Study on essential medicine system from the perspective of coordinated with centralized volume-based procurement policy / 中国药房

OBJECTIVE To provide a reference for further improvement of the essential medicine system. METHODS Statistical analysis method and comparative analysis method were used to explain the necessity of coordination between the two systems from the direct correlation and indirect impact of centralized volume-based procurement on the essential medicine system at the present stage. The relevant suggestions were put forward for the development of the essential medicine system in the new era from the perspective of improving institutional synergy. RESULTS & CONCLUSIONS There was a direct correlation between the policy of centralized procurement and the essential medicine system in terms of policy objectives and medicines selection. However， it also indirectly affects the use of essential medicines in medical institutions through production and supply， coincidence degree between the essential medicine list and the selected variety， and the consistency evaluation of generic drugs. It is suggested that in the selection of essential medicine list in the future， priority should be given to the selection of varieties through centralized procurement， and improve the drug supply guarantee capacity under the dual policy linkage； at the same time， incentive assessments for the allocation and use of essential medicines by various entities should be further strengthened to promote the further improvement and development of the essential medicine system.

Differences of endoscopic features between undifferentiated-typed early gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma / 中华消化内镜杂志

Objective:To analyze and compare the features of undifferentiated-typed early gastric cancer (UD-EGC) and gastric mucosa-associated lymphoid tissue(MALT) lymphoma under white light endoscopy (WLE) and magnifying endoscopy-narrow band imaging (ME-NBI).Methods:Data of patients with complete endoscopic images of WLE and ME-NBI in Shanghai General Hospital, Shanghai Jiao Tong University from March 2015 to July 2019 were retrospectively analyzed.Twenty-six UD-EGC patients and seven gastric MALT lymphoma patients in ⅠE1 stage were included, and the characteristics of the two diseases under WLE and ME-NBI were compared and summarized.Results:There were no significant differences in age, sex or infiltration depth of lesions between the two groups.Under WLE, UD-EGC was often manifested as a single lesion located in the lower part of the stomach, with unclear lesion boundaries. While MALT lymphoma lesions were mostly multifocal with clear boundaries, located in the middle of the stomach. Under ME-NBI, the microsurface pattern of UD-EGC showed dilation or disappearance of areas between the recesses, and the spiral microvascular pattern. However, the microsurface pattern of MALT lymphomas were characterized by " cross-road traffic sign" , " pebble sign" , and the presentation of residual glandular duct at the lesion was similar to that of Helicobacter pylori ( HP)-related gastritis. Furthermore, the microvascular pattern of MALT lymphomas often showed " tree like appearance (TLA)" . After HP eradication therapy, the morphology of microsurface pattern and microvascular pattern in the original lesion area gradually returned to normal. Conclusion:UD-EGC and gastric MALT lymphoma showed particular features in the number, site and boundary under WLE, and they showed significantly different microsurface pattern and microvascular pattern under ME-NBI. Differentiation of the two diseases will help reduce the risk of missed diagnosis and misdiagnosis.

Characteristic Analysis and Hepatic Transcriptomics of High-fat Diet-induced Cholesterol Gallstone Model in Mice / 胃肠病学

Background: The mouse model of high-fat diet-induced cholesterol gallstone is widely used in researches of pathogenesis, prevention and treatment of gallstones. Aims: To investigate the characteristics and hepatic transcriptomics of the mouse model of high-fat diet-induced cholesterol gallstone. Methods: Twenty male C57BL/6J mice were randomly allocated into chow diet (control) group and lithogenic diet (LD) group. After 8 weeks, the occurrence of gallstone was observed; the serum lipids and gallbladder bile lipids were detected; and the differentially expressed hepatic genes between the two groups were identified with Illumina NovaSeq sequencing systems. The enrichment analysis was mapped in GO and KEGG pathway databases. Real-time PCR was used to detect the expressions of genes related to bile acid synthesis in the liver. Results: The cholesterol gallstone formation rate was 100% in LD group, whereas no gallstone was observed in control group. Hepatomegaly and steatosis were obvious in mice of LD group. The serum levels of total cholesterol and triacylglycerol, as well as the cholesterol content and cholesterol saturation index of the gallbladder bile in LD group were significantly higher than those in control group (P<0.05). A total of 1 330 differentially expressed genes were identified by high-throughput sequencing and bioinformatics analysis. KEGG analysis showed that the differentially expressed genes were mainly enriched in lipid metabolism, bile secretion, and insulin secretion pathways. GO analysis showed that fatty acid metabolic process-related pathways were significantly enriched. Both hepatic transcriptomics analysis and real-time PCR showed that the expression levels of genes related to bile acid synthesis, including CYP7A1, CYP8B1 and CYP7B1 decreased significantly in the liver of LD group as compared with those of control group (P<0.05). Conclusions: The metabolism of cholesterol, bile acids and fatty acids is significantly disordered in mice with cholesterol gallstone. Transcriptomics analysis can screen out the differentially expressed genes that play roles in the formation of cholesterol gallstone, so as to provide references for studies focusing on these topics.

