Objective To put forward a reform assumption of physician payment model based on review of physician payment models abroad. Methods Literature review and expert interview. Results Physician payment model and its reform patterns overseas were discussed. Problems of current physician payment model in Chinese public hospitals were analyzed. Conclusions The physician payment reform in public hospitals should focus on raising physician salary. The investment of resources and technology of medical service projects should be measured reasonably. Setting up responsibility center , saving health care costs and improve the quality of health care are the most important three aspects of physician payment model reform in Chinese public hospitals.

Objective] The explanations of the six meridians theory in the book Shanghan Lun were always divergent, most of them explained it with medical theory of later ages.However, il ustrating it from the philosophic perspective was not commonly seen. Yi Jing, the book of changes, was the origin of traditional Chinese philosophy, and the six meridian system, which included three yin and three yang, was just derived from the four xiang(a traditional Chinese concept which refers to taiyang, shaoyin, shaoyang, taiyin). [Method] Through the eight trigrams and the images were analyzed with the Treatise on Six Classicsstate gasification combined with analysis Zhongjing Six Classics theoretical system and the principle of prescription. [Result] Found that eight trigrams can be good images of the corresponding six by the system, the difficult provisions in Tretise on Febrile Diseases were wel explained. [Conclusion]Through combining the images of Bagua(eight trigrams) in Yi Jing with six meridians in Shanghan Lun,il ustrating six meridians from philosophic aspect, and explaining the six meridians theory with philosophical ideas before Zhongjing ’s(the writer of Shanghan Lun) age, in order to provide new ways of thinking in comprehending the six meridians system.

Animals ; Neurotransmitter Agents ; metabolism ; Rabbits ; Syncope, Vasovagal ; metabolism ; physiopathology

Objective]To study the correspondence between human and universe theory in Shanghan Lun starting with Zhongjing ’s doctrine of treatment based on four seasons,analyse the influence of the changing seasons on giving names to the six meridians by Zhongjing ,research on the influence of pulse theory based on four seasons in Huangdi Neijing on the pulse system includes the six meridians system ,summarize the rules of the four seasons’ influence on the six meridians system in Shanghan Lun,and return to Zhongjing’s original viewpoint of four seasons and their yin and yang condition. [Method]By studying the Treatise on Four Seasons treatment Dafa Six Classics and veins in the school system, restore Treatise on Heavencorresponding way of thinking. [Result] It finds that seasons law is the core of six distinguished by its Zhongjing school system clock. [Conclusion] Studying the Four Seasonslaw andseasons therapy Dafa can know Treatise on Six by the corresponding season and six by the significance and reflects theTreatise onlearning system from four seasons pulse method.

Objective To evaluate the possible protective effect of isoflurane and propofol on myocardium during off pump coronary artery bypass grafting (CABG) surgery. Methods Twenty-six patients undergoing elective CABG without cardiopulmonary bypass were allocated into propofol group (n=13) and isoflurane group (n=13). Anesthesia was performed in propofol group with propofol plus fentanyl, while isoflurane and fentanyl were used in isoflurane group. Artery blood samples were collected before induction of anesthesia, and during and after the surgery. Plasma troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin-6 (IL-6), and lactate concentrations were determined respectively. Results At the 4 hours after operation, plasma level of cTnI was significantly increased in both groups, and no significant differences were found between them. Compared with baseline values, IL-6 in propofol group showed no significant changes at each endpoint. However, IL-6 values in isoflurane group were significantly higher than those in propofol group during and after surgery (P

Objective To explore the metabolic characteristic of prostate cancer (PCa) in central gland with magnetic resonance (MR) spectroscopic, and evaluate the value of MRS in the differential diagnosis of benign prostatic hyperplasia nodus. Methods MR images were performed in 38 cases with prostate disease by 3.0T MR, 11 cases with PCa in central gland and 27 cases with benign prostatic hyperplasia nodus. All the cases were scanned by routine, then by the combined MRS. MRS findings were reviewed in 27 cases with benign prostatic hyperplasia (BPH) and 11 cases with PCa (3 in central gland origin, 8 with large tumor invading both peripheral zone and central gland). (Cho+Cr)/Cit ratios of PCa and BPH were retrospectively measured, (Cho+Cr)/Cit of PCa voxels were compared with that of BPH voxels. Results Significantly higher choline levels and lower citrate levels were observed in central gland of PCa compared with BPH. In the glandular BPH region, the amount of Cit was high; while in the stromal region, the Cit and Cho level was much lower. The average (Cho+Cre)/Cit values of PCa and BHP were 1.94±1.43 and 0. 83±0. 28 respectively, the difference in ratio between both was statistically significant (P＜0. 01). Conclusions The combined use of MRI and MR spectroscopy is propitious for differentiating prostate cancer in central gland and benign prostatic hyperplasia nodus and for increasing the diagnostic accuracy of prostate cancer.

