This paper reviews outpatient security policy of typical developed countries .It provides reference for outpatient security system in China .Analysts believe that the experience for Chinese reference should be acquired in the following ways:The pooling of outpatient service is an inevitable trend in the development of health insurance , which is in principle an integral part of payment and financing system; the implementation of outpatient community first diagnosis system should be adapted to the local conditions; the community first diagnosis system is a necessary condition for capitation , so it is closely related to compensation methods and the elaborate degree of outpatient treat -ment catalog;Outpatient services should be supervised and payment policies should be developed respectively .There are two supervision models about outpatient service:external supervision and self supervision , but the key is to focus on the management of outpatient doctors .External regulation should be consistent with the current regulatory approach of the situation and patients have to bear some responsibilities for outpatient treatment expenses in some proportions , but the payment cap line should not to be low .The implementation of certain preferential policies for vulnerable groups can be considered under the harmonized system to partially reduce their medical expenses .

Objective:To compare the dissolution of domestic terazosin hydrochloride tablets and capsules to provide reference for clinical use. Methods:The dissolution of the products from different manufacturers was investigated respectively in 4 kinds of media:pH 1. 0 hydrochloric acid solution,pH 4. 5 phosphate buffer solution,pH 6. 8 phosphate buffer solution and water. The dissolution tests were carried out by a paddle method at the stirring speed of 50 r·min-1 and an HPLC method was used to determine the dissolution rate. The dissolution behavior of the samples from different manufacturers was compared by a similar factor method. Results:The do-mestic tablets showed higher similarity with the reference formula, and the dissolution behavior of the capsules had significant differ-ence. Conclusion:The calculation method for the specification in some manufacturers is different from that of the reference prepara-tion, which leads to the difference between the testing preparation and the reference preparation, and should be paid attention in clini-cal use.

Occupational Health

OBJECTIVE:To probe into the status quo and requirements of drug utilization in Haiqin Sanatorium Area of Nanjing Military Region Hangzhou Sanatorium.METHODS:The drug utilization in 710 convalescents in Sanatorium Area from May 2007 to April 2008 was analyzed statistically.RESULTS:A total of 10 categories of drugs were used in the 710 convalescents,chiefly including anti-cold drugs,antihypertensive drugs,drugs for external use,antimicrobial agents,ophthalmic drugs,otorhinolaryngological drugs,vitamins and gastrointestinal drugs.The rate of drug use conforming diagnosis was 87.32%.Oral administration occupied 71.13%.CONCLUSION:The drug utilization in convalescents in Haiqin Sanatorium Area is basically rational.However,there are also some unreasonable points in the drug utilization which remain to be tackled further.

Objective To design a new presigmoid translabyrinthine keyhole approach assisted by Stryker neuro-navigation system according to the keyhole idea,and observe microscopic anatomy structures, which could be.regarded as the bases of this approach in clinical application.Methods Navigation data were established on 8 cadaveric heads fixed by formalin and perfused intracranial vessels with colored silicone. A 7-cm postauricular C-shaped skin incision as we reported was performed.After elevating the skin flap and musculofascial flap,a 3.5 cm?3.0 cm bone window was made.On skeletonizing the sigmoid sinus,bony lab- yrinth and the canal for facial nerve,the presigmoid retrolabyrinthine,partial labyrinthectomy with petrous api- cectomy,translabyrinthine keyhole approaches were simulated in turn.The length of important structures ex- posed and the angle of vision were measured step by step, and the anatomic structures were observed.Re- suits The approach-correlated bone could precisely be drilled with the aid of neuro-navigation,which could avoid the bewilder in drilling process.The angles of visual field,the length of clivus andⅦcranial nerve were significantly increased after partial labyrinthectomy with petrous apicectomy or all labyrinth removal,but there were no significant difference between partial and all labyrinth removal.The retrolabyrinthine keyhole approach spares hearing and facial function but provided for limited window of petroclival region exposure.The partial labyrinthectomy with petrous apicectomy keyhole approach provided wider exposure to petroclival region,cere- bellopontine angle,prepontine region and posterior cavernous sinus;an area between theⅢ-XI cranial nerves was easily visible with an excellent chance of hearing and facial nerve preservation.The translabyrin- thine keyhole approach,producing more morbidity,provided for greater versatility in treating lesions,added little exposure of petroclival region.Conclusion The presigmoid translabyrinthine keyhole approach,which could provide excellent exposure of the petroclival region,was feasible to be performed in our study.The ap- proach-correlated bone could be precisely removed assisted by neuro-navigation system.The exposure was oh- viously increased hy partial labyrinthectomy with petrous apicectomy or all labyrinthine removal,the former provided an excellent chancre of hearing and facial nerve preservation.

Objective To determine the minimum alveolar concentration(MAC) of sevoflurane without body movement during laryngeal mask airway(LMA)intubation in premature infants less than 37 weeks of corrected gestational age undergoing total inhalation general anesthesia induction.Methods Twenty-one ASA Ⅰ or Ⅱ premature infants less than 37 weeks of corrected gestational age undergoing elective inhalation general anesthesia were enrolled in this study.At first,the general anesthesia induction was started by inhaling 6 ％ sevoflurane.After the premature infant lost consciousness,the end tidal sevoflurane concentration(ET-sev)was adjusted to the predetermined concentration and maintained stable for 15 min.After that,LMA was inserted.The up-anddown sequential allocation was used to determine MAC.The initial ETsev was 2 ％,which was increased or decreased by 1 gradient concentration in the next case according to the LMA insertion body movement response.The adjacent concentration gradient was 0.2％.The midpoint from th body movement response to non-body movement response was set as the balance point and the mean value of the concentrations of sevoflurane at all the balance points were calculated as MAC.Results The end tidal sevoflurane con centration without the body movement responses to LMA insertion was 1.71％.Conclusion The MAC of sevoflurane without the body movement responses to LMA insertion in premature infants less than 37 weeks of corrected gestational age is 1.71％,which is lower than that in the normal children and probably because imperfect central nervous system development in premature infants.