Analysis of Spatial Distribution and Association Network of Pharmaceutical Industry in the Yangtze River Economic Belt from the Perspective of Social Network Analysis / 中国药房

ABSTRACT OBJECTIVE：To analyze spatial distribution characteristics of pharmaceutical industry in the Yangtze RiverEconomic Belt，and to provide reference for regional pharmaceutical industry planning. METHODS：Based on the central analysis，agglomerated sub group analysis and secondary assignment program analysis of social network analysis，the industrial relevancebetween regional pharmaceutical industry and regional cities were studied（using the image matrix of agglomerated sub group），using regional pharmaceutical enterprises in the Yangtze River Economic Belt as the research object. RESULTS &CONCLUSIONS：The study involved 111 listed pharmaceutical companies in 82 regional cities，and 82 urban nodes formed aregional pharmaceutical industry distribution network，which could generate 8 urban cohesion subgroups，represented by Shanghai，Chengdu and Chongqing；Shanghai and Hangzhou in the Yangtze River Delta，Chengdu and Chongqing in the Chengdu and Chongqing economic circle have more advanced position in network centrality. The centrality of Shanghai was the highest（25.926），followed by Chongqing and Chengdu（both were 19.753）. It shows that the spatial distribution of the pharmaceuticalindustry in the Yangtze River Economic Belt shows a distribution pattern dominated by the Yangtze River Delta urbanagglomeration. At the same time，the Chengdu-Chongqing urban agglomeration also shows a greater influence. The regional citiesplay different roles in industrial development. Chongqing and Taizhou have shown stronger industrial radiation capabilities，while?Shanghai and Hangzhou have shown stronger industrial absorption capacity.

Risk Factors of Gastric Mucosal Intestinal Metaplasia: Gastroscopy and Pathological Analysis of 60 386 Cases / 胃肠病学

Background: Gastric mucosal intestinal metaplasia is one of the pathological manifestations of chronic atrophic gastritis. Early intervention of risk factors contributes to inhibiting the progression of atrophic gastritis to gastric cancer. Aims: To investigate the risk factors of gastric mucosal intestinal metaplasia. Methods: Results of gastroscopy and pathology of 60 386 patients from Jan. 2013 to Sept. 2018 at Shanghai General Hospital were collected. Logistic regression analysis was used to analyze the influencing factors of gastric mucosal intestinal metaplasia. Results: Gastric mucosal intestinal metaplasia was found in 15 318 (25.4%) patients, while bile reflux was found in 6 218 (10.3%) patients. Univariate Logistic regression analysis showed that gender, age, bile reflux and Hp infection were influencing factors of gastric mucosal intestinal metaplasia (P<0.05). Multivariate Logistic regression analysis showed that bile reflux had no effect on gastric mucosal intestinal metaplasia (OR=1.04, 95% CI: 0.97-1.11, P=0.25), however, gender (OR=1.13, 95% CI: 1.08-1.17, P<0.01), age (OR=1.59, 95% CI: 1.56-1.61, P<0.01) and Hp infection (OR=1.25, 95% CI: 1.19-1.31, P<0.01) were risk factors of gastric mucosal intestinal metaplasia. Conclusions: Gender, age and Hp infection are risk factors of gastric mucosal intestinal metaplasia. Bile reflux cannot be considered as the influencing factor of intestinal metaplasia of gastric mucosa.

Cell models and drug discovery for mitochondrial diseases / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Mitochondrion is a semi-autonomous organelle, important for cell energy metabolism, apoptosis, the production of reactive oxygen species (ROS), and Ca homeostasis. Mitochondrial DNA (mtDNA) mutation is one of the primary factors in mitochondrial disorders. Though much progress has been made, there remain many difficulties in constructing cell models for mitochondrial diseases. This seriously restricts studies related to targeted drug discovery and the mechanism and therapy for such diseases. Here we summarize the characteristics of patient-specific immortalized lymphoblastoid cells, fibroblastoid cells, cytoplasmic hybrid (cybrid) cell lines, and induced pluripotent stem cells (iPSCs)-derived differentiation cells in the study of mitochondrial disorders, as well as offering discussion of roles and advances of these cell models, particularly in the screening of drugs.

