Objective: By building database model, to put forward measures to solve the shortage of basic drugs. Methods: There were five factors influencing medicine shortage have been researched, collecting data, using SPSS 18.0 software to build the database model of different parts, and then analyzed the existing problems and inner link, scientifically came up with the basic framework and main solutions of guarantee measures on shortages of essential medicines. Results: The database model of country and six areas in it have been built, and the influence factors of drug shortage in different region have been analyzed, and raised five aspects measures to secure reliable supplies of drugs, including selection, bid and procurement; production and flow; reserve and adjust;pricing and pay;use training. Conclusion: This study extends the application of database, enriches research ideas of drug policy, and the policy put forward to avoid drug shortages to a certain extent.

Objective To analyze the influence of Bushenjiangu Capsules on rheumatoid factor (RF), hypersensitive c-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) with rheumatoid arthritis patients. Methods 94 patients with rheumatoid arthritis in the draw method was divided into control group and experimental group the 47 cases, control group treatmented by conventional western medicine, the experimental group based on the control group treatmented by Bushenjiangu Capsules, two groups' of RF, hs-CRP, ESR, Immunoglobulin A, M, G (IgA, IgM and IgG immune globulin), density lipoprotein (HDL-C), low density lipoprotein (LDL- C), triglyceride (TG), total cholesterol (TC), blood lipid, joint swelling, joint tenderness, morning stiffness time, curative effect and adverse reactions were compared. Results After treatmented, the RF, hs-CRP, ESR of experimental group was lower than the control group (57.53±8.13) U/L, (6.30±0.78) mg/L, (21.48±3.03) mm/h vs (74.29±10.56) U/L, (13.14±1.86 )mg/L, (35.60±4.36) mm/h, the difference was statistically significant (P<0.05). The IgA, IgM and IgG, HDL, LDL - C - C, TG, TC, joint swelling count, joint tenderness, morning stiffness time of experimental group was better than control group (2.17±0.29) g/L, (1.53±0.21) g/L, (12.14±1.50) g/L, (1.25±0.15)mmol/L (2.11 ±0.26) mmol/L, (1.34±0.17) mmol/L, (4.03±0.50) mmol/L, (4.35±0.53), (6.30±0.77), (29.71±3.70) min than g/L (2.30±0.28), (2.11±0.26) g/L, (13.76±1.70) g/L, (1.16±0.14) mmol/L (2.29±0.28) mmol/L, (1.53±0.19) mmol/L, (4.50±0.55) mmol/L, (7.63±0.96), (8.51±1.21), (76.38±9.50) min (P<0.05). The total effective rate of experimental group was higher than the control group (93.61%vs 76.59%) (P<0.05).The adverse reaction of two groups was no difference. Conclusion The effect is sure of Bushenjiangu capsule treatment of rheumatoid arthritis, can reduce the levels of RF, hs-CRP, ESR.

Metabolic syndrome is the fundamental factor in the pathogenesis of a variety of diseases, and it has not yet been fully understood due to its complicated mechanism. Multiple re-searches have implicated that Wnt/β-catenin signaling pathway may have a significant effect on the formation and development of metabolic syndrome. LRP6 is an important co-receptor of Wnt/β-catenin signaling pathway ,and there are some researches im-plicating the correlation between LRP6 and metabolic syndrome. The in-depth research on the gene polymorphism and its modula-tion mechanism can provide new ideas and directions for meta-bolic syndrome therapy.

Objective To investigate the changes of gamma-aminobutyric acid (GABA) in the anterior cingulate cortex of perimenopausal women with depression.Methods Forty perimenopausal women as the experimental group and ten healthy women as the control group were recruited and followed up for 18 to 24 months.The proton magnetic resonance spectroscopy (1H-MRS) was used to acquire the concentrations of GABA in the anterior cingulate cortex.The experimental group was examined before and after menopause.The control group was examined before into the group and after out of the group.The experimental group after menopause was further divided into the anxiety group and the depression group according to the Classification and Diagnostic Criteria of Mental Disorders in China-Third Edition (CCMD-3), 14-item Hamilton Anxiety Scale (HAMA-14) and 17-item Hamilton Depression Scale (HAMD-17).The data of three groups were compared respectively.Results The results showed that the concentrations of GABA after menopause in both of the anxiety group and depression group were significantly lower (P<0.05) than those before menopause, and were also significantly lower (P<0.05) than those in the control group.The concentrations of GABA after menopause in the depression group were significantly lower(P<0.05) than those in the anxiety group.Conclusion The changes of GABA in the anterior cingulate cortex are related with the pathophysiology mechanism of perimenopausal depression and the symptoms of perimenopausal depression.

The prevalence of gouty arthritis is increasing year by year.Acute attacks seriously affect work and life.Poor control of chronic recurrent attacks may lead to teratogenicity and disability.Targeted reduction of serum uric acid levels and crystallolysis is the key to gout treatment.Although its treatment guidelines are relatively complete and drug choices are relatively wide,the clinical effect is still not satisfactory.This review focuses on the molecular and cytopathological mechanisms behind the clinical manifestations of acute attack and spontaneous remission of gouty arthritis,so as to further understand the necessity of standardized clinical medica-tion and explore its potential treatment strategies.

