OBJECTIVE:To provide reference for improving the efficiency of medicine supply in primary health care institutions. METHODS:By stratified random sampling,6 counties of Dabie Mountains in Anhui province were selected as sample areas. Medicine purchase data of 143 primary health care institutions in 2015 were collected from Anhui provincial centralized purchase platform. Those data were analyzed in respects of purchase and distribution of National Essential Medicine,medicines of Anhui Province Essential Medicine List and cheap medicines. By stratified random sampling,12 primary health care institutions were selected for on-site interview. The reasons for medicine distribution and insufficient distribution were investigated. RESULTS:The rate of medicine distribution in the sample areas was 82.27%,and the rate of essential medicine distribution was more than 80%. Ratio of purchase amount for national essential medicines and medicines of Anhui Province Essential Medicine List were all up to standard in different types of primary health care institutions. The rate of cheap medicine distribution was in low level(only 80%). The distribution rate had great difference in the primary health care institutions and different areas;the highest rate of medicine distribution reached 99.86%,and the lowest was only 46.18%. The results of on-site investigation showed that main reasons for insufficient distribution were the divided area distribution model had a certain influence on the market competitiveness of the distribution enterprises,and distribution enterprises strength had huge differences. CONCLUSIONS:The primary health care institutions have high awareness of National Essential Medicine System in Dabie Mountains of Anhui Province;purchase rate and overall distribution rate of essential medicine are also high. There are great differences in distribution efficiency among different areas and health care institutions,and some health care institutions cannot distribute medicine in time with full capacity. It is suggested to conduct"two-receipt system"of medicine distribution,perfect medicine distribution enterprise supervision system, establish medicine circulation information platform and lead cheap medicine supply guarantee by government,etc. Those measures can guarantee the accessibility and selectivity of the masses to essential medicines in grass-roots areas.

Objective To investigate the application of modified negative pressure closure drainage in early stage of snakebite .Methods 60 patients with early bite ulcer were selected as study objects ,and they were randomly divided into two groups according to the digital table .30 patients in the observation group received vacuum sealing drainage(VSD) combined with chymotrypsin continuous rinsing treatment .30 patients in the control group were given conventional dressing bandaging treatment .The two stage skin grafting time,wound healing time,complications,disa-bility rate,hospitalization time and C reactive protein ( CRP) levels of the two groups were observed .And the treatment effect was analyzed .Results The incidence rates of complications and disability in the observation group were 0.00％and 3.33％,respectively,which were significantly lower than 16.67％and 26.67％in the control group ,and the differences between the two groups were statistically significant (χ2 =4.356,6.405,all P<0.05).The CRP levels of 3 d and 7 d in the observation group were (15.8 ±1.7)mg/L,(6.9 ±1.6)mg/L,respectively,which in the control group were (18.6 ±2.3) mg/L,(13.8 ±1.9) mg/L,respectively,there were statistically significant differences between two groups(t=5.362,15.214,all P<0.01).The two stage skin grafting,wound healing,hospital stay of the observation group were (9.5 ±1.8) d,(24 ±1.8) d,(25.3 ±1.9) d,respectively,which were significantly shorter than those of the control group [(16.2 ±2.6)d,(32.0 ±3.2)d,(33.2 ±3.7)d],the differences were statistically significant(t=11.604,11.93410.403,all P<0.01).Conclusion For patients with injury of cobra bite to early ulcer,using VSD technology combined with chymotrypsin continuous irrigation ,can significantly reduce the level of CRP and the occurrence of complications and disability rate ,shorten the time of two stage skin grafting ,wound healing time,hospitalization time,reduce the pain of patients,it is the best treatment to accelerate recovery .