Research on exporting competitiveness of pharmaceuticals in China / 中国药科大学学报

@#Pharmaceuticals were chosen as the entry point to analyze the status and characteristics of China′s pharmaceutical exports. An export competitiveness evaluation system was comprehensively constructed by selecting the scale, quality and progress of international trade as three dimensions. Net exports, export contribution rate, international market share, display comparative advantage index, competitive advantage index, Michaely index and export advantage growth index as seven indices. In order to avoid the discrepancy caused by the different angles of each index, the indicators were abstracted into two comprehensive ones through principal component analysis, to measure the export competitiveness of the world′s leading countries and regions in pharmaceuticals import and export directly. The result shows that China′s exporting competitiveness of pharmaceuticals ranks the sixth among the 10 major import and export countries in the world. On this basis, dialectical reference is made from Switzerland with strong export competitiveness of pharmaceutical products, in order to promote the long-term development of the export of pharmaceutical products in China.

Analysis of Urban Association of Pharmaceutical Manufacturing Industry in China from the Perspective of Social Network Analysis / 中国药房

OBJECTIVE:To study the spatial distribution characteristics of pharmaceutical manufacturing industry in China. METHODS:According to public data of listed company,social network analysis method was used to analyze the data of listed companies in China's pharmaceutical manufacturing industry in respect of network density analysis(including overall network density and individual network density),network centrality analysis,cohesion analysis,core-edge analysis. The discussion and suggestion was put forward. RESULTS & CONCLUSIONS:As of Sept. 30th,2015,there were 168 listed companies of national A share listed pharmaceutical manufacturing industry. Analysis of social network analysis software showed that the density of spatial city association network in China's pharmaceutical manufacturing industry was 0.021 0,and the network was also much dispersed, among which Beijing,Tianjin and Shanghai had the largest individual network. In network centrality analysis,the point outdegree of the whole network was 1.604% and the point indegree was 1.761%. The point outdegree and point indegree of Beijing were all in the forefront. The betweenness centrality of Beijing,Shanghai,Tianjin and Shenzhen was in high level relatively,and the eigenvector centrality of Beijing,Tianjin,Shanghai,Kunming,Shenzhen and Guangzhou was in high level relatively. Results of cohesion analysis were more comprehensive,the cities in the network could be divided into 8 subgroups. The whole network showed a more obvious core-edge feature. So,the coordinated development of China's pharmaceutical manufacturing industry can be promoted by paying attention to play radiation driving role of industrial center city,promoting coordinated development of regional industry and forming industrial agglomeration network.

Expression of c-FLIPL in Leukemia and Its Clinical Significance / 中国医科大学学报

Objective To investigate the expression of c-FLIPL in leukemia and explore its clinical significance. Methods The expression level of c-FLIPL mRNA in bone marrow mononuclear cells was determined by real-time polymerase chain reaction(PCR)in 103 leukemia patients with different types of leukemia,including 54 cases of acute lymphocytic leukemia(ALL)with 37 newly diagnosed,5 relapsed,and 12 complete remis-sion,38 cases of acute myeloid leukemia(AML)with 24 newly diagnosed,6 relapsed,and 8 complete remission,newly diagnosed 2 cases of acute undifferentiated leukemia(AUL),6 cases of chronic myelocytic leukemia(CML),and 3 cases of chronic myelomonocytic leukemia(CM-ML). The immunophenotype of patients were detected by flow cytometry. Results Expression level of c-FLIPL mRNA was higher in newly diag-nosed and relapsed leukemia patients. There was no significant difference between newly diagnosed and relapsed leukemia patients(P>0.05). Ex-pression level of c-FLIPL mRNA of AUL and CML was higher than that in other patients ,but there was no significant difference(P>0.05). Ex-pression level of c-FLIPL mRNA of all newly diagnosed and relapsed leukemia patients was significantly higher than that in control group and com-plete remission group(P<0.05). The expression level of c-FLIPL mRNA was correlated with risk stratification ,white blood cell(WBC),lactate dehydrogenase(LDH),hydroxybutyrate dehydrogenase(HBDH),CD45 and TEL-AML1,but was not associated with age,sex,fibrinogen and chromosome abnormality. Conclusion c-FLIPL mRNA is highly expressed in leukemia patients ,and is closely related with risk stratification , WBC,LDH,HBDH and prognosis.