OBJECTIVE: To prepare double-layer sustained release ornidazole films and investigate its release rate in vitro.METHODS: The double-layer sustained release ornidazole films film were prepared by the method of homogenate.The formula of the films were optimized by orthogonal experiment with the mass ratio of polyviol to CMC-Na(factor A),the total amount of polyviol and CMC-Na(B) and the amount of glycerol(C) as factors.The concentration of ornidazole was determined by ultraviolet spectrophotometry and its release rate was also computed.RESULTS: The double-layer sustained release film was well-shaped.The optimized formula of the film was as follows: factor A=1∶1,B=4.5 g,C=4.0 g.The standard curve of ornidazole was linear within a range of 1～20 ?g?mL-1(r=0.999 5,n=6),with an average recovery of 100.3%(RSD=1.3%,n=5).A continuous releasing of 11.0 hours was achieved for the prepared films and its cumulative release amount in vitro within 8 hours reached 81.50%.CONCLUSIONS: The preparative method of the films was simple,and the film had a slow-release property.

ObjectiveTo observe and explore the effects ofJiakangning Capsules on the expression of ERK1/2 gene and proliferation of FRTL-5 by studying the effects ofJiakangning Capsules collaborated with siRNA on interfering ERK1/2 gene in FRTL-5.Methods FRTL-5 cells in good conditions were divided into control group, negative control group,Jiakangning Capsules collaborated with siRNA group, siRNA interference group, and Jiakangning Capsules group. RT-PCR was performed to detect the expression of ERK1/2 gene in mRNA levels in FRTL-5; Western blotting was performed to detect the expressions of ERK1/2 and p-ERK1/2; CCK8 method was used to detect cell proliferation.Results RT-PCR results showed that the ERK1/2 mRNA expression of the control group and negative control group were of no significant difference (P>0.05); compared with the control group, siRNA interference group andJiakangning Capsules group could inhibit ERK1/2 gene mRNA expression in FRTL-5 (P<0.01). Compared with the control group and negative control group, the ERK1/2 mRNA expression of Jiakangning Capsules collaborated with siRNA group decreased obviously (P<0.01). Compared with the control group and negative control group, the expression of p-ERK1/2, ERK1/2 ofJiakangning Capsules group, Jiakangning Capsules collaborated with siRNA group, and siRNA interference group decreased obviously (P<0.01). At the time of 24 h and 48 h after transfection, according to the results of CCK8, compared with the control group and negative control group, the cell proliferation ofJiakangning Capsules group, Jiakangning Capsules collaborated with siRNA group, and siRNA interference group was inhibited (P<0.01).Conclusion Jiakangning Capsules have blocking effect on the phosphorylation of ERK1/2. After ERK1/2 gene was silenced, the thyroid cell proliferation was inhibited. Jiakangning Capsules can collaborate with ERK1/2-siRNA to inhibit FRTL-5 cell proliferation.

The experiment was conducted at the Basic Laboratory of Integrated Traditional Chinese and Western Medicine, Chengdu University of TCM from March 2005 to March 2006. A total of 40 BALB/C male mice aged 6-8 weeks were selected, and randomly assigned into 4 groups: bcl-2 control group, bcl-2 experimental group, cmy-c control group and cmy-c experimental group with 10 in each group. From the first day of experiment, all the mice were treated with 5 g/L cyclophosphamide solution by intraperitoneal injection for successively 5 days, 6 mL/kg per day. From days 11 to 12, the mice in the bcl-2 experimental group and cmy-c experimental group received Danggui buxue tang by gastric perfusion, 6 mL/kg per day for 10 days. The mice in the control group received saline of the same volume. At day 20, all the mice were killed to obtain bone marrow cells of one side femoral bone of mice. The smear received bcl-2 in situ hybridization immunohistochemical staining after centrifugalization and washing in the bcl-2 control and bcl-2 experimental group. The smear received cmy-c in situ hybridization immunohistochemical staining after centrifugalization and washing in the cmy-c control and cmy-c experimental group. Five fields of each section were red into image analyzer. The sum of positive cell area and the sum of integral absorbance in each field were analyzed. The results showed that the sum of positive cell area was (16.11?3.01)?102 ?m2, and the sum of integral absorbance was (19.9?2.42)?105 in the bcl-2 experimental group. Compared with the bcl-2 control group, there was significant difference (P

Objective:To observe the expression of P70 S6 kinase(P70 S6K) in parotid acinic cell carcinoma. Methods:P70 S6K expression was examined by means of SP immunohistochemical technique and Western blot test in 30 cases of parotid acinic cell carcinoma. Results:Western blot revealed that P70 S6K expression in parotid acinic cell carcinoma was 58% higher than that in normal parotid tissue. Immunohistochemical assay showed that positive expression ratio of P70 S6K in parotid acinic cell carcinoma and in normal parotid tissue was 100.0% and 33.3%(P