There are serious moral hazards in medical insurance because of information asymmetry.Moral hazards can make different degree influence on the medicare supply,demand and supervision of usage.From the 1960s,scholars have much research and discussion on the different main body that be of moral hazard,on the influence of moral hazard to welfare,on the measure of moral hazard and on the methods that how to control moral hazard.This paper summarizes the related viewpoints and conclusions that come from the above four aspects.

Objective: To explore the medical service price regulation of theoretic model and reform trends in China. Methods:Qualitative method. Results:Medical care is the service that mix the nature of public service and private service. The price regulation of medical care includes the regulation of price level and price structure. The asymmetric information, equality, externality and monopoly of the medical care are the reasons to implement the price regulation. Ramsey pricing model, investment rate of return pricing model, the price-cap model, yardstick price regulation model and Feldstein pricing model are the general models to implement the price regulation of medical care. Conclusion: China should reform and modify the current price level and structure of medical care based on the above models.

Objective To investigate the application of three dimensional blood vessel angiography(3D-CTA) in the patients of spontaneous subarachnoid hemorrhge diagonised as aneurysm.Methods 3D-CTA were examined in 32 cases of spontaneous subarachnoid hemorrhage.Results In 32 patients of spontaneous subarachnoid thirty patients were diagnosed as aneurysm.Two cases were not diagnosed.Conclusion 3D-CTA may be the first examination method in spontaneous subarchnoid hemorrhage.

Objective To investigate the effects of chrysin(ChR) on the induction of differentiation and apoptosis-promoting of HepG 2 human primary hepatocacinoma cells. Methods The HepG 2 cells were cultured in vitro, and then treated with ChR and all-trans retinotic Acid (RA), respectively, the alterations of nucleocytoplasm and tubulin arrangement after Gimsa staining and Coomassie brilliant blue staining were observed. The survival rate and the inhibitory rates of HepG 2 cells were determine by trypan blue counting method and MTT assay. The Alpha-fetoprotein(AFP) secretory amounts of the cells were detected by radioimmunoassay(RIA). The activities of alkaline phosphatase(ALP) andγ-glutamyltranspeptidase(γ-GT) were assayed by enzymatic reaction kit. The synthesis of tyrosine-α-ketoglutaric acid transaminase(TAT) in cells were investigated by Diamondstone spectrophotometry. Results After treatment with ChR or RA at 1.0~100μmol/L for 48 h, the proliferation of HepG 2 cells were inhibited significantly, compared with vehicle group (P<0.05 or P<0.01), the inhibitory potency of both ChR and RA on HepG 2 cells was equivalent and indicated in dose-dependent manner. After treatment with 10μmol/L ChR or RA for 48 h, HepG 2 cells disaggregated and grew to spindle-shape, their nuclei became smaller and the number of nucleolus were fewer. Furthermore, tubulin arrangement of cells tended to be more ordered and the tubulin synthesis increased significantly. At 24~96 hours treated with 10μmol/L ChR, the activities of TAT and ALP in cells were all increased distinctly (P<0.05, P<0.01), and the secretory amounts of AFP and the specific activities ofγ-GT were decreased significantly (P<0.05, P<0.01). Conclusion Chrysin can inhibit the proliferation of HepG 2 cells and induce them to differentiate to mature cells.

Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86％,which was significantly higher than of the control group(76.79％.P＜0.05).The incidence of MODS and complications were 0％ and 26.79％ respectively,which were significantly lower than those of the control group(P＜0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P＜0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P＞0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P＜0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P＜0.01).The favorable prognosis of observation group was 80.36％,which was significantly higher than that of the control group (62.50％,P＜0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.

Objectives:B type ultrasonic diagnosis instrument is used to measure the sebum thickness and the relevance vs evaluated with sebum thickness calipers in sebum thickness determination. Methods:The study included 219 healthy adult persons and 11 cases of corpse dead of non disease reason for less than 10 hours.The measurements of sebum thickness were made by B type ultrasonic diagnosis instrument and sebum thickness calipers respectively. Results:The measurement results of two different methods were not significantly different. Conclusions:It is feasible to use B type ultrasonic diagnosis instrument for the measurement of the sebum thickness in clinic.

Military pilot selection is an effective way to lower the training cost, ensure the safety of pilots and aircraft, and improve the military efficiency, which involves a comprehensive evaluation of medical fitness, psychology and flying aptitude of a pilot candidate.The concept and classification of comprehensive evaluation methods were introduced in this paper.Comprehensive evaluation methods used in domestic and overseas military pilot selection were reviewed.Finally, suggestions on the research and application of the military pilot selection system in China were raised.

