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OBJECTIVE To analyze the current situation of pediatric drug use under centralized drug procurement， and to provide reference for the subsequent design of pediatric drug centralized procurement rules. METHODS The comparative analysis method was used to analyze the problems in the centralized procurement， clinical use and supply of pediatric drugs from the aspects of centralized procurement selection results and actual use of pediatric drugs， price difference and online prices of pediatric drugs. The solutions were put forward to optimize the centralized procurement and pricing rules of pediatric drugs. RESULTS & CONCLUSIONS The demands for pediatric drugs in China were increasing， but the supply of marketed pediatric drugs was insufficient （including insufficient coverage of disease fields， insufficient varieties， insufficient suitable dosage forms for children， insufficient specifications for children， etc.）， and the development of pediatric drugs was relatively difficult. After merging the dosage forms of centralized procurement according to the medical insurance list， some suitable dosage forms and specifications for children couldn’t be selected， resulting in a shortage of clinical pediatric medication. Relevant enterprises’ enthusiasm for developing and producing pediatric drugs and participating in online competitions had decreased. There was also the problem of underpricing of pediatric drugs under the drug price difference ratio rule. It is recommended that when conducting centralized drug procurement， special drugs for children should be grouped separately for centralized procurement based on attributes and the population covered by the indications. The specifications of suitable pediatric drugs that were not selected are converted into the agreed purchase quantity of medical institutions in a certain proportion. It is necessary to further optimize the pricing rules for pediatric specialized drugs， ensure a certain profit margin for such drugs， increase the willingness of production enterprises to research， develop and supply drugs， and thus ensure the use and supply of pediatric drugs.
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Objective: To systematically evaluate the efficacy and safety of Yang Yin Sheng Ji pulvis (membranae) in the treatment of recurrent oral ulcers (ROU) . Methods: All clinical studies of Yang Yin Sheng Ji pulvis (membranae) for the treatment of ROU were searched from Cochrane Library (Issue 5, 2017), Pub Med, PMC, Medline, EMBASE, CNKI, CBM, VIP and WANFANG DATA.The quality of the included studies was evaluated referring to the Cochrane Reviewer's Handbook 5. 1. 0, Meta-analysis of the total effective rate was performed using Rev Man 5. 3. 5 software, ITC software was used to compare the efficacy of Yang Yin Sheng Ji pulvis and Yang Yin Sheng Ji membranae in Meta. Results: 11 studies including 1837 patients were included. The results of Meta-analysis showed that Yang Yin Sheng Ji pulvis (membranae) for the treatment of ROU is more effective than the roultine treatment (OR = 5. 22, 95％ CI:3. 93 ～ 6. 93, P ＜ 0. 000 01), subgroup analysis showed that Yang Yin Sheng Ji pulvis and Yang Yin Sheng Ji membrane are superior to the routine treatment (OR = 5. 08, 95％ CI: 3. 63 ～ 7. 10, P ＜ 0. 000 01 and OR = 6. 67 95％ CI: 3. 82 ～ 11. 66, P ＜ 0. 000 01), respectively. Indirect comparison results showed that the total efficiency of Yang Yin Sheng Ji membrane is higher than that of Yang Yin Sheng Ji Pulvis (P = 0. 009) . No adverse reaction of Yang Yin Sheng Ji pulvis (membrane) was reported. Conclusion: Yang Yin Sheng Ji pulvis (membranae) is more effective in the treatment of ROU than the routine treatment.
