Based on the related theories of physician behavior analysis, summarize and discuss the incentives mechanism of supplier payment on physician behavior and its inner mechanism, provide theoretical supports and political suggestions for further analysis on payment reform.

BACKGROUND:Nano bone putty and bone cement injection are two common methods to strengthen the fixation of pedicle screws, but there are relatively few reports on the comparison of their strengthening effects. OBJECTIVE:To compare the biomechanical characteristics of bone cement and nano bone putty strengthening pedicle screw implantation in the fixation of osteoporotic vertebral body. METHODS: Totaly 24 human cadaveric pedicles were obtained, which were al in line with osteoporosis standards, and randomly divided into 3 groups: control group (only implanted pedicle screws), bone cement group (first injected bone cement in the nail channel, and then implanted pedicle screws) and nano bone putty group (first injected nano bone putty in the nail channel, and then implanted pedicle screws). After 2 hours of implantation, the maximum axial pulout strength and the maximum rotation torque of specimens in each group were determined. RESULTS AND CONCLUSION:The maximum axial pulout strength and maximum rotation torque of the bone cement and the nano bone putty groups were greater than those of the control group (P < 0.05), and the maximum axial pulout strength and the maximum rotation torque of the bone cement group were greater than those of the nano bone putty group (P < 0.05). These results demonstrate that the maximum axial pulout strength and the maximum rotation torque of pedicle screw implantation in the fixation of osteoporotic vertebral body can be effectively improved by injection of bone cement and nano bone putty, and the strengthening effect of bone cement is more obvious. 

OBJECTIVE:To study the anti-inflammatory effect of ethanol extract of Polygonum multiflorum METHODS:To observe the oedema severity and vaso-permeability in inflamed animal and the response of animal to pain induced by acetate acid after the ethanol extract of Polygonum multiflorum had been intragastrically given for 3 days RESULTS:The oedema severity and vaso-permeability were obviously decreased by the ethanol extract of Polygonum multiflorum and this effect could last 4 hours At the large dose,analgesic effect was observed CONCLUSION:The ethanol extract of Polygonum multiflorum exhibits intensive anti-inflammation effect and the mechanism may be related to its immuno-depression effect

Electrophysiological studies have shown that the spinosolitary tract-dorsal column postsynaptic (SST-DCPS) neurons may project to both the dorsal column and solitary tract nuclei. In order to demonstrate the neurons morphologically, fluorescein dyes, PI and Bb, were injected into the dorsal column nuclei and the solitary tract nucleus respectively. A total 282 cells were found to be retrogradely labeled in the spinal dorsal horn in 10 adult rats. Of them, 51 (18%) cells were PI-Bb doubly labeled; 120 (43%) were PI labled alone; and 111 (39%) were Bb singly labled. Most of these double-labled cells were concentrated in laminae III-V. The existence of double projection neurons that project to both the dorsal column and solitary tract nuclei, namely the physiologically identified SST-DCPS neurons, is morphologically confirmed in the present study. These neurons may transmit information to both visceral and somatic sensory nuclei, indicating they may play an important role in the convergence of somato-visceral afferents.

Objective:To explore the effect of infection on autophagy-related proteins,Beclin-1 and LC3,expression in cerebral white matter in newborn rats.Methods: A total of 64 two-day-old Sprague-Dawley(SD) rats were randomly divided into control and experimental groups(n=32 each).At day 2 to 6 after birth,the rats in experimental group were intraperitoneally injected with 0.6 mg/kg of lipopolysaccharide(LPS) once a day to establish a white matter injury induced by infection in neonatal rats while the rats in control group were injected with equal amounts of normal saline.Rats were sacrificed to collect brain tissues at 12 hour,1,3,5 d after model establishment.HE staining was performed to observe the pathological changes.Changes in the expression of Beclin-1 and LC3 in rat white matter were examined by Western blot and RT-PCR.Results: Growth and development of rat in experimental group was slow,cerebral white matter lesions were obvious.Compared with the control group,the experimental group Beclin1 and LC3 protein and mRNA levels in the model after 12 h began to express,1 d reached the peak,and then decreased,each time points were higher than the control group(P<0.05).Conclusion: Early infection in neonatal rats can cause white matter damage;the expression of autophagy-related proteins,Beclin1 and LC3,showed that autophagy may be involved in the pathological process of white matter damage induced by infection.

