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OBJECTIVE To analyze the effects of the national centralized drug procurement (NCDP) policy on drug availability and the structure of drug use in public hospitals. METHODS Using hypoglycemic, lipid-lowering, antiviral drugs, and psychiatric drugs for the treatment of mental illness and depression as objects, the interrupted time series model was used to quantitatively evaluate the changes in consumption sum of drugs, consumption amount and daily cost of the target drugs in national sample hospitals as well as the changes in per capita medication frequency, outpatient prescription amount, and medical insurance surplus of target drugs in a third grade class A hospital before and after the implementation of NCDP policy. RESULTS After the implementation of the NCDP policy, the volume for the four bid-winning drugs increased significantly (P<0.01 for the remaining three categories except for hypoglycemic drugs), but DDDc (P<0.01) and the amount of related drugs (P<0.001) decreased significantly. The volume for the non-winning drugs (except for lipid-lowering drugs) decreased significantly (P<0.05), and DDDc also decreased significantly (P<0.05 for other 3 categories except for psychiatric drugs); the volume (P<0.01) and DDDc (P<0.01 only for psychiatric drugs) for alternative drugs all increased except for antiviral drugs. The structure of drug use for different drugs was affected differently by the NCDP policy,and that of hypoglycemic drugs was affected obviously; the proportion of alternative drugs increased after centralized procurement. The outpatient prescription amount of each hospital significantly decreased after centralized procurement,and the decrease in the cost paid by the patients using lipid-lowering and antiviral drugs related to centralized procurement was greater than 0.60; the remaining medical insurance amount for bid-winning drugs was approximately 1.252 5 million yuan. CONCLUSIONS NCDP policy effectively alleviates the burden of medical expenditure and also drives the structure changes of drug use such as the substitution of generic drugs for original drugs, the growth of the volume of alternative drugs.
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Objective:To evaluate the radiosensitivity enhancement effect of FePd@CNTs nanocomposites on human breast cancer MCF-7 cells.Methods:FePd@CNTs nanocomposites were synthesized by chemical reduction method. Transmission electron microscope and energy dispersive spectrometer were utilized to characterize the surface morphology and chemical composition of FePd@CNTs nanocomposites. The compatibility of FePd@CNTs nanocomposites with human normal breast epithelial MCF-10A cells was determined by CCK-8 assay. The radiosensitivity enhancement effect of FePd@CNTs nanocomposites on MCF-7 cells was assessed by CCK-8 assay, flow cytometry and clony formation assay.Results:FePd nanospheres were successfully modified on the surface of CNTs by chemical reduction method. FePd@CNTs nanocomposites showed a low toxicity to MCF-10A cells (IC 50=738.3 μg/m), and effectively enhanced the effect of X-ray radiation on MCF-7 cells (sensibilization ratio=1.22). Conclusion:FePd@CNTs nanocomposites exhibit a promising potential for treating breast cancer and enhancing radiosensitivity effect.
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Objective@#To investigate the surgical approaches and therapeutic effect by utilizing Keystone perforator island flap in repairing sacroiliac decubital necrosis.@*Methods@#From June 20013 to June 2016, 12 patients ( 8 males, 4 females; aged 35-83 years; raw surface 6.4cm×4cm-17cm×14cm) with Sacroiliac Decubital Necrosis underwent reconstructive operations by Keystone perforator island flap.@*Results@#16 flaps completely survived, without redundant tissues, and any signs of infection and introcession, no necrosis were noted, all appearances present satisfactory.@*Conclusions@#Superior Gluteal Perforator Arteries that provide blood supply are sufficient in Keystone perforator island flap , as they are anatomically fixed, few variations, nutrition skin and subcutaneous in large scope, The curative effect of Keystone design perforator island flap in repairing sacroiliac decubital necrosis was satisfactory.
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In the era of digital information,internet plus mode provides new opportunities for the development of traditional medical education.This paper introduces the application patterns of internet plus mode in the medical education,including the following aspects,such as the construction of medical quality resources sharing class,the implementing of medical massive open online courses and other kinds of open online courses,making comprehensive construction of textbooks,using social interactive software and some new wearable devices such as Google glass,distance education and so on.And from the construction of autonomy,sharing,dynamic teaching atmosphere and building a new relationship between teachers and students,it explores the application advantage of Internet plus in medical education,emphasizes thatInternet plus mode and traditional medical education should be organically integrated and financed.At the same time,we should improve the evaluation of information quality,study the integrity test,and the application of big data processing,so as to provide some ideas for the sustainable development.
