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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 TodeterminethevalueofT1WIsignalratioofbilateralglobuspallidustoputamenindiagnosisofhighbilirubin relatedencephalopathyoftermneonates.Methods ThecranialMRIsignalcharacteristicsandclinicaldataof105newbornswereanalyzed retrospectively.Accordingtothetotalserumbilirubin (TSB)andclinicalsymptoms,86caseswithoutriskfactorsofterm neonates weredividedinto4groups(Ⅰ~Ⅳand3groups(A~C).TheT1WIsignalintensityofbilateralglobuspallidusandputamenwere m easured and the ratio of G/P w as calculated.T he data of each group w ere co m pared and analyzed by t test and ANOVA.R O C curve ofG/Pratiowasperformedtopredicttheprogressofdisease.Results TherewasstatisticallysignificantdifferencebetweengroupⅠandgroupⅡ,groupⅠandgroupⅢ,groupⅠandgroupⅣ,groupⅡandgroupⅢ,groupⅡandgroupⅣ(P＜0.05),whereasno differencewasfoundbetweengroupⅢandgroupⅣ (P＞0.05).Comparingthethreegroupsdividedbyclinicalsymptoms,statistically significantdifferenceswereobserved(P＜0.05).TheROCcurverevealedthatforserum TSB,thepredictiveriskofhyperbilirubinemia with1.51and1.62,thepredictiveperformanceforhighbilirubinrelatedencephalopathywith1.70and1.69.Conclusion TheT1WI signalintensityratioofG/Ppotentiallyassistsinthediagnosisofhighbilirubinrelatedencephalopathy.Combinedwithclinicalmanifestations, itcanbecomprehensivelyanalyzeddialectically,therebyincreasingtheobjectiveaccuracyofdiagnosis.
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Objective To explore the value of spiral CT in venous phase in measuring the diameter of bilateral transverse sinus.Methods The CT vascular imaging findings of 200 cases at torcular herophili area in our hospital were analyzed retrospectively.The resource images, volume rendering (VR) and maximum intensity projection (MIP) were performed to observe the presentation of vascular anatomy in the torcular herophili area, and to determine the dominant transverse sinus and types of torcular herophili (typeⅠ-Ⅵ).The diameters of bilateral transverse sinus were measured by original CT images.Two groups were categorized according to the genders, and four ones (20-30 years, 30-40 years, 40-50 years and 50-60 years) according to the age.Results Between different genders, there was significant difference in right transverse diameter (P0.05).There was no significant difference among four age groups in bilateral transverse diameter (P>0.05).Conclusion Spiral CT is helpful for the evaluation of the diameter of bilateral transverse sinus.These findings can provide anatomical basis for clinical disease with significant implication.
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Objective To investigate the inhibitory effect of a new antihypertensive drug on carotid artery intimal hyperplasia in balloon-injured rats and its possible mechanism.Methods A total of 48 SD rats were randomly divided as follows:sham operation group,model group,low-dose Azilsartan medoxomil group and high-dose Azilsartan medoxomil group(n =12).The rats in sham operateion group and model group were treated by by gavage with 3ml normal saline every day,and rats in low-dose Azilsartan medoxomil group and high-dose Azilsartan medoxomil group were treated by by gavage at adose of 2mg/kg and 4mg/kg Azilsartan medoxomil(3ml) every day.14 and 28 days after operation,we can observe the morphological changes of the injured arteries by HE staining and measure intimal area (IA),medial area(MA),the intimal/medial area ratio (IA/MA).The expression of PCNA,TLR4,NF-κB p65 in each group were detected by immunohistochemistry and the plasma level of TNF-α,IL-6 were detected by enzyme-linked immunosorbent assay (ELISA).Results Compared with the model group,the intimal area and the intimal / medial area ratio were significantly reduced in the low-dose group and hige-dose group (P ＜ 0.05).The expression of PCNA,TLR4 and NF-κB p65 in carotid artery were significantly lower (P ＜ 0.05).The plasma level of TNF-α、IL-6 were significantly lower (P ＜ 0.05).Compared with the sham operation group,the intimal area and the intimal/medial area ratio were significantly increased in the operation group (P ＜ 0.05) and the expression of PCNA,TLR4 and NF-κB p65 in carotid artery were significantly increased (P ＜0.05).The plasma level of TNF-α、IL-6 were significantly increased (P ＜ 0.05).Conclusion Azilsartan medoxomil can alleviate the incidence of vascular restenosis.The mechanism of action possibly was related to reducing the expression of inflammatory factors such as TNF-α,IL-6 by TLR4/NF-κB pathway and inhibiting the carotid artery intimal hyperplasia.