Safety assessment in clinical trials is dependent on an in-depth analysis of the adverse events to a great extent. However, there are difficulties in summary classification, data management and statistical analysis of the adverse events because of the different expressions on the same adverse events caused by regional, linguistic, ethnic, cultural and other differences. In order to ensure the normative expressions, it's necessary to standardize the terms in recording the adverse events. MedDRA (medical dictionary for regulatory activities) has been widely recommended and applied in the world as a powerful support for the adverse events reporting in clinical trials. In this paper, the development history, applicable scope, hierarchy structure, encoding term selection and standardized query strategies of the MedDRA is introduced. Furthermore, the practical process of adverse events encoding with MedDRA is proposed. Finally, the framework of statistical analysis about adverse events is discussed.
Adverse Drug Reaction Reporting Systems ; standards ; statistics & numerical data ; Databases, Pharmaceutical ; standards ; Humans

BACKGROUND: In order to enhance the rate and degree of osseointegration of cementless implants, hydroxyapatile(HA) was applied on the different prosthesissurfaces. Themajoritiesofthesestudieshaveutilized non-weight-bearing in vivo dog models and have focused on the fixation of the femoral component. What is the osseointegration of macrotextured acetabular components in a weight-bearing model(dog) like?OBJECTIVE:To evaluate the various macrotextured surface coatings applied to acetabular components of the same design in aweight-bearing canine total hip replacement model.DESIGN: Randomized conparative study using theexperimentalanimals as subjectsSETTING: Department of Ortopaedics, Beijing Tongren Hospital;PathologyDepartment, Bone and Joint Laboratory,St. Michael' s Hospital, U of T,Toronto,CanadaMATERIALS: The experiment was completed in the Pathology Department,Bone and Joint laboratory, St. Michael' s Hospital, U of T, Toronto, Canada from October 2001 to December 2001. Acetabular components with the selected surface characteristics were implanted into forty dogs with the body mass of 29 - 44 kg of either gender and divided into seven groups, including group 1 (AD/HA), Group 2 (CoCr beads/PA), Group 3 (CPTi bead surface),Group 4(CPTi 30 PPI foam),Group 5(CPTi 30 PPI/PA foam),Group 6(CPTi 40 PPI foam), Group 7(CPTi 40 PPI/PA foam).METHODS: Exercise was restricted to leash walks for the first fourteen days post-operatively. After this, dogs were allowed unrestricted activity. The dogs were euthanized at either three or sixmonths after surgery as the project' s protocol. The whole acetabulum,divided into weight-bearing and non weightbearing areas, containing the component was harvested and submitted for histological and histomorphological assessment. MAIN OUTCOME MEASURES:The bone ongrowth and ingrowth with weight bearing and without weight bearing areas in each group.RESULTS:There was significantly greater bone apposition and bone ingrowth for implants withHAcoatingsascompared to uncoated implants. There was also significantly greater bone ingrowth in weight-bearing areas as compared tonon weight-bearing areas at both time periods. The bone growth into AD/HA was 17％ at 3 months and descended to 14％ at 6 months. The bone growth into CPTi beads surface was 21％ at 3 months,30％ at 6months in weight-bearing areas. All four foam-coating surfaces there were 15％ to 21％ ongrowth at 3 months,15％ to 32％ at 6 months and 21％to 32％ingrowth at 3 months,29％to 45％at 6 months in weight-bearing areas( P ＜ 0.05).CONCLUSION: Hydroxyapatite coating produces significantly greater boneingrowth andappositionin all thesurfacetreatmentstestedinthis study. Weightbearingproducesagreater boneingrowththannon weight-bearing areas and obviously increases with the time prolonging, especially the foam coating

Objective To evaluate the clinical effect of limited open reduction, poking reduction and QWIX cannulated screw internal fixation in treatment of posterior malleolar fracture. Methods A total of 14 patients with posterior malleolar fracture were treated by limited open reduction, poking reduction and QWIX cannulated screw internal fixation. Injury causes included traffic accidents in five patients, fall from height injury in four and inversion sprain in five. According to fracture type classification methods of Weber and Danis, there were two patients with type A3, seven with type B3 and five with type C3. Func-tional exercise was carried out based on postoperative exercise plan. Regular follow-up was performed to e-valuate the functional recovery of the ankle joint. Results All patients were followed up for 6-18 months (average 9.5 months). One patient with sural nerve injury returned to normal after six months. Twelve pa-tients showed excellent range of motion of the ankle joint and normal gait three months after operation. In 12 patients, dorsiflexion of the ankle joint was > 20° and plantar flexion > 40° six months after operation, which was approximately similar to contralateral normal ankle joint. The ankle joint function of all patients returned to normal six months after operation. According to Baird-Jackson ankle joint function evaluation, the result was excellent in 12 patients, good in one and fair in one, with excellence rate of 93%. Con-clusion The limited open reduction, poking reduction and internal fixation of QWIX caunulated screw are effective method for treatment of posterior malleolar fractures.

16 standered acrylic resin blocks with silicone resilient denture liner(10 mm ×8 mm ×3 mm)incorporated with nano-silver par-ticles at 5% (m/m,by dry wet)in-between were prepared.8 blocks were immersed in distilled water for 24 h at 37 ℃ as the controls (group 1).Another 8 were thermocycled for 4 000 cycles(group 2).16 acrylic resin bars were thermal cycled for 4 000 cycles.Then they were processed exactly as the control group (group 3).Tensile bond strength of the specimens was measured by a universal testing machine. The bond strength values(MPa)of group 1,2 and 3 were 2.683 ±0.435,2.179 ±0.633 and 1.460 ±0.566 respectively(group 1 vs 2,P>0.05;group 3 vs 1 or 2,P<0.05).The failure mode of the blocks in group 1 and 2 was mainly cohesive failure,in group 3 adhesion fail-ure.