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OBJECTIVE To provide reference for the regulation of electronic prescription circulation under the mode of “medical science + pharmacy”. METHODS Based on evolutionary game theory， a tripartite evolutionary game model was constructed for related parties of electronic prescription circulation （government agencies， internet hospitals and third-party drug platforms） under the mode of “medical science + pharmacy”. The influential factors of the three parties’ strategy selection were analyzed and verified by simulation. RESULTS & CONCLUSIONS The strategic choices of all parties in the game were affected by the other two parties. Reducing the cost of strict supervision or increasing the punishment for the other two parties would increase the probability of strict supervision of government agencies. Enhancing reputation losses， increasing penalties， and reducing the cost difference when choosing different strategies would have regulatory and binding effects on internet hospitals and third-party drug platforms. It is suggested that government agencies can introduce diversified supervision mode and establish an integrated “intelligent supervision + traceability” system； pay attention to the construction of reputation mechanism， and promote the coordinated linkage of all parties； increase the punishment for violations， provide policy support， reduce the cost of compliance behavior to promote the high-quality development of electronic prescription circulation under the mode of “medical science + pharmacy”.
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Objective:To investigate the influence of inhibitor of kappa B kinase ( IKK) inhibitor on carotid artery restenosis in rat by balloon catheter injury. Methods: A total of 32 male Wistar rats were randomly divided into control group, injured group and med?icine group. The balloon catheter injury was performed on left common carotid artery of rat by imitating the process of angioplasty. In?jured group and control group were injected saline, medicine group were injected IKK inhibitor. After 15 days, the process of neointi?mal and media hyperplasia was observed by HE staining and the expression level of NF?κB, IKK, inhibitor of nuclear factor kappa B ( IκB) was detected by Western blot, the content of IL?6, TNF?αwas detected by radioimmunoassay, and the content of MMP?1 was determined by MMP?1 kit. Results: Arterial neointima hyperplasia hapened in 3 groups. There was significantly difference between control group and medicine group and injured group in intimal area, the expression level of NF?κB, IKK, IκB, and the content of IL?6, TNF?α and MMP?1 ( P<0?05 or 0?01) . There was no significance in these indexes between control group and medicine group ( P>0?05) . Conclusion:IKK inhibitor can reduce the carotid artery restenosis after balloon injury by inhibiting inflammatory reaction induced by IKK?IκB?NF?κB pathway.
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Children without company of parents in pediatric intensive care unit,often irritable crying,injured,or scratching themselves,pulling in all kinds of wire and/or catheter on the body,and even adverse events,such as dropping of bed.To ensure the safety of the children,we invent a multifunctional strait-jacket,and it is applied in clinic in order to solve the above problems.The structure of this strait-jacket is open,easy to install wire and all kinds of operation;shoulder,cuff with button loops fix bed guardrail by a rope,to prevent the roll shift;cuff with double fold gloves can avoid scratch the skin,remove the line,having the effect of palm warm;waist adding two constraints,not improving constraints on the waist but abdomen to keep warm.By clinical application,this strait-jacket improves the comfort of the constraint,can prevent the occurrence of complications due to improper constraints,such as skin abrasions,physical damage,blood circulation obstacle,alleviate the pain for the children.
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BACKGROUND:Mental material has shadow intervention effects on multi-slice helical CT (MDCT).Mental wall thickness and lumens inner diameter in stent structure can significantly affect longitudinal axis imaging quality of MDCT target vessel stent.However.there are few studies involved in this aspect.OBJECTIVE:To analyze the effect of various coronary stent materials and structures on patency images of target vessel by MDCT evaluation,and to provide clinical evidences for improving stent technique.DESIGN,TIME AND SETTING:The comparison observation was conducted at the Shenzhou Hospital,Shenyang Medical College.and Shengjing Hospital,China Medical University from January 2006 to December 2008.PARTICIPANTS:A total of 139 patients with coronary heart disease who were treated with stent implantation were divided into material and construct groups (227 stents were implanted).There were 92 stainless steel stents,135 nick-eltitanium alloy stents,85 thin mental wall stents (<140μm).142 thick mental wall stents (≥140μm).71 small diameter stents (<3 mm),and 156 big diameter stents (≥3mm).METHODS:During following up,patients were checked using 64-slice helical CT and routine coronary arteriongraphy to compare patency images of target vessels in the two groups.MAIN OUTCOME MEASURES:MDCT was scored by four-mark standard to evaluate sensitivity,specificity,accuracy,positive and negative predictive values of MDCT.RESULTS:A total of 227 stents were implanted into 139 patients.CT images of stainless steel stent group were poorer than nickel-titanium alloy group,and the indicators including image score,sensitivity,specificity,positive and negative predictive values of the stainless steel stent group were significantly less than nickel-titanium alloy group (P<0.05).CT images of thick-wall stent were poorer than thin-wall stent,while the indicators including image score,sensitivity,specificity,positive and negative predictive values of the thick-wall stent were significantly less than thin-wall stent (P<0.05).CT images of small-diameter stent were poorer than large-diameter stent,while the indicators including image score,sensitivity,specificity,positive and negative predictive values of the small-diameter stent were significantly less than large-diameter stent (P<0.05).CONCLUSION:Materials,wall thickness and diameter of coronary stent may influence images of target vessels via MDCT evaluation.
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Objective To discuss the reasons for and preventive methods of acute encephalocele during traumatic cerebral operation.Methods Retrospective analysis of 38 patients with acute encephalocele was made.Results The main cause of acute encephalocele were delayed intracranial hematomas,acute diffuse brain swelling,cerebral contusion and laceration in Sylvain tissue and ischemic anoxia.Conclusion Complete removal of hematoma and delayed hematoma,sufficient decompression and decrease of ICP are effective methods for prevention and treatment of acute encephalocele.
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Objective To identify the factors influencing the response to clopidogrel.Methods Seventy-two patients with acute coronary syndrome who were treated at Beijing Tongren Hospital from September,2005 to April,2006 were eligible for this study.10 ?mol/L ADP induced platelet aggregation was measured before and 7 days after clopidogrel treatment by the traditional optical aggregometry.According to the inhibition of platelet aggregation(?A),the population was divided into low response group and normal response group.Then some factors possibly influencing the response to clopidogrel were analyzed by specific statistical methods.Results Baseline characteristic showed that compard with that of normal response group,the body mass index and the percentage of obesity and STEMI were lower in low response group,while its percentage of hypertension and diabetes were higher(P