Objective To analyze the clinical and laboratory characteristics of the ischemic stroke in patients with non-valvular atrial fibrillation (AF), and to provide evidence for the prevention of ischemic stroke. Methods A total of 198 patients with ischemic stroke were chosen and divided into two groups:with AF (71 patients)/and without AF (127 patients) groups. Clinical data and biochemical markers were collected and compared in two groups. CHADS2 and CHA2DS2-VASc score systems were used to determine the risk levels in patients with AF. Finally, related risk factors of ischemic stroke with AF were determined and analyzed. Results The values of age, length of hospital stay, the hypertention history, heart rate and plasma homocysteine (Hcy) were significantly higher in the with-AF group than those in the without-AF group ( P <0.05). The levels of total cholesterol (TC), triglyceride (TG) and very low density lipoprotein cholesterol (VLDL-C) were sig?nificantly lower in the with-AF group than those of the without-AF group (P<0.05). CHA2DS2-VASc scores reached to the moderate-to-high risk level in the with-AF group. Multiple-factor logistic regression analysis showed that age and heart rate were the independent risk factors of the ischemic stroke in patients with non-valvular AF. ROC analysis indicated that age (AUC=0.761, cut-off point=72.50 years old) and heart rate (AUC=0.612, cut-off point=76.50 bit/min) had predictive and di?agnostic value for the ischemic stroke in patients with non-valvular AF. The age of these patients had the best sensitivity (70.4%) and specifity (71.1%), and the cut-off point of which was 72.50 years old. Conclusion The characteristics of isch?emic stroke in patients with non-valvular AF includes older age, faster heart rate, higher CHA2DS2-VASc scores and higher Hcy level.

Objective To study the effect of dopamine receptors on neurological and physiological activities. Methods Dopamine D1 receptor gene (DRD1) knockout mice and dopamine D3 receptor (DRD3) gene knockout mice were introduced, and double gene knockout mice were bred in our lab.Seven SPF male mice in each group were used in this experiment.The food intake, water intake, body weight gain for 24 hours were tested on the age of 30 d, 50 d, and 70 d and were compared with those of wild type mice.Results DRD1 gene and DRD3 gene showed significant effect on the body weight in mice in age of 21 day and 35 day, but at the age of 90 day, the differences became insignificant among the mice of various genetypes.Conclusions Dopamine may effect on the foraging and satiety in newborn mice through regulating the hypothalamic-pituitary-adrenal ( HPA ) axis activity, and finally leads to a reduced body weight gain in newborn mice and puppies during lactation.Furthermore, DRD1 gene and DRD3 gene may influence on body weight of newborn mice through regulating mothers’ lactation, lead to a lower body weight at ablactation, and compensatory increase of body weight after ablactation.Our results provide a substantial foundation for studying the function and interaction of DRD1 and DRD3 genes.

Objective Folate receptors ( FRs) , overexpressed on the surface of a variety of tumor cells , are potential targets for tumor targeting therapy .This study aimed to prepare an FR-mediated drug nanocarrier with folate conjugated pullulan acetate ( FPA) to target chemotherapeutic agents to FR-overexpressed tumor cells and investigate its tumor-suppressing effect in vitro. Methods The cytotoxicity of epirubicin-loaded FPA nanoparticles ( FPA/EPI NP) against HepG2 and Hela cells was evaluated by MTS assay.The HepG2 and Hela cells were divided into five groups to be treated with NPs (NP control), chlorpromazine, chloro-quine, amiloride, and folate, respectively, followed by detection of the fluorescence intensity by flow cytometry . Results FPA/EPI NP was successfully formulated into NPs , with the mean particle size of (268.5 ±12.0) nm, by dialysis with an almost spherical shape . The drug-loading rate and entrapment rate of FPA/EPI NP were (6.45 ±1.04) and (72.45 ±11.50) %, respectively.The survival rates of the HepG2 and Hela cells were both >95%after 24 hours of incubation with FPA NP at 5, 40, 200, 400 and 1000μg/mL and 90.0%after 72 hours.The survival rates of the HepG2 cells treated with 5, 40, 200, 400 and 1000μg/mL FPA/EPI NP for 24 hours were (92.3 ±5.2), (70.4 ±4.6), (50.0 ±4.0), (41.1 ±4.1) and (27.0 ±3.6) %, respectively.Compared with the NP control group, the Hela cells of the chlorpromazine , amiloride and folate groups showed a significantly lower rate of NP uptake (P<0.05), and so did the HepG2 cells pretreated with chlorpromazine or amilo-ride (P<0.05).At 72 hours, the half maximal inhibitory concentrations (IC50) of FPA/EPI NP against HepG2 and Hela cells were 168 and 105μg/mL, respectively . Conclusion Clathrin-mediated endocytosis and macropinocytosis are involved in the internaliza-tion of FPA/EPI NP in HepG2 cells, while clathrin-and FR-mediated endocytosis in that of Hela cells .FPA NP may serve as a new drug carrier for tumor-targeted therapy .