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Objective To explore the age at which the anterior skull base is fully ossified as assessed on CT examinations in healthy children and it may be helpful for clinical assessment of anterior cranial lesions. Methods This was a retrospective review of the CT examinations of 204 patients (age range: 0-16 years old, median age: 2 years and 2 months) from February 2014 to March 2016 at Tianjin Children's Hospital. The raw images were reformatted as the sagittal and coronal images at Philips ISPSERVER workstation.Measurements of the length and width of the anterior skull base and the presence and rate of the anterior unossified portion were determined by 2 radiologists.Skewed distribution data were indicated with median (interquartile range). Spearman correlation test was used to analyze the correlation between the measurements and age, respectively. If data were not normally distributed, they were first converted by log transformation.The linear graph was used to evaluate the ossified pattern of anterior skull base in healthy children.Results The average length and width of anterior skull base was(58.7±15.6)mm and (15.2±6.8) mm, respectively. The length and width of unossified portion and corresponding unossified rate were 2.2(10.8)mm,2.5(7.5)mm,0.04(0.22)and 0.17(0.60).The linear graph showed that the length and width of the anterior skull base were positively correlated with age(r=0.935,0.896,P<0.001),while the length,width and corresponding unossified rate of unossified portion were negatively correlated with age(r=-0.840,-0.729,-0.887,-0.833,P<0.001).The unossified portion ossified progressively and rapidly at the first 6 months after birth.The average unossified rate of length was 0.58 and 0.15 in the 1stand 6thmonth, respectively.All children had at least 50% and 80% ossification of anterior skull base at the age of 5 months and 16 months, respectively. The anterior skull base was fully ossified at 45 months in all of our cases. Conclusions There is a certain rule of ossification in anterior skull base for healthy children.The anterior skull base may be fully ossified by 45 months after birth on CT imaging.
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Objective To evaluate 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama.Methods The 3D CT features on MIP,VR images were analyzed retrospectively in 589 pediatric cases.The normal anatomy,anatomic variations and fractures of occipital squama were observed respectively,and the differential diagnostic features including the individual location,appearance and extension were analyzed.Results Four hundred and thirty-three patients (75.2％) showed normal anatomy,including 154 patients with adult occipital anatomical features,279 patients with posterior intraoccipital synchondrosis,and 37 patients with Kerckring-supraoccipital synchondrosis.When cases with recent trauma history were excluded,113 patients (19.1％) showed anatomic variants,including unpenetrating sutures and penetrating sutures.The former could be subdivided to Mendosal sutures in 23 cases,superior median fissures in 19 cases,and midline supraoccipital fissures in 4 cases,while the latter could be subdivided to the interparietal bone variations in 54 cases,wormian bones in 23 cases,and accessory bones in 7 cases.Two or more variations coexisted in 33 cases.The occipital squama fractures were shown in 34 cases (5.6％),including linear fractures in 27 cases,comminuted fractures in 3 cases,with depression fracture in one case,separation of cranial sutures in 3 cases,and other fractures associated with variants in 3 cases.The fractures were sharp,or jagged,without limitation of the occification.Conclusion There are different 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama in children,which are important for making the accurate diagnosis.
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ObjectiveTo evaluate the clinical effect and safety of coronary artery disease (CAD) treated with Shexiang-baoxin pill and Complex Danshen drop pill.MethodsArticles of randomized controlled trials (RCTs) about the treatment of CAD with Shexiang-baoxin pill and Complex Danshen drop pill were retrieved and the quality of these studies were analyzed by RevMan 5.1.6 software with Meta analysis.Results Seven studies involving 603 patients were included.The results of meta-analysis showed that the experimental group was better in ameliorating angina symptoms of angina pectoris patients [RR=1.33,95％CI (1.21,1.45),P＜0.01 ] and ECG [RR=1.55,95％CI (1.34,1.79),P＜0.01 ] than the control group.Adverse reaction rate of the experimental group and the control group was 6.85％ and 14.38％ respectively,the difference was not statistically significant (P＞0.05).ConclusionThe existing researches demonstrated that Shexiang-baoxin pill was better in treating CAD angina pectoris than Complex Danshen drop pill.
