Objective: To understand the gambling relations between the stakeholders of catastrophic medical insurance policy under New Rural Cooperative Medical System ( NCMS) , and provide theoretical references for the smooth operation of catastrophic medical insurance policy of NCMS. Methods:Analyzing the game relationships among the four sides:the government, business insurance agencies, designated medical institutions and participating farmers suffering from catastrophic diseases through game theory. Results: The government and business insurance agency, and the government and designated medical institution belong to cooperative games. The farmers participated in catastrophic medical insurance tend to choose cooperative strategy. Non-cooperative games exist in business insurance agency, designated medical institution and participating farmers. Conclusion: Strategic relationship of close cooperation should be established between the business insurance agencies and designated medical institutions. The government should strengthen the regulatory constraints between the business insurance agencies and designated medical institutionsi, at the same time, it needs to establish the incentive mechanism soon.

Objective To investigate bone mineral density ( BMD ) after filling in the bone scaffolds with anti-tuberculosis controlled-release microspheres, and provide experimental basis for decrease of the side effects of anti-tuberculosis therapy after spinal surgery.Methods The bone densitometer was used to observe the changes of bone mineral density before and after the infusion with the artificial allograft bone (Group A), the controlled release complex of the RFP controlled-release microspheres-artificial allograft bone (Group B), and RFP-artificial allograft bone complex (Group C), respectively.Results BMDs of three groups before perfusion were not different significantly [Group A:(0.191 ±0.018)g/cm2;Group B:(0.186 ±0.016)g/cm2;Group C:(0.189 ±0.018)g/cm2;P >0.05].BMDs of three groups after perfusion were not different significantly [Group A:(0.191 ±0.018)g/cm2;Group B:(0.179 ±0.023)g/cm2;Group C:(0.185 ±0.021)g/cm2;P >0.05].Conclusions RFP microspheres using ultrasonic vibration method and the porous bone were prepared to controlled-release anti-tuberculosis complex .BMD of three groups after perfusion were not influenced obviously .

ObjectiveTo evaluate the efficacy about the different wearing manner with Milwaukee and Boston for the treatment of adolescent idiopathic scoliosis (AIS).MethodsRetrospectively summarization and analysis was performed in 85 adolescent patients with idiopathic scoliosis who were treated from February 2004 to March 2009.The skeletal growth of them had not completed.There were 57 cases who received brace treatment.In them,28 were treated with (CTLSO) Milwaukee brace,and the rest were treated with (TLSO) Boston brace and orthopedic gymnastics.The 30 cases wear regularly used for 21 to 23hours per day,and 27 cases could consist on wearing only 6 to 15 hours per day.The other 28 cases of 85AIS cases were only treated with orthopedic gymnastics instead of orthosis treatment.All patients were periodically observed with lateral side (X)-ray photograph at standing position and photograph,and Cobb angle and Risser sign were measured every 3 to 6 months.Since 2008 all adolescent idiopathic scoliosis patients treated with orthosis were requested to fill with simplified Chinese SRS-22.Results73 cases adolescent idiopathic scoliosis patients were followed up for 2 ～5 years [ mean(26.3 ± 33.7)months ].Milwaukee orthosis group showed the regular wearing group had 91.67 ％ ( 11/12) effective rate and the intermittent wearing group had 56.25％ (9/16) effective rate and the group without wearing orthosis only had 20％ (4/20)effective rate.The group regularly wearing Milwaukee brace had superior effect than the other two groups (P ＜ 0.05 ).Boston orthosis group showed the regular wearing group had 88.89％ (16/18) effective rate and the intermittent wearing group had 54.55％ (6/11 ) effective rate and the group without wearing brace with 25％ (2/8) effective rate.The group regularly wearing Boston brace had better effect than the other two groups ( P ＜ 0.05 ).Due to the different choice of AIS patients and orthosis,the effective rate of the Milwaukee and Boston orthosis was not compared.ConclusionsThe adolescent idiopathic scoliosis patients should insist on regularly wearing brace regardless of the Milwaukee or Boston orthosis ( this article suggest that the wearing time should not less than 21 ～ 23 h/d).The group regularly wearing with the Milwaukee or Boston orthosis had better effect than the intermittent group or the group without wearing brace.It's a good treatment for the AIS patients who have with the indication of orthosis treatment.

ObjectiveTo find out the risk factors causing iatrogenic spinal cord injury (ISCI) so as to provide theoretical support for reducing the spinal cord injury during spinal operation. Methods A retrospective study was done on 120 patients undergone cervical or thoracic spinal( C1-T12 ) surgery at Xiangya Hospital of Central South University from January 2002 to January 2009. The patients were randomly divided into injury group (n = 34) and control group (n = 86) and the univariate analysis was used to analyze 30 factors including clinical factors, iconography factors, operation and pathology factors as well as possible protective factors. Then, the factors with statistical difference were analyzed by using the multi-factor unconditioned Logistic analysis.Results The univariate comparison between the two groups showed statistical difference ( P ＜ 0. 05 ) in nine factors including combined hypertension, combined diabetes mellitus, preoperative ASIA grade, spinal canal stenosis rate, ratio of spinal cord area/efficient area of vertebral canal, spinal cord MRI T2WI high signal, bleeding amount during operation, intraspinal prominence adhesion to dura mate of spinal cord as well as intraoperative use of methylprednisolone. The multi-factor Logistic regression analysis revealed that ASIA grade, value of spinal cord area/efficient area of vertebral canal, spinal cord MRI T2W1 high signal and bleeding amount in operation had positive correlation with ISCI. Use of methylprednisolone during operation had negative correlation with ISCI. ConclusionsCombined diabetes mellitus, ASIA grade, spinal cord MRI T2W1 high signal, ratio of spinal cord/vertebral canal area and bleeding amount in operation are the risk factors for ISCI. Use of large dose methylprednisolone exerts preventive effect on ISCI.