Objective:To study the substitution effect of outpatient services on inpatient services and provide suggestions on designing outpatient policies. Methods:The data were from 13 districts/counties in one area of eastern China from 2007 to 2013 for the new cooperative medical scheme. This study em-ployed a fixed effects model to analyze the impacts of outpatient visit times, expenditure amounts and re-imbursements on inpatient services. Results: One outpatient visit reduced the total amount of inpatient services by 20 Yuan. An increase of 10 000 Yuan outpatient reimbursements saved 9 700 Yuan inpatient expenses. An increase of 10 000 Yuan outpatient expenses led to a decrease of 3 000 Yuan inpatient re-imbursements. The outpatient services did not increase the inpatient hospitalization times significantly. In particular, the effects of the outpatient services were mainly on the inpatient services at the district/coun-ty levels, and no significant impacts on the outpatient services at the city levels. Conclusion:There is a substitution effect of outpatient services on inpatient services. The health insurance departments should take this substitution effect into account and shift more funds on outpatient series, when they design out-patient and inpatient reimbursement policies.

We examined diseases occurring farmed Whitmania pigra(L.) in Hebei province in the aspect of situation of disease,clinical symptoms and pathological changes.In addition,the molecular identification were conducted to representative strain,the 16S rRNA gene was sequenced and compared with that of related strains,molecular phylogenetic tree was constructed.The results showed that the disease was infected by Aeromonas hydrophila.Pure cultures of 10 strains have the same serotype.Selected representative strain was proved to be the corresponding primitive causal agent of the disease by artificial infection experiment to healthy Whitmania pigra(L.).Antibiotic sensitivity of the isolates to used thirty-seven antimicrobial agents showed that the tested strains were high sensitive to cefotaxime et al.,were sensitive to streptomycin et al.,were resistant to oxacillin et al.

Objective:To introduce several international long-term care insurance systems so as to provide references for building China's long-term care insurance system.Methods:Literature of International long-term care insurance system were reviewed to extract and summarize the content so as to provide suggestion and references for China's system construction.Results:It concluded 4 modes of systems for long-term care insurance including the private long-term care social insurance like Netherlands,the public long-term care social insurance like German and Japan,long-term care commercial insurance like America and national long-term care insurance like England.The advantages of different modes could be learned to form Chinese system.Conclusion:The long-term care insurance systems of Netherlands,German,Japan,American could be learned for our system construction,but they also had disadvantages.Therefore,on the basis of the foster strengths and circumvent weaknesses,the reasonable long-term care insurance system was formed.

A lot of single species of bacteria was seperated from the pathological changes position of the liver in sick (or dead) soft-shelled turtle which was infected by septicae-uia. By identifying and the characteristic of physics and chemistry the six single culture strains of bacteria, preliminary showed that it was A. caviae in Aeromonas. Through examination ablut causing illness, it was proved that the A. caviae seperated and appraised was pathogenic bacteria of this infection septcaemia of soft-shelled turtle.

Objective To explore intervention effect of retinoic acid(RA) on hyperoxic lung fibrosis in neonatal rat,and to observe the role of transforming growth factor-?1(TGF-?1)and ?-smooth muscle actin(?-SMA)in hyperoxic lung fibrosis.Methods The SD neonatal rats were randomly divided into 4 groups:air-exposed control group(group Ⅰ),air-exposed and RA-treated group(group Ⅱ),hyperoxia-exposed control group(group Ⅲ),hyperoxia-exposed and RA-treated group(group Ⅳ).The rats of group Ⅲ,Ⅳ were kept in chambers containing 850 mL/L oxygen,the other 2 groups were exposed to air.The rats of group Ⅱ,Ⅳ were intraperitoneally injected with RA [500 ?g/(kg?d)],group Ⅰ,Ⅲ were intraperitoneally given the same dose of oleum lini.At the end of exposure,the lung histophatholoical changes and radical alveolar counts(RAC) were observed by HE staining under light microscope,the degree of pulmonary fibrosis was evaluated by Masson trichrome method and fibrosis score.The protein expression of TGF-?1 and ?-SMA were determined by immunostaining.Results At 14 d of exposure,group Ⅲ resulted in a significant increase in fibrosis score and expressions of TGF-?1 and ?-SMA compared with group Ⅰ,Ⅱ and Ⅳ(Pa0.05).Conclusion TGF-?1 and ?-SMA may have important role in hyperoxic induced lung fiborsis injury,the earlier period intervention of RA can reduce lung fibrosis regeneration and exceptional alveolus development.

