Widely accepted in other countries,DRG payment is also referred to in China now and then.The authors reviewed the status quo of medical payment in China,as well as the practices and studies of DRG payment overseas.Based on such studies,the paper probed into the feasibility of DRG application in China,in terms of policy environment,application demand,research basis and technical conditions.Proposed in the paper are ranges of application,possible roadblocks and countermeasures for the application in China,aiming to promote the research,application and use of the method in China.

BACKGROUND: Graft selection and histological fate for anterior cruciate ligament reconstruction is a hot topic in the fields of reconstruction and repair of anterior cruciate ligament.OBJECTIVE: To review structure of anterior cruciate ligament and graft selection.METHODS: Articles were retrieved from Medline database with the key words of "Anterior cruciate ligament, implant,reconstruction" between January 1980 and January 2010. inclusion criteria: ① Reconstructive surgery of anterior cruciate ligament injury; ② graft selection of anterior cruciate ligament. Exclusion criteria: ① the old literatures; ② repetitive studies. A total of articles related to reconstruction of anterior cruciate ligament were retrieved, but 33 ones were included in the final analysis. The old, duplicated, and similar studies were excluded.RESULTS AND CONCLUSION: At present, the major therapy for anterior cruciate ligament injury includes arthroscopy and arthroscopy-assisted reconstruction. For clincal application, there are a lot of grafts, including autogenous grafts, allografts,heterologous allograft, biological materials, artificial materials and tissue engineering grafts. Autogenous semitendinosus tendon and gracilis tendon or autogenous bone-patellar tendon (middle 1/3)-bone (BPTB) are mainly used for anterior cruciate ligament reconstruction at home and abroad.

Digital hospital construction is foundational project for the modern management,which challenges the management mode and idea in hospital.With regard to the status on the construction of digital hospital of infectious disease in 302 hospital of the People's Liberation Army,The article reviews the experience and prospect of digital hospital of infectious disease.

Objective:To explore the effect of lipoic acid on oxidative stress,inflammation and nutritional status in peritoneal dialysis patients.Methods:94 peritoneal dialysis patients were randomly divided into the observe group(n=47) the control group(n=47).They all accepted the conventional treatment,but the patients in the observed group were given the treatment of lipoic acid capsules(0.2 g tid) for 12 weeks.Superoxide dismutase(SOD),malondialdehyde(MDA),serum advanced oxidation protein products ( AOPPs ) were used to reflect the level of oxidative stress, high sensitive CRP, IL-6 and TNF-αwere used to reflect the micro inflammatory state, modified quantitative subjective global assessment ( MQSGA ) , mid-arm circumference, mid-arm muscle circumference,triceps skinfold thickness ( TSF ) , body mass index ( BMI ) , and serum albumin were used to reflect the nutritional status.The difference of oxidative stress, micro inflammatory state and nutritional status were compared between the two groups.Results:①In the observation group,the concentrations of AOPPs and MDA after treatment were significantly lower than that before treatment,and the concentration of SOD after treatment was significantly higher than that before treatment ( P<0.05 );after treatment,the concentrations of AOPPs and MDA in the observe group were significantly lower than that in the control group(P<0.05), and the concentration of SOD in the observe group was significantly higher than that in the control group ( P<0.05 ) .②In the observation group,the concentrations of high sensitive CRP,IL-6 and TNF-αafter treatment were significantly lower than that before treatment(P<0.05);after treatment,the concentrations of high sensitive CRP,IL-6 and TNF-αin the observe group were significantly lower than that in the control group ( P<0.05 ) .③In the observation group, the TSF, mid-arm circumference, mid-arm muscle circumference,BMI and albumin after treatment were significantly higher than that before treatment(P<0.05),and the MQSGA after treatment was significantly lower than that before treatment ( P<0.05 );after treatment, the MQSGA in the observe group was significantly lower than that in the control group(P<0.05),and serum albumin in the observe group was significantly higher than that in the control group(P<0.05).Conclusion:Lipoic acid could improve oxidative stress in peritoneal dialysis patients,so as to improve the micro inflammatory state and nutritional status.

Objective To explore the effects of levodopa and benserazide on upper extremity function after stroke. Methods 90 cases of sub-acute stroke patients were randomly divided into rehabilitation group (n=30), treatment group (n=30) and control group (n=30). The first 2 groups were treated with conventional movement therapy. The treatment group was treated with levodopa and benserazide tablet in addition.All patients were assessed with Fugl-Meyer assessment (FMA) and Motor Assessment Scale (MAS) before and 8 weeks after treatment.Results Before treatment, there was no significant difference in the scores of FMA and MAS among 3 groups (P>0.05). After 8 weeks treatment, the scores of FMA and MAS increased in the rehabilitation group and treatment group (P<0.05), the score was higher in the treatment group than in the rehabilitation group (P<0.05). Conclusion Levodopa and benserazide can further improve the functional performance of the upper extremities of stroke patients.

