OBJECTIVE:To supply references for the improvement of the essential drug policy of China. METHODS:The pros and cons of present essential drug poliy of China was discussed on the basis of the introduction of the concepts of "essential drug" and "essential drug policy". RESULT & CONCLUSION:The realization of the goal of essential drug policy needs a perfect system of regulations in regard to the selection, production, distribution, pricing and reimbursement of essential drug.

Background The effectiveness of medical tissue adhesive for the reparation of operative incision has been recognized,but its influence to ocular surface microenvironment is not quite clear.Objective This study was to appraise the safety and efficacy of α-cyanoacrylate,a medical issue adhesive,for the reparation of the conjunctival and skin laceration.Methods Twenty healthy New Zealand rabbits were randomly divided into suturing group and medical glue group.Routine ophthalmic examination,the level of tear secretion and breakup time of tear film (BUT) were tested before operation.The upper bulbar conjunctiva of each right eye was cut apart about 1.0 cm after surface anesthesia and the skin of back was incised about 2.5 cm length after local anesthesia.The conjunctival and skin lacerations were adhered with compound medical adhesive in the medical glue group,and continuous suture was done to repair the conjunctival laceration and interrupted suture to the skin laceration with 5-0 chorda serica chirurgicalis in the suture group.The routine ophthalmic examination,level of tear secretion,BUT and the states of wound healing were examined 1 day,2 days and 7 days postoperatively.Pathologic examination of the corresponding tissues was also carried out 1 week after the animals were sacrificed.The data were analyzed by SPSS 13.0 statistical software.This experiment followed the Administration of the Care and Use of Experimental Animals of Shanghai City.Results The conjunctival and skin lacerations healed well both in the suture group and the medical glue group.The levels of tear secretion 1 day and 2 days postoperatively in the medical glue group were (12.70±2.21)mm and (12.70±2.00)mm respectively,showing a significant lowness in comparison with (14.90±2.38)mm and (14.90±2.33)mm of the suture group (q =-4.02,P =0.03;q =-4.02,P =0.03).Compared with the baseline,the difference of the levels of tear secretion in the medical glue group was not statistically significant in various time points after operation (P=1.00,1.00,0.51).The BUT values at 2 days and 7 days postoperatively in the medical glue group were (4.50 ± 1.18) seconds and (4.10±0.88) seconds respectively,being significantly longer than (3.30 ± 1.06) seconds and (3.00±1.25) seconds in the suture group (q=4.37,P=0.02;q=4.19,P=0.03).Compared with the baseline,there was not statistically significant difference at each time point postoperatively in the medical glue group (P =0.28,0.59,0.21).However,BUT at each time point after operation in the suture group was significantly shorter than that of the baseline (P=0.01,0.01,0.00).Pathological examination showed that all the conjunctival and skin lacerations healed well.Trivial collagen hyperplasy was seen in the eyes of the suture group and infiltration of a few of inflammatory cells was found in the medical glue group.In the pathological result of the skin test,there was conspicuous scar and severe collagen hyperplasy in the suture group,but in the medical glue group,the skin structure was almost normal.Conclusions α-Cyanoacrylate is safe and effective for the repair of the conjunctival incision with little affection to ocular surface microenvironment.

0.05).Conclusions SNP of 2350G→A in ACE gene is associated with MI,AA genotype is probably a genetic marker of MI in Han nationality.

Breast Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Leiomyosarcoma ; diagnosis ; pathology ; Middle Aged ; Skin Neoplasms ; pathology ; secondary

Background The pathological foundation of diabetic retinopathy is the breakdown of the bloodretina barrier induced by multifactors.Objective This study was to investigate the retinal morphologic change and the levels of serum vascular endothelial growth factor(VEGF),endothelin(ET)and nitric oxide(NO)in diabetic rats.Methods Forty healthy female SD rats were randomly divided into experimental group and control group and 20 rats for each group.Acute diabetes models were established by the intraperitoneal injection of 60 mg/kg streptozotocin in experimental group and the equal volume of buffer solution was injected at the same way in the control group.The serum VEGF level,ET level and NO concentration of diabetic and control rats were detected using ELISA double antibody sandwich method,125I radioimmune method and nitrate reduction method respectively at 2,4,6 and 8 weeks after injection.The eyeballs of rats were enucleated at the eighth week for retinal pathologic examination.This experiment followed the Measures for the administration of experimental animals of Shanghai City.Results The retinal structure was normal throughout the experimental duration in the control group.However,retinal edema and cellular disorganization appeared at 4 months and retinal blooding could be seen with the extending of diabetes course.The levels of serum VEGF and ET in each experimental group were significantly higher than those in control groups(P＜0.05).The levels of serum NO elevated in 2-month experimental group compared with same-phase control group(Z =-2.193,P＜0.05),and those in 6-and 8-month experimental groups were significantly lower than in corresponding control groups(Z =-2.449,Z =-2.236,P＜0.05).With the progression of the disease,the levels of VEGF and ET increased gradually,but the levels of NO decreased gradually,showing statistically significant differences(P＜0.05).The level of serum VEGF showed a positive correlation with serum ET level and a negative correlation with the serum NO concentration(r=-0.814,r=-0.803,P＜0.01)in the experimental group.A negative leaner relation was also found between serum ET level and serum NO concentration(r=0.821,P＜0.01).Conclusions The serum VEGF,ET and NO levels are closely associated with the degree of retinal lesion in early diabetic models.These results suggest that serum VEGF,ET and NO levels may be the important indexes predicting the course of retinal disease in diabetic rats.