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Objective To discuss the value of MSCT in diagnosis of left pulmonary artery sling (LPAS) with tracheobronchial anomaly.Methods MSCT was performed in 9 children with LPAS and tracheobronchial anomalies,CT findings were analyzed retrospectively. Results According to the Wells classification of LPAS,which includes two main types and two subtypes,there were 2 patients of type 1A,3 patients of type 1 B,2 patients of type 2A and 2 patients of type 2B.All of children had tracheobronchial stenosis.Local tracheobronchial stenosis was found in 4 patients ( all were type 1 ) and long tracheobronchial stenosis in 5 patients ( 1 patient with type 1 and 4 patients with type 2).Conclusions MSCT is an ideal imaging modality for simultaneously identifying LPAS and associated tracheobronchial anomalies.The Wells classification is very useful for operation planning.
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Objective: To investigate the clinical and pathological factors related to metachronous liver metastases in patients with Dukes'C colorectal cancer.Methods: A total of 170 patients with Dukes'C colorectal cancer treated with radical surgery in our hospital between January 2003 and December 2006 were reviewed.Factors including sex, age, tumor size (cm), depth of invasion, histological type, and serum CEA level were analyzed.Univariate and multivariate analyses were used to evaluate the factors concerned by Binary logistic regression (SPSS 13.0 for windows).Results: Of the 170 cases, 36 cases had metachronous liver metastases and 26 of them (72.2%) were found with metachronous liver metastases with-in two years after surgery.Thirty-two cases (88.9%) were identified with metachronous liver metastases within three years after surgery.Univariate analysis showed that depth of invasion, histological type and serum CEA level were predictors that could affect metachronous liver metastases.Depth of invasion and serum CEA level were independent risk factors for meta-chronous liver metastases of colorectal cancer.Multivariate analysis revealed that histological type was independent favor-able factor for metachronous liver metastases of colorectal cancer.Conclusion: Depth of invasion, histological type and se-rum CEA level were independent factors related to metachronous liver metastases of colorectal cancer.It is necessary to closely follow up Dukes'C colorectal cancer patients for two or three years after surgery in order to detect metachronous liv-er metastases early, especially for patients with higher preoperative serum CEA level or with tumor invasion to serosa.
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Objective To assess the value of the multi-slice CT based OMENS classification in diagnosing pediatric hemifacial microsomia. Methods Eleven patients including 9 boys and 2 girls with suspicion of hemifacial microsomia underwent MSCT. Multi-planar reformation (MPR), maximum intensity projection (MIP) and volume-rendered image (VR) reconstruction were performed at the workstation. The malformations of the facial structures were analyzed respectively with the OMENS classification system.Results On CT reconstruction images, hemifacial microsomia in all 11 patients was demonstrated clearly.Nine patients were found to have unilateral lesion, including 6 on the left side and 3 on the right side. Two patients presented bilateral involvement with various severity degree. The OMENS classification system can be perfectly used to analyze the deformities. Respectively, the orbit and zygomatic arch deformity involved 8 sides in 8 cases, the mandible deformity involved 10 sides in 9 cases, the auricular deformity involved 13 sides in 11 cases, and the soft tissue deformity involved 12 sides in 11 cases. Conclusion MSCT based OMENS classification system can make accurate and comprehensive evaluation of the morphological changes in hemifacial microsomia, which provide strong imaging evidence to clinical evaluation.
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Objective To study the difference of proteomic spectra in serum of patients with colorectal cancer(CRC) in order to build a proteomic pattern and find a method for early diagnosis of CRC.Methods We screened for potential tumor biomarkers of serum samples from 48 CRC patients and 34 healthy subjects by using CM10(Ciphergen Company,USA) and the technology of Surface enhanced laser desorption/ionization time-of-flight mass spectrometry(SELDI-TOF-MS).Using Ciphergen Protein Chipsoftware 5.1,a proteomic pattern was constructed.The constructed pattern was then tested by an independent set of masked serum samples from 33 colorectal cancer patients and 34 healthy subjects.Results(1) The contents of 27 proteins in the CRC to healthy subjects groups were significantly different(P