Objective To investigate the relationship between metabolic syndrome(MS) and severity of coronary atherosclerosis. Methods Sixty-four hospitalized patients diagnosed as coronary heart disease were divided into MS group(n=26)and non-MS group(n=38).All the patients underwent 16-row multi-slice CT coronary angiography,and cardiovascular risk factors were evaluated. Results The prevalence of MS increased with the number of stenosed coronary arteries(P

Objective To study the chemical constituents of Acanthus ilicifolius. Methods Compounds were isolated and purified on silica gel,SephadexLH -20 and HPLC,and their chemical structures were elucidated by spectral evidence,physical and chemical analyses. Results and Conclusion Nine compounds,named as stigmasta-4-en-3-one(1),stigmasta-4,22-diene-3-one(2),campest-4-en-3-one(3),tigmasta-4-en-3,6-dione(4),Stigmasta-4,22-diene-3,6-dione(5),Stigmasta-4,22-diene-6?-ol-3-one(6),6?-hydroxyl-stigmasta-4-en-3-one(7),3?-hydroxyl-stigmasta-5,22-diene-7-one(8),3?-hydroxyl-stigmasta-5-en-7-one(9),respectively,were obtained from the petroleum ether soluble portion in the methanol extracts of Acanthus ilicifolius. Among them,compounds 4~8 were reported from this plant for the first time,compounds 2,4 and 9 showed moderate activity against selected tumor cell lines.

Objective:To study direct medical cost of hypertensive patients without complicated disea-ses,to analyze substitution impacts of outpatient expenditure on inpatient expenditure,and then to make recommendations to health policy makers and hypertensive patients for managing hypertension.Methods:The claims data of hypertensive patients insured by the rural new cooperative medical scheme in a city in northern China from 2008 to 201 3 were analyzed,descriptive statistics employed to analyze direct medical cost of hypertensive patients and hypertensive patients without complicated diseases which was one of the three groups divided by medical treatment conditions (hypertension without complicated diseases,hyper-tension with complicated diseases,and other diseases),and the differences between groups compared by t test.The fixed effect two-part model was employed to analyze the substitution effect of outpatient services on inpatient services,and specific effects of outpatient times and reimbursement expenses on the inpatient expenditure were calculated by Logistic regression analysis.Results:For the hypertensive pa-tients,the average cost of outpatients was 283.49 Yuan in 2008 and rose to 370.93 Yuan in 201 3.After being divided into three groups,for hypertensive patients without complicated diseases,the average cost of outpatient was 449.79 Yuan in 2008 and rose to 582.53 Yuan in 201 3.In the total cost of the outpa-tient,45.73% was for the hypertensive patients without complicated diseases;in the total cost of the in-patient,only 9.29% was for the hypertensive patients without complicated diseases.By calculating the marginal effect of parameter estimation through the fixed effect two-part model,the inpatient cost could be significantly reduced by increasing the visit times of outpatient utilization or the cost of outpatient reim-bursement.For example,in 201 3,a 1 % rise of outpatient visit times increased outpatient expenditures by 6.48 million Yuan,which could reduce inpatient expenditures by 39.86 million Yuan.The substitu-ted ratio of outpatient cost on inpatient cost had been around 5 in 201 0 and later.Conclusion:The health policy-makers and hypertensive patients should pay more attentions to the substitution of outpatient cost for inpatient cost,especially for the hypertensive patients without complicated diseases whose direct medical cost was mainly due to outpatient rather than inpatient costs.

Anemia, Hemolytic ; etiology ; Humans ; Lupus Erythematosus, Systemic ; complications ; Syndrome

Congenital Hypothyroidism ; diagnosis ; Diagnostic Errors ; Humans ; Infant, Newborn ; Male ; Water-Electrolyte Imbalance ; complications