?AlM: To analyze and study the changes of intraocular pressure ( lOP) , visual field and P-ERG on patients with big cup/disk (C/D) in 24h.
?METHODS: A total of 120 cases ( 240 eyes ) diagnosed with big C/D (C/D>0. 3) were divided into group A (C/D<0. 6, 67 cases, 114 eyes ) and group B ( C/D≥0. 6, 73 cases, 126 eyes). Forty cases (80 eyes) with small C/D (C/D≤0. 3) were chosen as control group. All cases underwent 24h lOP examination, vision examination of 30-2 SlTA - standard static threshold and pattern electroretinogram ( P-ERG) examination. The differences between the examination indexes of the three groups were analyzed.
?RESULTS:There was no significant statistical difference in the 24h average lOP (P>0. 05) among the three groups, while the amplitudes had significant statistical differences (P<0. 05). Compared with the control group, the lOP amplitudes of group B were obviously higher, and the difference was of statistical significance (P<0. 05). ln terms of static threshold visual fields, the mean deviations (MD) and pattern standard deviations (PSD) of the three groups had significant statistical differences ( P < 0. 05 ). Comparison between every two groups:compared with the control group, the MD and the PSD were significantly increased in group B, and the difference was of statistical significance (P<0. 05); while there was no significant statistical difference in group A (P>0. 05);Compared with group A, the MD and the PSD were significantly higher in group B, and the difference was of statistical significance (P<0. 05). ln terms of P-ERG examination, there was no significant statistical difference in P50’s latent periods among the three groups (P>0. 05), but there were significant statistical differences in amplitudes (P<0. 05). Comparison between every two groups: compared with the control group, the P50’s amplitude was significantly decreased in group B, and the difference was of statistical significance (P<0. 05), while there was no significant statistical difference in group A (P>0. 05); Compared with group A, the P50’s amplitude of group B was significantly lower, and the difference was of statistical significance (P<0. 05).
?CONCLUSlON: When the patients’ C/D is no less than 0. 6, there are obvious changes of 24h lOP, static threshold visual field and P-ERG’s P50 wave. For patients with big C/D, a single lOP examination is far from sufficient, so an in-depth visual function examination should be performed. Meanwhile, it’s feasible to regard C/D 0. 6 as a screening criterion for suspected glaucoma.

Objective To investigate the effect of matrix metalloproteinases(MMPs) in ventilator-induced lung injury inflammatory reaction of newborn rabbits.Methods Seventy-five newborn rabbits aged 1-5 days were randomly arranged to 3 groups:control group(n=3),other 72 rabbits designed by 2?2?3 factorial were divided into high concentration oxygen(100%)and low concentration oxygen(45%) groups,and each group was subdivided into 2 groups:High peak inspiratory pressure(PIP)group and low PIP group.All rabbits were done by mechanical ventilation and killed to obtain lung tissue at 1,3,6 hours after trailing respectively.The concentration of MMP-9 and MMP-2 in lung tissue bomogenate were detected by ELISA,at the same time the ratio of wet to dry was detected and pathological section was analyzed.Results 1.The concentration of MMP-2 in high concentration oxygen group,high PIP group and low PIP group increased compared with that in normal group,and there were significant differences.2.The mean concentration of MMP-9 was lower in high concentration oxygen group than that in normal control group,and there was significant difference between 2 groups.The mean concentration of MMP-9 in low concentration oxygen group was higher than that in normal group,and there was no significant difference between 2 groups.There was no significant difference in effect to mean concentration of MMP-9 by different PIP.3.There were positive correlation between MMP-2 and MMP-9,MMP-2 and the ratio of wet to dry in lung.Conclusions Within 6 hours in newborn rabbits by mechanical ventilation,ventilation with high concentration oxygen up-regulate MMP-2,but down-regulated MMP-9.The lungs stretch by mechanical ventilation increase MMP-9,but decrease MMP-2.Mechanical ventilation can affect the synthesis of MMPs,and MMPs plays an important role in ventilator-induced lung injury of newborn rabbits.

Bone Diseases, Developmental ; diagnosis ; surgery ; Female ; Humans ; Metacarpal Bones ; diagnostic imaging ; surgery ; Metacarpus ; diagnostic imaging ; surgery ; Middle Aged ; Radiography

Objective To investigate the clinicopathological characteristics and prognostic factors of hepatolithiasis associated with intrahepatic cholangiocarcinoma (HLAIHCC).Method A ret rospective study was conducted on 36 patients who suffered from histopathologically confirmed HLAIHCC.These patients received surgical resection of the tumor from June 2006 to September 2009.Results The overall 1,3,5 year survival rates for patients with HLAIHCC were not significantly better than those patients with ICC (63.6％,36.4％,and 30.3i％ vs.65.4％,34.3％,and 28.6％,P=0.57).For the patients who received curative resection,the 1-,3-,and 5-year survival rates (81.4 ％,61.7 ％,and 58.6 ％) were significantly better than those who received palliative resections (x2 =20.426,P＜0.001).The white blood cell count was significantly higher in the HLAIHCC group than in the ICC group (x2 =19.70,P＜0.001) and tumor size was significantly smaller in the ICC group than in the HLAIHCC group (P=0.04).Serum CA19-9 level (P=0.049) and resection margin (P=0.019) were independent risk factors of prognosis.Conclusions This study showed HLAIHCC to have different clinicopathological characteristics from ICC.Curative resection was the optimal surgical treatment for HLAIHCC.Serum CA19-9 level and resection margin were independent risk factors of prognosis.