Objective To evaluate the clinical value of CT angiography (CTA) in the diagnosis of acute pulmonary embolism (APE) after standardized chest pain assessment in patients with acute chest pain.Methods From January 2014 to May 2016,The clinical data of 43 patients with acute chest pain in Wuzhou Hospital of Traditional Chinese Medicine and Wuzhou Worker's Hospital received CTA examination were retrospectively analyzed.After standardized assessment,16 patients with suspected APE through pulmonary artery CTA scan screening were selected as observation group.27 cases of chest pain who were not received standardized assessment were selected as the control group,the chest CTA scan was used to investigate the causes of chest pain.The number of CTA confirmed by APE in two groups was compared.The effect of APE screening scale score and D-Dimer on the diagnosis of APE in the observation group was analyzed,and the application value of standardized evaluation of chest pain in APE was analyzed.Results The positive rate of CTA in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(x2 =3.93,P ＜ 0.05).The APE screening scale and D-Dimer in the observation group were (9.64 ±4.74) points and (886.73 ± 191.83) μg/L,respectively.which in the APE excluded patients were (2.20 ± 1.64) points,(587.20 ± 35.79) μg/L,respectively,the differences were statistically significant(t =3.363,3.402,all P ＜ 0.01).Conclusion Patients with acute chest pain and chest pain are standardized after the evaluation,optimization of CTA examination and improve the diagnostic rate of APE,reduce the rate of misdiagnosis and missed diagnosis,provide timely and accurate diagnostic basis for clinicians to gain valuable opportunity for further disposal.

BACKGROUND: Recent literatures have showed that percutaneous kyphoplasty can effectively avoid nerve damage, pulmonary embolism, and insufficient vertebral height and other security risks when bone cement is infused into affected vertebrae in percutaneous vertebroplasty. OBJECTIVE: To compare the effect of percutaneous kyphoplasty and percutaneous vertebroplasty in repair of osteoporotic vertebral compression fractures. METHODS: A total of 106 patients with senile osteoporotic vertebral compression fractures were randomly divided into trial group and control group (n=53 per group). Patients in the trial group were treated with percutaneous kyphoplasty, and those in the control group treated with percutaneous vertebroplasty. Al patients were fol owed up for 6 months after repair. The vertebral compression deformation, bone cement distribution, midline vertebral bone cement condition, vertebral height restoration, bone cement leakage, vertebral kyphosis, progressive spinal col apse, nerve damage, as wel as visual analog scale scores and Oswestry disability index scores in these two groups were compared. RESULTS AND CONCLUSION: Compared with the control group, there was less bone cement leakage and vertebral compression deformation in the trial group. Moreouer, in the trial group, bone cement distributed uniformly, vertebral height restoration was good and effective, pain was obviously relieved, and the probability of vertebral kyphosis, progressive spine col apse and nerve damage was significantly reduced (al P < 0.05). These results suggest that percutaneous kyphoplasty can effectively relieve the pain of patients with osteoporotic vertebral compression fractures, restore vertebral body height and reduce the incidence of complications, which effectively guarantees the postoperative restoration of motor function.

Aim To investigate the effects of silencing MALAT1 gene on cell proliferation inhibition and apop-tosis induced by Melittin in human hepatocellular car-cinoma HepG2 cells. Methods The inhibitory rate of cell proliferation treated with Melittin in HepG2 cells was examined by MTT assay. Apoptotic rate was detec-ted by flow cytometry. The MALAT1 expression level in HepG2 cells was measured by qPCR. Specific siR-NAs were utilized to silence MALAT1 expression. The rates of cell proliferation inhibition and apoptosis in HepG2 cells treated with siRNA and Melittin were compared with those of Melittin alone. Results Melit-tin significantly suppressed the growth of HepG2 and induced cell apoptosis in a dose-dependent manner. Compared with normal liver cell lines, MALAT1 was highly expressed in HepG2 cells ( P<0. 05 ) . The ex-pression of MALAT1 in HepG2 cells was inhibited by Melittin, and the inhibitory rate increased with the in-crease of concentration. The rates of cell proliferation inhibition and apoptosis in HepG2 cells treated with siRNA and Melittin were significantly higher than those treated merely with Melittin. Conclusion Melittin can reduce the expression of MALAT1 and silencing MALAT1 can effectively promote proliferation inhibi-tion and apoptosis in HepG2 cells induced by Melittin.