Objective:To determine berberine and palmatine in Phellodendron chinense Schneid.and its granules.Methods: The reversed-phase ion pair high performance liquid chromatography(RP-HPLC) was used and the validation of the method was tested.The chromatography condition was with Lichrospher C18 column(4.6 mm?250 mm,5 ?m), mobile phase was ACN∶25 mmol/L NaH 2PO 4∶25 mmol/L SDS(2∶1∶1),flow speed was 1.0 ml/min,detection wavelength was 345 nm,and temperature of column was 25℃,Phellodendron chinense Schneid.and its granules were extracted with methanol solution of hydrochloric acid.Results: The theoretical plate number of berberine and palmatine were 14 906 and 14 847,the resolution were 2.33 and 2.86,the tailing factor were 1.09 and 1.06,respectively; all the parameters were suitable for determination.The calibration curves were linear in the range of 40-500 ng,Y=698 278X-3 846,r=1.000(berberine) and 20-250 ng, Y= 536 632X- 7 738, r=0.999 9,r=0.999 4(palmatine).The intra-day and inter-day precision(RSD) at low,middle and high injection amount was all less than 2.5%(berberine) and 1.5%(palmatine).The stability(RSD) was 0.66%(berberine) and 0.70% (palmatine) in 48 h.The recurrence(RSD,n=5) was 0.11%(berberine) and 0.12%(palmatine).The limits of detection was 2.0 ng(berberine) and 1.0 ng(palmatine).The recoveries were 100.4% (RSD=0.12%,n=3) for berberine and 99.80%(RSD=0.22%,n=3) for palmatine.The contents of berberine and palmatine in 3 batch of Phellodendron chinense Schneid.and 5 batch of its granules were determined.Conclusion: Our method can be used for determination of berberine and palmatine in Phellodendron chinense Schneid.and its granules, which is simple and reliable.

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of immunosuppressive cells derived from bone marrow stem cells.MDSCs can not only strongly inhibit the anti-tumor immune reactions mediated by T cells,but also directly accelerate angiogenesis,tumor progression and metastasis.Nonresolving inflammation (NRI),a major driving factor in the occurrence and development of tumor,and MDSCs are present in tumor microenvironment and become hot topics in recent years.However,the relationships between MDSCs and NRI,especially in the relevant molecular regulatory networks,have not been fully elucidated.The relationships between MDSCs and NRI,the molecular regulatory networks,the key regulatory points and the strategies for targeted treatment are reviewed in this paper based on the current literatures and the work achieved by our research team.

AIM: To observe the effect of continuous inhaled nitric oxide (NO) on airway resistance in guinea pigs. METHODS: 36 healthy male guinea pigs were divided into control group, isoproterenol group and two inhaled NO (20?10 -6 and 60?10 -6 ) groups. Respiratory resistance (R_E) and dynamic compliance(C_ dyn )were recorded before and after evoked by histamine at different doses. RESULTS: After injections of intravenous histamine at 80,120 and 160 ?g/kg, the R_E of inhaled NO groups were apparently lower than that of control group. Compared with control group, the C_ dyn of inhaled NO groups were significantly higher after administration of histamine at 80, 120 and 160 ?g/kg. After given histamine at more than 80 ?g/kg,the R_E of inhaled NO groups were higher and the C_ dyn lower than those of isoproterenol group. CONCLUSION: Inhalation of 20?10 -6 NO and 60?10 -6 NO can inhibit the increase in airway resistance induced by higher doses (80,120 and 160 ?g/kg )of intravenous histamine, but the effect of intravenous isoproterenol seems stronger.

Objective To study inflammatory cytokines changes in brain tissue of neonatal rats with periventricular leukomalacia (PVL).Method A total of 80 neonatal SD rats (P3) were randomly assigned into 2 equal groups,sham-operated group and PVL group.Rats in each group were further assigned into four subgroups (12,24,48,72 h),with 10 rats in each subgroup.The hypoxic-ischemic PVL modal were established following the procedure:first,isolation and ligation of left common carotid artery,and then exposed to 8％ O2 and 92％ N2 for 2.5 h.The sham-operated rats were processed with isolation of left common carotid artery only.Rats of the four subgroups were sacrificed at 12,24,48 h and 72 h respectively,then the brains were rapidly removed in corresponding time.Pathological changes of brain tissues were observed using HE stain.The mRNA expression levels of tumor necrosis factor α(TNF-α)and inter leukin-1β (IL-1β) were assessed using real-time quantitative PCR assays,the protein levels of TNF-α and IL-1β were detected using enzyme linked immunosorbent assay method.Result The brains tissues of rats in PVL group showed remarkably hyperemia and edema,with left ventricle enlargement.Periventricular white matter structure was disintegrated comparing with sham-operated group.The expression of TNF-α and IL-1 β mRNA in PVL group increased significantly,reaching peak by 24 h and then gradually decreased 72 h after the procedure.The mRNA levels of TNF-c and IL-1 β were significantly different between each two time points of 12,24 h and 48 h in PVL group (P ＜0.05).However,there was no differences between 72 h and 48 h within PVL and sham-operated group group(P ＞0.05).In PVL group,the protein expression trends of TNF-α and IL-1 β were similar to mRNA expression trends.Moreover,the protein levels were significantly different between each two time points of TNF-α and IL-1 β,respectively (P ＜ 0.01).The protein expression levels of TNF-α were different at each time point between PVL group and sham-operated group[(189.2 ± 20.4) pg/ml vs.(131.4 ±5.2) pg/ml at 12 h,(213.8 ± 16.7) pg/ml vs.(127.7 ±7.4) pg/ml at 24 h,(181.7 ± 15.0) pg/ml vs.(126.3 ± 6.0) pg/ml at 48 h,(159.6 ± 25.3) pg/ml vs.(131.4 ± 6.0) pg/ml at 72 h;P ＜0.01].The protein levels of IL-1β were different between the two groups only at 24 h and 48 h.[(121.8 ±30.0) pg/ml vs.(67.4 ± 13.7) pg/ml,(83.3 ± 15.7) pg/ml vs.(65.3 ± 14.9) pg/ml;P ＜0.05].In sham-operated group,no differences of TNF-α and IL-1 β protein levels were found between any different time points (P ＞ 0.05).Conclusion Inflammatory cytokines such as TNF-α and IL-1β are involved in ischemic-hypoxia induced PVL.Dynamic detection of inflammatory factors is expected to be an important method of early diagnosis,assessment of treatment efficacy and prognosis of PVL.