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This paper introduces the structure, contents, function of the digital teaching re-courses database in Clinical Skills course of Central South University, analyses the essence and char-acter of the flipped classroom (FC), and emphasizes flexible environment, learning culture, inten-tional content, professional educator in its implementation process. Meanwhile, it introduces the appli-cation of flipped classroom based on digital resources database in the teaching of Clinical Skills course, mentions the importance of the four aspects:preparing teaching materials, learning before class, guidance and cooperation in class, evaluation and knowledge expansion after class. Lastly, it analyses the advantages and foreground of it.
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Aim To develop a sensitive,specific and accurate method for quantifying a novel derivate of all-trans-retinoic acid, 4-amino-2-trifluoromethyl-phenyl retinate (ATPR)in rat tissues to investigate the tissue distribution of ATPR in rats.Methods Sprague-Daw-ley (SD)rats were killed by exsanguination at 2,4,7 h after a single intragastric administration with one dose of ATPR (20 mg·kg-1 )or at 5 min,1 h,5 h after a single intravenous administration with one dose of AT-PR (7 mg·kg-1 ).The concentration of ATPR in the tissues was determined by high performance liquid chromatography (HPLC)method.Results After the rats were administrated intragastrically, the highest concentration of ATPR was observed in intestine,fol-lowed by liver,spleen and lung,while the distribution in heart,kidney,fat and brain was very little.Howev-er,the highest concentration of ATPR was in liver after given intravenously,followed by spleen and lung,and very low in heart,kidney,intestines,fat and brain. Conclusion The distribution of ATPR is higher in liv-er after administrated both intragastrically and intrave-nously,suggesting the potential anti-proliferation and differentiation inducing effects of ATPR targeting at liv-er cancer.
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Objective To study TLC and HPLC fingerprint of Paeoniae Radix Alba;To provide reliable methods for its quality control and evaluation. Methods TLC was performed to detect paeoniflorin with CHCl3-EtOAc-methanol-formic acid (40∶5∶10∶0.2) as the developing solvent system. The HPLC chromatographic separation was performed on Kromasil C18 column (250 mm× 4.6 mm, 5μm, 12 nm). The mobile phase was a mixture of acetonitrile-0.05%phosphoric acid in gradient elution with flow rate of 1 mL/min. The detection wavelength was set at 254 nm, and the column temperature was 35 ℃. Results The TLC spots were clear. Fifteen common peaks including paeoniflorin (the ninth peak) in the HPLC profile were found in ten batches of samples of Paeoniae Radix Alba in different growing areas, the fingerprints of samples from Anhui Province and Zhejiang Province showed little difference. Conclusion Fingerprint of Paeoniae Radix Alba showed unique features, and can be used to control its quality.
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Objective: To investigate the expression of Th1/Th2 inflammatory cytokines IL-2, interferon-γ (IFN-γ), IL-4, and IL-10 in rat treatment model of dextran sulfate sodium (DSS) -induced ulcerative colitis. Methods: Forty Sprague Dawley (SD) male rats were divided into a normal group, a colitis model group, a sulfasalazine(SASP)-treatment group (SASP group) and a Jiechangning-treatment group (Jiechangning group) (each groupn=10). Disease activity index (DAI) and colorectal histological damage scale were assessed. The expression levels of cytokines IL-2, IFN-γ, IL-4, and IL-10 in the serum and the colon mucosa tissues were detected by enzyme-linked immuno sorbent assay (ELISA) and real time polymerase chain reaction (RT-PCR). Results: Compared with the colitis model group, the DAI and colorectal histological damage scale were decreased in the Jiechangning group (bothP0.05). There was no signiifcant difference in IL-2 expression both in the serum and the colon mucosa tissues before or after the treatment in various groups (P>0.05). Compared with the colitis model group, IFN-γ level both in the serum and the colon mucosa tissues was decreased in the SASP group and the Jiechangning group, with significant difference in the serum (bothP0.05). IL-10 level both in the serum and the colon mucosa tissues in the SASP group and the Jiechangning group was increased compared with that in the colitis model group, with significant difference (allP0.05). Conclusion: DSS can break the balance of Th1/Th2 expression in the colon. Jiechangning enema can ameliorate DSS-induced acute experimental colitis in rats by decreasing IFN-γ level and increasing IL-10 level both in the serum and the colon mucosa tissues to regulate the Th1/Th2 balance and improve immunity.
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Preliminary screening test and interfering test were used to study the bacterial endotoxin test (BET) for Shengmai Injection (SI). The results showed that there is no interference when the SI is diluted by 10 times and limulus reagent with a sensibility of 0.25EU/mL is used for BET.