Analysis on the feasibility of genechip method in detecting Mycobacterium tuberculosis drug resistance / 国际检验医学杂志

Objective To analyse the sensitivity ,specificity and coincidence rate of genechip method in the detection of resistance to antibacterial agents in Mycobacterium tuberculosis(MTB) ,in order to provide a convenient ,accurate and rapid method for detec‐ting antibacterial resistance in MTB .Methods The DNA sequencing was taken as gold standard ,and antibacterial resistance of the strains of MTB isolated from sputum specimens of 250 cases of patients with tuberculosis from August to December 2014 were de‐tected by using the genechip method and proportion method for susceptibility testing at the same time .Efficacies of the two methods in detecting MTB resistance to rifarnpin and isoniazid were compared .Results The MTB resistance rate to rifarnpin detected by u‐sing the genechip method and proportion method for susceptibility testing was 3 .0% and 3 .5% respectively ;that to isoniazid was 6 .7% and 8 .2% respectively .For detecting M TB resistance to rifarnpin and isoniazid ,the DNA sequencing was taken as gold standard ,the sensitivity ,specificity and coincidence rate of genechip method was higher than those of proportion method for suscep‐tibility testing ,and the test time of genechip method was shorter than that of proportion method for susceptibility testing ,there were statistically significant differences(P<0 .05) .Conclusion Using the genechip method to detecting MTB resistance to rifampin and isoniazid has high sensitivity ,specificity and coincidence rate ,which could replace the proportion method for susceptibility tes‐ting and become an effective method .

CT imaging features of anaplastic thyroid carcinoma / 中华放射学杂志

Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease.Methods The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed.The patients included 7 females and 3 males.Their age ranged from 25.0 to 78 years with median of 61 years.Multi-slices plain and post contrast CT scans were performed in all patients.Results Unilateral thyroid was involved in 6 patients.Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size.Bilateral thyroid were involved in 2 patients.The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm.All lesions demonstrated unclear margins and envelope invasion.The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images.Seven lesions showed varied calcifications,and coarse granular calcifications were found in 5 lesions among them.All lesions showed remarkable heterogenous enhancement on post-contrast CT.The CT value of solid portion of the tumor increased 40 HU after contrast media administration.The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18)and 1.25-1.41 (1.33 ± 0.28)on pre and post CT,respectively.Enlarged cervical lymph nodes were found in 6 cases (60.0％).It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case.Conclusions Relative larger single thyroid masses with coarse granular calcifications,necrosis,envelope invasion,remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma.

Meta analysis on the relationship between cuplike nuclei morphology and FLT3-ITD mutation in acute myeloid leukemia / 白血病·淋巴瘤

ObjectiveTo investigate the association between cuplike nuclei morphology and FLT3-ITD mutation, so as to provide evidence for the minor classification of AML. MethodsThe articles on the association of cuplike nuclei morphology and FLT3-ITD mutation were retrieved by searching international and national databases from 1999 to 2011. The relationship was assessed by meta analysis with Statal 1 software.The OR value and confidence interval(CI)were calculated, and the publication bias was assessed by Begg test and Egger test.ResultsThere was significant difference between cuplike nuclei morphology appearance and FLT3-ITD mutation (OR =2.59,95 ％ CI 1.55-4.33,P =0.00).Results from both Begg' s test and Egger’ s test did not show significant difference indicating that there was no publication bias existed.ConclusionThe uncommon morphologic variant of AML with cuplike nuclei is highly associated with FLT3-ITD mutation, and the presence of cuplike nuclei in AML represents a distinctive morphologic finding that can be used to prioritize the molecular workup of patients with AML.

Clinical significance of determining anti-endothelial cell antibodies and thrombopoietin in the differential diagnosis of ITP and SLE / 中国病理生理杂志

AIM: To study the clinical significance of determining serum anti-endothelial cell antibodies (AECA) and thrombopoietin (TPO) in the differential diagnosis of idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE). METHODS: Serum AECA and TPO in 76 patients with ITP, 41 patients with SLE and 50 normal individuals were detected by ELISA method. RESULTS: Serum AECA level in SLE and ITP was much higher than that in normal group (P0.05), but serum TPO level in SLE was much higher than that in ITP and normal groups (P