Objective To analyze the etiological characteristics and the variation of pathogens spectrum in hospitalized children with a-cute respiratory tract infection(ARTI)before and after COVID-19 under"the level B of management for class B"of infectious diseases(Level B for Class B)in Shenzhen,in order to provide reference for the clinical diagnosis,treatment and prevention of ARTI.Meth-ods The ARTI cases from January 8,2022 to July 30,2022 were selected as before"Level B for Class B",and the cases from Janu-ary 8,2023 to July 30,2023 were selected as after"Level B for Class B".The pharyngeal swab samples submitted for analyzing 11 common pathogens,such as COVID-19,influenza virus(Ⅳ),respiratory syncytial virus(RSV)and mycoplasma pneumoniae(MP)in the children with ARTI admitted to Shenzhen Children's Hospital.Results SARS-CoV-2 were detected as positive in 347 cases,a-mong which 225 cases were before"Level B for Class B"including 29 cases combined with other pathogens(12.89％,29/225)and human parainfluenza viruses(HPIV)was the most common(31.03％,9/29).After"Level B for Class B",SARS-CoV-2 were detec-ted as positive in 122 cases,including 28 cases combined with other pathogens(22.95％,28/122),and RSV was the most common(28.57％,8/28).There was a statistical difference between the positive rate of SARS-CoV-2 combined with other pathogens before and after"Level B for Class B"(X2=5.834,P=0.016).After"Level B for Class B",the total pathogen detection rate(positive for at least one pathogen)was 60.82％(2 864/4 709)in the spring(January 8,2023 to April 30,2023),and influenza virus A(IVA)(22.64％,1 066/4 709),rhinovirus(HRV)(19.86％,935/4 709)and RSV(13.29％,626/4 709)were the main pathogens,and there were 301 cases(6.39％,301/4 709)of mixed infections.In the summer(May 1,2023 to July 30,2023),the total detection rate of pathogens was 70.26％(4 012/5 710),among which RSV(21.63％,1 235/5 710),MP(13.91％,794/5 710),HPIV(10.05％,574/5 710)were the main pathogens,and there were 710 cases(12.43％,710/5 710)of mixed infections,all of which were significantly higher than the same period before"Level B for Class B".The difference was statistically significant(P＜0.05).Conclusion After"Level B for Class B"for COVID-19,the detection rate of 11 common pathogens increased significantly and the pathogen spectrum of ARTI changed significantly.

Objective:To explore the risk factors for lymphoproliferative disorders (PTLD) in children with thalassemia major (TM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This was a retrospective case-control study.A total of 482 children with TM who underwent allo-HSCT at Shenzhen Children′s Hospital between January 2020 and December 2022 were selected and classified into the PTLD and non-PTLD groups according to the occurrence of PTLD.The risk factors for PTLD after allo-HSCT in children with TM were analyzed, and the diagnostic efficiency of relevant risk factors for PTLD was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 25 out of 482 patients (5.2%, 25/482) developed PTLD about 114 (54-271) days after allo-HSCT.Among them, 12 cases (12/25, 48.0%) occurred within 100 days, and 22 cases (22/25, 88.0%) occurred within 1 year after allo-HSCT.Univariate analysis showed that there were significant differences in gender composition, type of transplant donor, number of natural killer cells and B lymphocytes in peripheral blood at 30 days after allo-HSCT, positive rate of plasma Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) and incidence rate of acute graft-versus-host disease (aGVHD) between the 2 groups (all P<0.05).Multivariate Logistic regression analysis showed that female ( OR=3.196, 95% CI: 1.144-8.929), positive plasma EBV-DNA ( OR=17.523, 95% CI: 5.449-56.344) and aGVHD ( OR=3.156, 95% CI: 1.161-8.575) were independent risk factors for PTLD after allo-HSCT in TM children (all P<0.05).The ROC curve analysis showed that positive plasma EBV-DNA had an excellent accuracy in predicting the occurrence of PTLD after allo-HSCT (sensitivity was 0.796, specificity was 0.800, area under the curve was 0.803).If combined with aGVHD and gender, the area under the curve for the prediction of PTLD increased to 0.831. Conclusions:Female, positive plasma EBV-DNA and aGVHD are independent risk factors for PTLD after allo-HSCT in children with TM.It provides useful early warnings for the prediction and prevention of PTLD.

OBJECTIVETo study the pathologic characteristics and prognosis in different subtypes of adult medulloblastoma (MB).

METHODSThe clinical information, imaging findings and pathologic characteristics of 151 cases of adult medulloblastomas were retrospectively reviewed and analyzed by chi-square test. The survival data were assessed using the Kaplan-Meier method.

RESULTSAmongst the 151 MB cases studied, there were 73 cases of classic MB, 36 cases of desmoplastic/nodular MB, 39 cases of anaplastic MB and 3 cases of large cell MB. The primary tumors were more frequently located in cerebral hemisphere in desmoplastic/nodular MB than in other subtypes (P=0.000).On the other hand, large cell/anaplastic MB were associated with more frequently local recurrence and distant metastasis (P=0.003). The post-operative overall survival time ranged from 6 to 150 months, with median survival being (103.3±5.7) months (95%CI, 92.52 to 115.09). The median survival of classic MB, desmoplastic/nodular MB and large cell/anaplastic MB was (110.7±7.8) months, (125.5±7.6) months and (57.6±7.6) months, respectively. The differences were statistically significant (P=0.000).

CONCLUSIONSThe three variants of MB show different biologic behavior. Large cell/anaplastic MB represents an independent poor prognostic indicator in adults.

Adolescent ; Adult ; Cerebellar Neoplasms ; classification ; metabolism ; pathology ; radiotherapy ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Kaplan-Meier Estimate ; Ki-67 Antigen ; metabolism ; Male ; Medulloblastoma ; classification ; metabolism ; pathology ; radiotherapy ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Phosphopyruvate Hydratase ; metabolism ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; Synaptophysin ; metabolism ; Young Adult