To study the characteristic of glycoprotein gene sequence of rabies virus in Guizhou Province in recent years and provide scientific basis for effective control and prevention of rabies,RT-PCR assay were used to detect human and dog brain tissues derived from different prefectures of Guizhou.The amplification products were sequenced and analyzed with bioinformatics software.The results showed that the full-length G gene sequences of 8 positive samples were obtained by RT-PCR amplification,sequencing and splicing.The homology of eight G gene sequences from Guizhou Province were between 87.4％ -99.9％ and 83.3.％- 100％ on nucleotide and deduced amino acid level,respectively,and the highest homology were found with the genotype 1 strains ( 86.5 ％- 87.0％ for nucleotide and 83.3 ％- 100 ％ for amino acid) among genotype 1- 7 representative strains.Besides,phylogenetic analysis based on the G gene indicated that the relationship of 8 strains derived from Guizhou were closest to genotype 1 Lyssavirus,and the strains of Guizhou were very close to the strains come from Hubei,Hunan,Anhui,Guangxi,Jiangsu provinces and Shanghai,except for GZ01 and GZ09.Moreover,GZ09 were evolutionarily closed to the strains come from Malaysia and Thailand,while the remaining sequences were closed to the strain of Indonesia.This study confirmed on the G gene level that rabies virus epidemic strains circulated in Guizhou Province in recent years belonged to rabies virus genotype 1 and the evolutionary relationship with reported strains come from different provinces of China and different countries were revealed in this study.It will provide scientific basis for effective control and prevention of human and animal rabies in Guizhou Province.

Objective To confirm the death of a child injured by a dog was due to rabies and to understand the molecular biologic features of rabies virus in Kaili,Guizhou province.Methods Brain tissue samples of patient and dog were collected to detect the rabies virus by direct immunofluorescence assay (DFA) and RT-nested PCR assay.Homology and phylogenetic tree were analyzed based on the whole nucleotide and deduced amino acid sequence of N gene of rabies virus followed by molecular epidemiological analysis.Results Both the human and dog brain tissue samples were confirmed positive by DFA and RT-nested PCR assay.The homology analysis of N gene sequences among GZH,GZD and other epidemic and vaccine rabies strains isolated from other provinces and other countries indicated that the detected samples shared the highest homology with the strain detected in Anlong prefecture in Guizhou in the year of 2006,and the homology between GZH and GZD was as high as 100％.Besides,among the vaccine strains,GZH and GZD showed the highest homology with strain CNT.Phylogenetic analysis indicated that the two samples were very close and belonged to genetype 1 lyssavirus,with the closest relationship between samples reported in Guizhou and Beijing.Conclusion It was confirmed on the viral molecular level that both the human and dog in Kaili were suffered from rabies,and the pathogens were genetype 1 lyssavirus.The prevalent strains in Kaili city was probably imported from other prefectures of Guizhou province,suggesting that prevention and control measures on rabies in Guizhou province should be strengthened.

Objective To study the differences of glycoprotein gene (G gene) between rabies virus epidemic strains of Guizhou province in recent years and vaccine strains,and to provide scientific basis for the development of rabies vaccine and establishment of effective control and prevention measures.Methods RT-PCR assay was used to amplify the G gene of rabies positive brain tissues samples of human and dog derived from Guizhou province in recent years.The amplification products were sequenced and comparatively analyzed with that of vaccine strains by using bioinformatics software.Results Eight full-length G gene sequences were obtained by RT-PCR amplification,sequencing and splicing.The homogeny of G gene between 8 epidemic strains of Guizhou province and 9 vaccine strains were 82.0％-94.1％ and 87.6％-97.5％ on nucleotide and deduced amino acid level,respectively,and the highest homogeny were found with the human vaccine strain CTN (87.0％-94.1％ for nucleotide and 93.7.％-97.5％ for amino acid) among the 6 human rabies vaccine strains,while highest homogeny were found with strain Flury (83.9％-84.6％ for nucleotide and 91.1％-93.0％ for amino acid) among the three animal vaccine strains.Besides,among the 8 epidemic strains from Guizhou province,strain GZ09 collected in the year of 2005 was of the highest homogeny with human rabies vaccine strain CTN and animal rabies vaccine strain Flury,while strain GZ30 collected in the year of 2010 was of lowest homogeny with human rabies vaccine strain CTN and animal rabies vaccine strain Flury.Moreover,phylogenetic analysis based on the G gene indicated that the relationship of 8 epidemic strains derived from Guizhou,the 9 vaccine strains and genotype 1 Lyssavirus were clustered to a same branch.Vaccine strain CTN among the 9 vaccine strains was closest to the 8 epidemic strains,and the other 8 vaccine strains were relatively more distant from the epidemic strains of Guizhou province.In addition,phylogenetic analysis indicated that among the 8 epidemic strains from Guizhou province,strain GZ09 collectcd in the year of 2005 was of closest evolutionary relationship to CTN,while the other 7 epidemic strains were relatively more distant from CTN.Conclusion This study confirmed on the G gene level that rabies virus strains circulated in Guizhou province in recent years and the vaccine strains used in China belonged to rabies virus genotype 1,and the virus strains circulated in Guizhou province in recent years is of smallest difference with the human vaccine strain CTN and animal vaccine strain Flury.Besides,as time goes on,the difference between the epidemic strain and the vaccine strains becomes more and more obvious.The results of this study will provide scientific basis for the development of rabies vaccine and establishment of effective control and prevention measures.

Gravity is one of the most widespread mechanomechanical signals affecting surface organisms and plays a key role in maintaining normal cardiovascular structure and function.The absence of gravity in the space environment leads to changes in the physiological-mechanical environment of the cardiovascular system,potentially causing adaptive changes or remodelling of the cardiovascular system in terms of structure and function.However,how the cardiovascular system senses,transduces,and responds to altered mechanical stress in the microgravity environment remains poorly understood by humans.In this paper,we reviewed the research findings on mechanoreceptors and mechano-transduction of cardiovascular system in recent years,analyzed the mechanisms of mechanical perception and response to microgravity in cardiovascular system,and predicted the novel mechanoreceptors,key signaling pathways,and potential targets for intervention in space microgravity.This article aims to provide new ideas for combating adaptive changes in the cardiovascular system due to space microgravity.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.