The fibrosis can occur in many kinds of organs,and its sustained progress may lead to organ structural damage and functional decline,and even the organ failure,which threatens the human health and the life seriously.Adenosine is an endogenous purine nucleoside that can be generated in various tissues of the body and regulate a multitude of body functions via the combina-tion with four different kinds of G protein-coupled receptors.Re-cent studies have found that adenosine receptors play an impor-tant role in regeneration tissue and fibrosis process.To under-stand the processes may be helpful to the treatment of fibrosis diseases.This review makes a summary on latest research pro-gress of adenosine receptors in fibrosis diseases.

Aim To investigate the influence of down-regulating adenosine A1 receptor and adenosine A2 A receptor gene expression on proliferation and activation of acetaldehyde-induced hepatic stellate cell-T6 cells through siRNA. Methods Alcoholic liver fibrosis in vitro model was constructed by inducing HSC-T6 cells with acetaldehyde. siRNA targeting A1R and A2AR were designed and synthesized according to its mRNA. The siRNA was transfected into rat HSC-T6 cells by li-posome LipofectamineTM 2000. HSC cell proliferation was measured by MTT. The mRNA levels of A1R, A2AR, α-SMA, Collagen I in the supernatant of the cell culture were measured by Quantitative Real-Time PCR. The protein levels of A1R, A2AR, α-SMA, Collagen I were measured by Western blot. Results A1 R and A2 AR siRNA effectively inhibited the cell proliferation, and they also significantly decreased the levels of A1R, A2AR,α-SMA, Collagen I, suggesting that A1 R and A2 AR might be potential target genes in the alcoholic liver fibrosis. Conclusions Silencing A1 R or A2 AR by RNAi can significantly inhibit the HSC proliferation, A1R and A2AR may be potential therapeutic target genes for alcoholic liver fibrosis.

Intellectual property in medical institutions has been getting more attention in research activity.Large general hospitals have made significant achievements in intellectual property,and the management of intellectual property right has also gradually become the norm.This article discussed the possibility to carry out the intellectual property management in the primary health care sector,based on their current status and characteristics,proposed an evaluation system which suitable for the primary health care sector.We described the structure and method of this system,explored a standardized intellectual property management process used in primary health care institutions.

Objective To investigate the surgical techniques and skills for recurrent pseudocyst of auricle.Methods Retrospective analysis of 20 cases from January 2006 to May 2014 in our department,who were treated by the operations with skills as follows, resection the anterior wall of pseudocyst cartilage and perichondrium, grooves cutting the roughing the posterior cartilages wall, and local compression.Results All 20 patients were followed up for 8 to 42 months and all were cured.No recurrence, infections and malformation were happened.Conclusion Resection the anterior cartilage wall perichondrium of the pseudocyst, grooves cutting and roughing of posterior cartilages of the peudocyst, and in combined with local compression are effective treatment for recurrent cases.

Objective To study whether the HBC-A2/scFv fusion protein mediates killing of tumor cells by viral specific cytotoxic T cells. Methods The fusion protein was attached to the CD71-expressing, HLA class Ⅰ negative tumor cells. And then, cytolysis by viral peptide-specific CTLs which were generated by co-culture of peripheral blood lymphocytes from HLA-A2 positive donors with inactivated T2 cells pulsed with the viral peptide were tested by lactate dehydrogenase (LDH) releasing. Results The fusion protein can attach the active viral peptide/HLA-A2 complex to K562, HepG2 and U937 cells through binding of CD71 scFv to CD71 (37.30% ±8.25%, 27.20% ±3.88%, 21.80% ±6.49% ) and mediate cytotoxicity of viral peptide-specific CTLs against those cells in vitro ( K562: 42.08% ± 1.14% vs 8.07%± 1.39%; HepG2: 49.72% ± 1.59% vs 12.46% ± 1.26%; U937: 39.72% ± 3.26% vs 7.13% ±1.48% ). Conclusion This viral peptide/HLA-A2 complex targeted by CD71 scFv is able to redirect viral peptide-specific T-cell mediated immune responses against tumor cells.