower than that in group A ((0.659±0.074) EU/L),Group B ((0.589 ±0.027) EU/L) and Group C((0.587±0.026) EU/L),and the difference was significant(P＜0.05).(3) Dlactic acid level in Group D was (102.996±10.102) μg/L,significant lower than that in group A((133.538 ±8.621) μg/L),Group B ((121.223± 10.519) μg/L) and Group C ((122.700± 11.146) μg/L),and the difference was significant(P＜0.05).Conclusion In early stage of burn shock,the therapy of combined with carlbachol and compound dietary fiber has obvious protective effect on rat intestinal barrier.Meanwhile,it is better than the treatment effect of single carlbachol or compound dietary fiber to some extent.

Objective To explore the mechanism of anti-tumor effects of transferring tumor-specif-ic lymphocytes obtained from pre-immunized BALB/c mice with inactive rolL-21 tumor vaccine (mIL-21-Sp2/0)to syngeneic mice, associated with mIL-21 tumor vaccine immunization, in the condition of cyclo-phosphamide (Cy)-induced lymphopenia. Methods Activated lymphocytes of spleen and lymph nodes ob-tained from pre-immunlzed syngeneic mice with irradiated mIL-21-Sp2/0 cells were infused into BALB/cmice treated with Cy 2 days before, subsequently vaccinated with mlL-21 tumor vaccine, after 7 days, chal-lenged with Sp2/0 tumor cells, observed the growth of tumor of mice. T lymphocyte subsets differentiation was measured by flow cytometry (FCM) analysis. The proliferation and cytotoxie activities of activated lym-phocytes were analyzed by FCM, respectively, staining with CFSE and 7-AAD. The number of IFN-γ-secre-ting cells was evaluated by ELISPOT. Results The lymphopenic mice were transferred with activated lym-phocytes and inoculated with raiL-21 tumor vaccine might provide superior anti-tumor immunoprotection, re-tard tumor growth of the mice. The proliferating capabilities and killing rate of transferred tumor Ag-specific lymphocytes enhanced obviously, the number of IFN-γ-secreting cells was significantly higher compared with the control groups. Conclusion Under Cy-induced lymphopenia condition, tumor Ag-specific lymphocytes sensitized by raiL-21 tumor vaccine were transferred to mice and immunized with mlL-21 tumor vaccine at the same time, benefit the proliferation of transferred effective cells and immune cells itself, assist to form and sustain special anti-tumor effects.